Eye doctors charged for illegal Medicare boycott

Co-operativa de Medico Oftalmologos de Puerto Rico (OFTACOOP), which has around 100 mbers, settled charges with the FTC for the alleged illegal activity and is awaiting the end of a 30 day public comment period before learning its fate.According to the FTC, OFTACOOP refused to sign an agreent for health services by provider MCS Advantage (MCS) which would have meant lower Medicare reimbursents to ophthalmologists.MCS is under contract with Medicare to arrange and pay for healthcare services for enrolees of the Medicare Advantage plan.{{quote-A:R-W:450-Q: All need to be united to stop the trampling from the medical plans. }}The FTC has alleged that OFTACOOP organised a meeting of mbers and non-mber ophthalmologists, where they agreed not to sign the new contracts to try and prevent the creation of the new pay network.ails, which originated from OFTACOOP with the subject line “Do not sign the mcs/eye managent contract” that were secured by the FTC, supported this claim.Another quote lifted from the ail stated: “All need to be united to stop the trampling from the medical plans.”At a subsequent OFTACOOP meeting, it is alleged that the president told attendees to make their own decision, however, he did not inform th that a collective refusal to deal violated antitrust laws.As a result, only a few ophthalmologists signed up for the network, which failed to meet the required number of practitioners under the Medical Advantage program.Compounding the issue, almost half of the 200 existing ophthalmologists enrolled in MCS cancelled their service contracts with the health plan provider, causing it to abandon the rate reduction plan.MCS sought lower fees in 2014 after Medicare reduced its priums and in response, hired the services of network administrator Eye Managent to establish a new network of ophthalmologists.OFTACOOP mbers received contract proposals from Eye Managent with 10% average lower rates compared to existing contracts.{{quote-A:L-W:450-Q: The law was passed to protect consumers and at the same time discourage practitioners from unfair pricing practices. }}The medical director of Eye Managent was an unintentional recipient of the quoted ail, who brought the matter to the attention of the FTC.The FTC found the alleged behaviour of OFTACOOP was not related to achieving any efficiency or enhancing integration that may have made its actions permissible. The FTC also found that the anticompetitive impacts of the action by OFTACOOP increased costs of ophthalmology services and unreasonably restrained price and other competition.In Australia, a similar law regulated by the Australian Competition and Consumer Commission (ACCC) has put in place guidelines for medical professionals to set fees that are consistent with the structure of their practice.The law was passed to protect consumers and at the same time discourage practitioners from unfair pricing practices.It also established a check and balance process to monitor pricing activities in the performance of professional services.