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Federal: Justice Department settles orthopedic antitrust case

by Astrid Fiano, DOTmed News Writer | August 04, 2010
This report originally appeared in the July 2010 issue of DOTmed Business News

The U.S. Department of Justice (DOJ) has filed a settlement agreement in federal court in a case accusing several orthopedists of antitrust violations. The complaint in the case, filed in May, alleged that the defendants Idaho Orthopedic Society, Idaho Sports Medicine Institute, and several individual physicians violated federal and state antitrust laws. Under the settlement agreement, the defendants do not have to make admissions of guilt in the matter.

According to the statement the DOJ filed, the defendants and other competing orthopedists in the Boise, Idaho area formed conspiracies to gain more favorable fees and other contractual terms. In one conspiracy, the defendants and co-conspirators agreed not to treat most patients covered under workers' compensation insurance. This was done to coerce the Idaho Industrial Commission to increase rates for orthopedists to be reimbursed for treating injured workers.
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During the boycott, the impact statement claims, a shortage of orthopedists available to treat those patients led the commission to increase reimbursement rates substantially above the previous year's level. In a second conspiracy, most of the defendants and other conspirators are alleged to have threatened to terminate their contracts with Blue Cross of Idaho in order to force the company to offer better contract terms to orthopedists. By the terms of the settlement agreement, the defendants are enjoined from any like conduct of which they have been accused, and to allow compliance inspections.