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US: Affordable Care Act forces antitrust on doctors’ minds

 |  November 19, 2013

Doctors may now have to worry about the antitrust challenges they face now due to the implementation of the Affordable Care Act, the controversial legislation aimed at providing health insurance coverage for all Americans.

According to pulmonary specialist Dr. Edward J. Diamond, the ACA is calling on healthcare providers to improve care and lower costs; this can be done, said Dr. Diamond, through “clinical integration,” in which physicians group together to collect and pool protocol data.

This practice, however, threatens sanctions by the US Department of Justice under antitrust law, however, as the DOJ holds a strict definition of clinical integration.

The act is described by the regulator as a “network implementing an active and ongoing program to evaluate and modify practice patters…and create a high degree of interdependence and cooperation among the physicians to control costs and ensure quality.”

According to Dr. Diamond, “you have to really adhere to this definition to avoid antitrust issues.”

Dr. Diamond made the remarks when speaking at the annual meeting of the American College of Chest Physicians, where he is a member of the faculty.

To appease both the ACA as well as antitrust law, Dr. Diamond said physicians must be careful to avoid accusations of collective bargaining.

”There is a disconnect between what the Department of Justice and what the ACA are asking,” he said.

Full Content: Family Practice News

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