AHA urges quick antitrust guidance on care integration

The American Hospital Association urged antitrust agencies to provide timely and clear guidance on care coordination arrangements among hospitals and other caregivers during a House Judiciary subcommittee hearing Wednesday morning.

The hearing was held as uncertainty grows about how accountable care organizations (ACOs) might run afoul of antitrust and anti-kickback laws. ACOs, which are encouraged by the healthcare reform law, are care delivery models in which providers coordinate care for a group of patients.

AHA general counsel Melinda Hatton said patients will benefit from having a less fragmented system in which providers and hospitals work together to coordinate care. The best way to do this within legal parameters is “to issue user-friendly, officially backed guidance that clearly explains to caregivers what issues they must resolve to embark on a clinical integration program without violating antitrust laws,” Hatton said.

According to her testimony, lawmakers have already urged antirust agencies in three separate letters to provide such guidance.

The AHA also urged the Department of Justice increase its vigilance of health insurers’ anticompetitive behavior. Hatton’s testimony stated hospitals have been subject to much more scrutiny by antitrust agencies, while health insurers “have not faced nearly as much public antitrust scrutiny and oversight.”