American Academy of Family Physicians

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AAFP Renews Call to Change Existing Antitrust Laws

By James Arvantes

The AAFP has again asked Congress to ease federal rules and regulations that govern physician contract negotiations with third-party payers, saying in a recent letter that current restrictions are "particularly onerous for primary care physicians."
In an Aug. 21 letter (7-page PDF; About PDFs) to congressional leaders, AAFP Board Chair Rick Kellerman, M.D., of Wichita, Kan., says, "the number of practicing primary care physicians nationwide is shrinking in the face of inadequate third party payments. Physicians remain at a critical disadvantage when negotiating for better pricing and payments without risking sanctions under current federal antitrust enforcement policies."

The Academy's letter urges Congress to make changes in existing antitrust laws that would enable physicians to actively negotiate contracts with health plans.

"FTC regulatory barriers to physician collaboration combine with insurance market consolidation and 'take-it-or-leave-it' contract offers to hamper the delivery of quality primary care," Kellerman says.

In the letter, Kellerman cites testimony given last October by AAFP President Jim King, M.D., of Selmer, Tenn., before the House Committee on Small Business. In his remarks, King had decried the persistent consolidation that continues today in the insurance industry.

In the prevailing marketplace, King testified, physicians cannot realistically negotiate payment rates or even challenge the terms of provider agreements.

King asked the committee at that time to consider changing current antitrust laws so patients could continue to receive quality health care from primary care physicians. "One step in this direction would be to engage the medical community on how the antitrust laws could be changed to better support the small businesses that are medical practices, so that they can negotiate contracts with insurers from a position of equality," said King.

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