According to the suit, the Idaho Orthopaedic Society, Idaho Sports Medicine Institute, five individual orthopedists named in the suit and others conspired to gain more favorable fees and other contractual terms by coordinating a boycott of workers’ compensation patients covered by Blue Cross of Idaho.
According to the government’s complaint, from 2006-2008, the orthopedists took part in a series of meetings and eventually agreed not to treat most patients covered by workers’ compensation insurance in order to force the Idaho Industrial Commission to increase the rates at which orthopedists were paid for treating injured workers. The government charged the boycott resulted in a shortage of orthopedists willing to treat these patients, causing higher rates for orthopedic services. All but one of the defendants were also charged with conspiring to threaten to terminate their contracts with Blue Cross of Idaho in order to force the insurer to offer better contract terms.
The proposed settlement, which must now be approved by the court, prevents the Idaho Orthopaedic Society and the named orthopedists from agreeing with their competitors on fees and contract terms. The settlement also prohibits them from collectively denying medical care to patients, refusing to deal with any payer or threatening to terminate contracts with any payor, according to the report.
Read the DOJ’s release on the Idaho orthopedist antitrust lawsuit.
