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Idaho reaches settlement with orthopedists on workers’ comp pricing

Idaho reaches settlement with orthopedists on workers’ comp pricing

Idaho Freedom Foundation staff
May 28, 2010

Idaho Attorney General Lawrence Wasden and the U.S. Department of Justice have reached a legal agreement with a group of orthopedic doctors to prevent the doctors from collaborating to raise prices for providing care to injured workers.  Wasden alleged that the orthopedists boycotted treating patients covered by Idaho’s workers compensation insurance to get more money from a state insurance fund and threatened to terminate a contract with Blue Cross of Idaho, a large insurance company in the state, to get a more favorable contract.

“These doctors were willing to use injured workers awaiting treatment as leverage to gain higher reimbursement fees,” Wasden said in a news release.  The group involved in the anti-trust settlement, the Idaho Orthopaedic Society, the Idaho Sports Medicine Institute, and five Boise orthopedists, did not admit breaking the law and will not pay back the Idaho State Insurance Fund for the higher costs, according to an official in Wasden’s office.

“The settlement was focused on stopping the practice and preventing them from occurring in the future, but there isn’t a financial component to the settlement,” Brett DeLange, deputy attorney general, told IdahoReporter.com.  The anti-trust settlement covers alleged activities from 2006 to 2008.  The orthopedists can no longer agree with competitors on prices, collectively deny medical care to patients, or refuse to deal with public or private insurance companies paying them.

“Anticompetitive activity harms the marketplace, businesses and consumers,” Wasden said.  “Enforcement of the antitrust laws restores competition to the marketplace to the benefit of businesses and consumers and the marketplace as a whole.”

The Idaho State Insurance Fund covers workers’ compensation for on-the-job injuries.  Businesses pay premiums to cover the insurance fund, which gets no money from tax revenues from the state general fund.  The Idaho Industrial Commission sets the prices for medical services that orthopedists and other health care providers receive for treating patients covered by workers compensation.

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