The Federal Trade Commission today announced its decision to challenge the Puerto Rico Association of Endodontists, Corp. (PRAE) for coordinating and carrying out agreements among its 30 competing members to set the prices they would charge dental insurance plans, and to refuse to deal with plans that would not accept the collectively determined prices. The FTC’s complaint charged that PRAE’s actions led to higher costs for consumers by hindering competition and restraining trade unreasonably in violation of Section 5 of the FTC Act. In settling the FTC’s charges, PRAE will refrain from engaging in such anticompetitive conduct in the future.
“Competing health care providers cannot collectively bargain or refuse to deal with health insurance plans that reject their terms,” said Jeffrey Schmidt, Director of the FTC’s Bureau of Competition. “By challenging these kinds of anticompetitive practices, the FTC ensures that essential health care services will be available to consumers at prices established in an open, competitive market.”
The FTC’s complaint alleges that in 2003, PRAE’s bargaining efforts resulted in at least five dental plans increasing the fees they paid to PRAE members. The complaint also alleges that in 2004, PRAE sought another rate hike by asking dental plans to allow PRAE members to “balance bill” patients for the difference between agreed upon rates paid by the dental plans and the endodontists’ desired rates. As a cost-containment benefit for consumers, health care plans typically prohibit balance billing by health care providers who contract to provide care for their policyholders. According to the FTC’s complaint, PRAE’s actions were not reasonably related to any financial risk sharing or efficiency-enhancing integration of its members’ practices that would lead to better quality or reduced costs of care.
The Commission’s proposed consent order is designed to remedy the effects of the alleged anticompetitive conduct and prevent its recurrence. It would prohibit PRAE from entering into or facilitating agreements among endodontists to negotiate with any payor on any
member’s behalf; to deal, refuse to deal, or threaten to refuse to deal with any payor regarding any term upon which any member deals, or is willing to deal, with any payor; and not to deal individually with any payor or through any arrangement other than PRAE.
The Commission vote to accept the consent order subject to public comment was 5-0. The Commission is accepting public comment on the order for 30 days, until August 18, after which it will decide whether to make it final. Comments should be sent to: FTC Office of the Secretary, 600 Pennsylvania Ave., N.W., Washington, DC 20580.
NOTE: A consent agreement is for settlement purposes only and does not constitute an 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. Each violation of such an order may result in a civil penalty of $11,000.
Copies of the complaint, consent order, and an analysis to aid in public comment are available from the FTC’s Web site, http://www.ftc.gov, and its Consumer Response Center, Room 130, 600 Pennsylvania Avenue, N.W., Washington, D.C. 20580. The FTC’s Bureau of Competition seeks to prevent business practices that restrain competition. The Bureau carries out its mission by investigating alleged law violations and, when appropriate, recommending that the Commission take formal enforcement action. To notify the Bureau concerning particular business practices, write the Office of Policy and Evaluation, Room 394, Bureau of Competition, Federal Trade Commission, 600 Pennsylvania Ave., N.W., Washington, D.C. 20580, or email@example.com, or call (202) 326-3300. For more information on the laws that the Bureau enforces, the Commission has published Promoting Competition, Protecting Consumers: A Plain English Guide to Antitrust Laws, available at http://www.ftc.gov/bc/compguide/index.htm. For more information on the FTC’s antitrust actions in health care, see http://www.ftc.gov/bc/bchealthcare.htm.Media Contact:
(FTC File No. 051-0170)