The Utah attorney general's investigation into Utah's health-care industry appears to be in concert with a nationwide drive by the U.S. Department of Justice and the Federal Trade Commission to crack down on health-care organizations across the country violating the Sherman Antitrust Act.
Utah's investigators have issued civil investigative demands to a pediatric physicians' corporation based at the University of Utah and similar requests to the U.'s School of Medicine and the University Hospital, according Dr. Michael A. Simmons, head of the department of pediatrics and chairman of corporation, Pediatric Faculty Physicians Inc.The attorney general issues CIDs when he has reason to believe someone may be in possession of documents or information pertinent to a suspected civil antitrust violation.
Rising medical costs have spurred the federal crackdown on medical antitrust violations. Kevin J. Arquit, director of the Federal Trade Commission's Bureau of Competition, said that with $500 billion of the nation's gross national product spent on health care, the government is committed to ensuring competition to keep prices down.
The Oct. 27, 1990, issue of American Medical News detailed the federal government's aggressive investigation of price-fixing, boycotting and other antitrust activities in the health-care industry. Three Arizona dentists were convicted in October for price-fixing, the AMN reported.
"The Justice Department is also involved in at least three investigations involving physicians. Physicians in Bridgeport, Conn., are under civil investigation for boycotting an HMO; obstetricians in Savannah, Ga., are under civil investigation for fixing delivery fees they charged a preferred provider organization; and allergists in Boston are under criminal investigation for price-fixing involving an HMO," according to American Medical News, the weekly publication of the American Medical Association.
Still, one Utah doctor who's part of the investigation accused the Utah attorney general's office of conducting a "witch hunt."
"There aren't very many things in life that I describe as good and evil. But that office is evil," he said. "What they are going to tear apart by their behavior with reference to the U. of U. is unconscionable.
"The attorney general is on a witch hunt that someone in the press ought to investigate. That office is in total disarray," said the physician, who wished to remain anonymous.
The comment didn't sit well with the Utah attorney general's office.
"No one to our knowledge has ever accused this administration of a witch hunt before. We certainly aren't doing that," said Chief Deputy Attorney General Joe Tesch. "As to the particulars of any investigation, it is our policy not to comment on them. I can tell you that we are looking into health care in Utah generally for antitrust concerns."
A university administrator also expressed dismay at the physician's comment.
"The media attention that has resulted from this inquiry has resulted in considerable controversy and confusion among faculty and staff of all of the institutions concerned and to some extent the community at large. This has led to some individuals making statements which are perhaps ill-advised and in some instances inaccurate," said Dr. William Gay, vice president of health sciences. "These statements must be interpreted as representing the position of the individual and not that of the university."
Gay continued, "We at the university accept the proper role of the attorney general's office as advisory and look for their assistance in helping us to comply with all antitrust laws."
Last month, department heads at the U. Medical School wrote U. President Chase N. Peterson expressing support for Simmons, whose leadership positions at both the U. and Primary Children's Medical Center put him at the heart of the controversy.
As the controversy continued last week, senior pediatric faculty at the U. also wrote their own letter to Peterson affirming their support for Simmons and asking Peterson to counteract the negative publicity surrounding the investigation.
Simmons himself has gone on the offensive, saying many medical centers in the country have agreements with private pediatric hospitals similar to the one between the U. Medical Center and Primary Children's, an Intermountain Health Care Facility. (See box.)
"But there's no place where this (kind of arrangement) has become controversial in terms of legal issues," he said.
The state has questioned some aspects of the relationship between the U. department of pediatrics and Primary Children's. Simmons doesn't understand the concerns.
"You cannot have a world-class or even national-class pediatric academic program if you don't have a children's hospital," he said. "And you don't have a children's hospital if the academic influence isn't brought to bear."
Private hospital affiliations with state-owned medical schools
- University of Michigan and Mott Children's
- Wayne State and Children's Hospital of Michigan
- Southwestern University of Medicine and Texas Children's
- Indiana University and James Whitcomb Riley Children's
- University of Colorado and Denver's Children's
- University of California at San Diego and San Diego Children's
- University of Washington and Seattle Children's