HIPAA Blog

[ Tuesday, July 23, 2002 ]

 

Exclusive Provider Cases in the News (somewhat off topic). My partner Monte James is representing St. David's in this lawsuit. The basic argument of the plaintiff is that Seton and St. David's engage in antitrust and unfair competition by contracting with a single group of ER doctors to staff their emergency departments. The defense says that the doctor groups get an exclusive deal because they agree to provide coverage. If individual doctors get in, they can cherry-pick the good cases and the hospital will have no guarantee that there will always be sufficient doctors in their ER. The exclusive deal isn't antitrust or anti-competitive; it's a trade-off between the group, which promises full coverage, and the hospital, which promises to let the group have the whole pie. The group won't agree to provide full coverage if they think someone else could get in and pick off the good, high-paying cases, leaving the group with the uninsured or poor paying cases.

Jeff [9:30 AM]

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