Antitrust:
1.    ACGME is a monopoly…
2.    Private entities cannot engage in antitrust behavior (monopolies).
a.    Senate Bill 1468: set up a scheme where physicians could engage in monopolistic behavior and establish common feats.  Groups could get together as a single entity and contract with managed care/insurance, etc.  As private individuals, this would have violated antitrust laws, so the bill had to make this a state action.  It is ok as long as the negotiating posture is approved by the state Attorney General’s office.
3.    Antitrust Article on page III-30:
a.    Association of Family Practice Residency Directors restricts competition among its members for family practice medical residents.
b.    The Justice Department sued the association b/c doctors offered an economic incentive to bribe residents to come to their particular problems.  The Justice Dept disliked this idea b/c it would restrict competition among the hospitals and residency programs.
c.    In some ways, these programs are monopolistic, and care out antitrust activities.  But if the activity relates specifically to educational issues, the courts are less likely to frown on them, than if it is economic.
4.    Sanjuan v. American Board of Psychiatry and Neurosurgery:
a.    Psychiatrists did not pass the oral exams and failed certification, and then sued the baord b/c dissatisfied with the board’s appeals process.  Psychiatrists claim that without certification, they will not make as much money, and get hospital privileges, etc.
b.    HELD:  Antitrust law has a purpose to protect consumers.  And psychiatrists are not consumers, but producers.  And in fact, the certification will allow the psychiatrists to increase costs.  And the idea of the certification program is to have competition to keep prices down.