FTC

FTC cracks down on medical identity theft

Anne Zieger — Mon, 29 Sep 2008 11:05:39 -0400

The FTC plans to issue a new consumer protection rule that will take on the issue of medical identity theft, a growing concern now that identity thieves have recognized that medical records are rich sources of financial information. The FTC's Red Flag and Address Discrepancy Rule is written to address a wide range of financial institutions a creditors--including healthcare organizations--and requires such organizations to address identity theft risks and develop a mitigation plan.

Healthcare providers, who are addressed expressly in the Red Flag Rules Guidelines, are required to identify "red flags" that help them determine when medical identity theft may be occurring, detect when a red flag event takes place, respond appropriately and update their red flag program periodically to reflect changes in potential risks.

While the FTC isn't requiring any specific red flags for healthcare providers, the World Privacy Forum has provided a detailed list of suggestions for such triggers for investigation, including a dispute of a bill by a patient who claims to be the victim of identity theft; patient's having gotten a bill for another individual or a bill for a product or service they deny receiving; records showing medical treatment that is inconsistent with a physical exam or medical history reported by the patient; a patient or insurance company report that coverage for legitimate hospital stays is denied because insurance benefits have been depleted or a lifetime cap has been reached.

To learn more about this regulation:
- read this World Privacy Forum report (.PDF)

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FTC allows AZ merger to move ahead

Anne Zieger — Mon, 30 Jun 2008 09:51:45 -0400

The FTC has decided not to challenge a planned merger between two-hospital Sun Health and 19-hospital Banner Health, both based in Arizona. Phoenix-based Banner and Sun City-based Sun Health signed a letter of intent to merge in September of 2007, and applied for antitrust clearance in November. The FTC did issue a second request for information on the deal, but was ultimately satisfied. Perhaps the hottest competitive region the hospitals will play in is a section of the state's Maricopa County known as the Northwest Valley, observers note. Sun Health's two hospitals are both located there, as is Banner Health's Thunderbird Medical Center. The two should face competition from Catholic Healthcare West, which last year purchased 45 acres of land for a hospital about five miles away from one of the Sun Health facilities.

The approval must come as a relief to the two systems, particularly given the FTC's decidedly mixed record on hospital mergers of late. Most recently the FTC, along with the Virginia attorney general, stepped in to block the planned merger of northern Virginia's Inova Health System with rival Prince William Hospital, a move the agencies said would lock up the market in that region unfairly.

To learn more about the deal:
- read this Modern Healthcare piece (reg. req.)

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FTC slams IL physicians' retail clinic rules

Anne Zieger — Mon, 16 Jun 2008 09:13:53 -0400

In a move that could set back national physician efforts to control the evolution of retail clinics, the Federal Trade Commission has labeled retail clinic regs backed by Illinois doctors as anti-competitive and bad for consumers. The FTC letter criticizes a bill pending in the Illinois state legislature that would require permits for the facilities, limit their capacity for advertising and mandate greater physician involvement in their operations. It issued the critique at the request of a state legislator who asked for the agency's input on the pending bill.

The FTC, in short, said it didn't like what it saw. "Because several of the bill's requirements would pertain only to retail clinics--and not other health-care facilities offering the same services or staffing--those requirements could put retail clinics at a competitive disadvantage without offering countervailing consumer benefits," the agency said.

Even this critique may not stop the Illinois State Medical Society, which has been a vocal opponent of retail clinic models. However, the FTC's input has shaped how regulations have evolved in other states, such as Massachusetts, where state health officials dropped proposals to regulate retail clinic ads on FTC advice.

To learn more about the FTC's position:
- read this Chicago Tribune piece

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With FTC against deal, No. VA system gives up on acquisition

Mon, 09 Jun 2008 06:59:58 -0400

With the Federal Trade Commission coming out against the deal on antitrust grounds, Northern Virginia's five-hospital Inova Health System has given up on its plans to acquire Prince William Health System. The non-profit Inova system said it was giving up because the FTC challenge could easily have delayed the merger by as much as two years, a delay it apparently found unacceptable. In early May, the FTC filed an administrative complaint contending that adding Prince William Hospital would allow the Falls Church, VA-based Inova system to gain too much control of the region's hospital market, giving it enough leverage to force up managed-care reimbursement for inpatient services.

To learn more about the deal:
- read this Modern Healthcare article (reg. req.)

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FTC comes down on IL bill restricting retail clinics

Wed, 04 Jun 2008 06:59:58 -0400

The Federal Trade Commission has let it be known that it isn't thrilled with pending legislation that could place limits on the state's growing retail clinic industry. The agency found that the bill, which is backed by the Illinois State Medical Society, could "excessively restrict retail clinics to the detriment of Illinois healthcare consumers." The 12-page analysis, which was requested by state Rep. Elaine Nekritz, found a number of problems with the bill, including a definition it said could be interpreted to exempt retail clinics owned by hospitals or physicians from the rules.

It also objected to several other provisions, including proposed rules limiting medical directors to overseeing no more than two clinics; prohibiting payers from negotiating lower co-pays and deductibles for retail clinic services; barring retail clinics from opening in establishments that sell alcohol or tobacco; and requiring that retail clinics have a designated receptions and waiting area.

The controversy over this bill is not the first conflict over retail clinic regulations--a few states, including Massachusetts, have already seen heated battles over this issue--and it probably won't be the last. For example, the AMA continues to challenge the safety of retail clinic services, as well as their potential for posing a conflict of interest by being housed where prescription drugs are sold. Other critics (such as Boston's Mayor Thomas Menino) have proposed rules barring clinics from operating where tobacco is sold, which de facto prevents the clinics from operating in drugstores that rely on tobacco income.

To learn more about the FTC analysis:
- read this Modern Healthcare piece (reg. req.)

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FTC: Pharmas cut 14 deals to delay generic sales in '07

Tue, 27 May 2008 06:59:57 -0400

Makers of brand-name prescription drugs reached 14 agreements with makers of generic drugs to delay the generic drug makers entry into the market, according to a new report released by the Federal Trade Commission. The FTC says these deals, which it has dubbed 'pay-for-delay,' are harmful to consumers, but it hasn't been very successful in blocking them to date. The agency is on record as supporting legislation that would ban such deals, but such measures haven't made much progress on the Hill due to opposition from both brand-name and generic drug makers.

The 14 deals discussed were part of a total of 33 deals between brand-name and generic drug makers for FY 2007 reported to the agency (as required by 2003 Medicare legislation). In each of the 14 deals, the generic maker got some kind of compensation to delay the market entry of their generic product, and in 11 of the agreements, the brand-name drug maker agreed not to sell its own generic when its patents expired.

To learn more from the report, and get more context:
- read this Kaiser Daily Health Policy Report item

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Dialysis, cancer service firm gets $75M for deals and growth

Thu, 22 May 2008 06:59:57 -0400

If you haven't heard of Ambulatory Services of America, you might in the future. The Brentwood, TN-based firm, which offers alternate-site dialysis and cancer treatment centers in partnership with physicians, has snagged a $75 million investment from a New York-based venture firm it will use to expand. The venture firm, Lindsay Goldberg, manages more than $5 billion in equity capital.

ASA is run by Timothy Martin, who previously served as COO of Renal Care Group when Fresenius Medical Care of Germany bought the firm for $4 billion two years ago. Its most recent deal was in December 2007, when it closed the acquisition of Innovative Dialysis Systems and related ventures. It now owns 38 dialysis programs in 11 radiation oncology centers in eight states and Guam.

To learn more about the company's plans:
- read this article from The Tennessean

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ALSO NOTED: Dems capturing pharma political dollars; FTC upset about pharmacos' anti-generics deals; and much more...

Thu, 22 May 2008 06:59:50 -0400

> Wondering who's getting pharmaceutical dollars in this election cycle? Guess what--it's the Democrats. FiercePharma

> The FTC is not too pleased with an ongoing series of legal maneuvers by pharmaceutical companies used to keep generics off the market--but it hasn't had much luck in stopping them. FiercePharma

> A San Francisco public hospital is seeking a record $887 million in bond financing to rebuild so it's up to earthquake-protection standards. FierceHealthFinance

> The city of San Antonio has established a city registry that remotely tracks diabetics in an effort to improve their care. FierceHealthIT

And Finally... Stop or we'll tusk you! Article

Independent TX practices engaged in price fixing

Mon, 19 May 2008 06:59:57 -0400

In backing a 2005 Federal Trade Commission decision against North Texas Specialty Physicians, the fifth U.S. Circuit Court of Appeals agreed that the association of independent practices in Forth Worth took part in illegal price fixing, according to Modern Healthcare. North Texas Specialty Physicians tried to set up a system "in which members were polled as to the minimum rates they'd accept, and the association would circulate contract offers from payers only if they exceeded an acceptable fee calculated from the poll results." The appeals court favored the original finding by the FTC; neither organization believed that North Texas provided a valid explanation of how patients benefited from the system.

For more:
- read the Modern Healthcare article

FTC works to stop VA hospital merger

Mon, 12 May 2008 06:59:58 -0400

The FTC, along with Virginia's attorney general, have announced that they plan to step in to block the planned the planned merger between a Virginia hospital chain and one of its current rivals. Inova Health System Foundation, which runs the largest hospital chain in Northern Virginia, would like to add Prince William Hospital of Manassas to its current roster of five hospitals. Prince William would get access to millions in capital, which execs say they need to keep up with their region's rapid growth.

However, the FTC and state attorney general contend that the merger would violate federal antitrust laws, arguing that eliminating the existing "robust competition" between Prince William and Inova could raise healthcare prices in the region. The FTC and Virginia AG Robert McDonnell plan to seek a temporary restraining order and preliminary injunction this week to stop the deal, which was supposed to close this month. If the order is granted, an administrative trial will follow.

To learn more about the planned deal, and FTC action:
- read this piece from The Washington Post

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