Attachment A


The Order accompanying this Notice, among other provisions, prohibits Texas Surgeons, P.A. (an association of 26 general surgeons in the Austin, Texas, area) ("Texas Surgeons") and six named medical practice groups (whose physicians comprise almost all of the members of Texas Surgeons) from participating in or facilitating any agreement to:

  • negotiate on behalf of physicians with any health plan or any other purchaser of physician services;
  • deal, refuse to deal, or threaten to refuse to deal with, or boycott or threaten to boycott, any health plan or any other purchaser of physician services;
  • restrict the ability of any physician to negotiate or deal on an independent basis with any health plan or any other purchaser.

Another provision of the Order prohibits Texas Surgeons and the six practice groups from exchanging, or facilitating the exchange of, among any Austin area physicians, certain information relating to negotiations and dealings with health plans and other purchasers of physician services.

The Order permits an arrangement that sets collective price terms or other collective terms and conditions of dealing only if it is a "qualified risk-sharing joint arrangement" or "qualified clinically-integrated joint arrangement" (as defined in the Order). Nothing in the Order prohibits any of the six practice groups from furthering any arrangement to provide physician services that is limited to physicians within the practice group. Further, the Order does not prohibit any conduct that is approved and supervised by the State of Texas and is protected from liability under the federal antitrust laws by the state action doctrine.

The Texas Surgeons and the six practice groups may participate in an arrangement in which the individual practice groups or individual physicians convey and receive, through a third party, information, offers, and responses from and to health plans or other purchasers, so long as such negotiations remain individual and do not violate the Order. For additional information about how such negotiations can remain individual, see the August 1996 Statements of Antitrust Enforcement Policy in Health Care jointly issued by the Federal Trade Commission and the U.S. Department of Justice, including pages 43-52, 89-92, 125-27, and 138-40. A copy of that publication is available through the Commission's web site: