State, feds, Boise-area doctors settle antitrust case: 5 physicians and the Idaho Orthopedic Society were accused of conspiring to obtain higher fees by refusing treatment to injured workers. [The Idaho Statesman, Boise]

May 29--The U.S. Department of Justice and Idaho's attorney general have reached a settlement in an antitrust case against an orthopedic society, a group orthopedic practice and five doctors.

The orthopedic society and the doctors conspired to boycott treatment of injured workers, and all but one of the doctors threatened to withdraw from health care plans offered by Blue Cross of Idaho, according to news releases from the agencies.

The doctors and groups named in the case are: Idaho Orthopaedic Society, the Idaho Sports Medicine Institute, Dr. Timothy Doerr, Dr. Jeffrey Hessing, Dr. John Kloss, Dr. David Lamey and Dr. Troy Watkins.

The doctors could not be reached for comment late Friday afternoon.

"The orthopedists who participated in these group boycotts denied medical care to Idaho workers and caused higher prices for orthopedic services," said Christine Varney, assistant attorney general in charge of the U.S. Department of Justice's antitrust division.

"Today's action seeks to prevent the recurrence of these illegal acts and protects Idaho consumers by promoting competition in the health care industry," Varney said.

The civil antitrust settlement was filed in U.S. district court for Idaho. It would go into effect after a 60-day comment period. The settlement bars competing doctors from doing the same thing again.

The doctors are accused of two conspiracies from 2006 to 2008. In the first, the orthopedic doctors agreed not to treat most patients covered by workers compensation insurance.

The goal was to force the Idaho Industrial Commission to pay them more money for treating injured workers.

The Idaho Industrial Commission sets the fee schedule that determines how much money health care providers usually receive for treating patients, causing higher rates for orthopedists' services.

"In short, these doctors were willing to use injured workers awaiting treatment as leverage to gain higher reimbursement fees," Idaho Attorney General Lawrence Wasden said in the news release.

In the second conspiracy, all of the defendants except Dr. David Lamey agreed to threaten to terminate their contracts with Blue Cross .

Orthopedic surgeons in practices across Idaho published newspaper advertisements in 2008 airing a dispute with Blue Cross. The surgeons said the insurer wanted to pay them too little to treat its patients.

"We operate in good faith when we negotiate with providers," Blue Cross spokeswoman Karen Early said in an e-mail Friday.

"However, we will continue to work with the providers in our networks to help hold down the cost of health care while preserving and improving the quality of medical care our members receive," she said.

Colleen LaMay: 377-6448

To see more of The Idaho Statesman, or to subscribe to the newspaper, go to http://www.idahostatesman.com

Copyright (c) 2010, The Idaho Statesman, Boise

Distributed by McClatchy-Tribune Information Services.

For reprints, email [email protected], call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.