Government Supports Proposed Final Judgment Against Chiropractic Entity

The government submitted a motion and supporting memorandum to the U.S. District Court for the District of South Dakota outlining the government’s request and procedural steps undertaken for a proposed Final Judgment to be entered against Chiropractic Associates, LTD. of South Dakota (CASD) in the matter of U.S. v Chiropractic Associates, LTD. of South Dakota. The government had filed a complaint against CASD for violations of the Sherman Act for conspiracy of unreasonable restraint of interstate trade and commerce related to the entity’s chiropractic services.

Process

The Antitrust Procedures and Penalties Act (APPA) imposes a 60-day period for the submission of public comments on any proposed Final Judgment. The government completed the public comment period on June 20, 2013, receiving one comment from an anonymous South Dakota resident who uses chiropractic services. The comment and government’s response was published in the Federal Register, completing the requirements of the APPA.

Prohibited Conduct

According to the government, the Final Judgment, as submitted, would prevent the recurrence of violations by enjoining CASD from jointly determining prices and negotiating contracts with payers. Additional provisions of the Final Judgment and the provisions’ application to CASD’s payer contracting activities included prohibiting CASD from:

(1)

negotiating or contracting with payers on behalf of any physician, except to provide credentialing and utilization review services;

(2)

reviewing or analyzing any contractual terms between a physician and a payer;

(3)

engaging in conduct that promotes members’ collective boycotts or refusals to contract with payers;

(4)

requiring that CASD members negotiate with payers through CASD; and

(5)

responding to any question or request initiated by a payer relating to (i) a physician’s negotiating, contracting or participating status with any payer; (ii) a physician’s fees or reimbursement rates; or (iii) any proposed or actual contract or contract term between any physician and any payer.

 

The Final Judgment would also cancel all of CASD’s current contracts with payers and members upon written request to terminate, termination date, renewal date, or anniversary date of said contract, or within three months from the date of the entry of the Final Judgment, whichever comes first.