AHIP AHM-510 Exam - Topic 4 Question 40 Discussion

Question

Determine whether the following statement is true or false:

Although most-favored-nation (MFN) clauses in contracts between health plans and healthcare providers are not per se illegal, they should be reviewed under the rule of reason analysis for antitrust purposes.

Lorean · Accepted Answer

B) True, because although MFN clauses are not per se illegal, they violate antitrust laws if they have a predatory purpose and an anticompetitive effect.

Lorean · Answer

A) True, because the Federal Trade Commission (FTC) ruled that MFN clauses are not per se illegal and the FTC encourages health plans to include them in provider contracts.

Lorean · Answer

C) False, because MFN clauses involve decisions by providers concerning the level of fees to charge, and thus they are per se illegal.

Lorean · Answer

D) False, because MFN clauses are not per se illegal, and thus they are exempt from antitrust laws and regulation by the FTC.