Patricia Wagner Comments on Antitrust Issues with IPAs

Managed Care Contracting & Reimbursement Advisor

Patricia Wagner, a Member of the Firm in the Health Care and Life Sciences practice in the Washington, DC, office, was quoted in an article titled "Tread Carefully to Avoid Antitrust Issues with IPAs."

According to the article, an IPA can seem like a good option for practices looking to join forces and improve their revenue potential, but experts caution that you must be careful with structuring an IPA to avoid running afoul of antitrust laws.

It is important that the messenger model be followed to the letter and that it not be set up as a sham to get around antitrust concerns, said Wagner.

"Physicians should not be talking to one another about offers and whether they are going to participate with that payer. That's a big thing to avoid," Wagner said. "Another red flag for payers is the IPA saying it won't messenger the offer to physicians unless the payer comes back with a better offer. A true messenger arrangement does not allow the IPA administrator to block offers."