The policy in question is regarding health care organizations — more specifically Accountable Care Organizations (ACO) that participate in the Medicare Shared Savings Program.
“The proposed Policy Statement would create an antitrust “safety zone” for certain ACOs and establish expedited antitrust reviews for others,” states an FTC press release.
Here are a couple interesting points in the report:
“The antitrust laws treat naked price-fixing and market-allocation agreements among competitors as per se illegal,” states the report.
It also contains a “safety zone” for companies that will not be challenged by the FTC or DOJ, and have no obligation to contact the agencies.
“For an ACO to fall within the safety zone, independent ACO participants (e.g., physician group practices) that provide the same service (a “common service”) must have a combined share of 30 percent or less of each common service in each participant’s PSA, wherever two or more ACO participants provide that service to patients from that PSA,” states the report.
According to the feedback form, the FTC and DOJ have a few main points up for discussion:
1) whether and, if so, why the guidance in the proposed Policy Statement should be changed in any respect; and
2) Whether other sources of data exist that ACO applicants could use to determine relevant PSA shares (as identified in Step 3 of the Appendix) for:
a) physician services rarely used by Medicare beneficiaries (e.g., pediatrics, obstetrics, and neonatal care); and
b) inpatient hospital services located in states where all-payer hospital discharge data are not available.
Photo caption: Lady Justice. Gleich und Anders, Ed. Robert Aldrich 3-938017-81-3.