Optometrists lose IHC lawsuit

A decade-long effort by a group of 49 Utah optometrists to compel the largest managed health-care company in the state to include them under its coverage has suffered a serious legal blow.

In a 37-page ruling published Wednesday, a three-judge panel with the 10th Circuit Court of Appeals found there was no evidence of a conspiracy between ophthalmologists and Intermountain Healthcare to exclude the group.

The group had claimed that IHC covered certain ophthalmologists but does not cover optometrists. While both are eye-care professionals who sell optical hardware, such as glasses, and can perform non-surgical eye care, ophthalmologists are licensed physicians and are authorized in Utah to perform eye surgery.

With IHC consisting of some 60 percent of total managed-care plan enrollees along the Wasatch Front, the optometrist group argued that IHC was violating federal anti-trust laws by shutting them out of its typical coverage. At the same time, the group claimed IHC and its panel of ophthalmologists had an agreement designed to preserve the ophthalmologists' exclusive ability to provide non-surgical eye care to 60 percent of health care customers along the Wasatch Front.

The optometrists' group claimed that part of the agreement included a promise by ophthalmologists to refer their patients to hospitals managed by IHC and not its competitors.

However, the Denver-based appellate court found that the optometrists failed to bring any evidence that such an agreement exists. The court also found that the plaintiffs failed to show that IHC has an economic

interest in the sale of non-surgical eye care.

The ruling upholds a lower federal ruling that reached the same conclusion.

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