“Gag-Clauses” In PPO Contracts Challenged

CALIFORNIA: The 2011 version of a hospital transparency bill was unanimously voted out of the Senate Health Committee last week. The legislation would prohibit hospitals from including provisions, commonly referred to as “gag-clauses,” in contracts with health insurers.

These provisions prevent disclosure of hospital cost and quality information to health plan members. Individual hospital systems, the UC System and the California Hospital Association continue to oppose the bill, while insurers, payers and labor unions support the measure.

Editor’s Note: Texas is doing the same – http://blog.riskmanagers.us/?p=5451

Feds And Amarillo Health Care Providers Settle Price Fixing Charges

An association representing 900 physicians in the Amarillo area has agreed to a Federal Trade Commission order barring it from jointly negotiating the prices it charges insurance providers, according to a news release.

The FTC alleged in a complaint filed with the order that Southwest Health Alliances, Inc. and BSA Provider Network, a division of Baptist St. Anthony’s Health System, has violated federal law since 2000 by fixing the prices its member doctors would charge insurers.  This led to higher prices for consumers and businesses.

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