CADE condemns four cases of price fixing of medical services

The Tribunal of the Administrative Council for Economic Defense – CADE condemned, on 29 October 2014, four cases of price fixing of medical services on the health insurance market. The conducts were practiced by organizations representing the medical profession in the states of Pará, Mato Grosso do Sul, Maranhão, and Roraima. The National Union of Self-Management Institutions in Healthcare - UNIDAS for its acronym in Portuguese- was also condemned of anticompetitive practices. In total, fines of approximately USD 1.3 million were imposed.

The medical organizations were condemned for seeking to unilaterally fix the minimum value of medical appointments and fees paid by health plans operators. In the four cases judged, this fixation was given by Brazilian Hierarchical Classification of Medical Procedures – CBHPM for its acronym in Portuguese- which was considered a table of minimum prices both for doctor’s fees and hospital procedures and examinations.

In addition, the entities promoted movements for stopping and boycotting of the services of the operators which did not accept the stipulated values. In some cases, the non-adherence to these movements subjects doctors to ethical and disciplinary sanctions.

For the anticompetitive practices, CADE condemned the Medical/Surgical Society of Pará, the Regional Council of Medicine of Pará and the Union of Medial Doctors of Pará to pay fines in the amount of BRL 383,076.00 (Administrative Proceeding no. 08012.001790/2004-55).

The Brazilian Society of Orthopedics and Traumatology of Mato Grosso do Sul and the National Union of Self-Management Institutions in Healthcare -UNIDAS must pay fines totaling BRL 510,768.00 (Administrative Proceeding no.08012.002381/2004-76).

The Regional Council of Medicine of Maranhão (Administrative Proceeding no. 08012.002985/2004-12) and the Regional Medical Council of Roraima (Administrative Proceeding no. 08012.003568/2005-78) must pay fines amounting to BRL 212,820.00 each.

Besides paying the fines, CADE’s Tribunal also determined the entities to refrain from promoting or supporting the boycott movement, collective stoppage of care to beneficiaries of health plans, and mass de-accreditations. Entities also cannot prevent the direct and individual negotiation of fees between doctors and health insurance providers or hospitals.

Other cases convicted - On the judgment session of 15 October 2014, CADE’s Tribunal imposed a fine totaling BRL 2.7 million to 19 medical organizations for fixing prices of medical services on the health insurance market.