Hmo_Stocks

There isn't much incentive now for the health-care industry to do right on its own therefore the department of justice (DOJ) and the Federal Trade Commission have been vigilant with a number of antitrust actions over the past few months. This agency has successfully challenged unlawfully agreements among doctors and hospitals and challenge healthcare mergers. On October 1 1999 Joseph Sellers, an attorney with Cohen, Milstein, Hausfeld & Toll in Washington, said his firm will file a suit alleging fraud by "one of the industry leaders." Although Sellers wouldn't name the company, but the suit will probably be filed in the coming weeks of October. HMOs, which combine the functions of health insurance companies and health-care providers, have been accused of withholding vital services from patients to maximize profits. Congress is preparing to debate new regulations for HMOs designed to make them more accountable to patients, including provisions that could make it easier to sue health-care providers Consumers are expected to allege they've been denied information on benefits, leaving them unable to tell whether they've spent more on health care than they should have. ERISA requires companies to disclose benefit information, including details of their claims' approval processes the suits will ask a judge to order insurance companies to disclose such information and will seek unspecified damages. For this to not happen in the future companies should adhere to the recent antitrust actions that have been updated. The first actions prohibit healthcare systems from conspiring to anticompetitive tactics to allegedly use to help increase health insurance reimbursement. Punishment for this would be to terminate contracts. DOJ Reportedly Investigating Large Hospital-Physician Network in Boston: It is reported that DOJ is conducting a civil investigation into possible anticompetitive practices by Partners HealthCare System, a large hospital-physician network in the Boston area. Civil investigative demands have been sent to Partners and three large health insurers regarding Partners' contracting and other practices (Los Angeles Times). The DOJ contends that big company merging would lead to higher prices, fewer choices and a reduction in the quality of commercial health insurance plans. This in turn would give the ability to control physician reimbursement rates in a harmful manner to consumers. FTC Act to challenge conduct that does not violate the antitrust laws, barring monopoly practices would prevent dominant market position and increase prices. The healthcare system maintains this position by refusing to deals with sellers of the competition and bundling. Reference Cleverly, W.O, Song, P.H., Cleverly, J.O. (2011). Essentials of Health Care Finance, 7 ed. Boston: Jones and Bartlett HMO Stocks Take Hard Falls Amid the Threat of Class Actions; Health care: High-profile lawyers plan suits to force companies to improve service and disclose benefit information :[Home Edition]. (1999, October ). Los Angeles Times,p. 1. Retrieved June 19, 2011, from Los Angeles Times.