IL medical practice reaches antitrust settlement with state

By Anne Zieger

Illinois medical group Carle Clinic Association has cut a deal to settle an antitrust lawsuit alleging that it had conspired with the area’s other dominant practice to avoid Medicaid business. In the suit, Attorney General Lisa Madigan argued that the 330-physician group turned away Medicaid patients en masse in an effort to force the state to raise its reimbursement levels.

Earlier this year, a state judge kicked out an antitrust suit against Carle and its alleged partner in the scheme, Christie Clinic, which supposedly helped Carle push patients into more-lucrative emergency departments associated with the practices. Undeterred by the loss, Madigan refiled the case.

Under the terms of the settlement, the Urbana-based clinic denies liability or wrongdoing. It has already agreed to see Medicaid patients through the state’s new Illinois Health Connect program–which focuses on medical homes and pays higher reimbursement than usual. The agreement requires Carle to take a certain number of patients in that program.

Carle must also not refuse to see patients who incurred medical debt from 2003 through 2007, who despite being Medicaid-eligible were treated as self-pay by practice policy.

To learn more about the case:
– read this Modern Healthcare piece (reg. req.)

see original

You may also like

Legislative panel approves medical malpractice bill
Read more
Urgent-care centers: Illinois numbers grow as time-pressed families seek low-cost option to ERs
Read more
Global Center for Medical Innovation launches
Read more

Recent Posts

Medical review panels in Louisiana are not allowed to take into account COVID immunity

By fixing the damage cap, New Mexico managed to prevent a crisis in medical malpractice insurance

ATRF Publishes Annual ‘Judicial Hellholes’ Report, Medical Professional Liability Again Plays Determining Role

Popular Posts

2022 Medical Malpractice Insurance Rates: What the data tells us

Global Center for Medical Innovation launches

PIAA 2017: Current Trends & Future Concerns

Start Your Custom Quote Process™

Request a free quote