Federal Register, Volume 74, Number 2, January 5, 2009, Pages 201-392 Page: 291
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Federal Register/Vol. 74, No. 2/Monday, January 5, 2009 /Notices
attempts to engage in any action
prohibited by Paragraph II.A, or II.B,
and Paragraph II.D. proscribes BVIPA
from inducing anyone to engage in any
action prohibited by Paragraphs II.A
through II.C.
As in other Commission orders
addressing providers' collective
bargaining with health-care purchasers,
Paragraph II excludes certain kinds of
agreements from its prohibitions. First,
BVIPA is not precluded from engaging
in conduct that is reasonably necessary
to form or participate in legitimate joint
contracting arrangements among
competing physicians, such as a
"qualified risk-sharing joint
arrangement" or a "qualified clinically-
integrated joint arrangement." The
arrangement, however, must not restrict
the ability of, or facilitate the refusal of,
physicians who participate in it to
contract with payers outside of the
arrangement.
As defined in the proposed Order, a
"qualified risk-sharing joint
arrangement" possesses two
characteristics. First, all physician
participants must share substantial
financial risks through the arrangement,
such that the arrangement creates
incentives for the physician participants
jointly to control costs and improve
quality by managing the provision of
services. Second, any agreement
concerning reimbursement or other
terms or conditions of dealing must be
reasonably necessary to obtain
significant efficiencies through the joint
arrangement.
A "qualified clinically-integrated joint
arrangement,"on the other hand, need
not involve any sharing of financial risk.
Instead, as defined in the proposed
Order, physician participants must
participate in active and ongoing
programs to evaluate and modify their
clinical practice patterns in Order to
control costs and ensure the quality of
services provided, and the arrangement
must create a high degree of
interdependence and cooperation
among physicians. As with qualified
risk-sharing arrangements, any
agreement concerning price or other
terms of dealing must be reasonably
necessary to achieve the efficiency goals
of the joint arrangement.
Paragraph III, for three years, requires
BVIPA to notify the Commission before
it enters into any arrangements to act as
a messenger or an agent on behalf of any
physicians, with payers regarding
contracts. Paragraph IV sets out the
information necessary to make the
notification complete.
Paragraph V, for three years, requires
BVIPA to notify the Commission beforeparticipating in contracting with health
plans on behalf of either a qualified risk-
sharing or a qualified clinically-
integrated joint arrangement. Paragraph
VI sets out the information necessary to
satisfy the notification requirement.
Paragraph VII imposes other
notification obligations on BVIPA and
requires the termination of certain
contracts that were entered into
illegally. Paragraphs VII.A requires
BVIPA to distribute the Complaint and
the Order to (1) physicians who have
participated in BVIPA since 2001; (2) to
various past and current personnel of
BVIPA; and (3) to payers with whom
BVIPA has dealt since 2001. Paragraph
VII.B requires BVIPA, at any payer's
request and without penalty, to
terminate its existing contracts with the
payer for the provision of physician
services. Paragraph VII.B. allows certain
contracts currently in effect to be
extended at the written request of the
payer no longer than one year from the
date that the Order becomes final.
Paragraph VII.C requires BVIPA to
distribute payer requests for contract
termination to physicians who
participate in the contract. Paragraph
VII.D requires BVIPA, for three years, to
provide new members, personnel, and
payers not previously receiving a copy,
a copy of the Order and the Complaint.
Paragraph VII.D also requires BVIPA to
publish annually a copy of the Order
and the Complaint in its newsletter.
Paragraphs VIII, IX, and X impose
various obligations on BVIPA to report
or provide access to information to the
Commission to facilitate the monitoring
of compliance with the Order. Finally,
Paragraph XI provides that the Order
will expire in 20 years.
By direction of the Commission.
Donald S. Clark,
Secretary.
[FR Doc. E8-31384 Filed 1-2-09: 8:45 am]
BILLING CODE 6750-01-S
FEDERAL TRADE COMMISSION
[File No. 061 0258]
Independent Practice Associates
Medical Group, Inc.; Agreement
Containing Consent Order To Aid
Public Comment
AGENCY: Federal Trade Commission.
ACTION: Proposed Consent Agreement.
SUMMARY: The consent agreement in this
matter settles alleged violations of
federal law prohibiting unfair or
deceptive acts or practices or unfair
methods of competition. The attached
Analysis to Aid Public Commentdescribes both the allegations in the
draft complaint and the terms of the
consent order-embodied in the consent
agreement-that would settle these
allegations.
DATES: Comments must be received on
or before January 22, 2009.
ADDRESSES: Interested parties are
invited to submit written comments.
Comments should refer to "AllCareIPA,
File No. 061 0258," to facilitate the
organization of comments. A comment
filed in paper form should include this
reference both in the text and on the
envelope, and should be mailed or
delivered to the following address:
Federal Trade Commission/Office of the
Secretary, Room 135-H, 600
Pennsylvania Avenue, N.W.,
Washington, D.C. 20580. Comments
containing confidential material must be
filed in paper form, must be clearly
labeled "Confidential," and must
comply with Commission Rule 4.9(c).
16 CFR 4.9(c) (2005).1 The FTC is
requesting that any comment filed in
paper form be sent by courier or
overnight service, if possible, because
U.S. postal mail in the Washington area
and at the Commission is subject to
delay due to heightened security
precautions. Comments that do not
contain any nonpublic information may
instead be filed in electronic form by
following the instructions on the web-
based form at (http://
secure. commentworks. com/ftc-
AllCarelPA). To ensure that the
Commission considers an electronic
comment, you must file it on that web-
based form.
The FTC Act and other laws the
Commission administers permit the
collection of public comments to
consider and use in this proceeding as
appropriate. All timely and responsive
public comments, whether filed in
paper or electronic form, will be
considered by the Commission, and will
be available to the public on the FTC
website, to the extent practicable, at
www.ftc.gov. As a matter of discretion,
the FTC makes every effort to remove
home contact information for
individuals from the public comments it
receives before placing those comments
on the FTC website. More information,
including routine uses permitted by the
Privacy Act, may be found in the FTC's
privacy policy, at (http://www.ftc.gov/
ftc/privacy.shtm).
1 The comment must be accompanied by an
explicit request for confidential treatment,
including the factual and legal basis for the request,
and must identify the specific portions of the
comment to be withheld from the public record.
The request will be granted or denied by the
Commission's General Counsel, consistent withapplicable law and the public interest. See
Commission Rule 4.9(c), 16 CFR 4.9(c).291
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United States. Office of the Federal Register. Federal Register, Volume 74, Number 2, January 5, 2009, Pages 201-392, periodical, January 5, 2009; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc132864/m1/98/: accessed April 25, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.