Idaho orthopedists settle antitrust case
BOISE, Idaho (Legal Newsline)- Idaho Attorney General Lawrence Wasden announced on Friday that his office, along with the United States Department of Justice, has settled an antitrust case with several orthopedists in the state.
The Idaho Orthopaedic Society, the Idaho Sports Medicine Institute, Dr. Timothy Doerr, Dr. Jeffrey Hessing, Dr. John Kloss, Dr. David Lamey and Dr. Troy Watkins had been charged with allegedly gaining more favorable fees and contractual terms after agreeing to coordinate their actions, which violates state law.
The defendants allegedly denied medical care to injured workers and engaged in group boycotts to obtain higher fees. They were charged with two conspiracies, which led the State Insurance Fund to pay higher rates for orthopedic services.
The first conspiracy, it is alleged, had the orthopedists agreeing not to treat most patients covered by workers compensation insurance, forcing the Idaho Industrial Commission to pay them more money for treating injured workers. The doctors' boycott caused a shortage of orthopedists willing to treat workers compensation patients, which led to higher rates for orthopedic services, it is alleged.
The second conspiracy the defendants were charged with alleged that the conspirators, other than Lamey, agreed to threaten to terminate their contracts with Blue Cross of Idaho as a way of force them to offer contract terms more favorable to orthopedists.
"In short, these doctors were willing to use injured workers awaiting treatment as leverage to gain higher reimbursement fees," Wasden said.
If the settlement is approved by the United States District Court for Idaho, the orthopedists would be prevented from grouping with their competitors on fees and contract terms. It would also stop them from collectively denying medical care to patients, refusing to deal with any payor or threatening to terminate any contract with a payor.
"The free marketplace works best when there is fair competition. Anticompetitive activity harms the marketplace, businesses and consumers," Wasden said. "Enforcement of the antitrust laws restores competition to the marketplace to the benefit of businesses and consumers and the marketplace as a whole."