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The Impact of Recent Antitrust Case Law on Health Care Professionals

Published online by Cambridge University Press:  27 April 2021

Jules M. Fried
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Extract

The application of the antitrust laws to the health care field has generated intense debate over the last few years. Responsible for this debate in no small measure are the numerous health care antitrust cases that have reached and been decided by the United States Supreme Court. In the final weeks of the October 1981 term, the Court decided three such cases which should be of great interest to health care professionals. Although each involves a different point of law, collectively the decisions underscore the increasing amount of litigation that challenges joint conduct by health care providers, and the increasingly rigorous scrutiny that courts are giving such conduct under the antitrust laws.

The case that has received the most recent attention is Arizona v. Maricopa County Medical Society,’ which involved an alleged price-fixing agreement among physicians. Defendants were the county medical societies in Maricopa and Pima Counties in Arizona, and the foundations for medical care which each society had created.

Type
Article
Information
Law, Medicine and Healthcare , Volume 10 , Issue 4 , December 1982 , pp. 254 - 272
Copyright
Copyright © American Society of Law, Medicine and Ethics 1982

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References

102 S. Ct. 2466 (1982) [hereinafter referred to as Maricopa].Google Scholar
For a more detailed discussion, seeCohen, H.P. Tiano, L.V., The Aftermath of Maricopa, Law, Medicine & Health Care 10(6):248 (December 1982) [hereinafter referred to as Cohen & Tiano]. For a discussion of the lower court's decision, see Cohen H.P., IPAs and Per Se Rules: Arizona v. Maricopa County Medical Society, Law, Medicine & Health Care 9(4):8 (September 1981) [hereinafter referred to as Cohen].Google Scholar
Arizona v. Maricopa County Medical Soc'y, 643 F.2d 553, 554 (9th Cir. 1981).Google Scholar
The classic statement of the rule of reason was given by Justice Brandeis more than 60 years ago: The true test of legality is whether the restraint imposed is such as merely regulates and perhaps thereby promotes competition or whether it is such as may suppress or even destroy competition. To determine that question, the court must ordinarily consider the facts peculiar to the business to which the restraint is applied; its condition before and after the restraint was imposed; the nature of the restraint and its effect, actual or possible. The history of the restraint, the evil believed to exist, the reason for adopting the particular remedy, the purpose or end sought to be attained are all relevant facts. This is not because a good intention will save an otherwise objectionable regulation or the reverse; but because knowledge of intent may help the court to interpret facts and to predict consequences. Chicago Board of Trade v. United States, 246 U.S. 231, 238 (1918).Google Scholar
See, e.g.,Cohen Tiano, supra note 2; Cohen, supra note 2.Google Scholar
SeeCohen Tiano, supra note 2, at 252.Google Scholar
See, e.g., United States v. American Soc'y of Anesthesiologists, 473 F. Supp. 147 (S.D.N.Y. 1979).Google Scholar
For example, IPA-type HMOs, like their group practice model and medical staff model analogues, have been the recipients of federal qualification status. 42 C.F.R. Part 110, Subpart F (1977).Google Scholar
See 46 Fed. Reg. 48, 982 (1981).Google Scholar
Kartell v. Blue Shield of Massachusetts, 542 F. Supp. 782 (D. Mass. 1982).Google Scholar
Cf. Hyde v. Jefferson Parish Hosp. Dist. No. 2, 686 F.2d 286 (5th Cir. 1982) (exclusive contract between hospitals and anesthesiology group found to be tying arrangement that was unlawful per se).Google Scholar
102 S. Ct. 2540 (1982) [hereinafter referred to as McCready].Google Scholar
Blue Shield of Virginia v. McCready, 649 F.2d 228, 229 (4th Cir. 1981).Google Scholar
The underlying dispute between psychologists and psychiatrists had been the subject of other litigation, and the psychologists had already won a case in which such a restraint was found to be an antitrust violation. See Virginia Academy of Clinical Psychologists v. Blue Shield of West Virginia, 624 F.2d 476 (4th Cir. 1980).Google Scholar
McCready, supra note 13, at 232.Google Scholar
McCready, supra note 12, at 2546.Google Scholar
102 S. Ct. 3002 (1982) [hereinafter referred to as Pireno].Google Scholar
650 F.2d 387, 388 (2d Cir. 1981). See Antitrust Implications of Chiropractic Peer Review Committees, American Journal of Law & Medicine 8(1):45 (1982).Google Scholar
Id. at 387.Google Scholar
Pireno, supra note 17, at 3011.Google Scholar
Chief Justice Burger and Justices Rehnquist and O'Connor dissented.Google Scholar