Case Summary
The Commission challenged the conduct of Boulder Valley Individual Practice Association for refusing to deal, or threatening to refuse to deal with insurance providers that failed to increase fees paid to group doctors, and also prevented members from contracting with payers, except through Boulder Valley. During the period between 2001 and 2006 Boulder Valley IPA threatened to terminate contracts with payers unless the payers agreed to pay increased fees-for-service set by Boulder Valley, effectively engaging in illegal price fixing, and harming Boulder country area consumers by charging higher prices for the various physician’s services offered. The settlement prohibits Boulder Valley from entering into agreements between or among physicians: 1) to negotiate on behalf of any physician with any payer; 2) to refuse to deal, or threaten to refuse to deal, with any payer; 3) to designate the terms, conditions, or requirements upon which any physician deals, or is willing to deal, with any payer, including, but not limited to price terms; 4) not to deal individually with any payer, or not to deal with any payer through any arrangement other than one involving Boulder Valley.