ANTITRUST LAW AND MEDICAL SOCIETIES

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ANTITRUST LAWAND MEDICAL SOCIETIES
Larry D. Weiss, M.D., J.D. Albert J. Lauro
Professor of Medicine L.S.U. School of Medicine
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INTRODUCTIONObjective of Antitrust Laws

• promote fair competition
• benefit consumers

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STANDARDS OF REVIEW

• "per se" illegal
• "rule of reason" analysis
• "quick look rule of reason"

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"PER SE" ILLEGAL

• price fixing
• division of markets
• group boycotts
• tying arrangements

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SHERMAN ACTSection 1

• prohibits contracts, combinations,and
  conspiracies in the restraintof trade
• requires concerted action byat least two parties
• applies to interstate commerce

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APPLIC TO MEDICINETraditionally did not apply

• profession not "commerce"
• local character
• hosps not for-profit

e.g. US v. OSMS, 343 U.S.326 (1952)
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GOLDFARB v. VA STATE BAR421 U.S. 773 (1975)

• Bar set prices for title searches
• Opinion
• no sweeping exclusion
• Footnote 17
• professions not ordinary businesses

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NSPE v. U.S.435 U.S. 679 (1978)

• Soc. prohibited comp. bidding
• Opinion
• no broad exemption
• ? should petition Congress

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OTHER CASES

• AMA v. FTC (1982)
• advertising ban
• Arizona v. Maricopa CMS (1982)
• price ceiling
• FTC v. Indiana Fed. Dentists (1986)
• group boycott
• 1 violation not dependent on market power

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MEDICAL SOCIETIESMembership and Credentialing

• standards not anti-comp
• no boycotts
• DP rights
• beware if m'ship essential to practice

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MEDICAL SOCIETIES Ethical Codes and Other
Policies

• avoid anti-comp. rules
• including prohibition of advertising
• defense pro-comp. effects
• market power not controlling
• compliance policy/program

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OTHER DANGER AREAS

• statistical collection
• standard-setting
• members as agents
• prohibited discussions . . .

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MEDICAL SOCIETIESProhibited Discussions

• prices
• boycotts
• dividing markets
• productivity levels
• restr avail of prof services

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MEDICAL SOCIETIESAdvocacy v. Restraint
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MEDICAL SOCIETIESEmergency Medicine Issues

• policies
• hindering certain practice models
• group boycotts
• petitioning the govt . . .

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NOERR-PENNINGTONDoctrine created by US SCt and
Congr.

• priv parties may solicit gov'tto investig
  anti-comp actions
• protects petitioners
• "Sham" exception

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SEPT. 2004 FTC LETTER

• re two ACEP resolutions
• raise antitrust concerns
• Open Bidding
• ignored pro-comp. effects
• Certif. of Compliance
• not enough info, then speculated

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SEPT. 2004 FTC LETTERFinal Paragraph

• right to respond to behavior
• detrimental to members
• detrimental to the public
• may provide information
• may express opinions
• may adopt reasonable self-reg

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QUESTIONS?