The Federal Trade Commission has given final approval to a consent agreement with the Medical Association of Puerto Rico, its Physiatry Section and two of its individual physiatrist members, Dr. Rafael L. Oms and Dr. Rafael E. Sein. The agreement settles charges that they illegally conspired to boycott a government insurance program in an attempt to obtain exclusive referral powers from all public and private insurers and to increase their reimbursement rates. The conspiracy delayed medically-necessary treatment for some patients and subjected the government insurance program and its patients to other costs and inconveniences, the FTC had alleged. The Commission's action makes the consent order, which is designed to prevent another illegal boycott, binding on the respondents.
Physiatrists are medical doctors who specialize in treating muscular, musculoskeletal or neurological problems.
Under the final order, the respondents are barred from encouraging, organizing or entering into any boycott or refusal to deal with any third-party payor. They also are prohibited from encouraging, organizing or entering into any agreement to refuse to provide services to patients covered by any third-party payor.
The settlement also places restrictions, for five years, on the continuation of any meetings of physiatrists where the refusal to deal with any third-party payor or to provide services to any third-party payor's patients is discussed. The respondents also are prohibited, for five years, from soliciting information from physiatrists about their decisions regarding whether to participate in agreements with insurers and provide service; from passing such information along to other doctors; and from advising physiatrists about such decisions.
The consent agreement was announced for a public-comment period on March 22. The Commission vote to issue it in final form occurred on June 2, and was 5-0.
NOTE: A consent agreement is for settlement purposes only and does not constitute admission of a law violation. When the Commission issues a consent order on a final basis, it carries the force of law with respect to future actions by the respon- dents. Each violation of such an order may result in a civil penalty of up to $10,000.
A news release summarizing the complaint and consent agree- ment was issued at the time the Commission accepted the consent agreement for public comment. Copies of that release and of the complaint and final order are available from the FTC's Public Reference Branch, Room 130, 6th Street and Pennsylvania Avenue, N.W., Washington, D.C. 20580.
(FTC File No. 911 0095)
(Docket No. C-3583)