ARIZONA v. MARICOPA COUNTY MEDICAL SOCIETY (1982) Respondent foundations for medical care were organized by respondent Maricopa County Medical Society and another medical society to promote fee-for-service medicine and to provide the community with a competitive alternative to existing health insurance plans.
In October 1978 the State of Arizona filed a civil complaint against two county medical societies and two "foundations for medical care" that the medical societies had organized. The complaint alleged that the defendants were engaged in illegal price-fixing conspiracies.
A society of doctors in Maricopa County, Arizona, established maximum fees that their members could claim for seeing patients who were covered by certain health insurance plans. Arizona charged them with violations of state antitrust law regarding price fixing.
The Maricopa Foundation was organized in 1969 for the purpose of promoting fee-for-service medicine and to provide the community with a competitive alternative to existing health insurance plans. 7 The foundation performs three primary activities.
The Maricopa and Pima Foundations for Medical Care are professional associations of physicians organized by the medical societies in their respective counties. 1 The foundations were established to make available a type of prepaid medical insurance plan, aspects of which are the target of this litigation. Under the plan, the foundations insure no risks themselves. Rather, their key function is to secure agreement among their member physicians to a maximum-price schedule for specific medical services. Once a fee schedule has been agreed upon following a process of consultation and balloting, the foundations invite private insurance companies to participate by offering medical insurance policies based upon the maximum-fee schedule. 2 The insurers agree to offer complete [457 U.S. 332, 359] reimbursement to their insureds for the full amount of their medical bills - so long as these bills do not exceed the maximum-fee schedule.
The complaint alleged that the defendants were engaged in illegal price-fixing conspiracies. 1 After the defendants filed their answers, one of the medical societies was dismissed by consent, the parties conducted a limited amount of pretrial discovery, and the State moved for partial summary judgment on the issue of liability. The District Court denied the motion, 2 but entered an order pursuant to 28 U.S.C. 1292 (b), [457 U.S. 332, 337] certifying for interlocutory appeal the question "whether the FMC membership agreements, which contain the promise to abide by maximum fee schedules, are illegal per se under section 1 of the Sherman Act." 3
Continued Medical Education (CME) that physicians can earn throughout the year.
Continued Medical Education (CME) that physicians can earn throughout the year.