- The Washington Times - Tuesday, November 9, 2004


The Supreme Court said yesterday it would not consider whether health insurers violate antitrust laws when they team up with doctors to adopt reimbursement policies that siphon business from chiropractors.

At issue was whether Trigon Healthcare, Virginia’s largest private health insurer, illegally conspired to develop clinical guidelines that unfairly favored doctors over chiropractors. Two chiropractic organizations who sued in 2000 say yes, while the 4th U.S. Circuit Court of Appeals in Richmond ruled there was insufficient evidence.

The Supreme Court had been asked to consider a technical legal question: whether Trigon’s advisory panel, made up of mostly medical doctors who developed the policies, represented an unlawful collusion between doctors and the health insurer. Trigon says the doctors were effectively its employees; thus, by legal definition, the panel was a single entity incapable of conspiring with itself.

Trigon also argued its independent board of directors made the final decision on the panel’s recommendations, and that the conspiracy argument made no sense because the company had no economic motive to prevent referrals to lower-cost chiropractors.

The chiropractic groups say the insurer’s policies have unfairly cost its industry $100.9 million in lost fees in Virginia from 1996 to 2001.

Left unchecked, patients and employers will have to pay higher out-of-pocket costs, and many chiropractors may be forced out of business, they say.

In other court developments yesterday, the justices:

• Heard arguments in two cases without Chief Justice William H. Rehnquist, who is working from home while he receives radiation and chemotherapy for thyroid cancer.

• Declined to hear an appeal from Washington state to stop minority felons from seeking the right to vote. The felons challenge as racially discriminatory a law stripping them of their right to vote. Every state, except Maine and Vermont, bars imprisoned felons from voting.

• Wrangled with a case that seeks to clarify when police can be sued for arresting suspects on charges that later fall apart. The Washington state case being argued involves a man who sued over his arrest during a traffic stop.

• Decided not to consider whether the U.S. Coast Guard can be sued for providing questionable emergency care to an injured Florida diver who later became paralyzed.

• Declined to review four Massachusetts discrimination cases involving rulings awarding thousands of dollars that employers say should have been decided by juries, not judges.

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