Case Details

Year Initiated/Committed

1996

Year Resolved

1996

Settlement Amount

n/a

Court

Kennebec Superior Court, Maine

Docket Number

CV-96-16

Lead State

ME

Participating States

ME

Defendant(s)

Central & Western Maine Regional PHO, Inc; Healthcare Corp.; Central Maine Medical Center,;Stephens Memorial Physician Hospital Organization, Inc.; Stephens Memorial Hospital, Inc.; Rumford Community Hospital Organization, Inc.; Rumford Community Hospital, Inc.; Northern Cumberland Memorial Hospital PHO, Inc.; Northern Cumberland Hospital, Inc.

Case Description

Complaint under state Hospital Cooperation Act regarding merger of 4 physician-hospital networks into regional network to jointly negotiate with managed care. Consent Decree enjoined merged entity from operating an exclusive network; implementing right-of-first-refusal policies, pressuring physician participants to terminate, refusing to negotiate or renew contracts with payors and setting fees or negotiating on behalf of participating providers. Also, no provider contract longer than 2 years permitted unless required by the payor. PHOs subject to monitoring by the Attorney General who can limit the network’s ability to contract with managed care if it does not meet promised performance standards in the form of cost savings and utilization reductions.