Commission Actions

re: Concerning a proposal by an association of nine Professional Standards Review Organizations to bid for contract with HHS to serve as a Peer Review Organization for Ohio under the Medicare program.

re: Concerning a proposal by a physician-owned IPA/HMO, with most of the local physicians as participants, to close off access to the plan to new/additional physicians.

re: Concerning the use by an IPA of a fee schedule to allocate capitation payment among participating physicians, and a proposal to require exclusive dealing by IPA members with the IPA.

re: Concerning the use of HCFA's Medicare fee profile by the association as a reference aid in reviewing the reasonableness of disputed fees.

re: Concerning the use of HCFA's Medicare fee profile by the association as a reference aid in reviewing the reasonableness of disputed fees.

re: Concerning provisions in the association’s code of ethics regarding advertising, prior approval of advertising, and fee discounts.