Plaintiffs alleged that orthopedic doctors gained more favorable fees and contractual terms by agreeing to coordinate their actions, including denying medical care to injured workers covered by the State Insurance Fund and patients covered by Blue Cross.
In the first conspiracy, the orthopedists agreed not to treat most patients covered by workers compensation insurance. The doctors entered into a group boycott in order to force the Idaho Industrial Commission to pay them more money for treating injured workers covered by workers compensation insurance. The boycott resulted in a shortage of orthopedists willing to treat workers compensation patients, causing higher rates for orthopedists’ services. In the second conspiracy, all the orthopedists and other conspirators, except Dr. Lamey, agreed to threaten to terminate their contracts with Blue Cross of Idaho. The purpose for threatening to terminate their contracts was to force Blue Cross of Idaho to offer contract
terms more favorable to orthopedists. The settlement prevents the orthopedists from agreeing with their competitors on fees and contract terms. The settlement also prohibits the settling orthopedists from collectively denying medical care to patients, refusing to deal with any payor, or threatening to terminate any contract with a payor.