Recently, a merged group, Urology of Central Pennsylvania Inc. (UCPI), consisting of five formerly independent urology practices in the Harrisburg area, and the Pennsylvania Attorney General’s Office reached an agreement to settle the case filed by the attorney general alleging antitrust theories arising out of the merger. The consent agreement was reached just a day after the suit was filed by the Attorney General’s Office in the U.S. District Court for the Middle District of Pennsylvania styled as Pennsylvania v. Urology of Central Pennsylvania Inc.
In this era of “accountable care” and other pressures and incentives for increased cooperation between, and amalgamation of, health care entities in order to become larger to accept the risks, as well as the costs, to be able to participate in the new reimbursement models in the industry, one large concern that is ever present as a counterbalance toward this push of bigness is the risk of an antitrust lawsuit. While oftentimes there are many benefits to the merging of physician groups, this case demonstrates the risks that are run from an antitrust perspective, even when the resultant group does not become the sole provider of a certain sort of medical services in a designated geographic area. The case also highlights part of the reasons that many providers want more definitive rules for forming accountable care organizations and assurances of the propriety of the same, so as not to run afoul of federal and state antitrust laws, as well as many other laws that may be implicated.
