Managed care plans accuse Hawaii physicians of antitrust violations

Physician groups gave too much guidance to doctors on HMO contracts, the managed care companies say. The Hawaii Medical Assn. and others disagree.

By Tanya Albert, AMNews staff. Feb. 5, 2001.

Two Nevada managed care companies have sued a doctor-consumer advocacy group and the Hawaii Medical Assn., charging that they broke federal antitrust laws by getting too involved with contract negotiations.

International Healthcare Management and Health Hawaii Network say the medical groups overstepped their bounds by talking to doctors about the fees they should be willing to accept in a managed care contract, according to a lawsuit filed in November 2000 in U.S. District Court in Hawaii. Federal antitrust laws prohibit independent physicians from joining together to negotiate contracts.

The Nevada companies, which were trying to establish a physician network in Hawaii, also claim that the medical groups organized a boycott that kept them off the islands.

The HMA and the nonprofit advocacy group Hawaii Coalition for Health say they didn't break any laws.

"We're very disappointed because they came to us for technical advice and now they are suing us," said Robert F. Miller, a Honolulu attorney representing the HMA.

Medical associations often provide their members with model managed care contracts that work as educational tools. The models are designed to help doctors understand contracts they are signing and to help them negotiate with health plans.

But the lawsuit says that the health coalition, the HMA, a group of 700 physicians known as the Queens Physician Group and several individual physicians went beyond that. They discussed doctor fees, said John I. Alioto, a San Francisco attorney representing the health plans. [...]