IPAs: Are you in the FTC’s crosshairs?
The following reader-submitted question on this subject generated a fervent response from several managed care experts:
I want to know whether a messenger model IPA can speak with health plans about certain fee schedule issues. Since the physician community [may face] … cuts in overall reimbursement from Medicare in 2010, can these IPAs go back to the plans and ask for new reimbursement methodologies?
Most managed care contract fee schedules are tied to a percentile of Medicare. In 2010, all plans will experience a huge windfall in savings. I am trying to convince the IPA that I affiliate with to ask for a new methodology in calculating fee schedules. Is this within the legal bounds to do and not viewed as price fixing?
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