Staff Advisory Opinions
Business Health Companies, Inc.
Commission staff advised Business Health that a planned survey of hospital prices in Texas appeared to fall within the safety zone for exchanges of price and cost information outlined in the 1996 Healthcare Guidelines issued by the Commission and the Department of Justice. Business Health was retained by the Central Texas Healthcare Coalition to collect and analyze data on average charges and patient outcomes of the two major Waco hospitals and three other Texas hospitals.
Direct Marketing Association
The Commission staff advised the Direct Marketing Association that it could require its members to (1) honor requests from consumers that direct marketers (direct mail marketers or telemarketers) not contact them, (2) disclose to consumers how their members sell or otherwise transfer personal information about those consumers to others, and (3) honor consumers' requests that the members not sell or transfer their personal information.
First Look, LLC
Commission staff advised First Look that the staff would not recommend a challenge on antitrust grounds to a proposed network of optical firms that First Look organized. The network would respond to requests for proposals for employer contracts for optical and vision care services for individuals living in an area larger than that served by any one provider.
Foundation for the Accreditation of Hematopoietic Cell Therapy
Commission staff advised the Foundation for the Accreditation of Hematopoietic Cell Therapy that the staff would not recommend a challenge to a proposal to establish a program of standards, inspection, and voluntary accreditation of entities involved in medical or laboratory practice related to hematopoietic progenitor cell therapy. Hematopoietic progenitor cell therapy refers generally to the infusion into a patient of blood-forming stem cells for the treatment of leukemia, certain other cancers, and other blood disorders. The Foundation developed standards for facilities and individuals performing such therapy or providing support services for the procedures and will implement an accreditation program incorporating on-site inspections.
Henry County Memorial Hospital
Commission staff advised Henry County Memorial Hospital that the hospital's purchase of drugs for resale to patients in a physician hospital organization (PHO) would not qualify as "own use" under the Non-Profit Institutions Act. The Act exempts from the Robinson-Patman Act "purchases of their supplies for their own use by . . . hospitals, and charitable institutions not operated for profit."
Mobile Health Resources, LLC
Commission staff advised Mobile Health Resources that the staff would not recommend a challenge to a proposal to establish a network of seven ambulance companies that would provide medically related transportation services in Michigan to health care plans, health maintenance organizations, and other large purchasers. The network proposed to enter into contracts involving significant economic and functional integration among participating providers in the network.
New Jersey Pharmacists Association
Commission staff advised the New Jersey Pharmacists Association that the staff would not recommend a challenge on antitrust grounds to a proposed pharmacist network offering health education and monitoring services to diabetes and asthma patients. These services would be marketed to insurance companies, health maintenance organizations, managed care organizations, pharmacy benefits managers, and other third-party payers in an attempt to reduce payers' costs .
North Mississippi Health Services
Commission staff advised North Mississippi that the sale of discounted pharmaceuticals to retired or former employees of the hospital would not be entitled to the exemption from the Robinson-Patman Act provided by the Non-Profit Institutions Act. North Mississippi's Medical Center pharmacy provides pharmaceuticals at discounted prices to employees, students, medical staff, and their dependents. Commission staff advised that the provision of pharmaceuticals to persons who no longer have a direct relationship with the Medical Center would not constitute purchases for the Medical Center's "own use" under the Act.
North Ottawa Community Hospital
Commission staff advised North Ottawa that its plan to sell pharmaceuticals to Hospice of North Ottawa County would be exempt from the Robinson-Patman Act under the Non-Profit Institutions Act so long as it did not realize a profit from the sale. North Ottawa could receive from Hospice the price it paid for the drugs plus reimbursement for any costs it incurs as a direct result of providing the drugs to Hospice patients. North Ottawa could charge a monthly per-patient fee for the drugs if the fee accurately reflects its direct expenses in servicing Hospice patients.
Ohio Ambulance Network, Inc.
Commission staff advised the Ohio Ambulance Network that the staff would not recommend a challenge to a proposal to create a network of licensed ambulance and ambulette service providers to offer scheduled, non-emergency service throughout northeast and south-central Ohio. The network members will provide services in accordance with the terms of participating agreements and contracts entered into individually by each network member with purchasers; an independent contractor will act as "messenger," conveying contract offers between potential purchasers and each member provider. The network will administer contracts by coordinating scheduling and dispatch, centralizing billing and payment, and facilitating communication between a purchaser and participating providers. Members will be free to join other networks or to contract with purchasers independently.
Southwest Florida Oral Surgery Associates
Commission staff advised that the staff would not recommend a challenge to Southwest's proposal to form a cooperative for the purpose of jointly marketing oral surgery services to employers, managed care plans, and other payers. The cooperative, composed of three oral and maxillofacial surgery practices, will use a "messenger" to solicit payer and managed care contracts and to transmit contract offers to members for individual acceptance or rejection. The cooperative will engage in group purchasing, joint marketing, and the sharing of medical information systems. Each practice will continue to operate individually and to provide its own claims processing and other administrative functions. Members will have the ability to join in other networks and to market their practices independently of the cooperative.
Yellowstone Physicians, LLC
Commission staff advised Yellowstone Physicians, a proposed multispecialty physician network joint venture in Montana, that the staff would not recommend a challenge to the formation and operation of the for-profit company to be owned by its members, who will also be the health care providers for the network. The network plans to enter into managed care provider contracts on behalf of its members, whereby participating physicians will share risk through either the use of capitated rates or contracts with substantial risk withholds.