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The Department of Justice (DOJ) takes action to stop anticompetitive behavior and practices by physicians and physician groups.January 10, 2003 The DOJ published today in the Federal Register a proposed final judgment against Mountain Health Care ("MHC"), an 1,100 physician IPA in western North Carolina. MHC is charged with adopting a uniform price schedule used for negotiations with health plans on behalf of its members, even though MHC lacked financial or clinical integration. The fee schedule was developed in part by comparing and blending rates of multiple physicians and then adopting the uniform fee schedule applying it to all its members. The DOJ found that reimbursement rates were higher than those which would have resulted from individual negotiations with each competing independent physician or medical practice participating in MHC. In addition, there were few, if any, competitive alternatives remaining for managed care purchasers. The Federal Register publication allows comments to the proposed judgement for 60 days and the DOJ will evaluate and respond to the comments. The proposed final judgment and the explanation may be found on the web by using the following links:
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