Antitrust laws are designed to prevent restraints on trade that harm consumers and less powerful competitors. However, in 1945, Congress passed the McCarran-Ferguson Act, which expected certain insurance practices from federal antitrust laws. Over the past several decades, the health insurance market has become exceedingly concentrated, and this antitrust exemption, together with the recent health care industry consolidations, has enables a select few health plans to dominate the health care market. As a result, physicians are frequently placed in positions of diminished bargaining strength, and health plans are able to impose unilateral, non-negotiable contracts.
The AAOS believes that equitable negotiations between physicians and health insurance plans must be allowed to ensure access to quality care. Allowing physicians to negotiation with dominant insurers on a level playing field ensures heightened quality standards for patient care, removes administrative barriers, and allows physicians to engage in care coordination endeavors without fear of antitrust prosecution.