Who should treat allergies? The turf battle between primary care physicians and allergists has escalated into a lawsuit charging anti-competitive practices.
The recently-formed Academy of Allergy & Asthma in Primary Care (AAAPC) and its major sponsor, allergy-testing and immunotherapy company United Allergy Services, filed an antitrust suit in federal district court in San Antonio claiming that allergy groups influenced payers to deny or limit reimbursement to physicians who weren't board-certified allergists.
"Additional alleged anti-competitive conduct includes intimidating primary care physicians from practicing allergy care within their scope of practice, coercing and persuading allergist colleagues to boycott primary care physicians and UAS [United Allergy Services], and supporting and weighing in on self-generated complaints by allergists to medical boards," a statement from the plaintiffs explained.
The suit named as defendants:
- The American Academy of Allergy, Asthma & Immunology (AAAAI)
- The American College of Allergy, Asthma & Immunology (ACAAI)
- The Joint Council of Allergy, Asthma & Immunology (JCAAI)
- Specific board members and officers within each organization
"There's been a lot of work done to try to prevent it from escalating to this point," the primary care group's president, Jeff Bullard, MD, told MedPage Today. "But the other organizations are significantly more established and have a much stronger voice than we do, being a fairly new organization."
The Academy of Allergy & Asthma in Primary Care was formed less than a year ago and has a little over 2,000 members.
United Allergy Services is the sole member of its industrial advisory board. The company is a sponsor of the organization, but not the only one, explained Bullard, of MaxHealth Family Medicine, a small independent group practice in Colleyville, Texas.
Financial information on the nonprofit is not yet publicly available.
United Allergy Services provides trained staff to physician offices to do skin-prick tests for mold and airborne allergens and to administer immunotherapy against those allergens under the supervision of the physician, whom the company provides education on the whole process.
But Bullard argued that the suit is about more than business opportunities.
"There are so many allergies and so few allergists, there's plenty of business and no need for a turf war," he said in an interview. "What the AAAPC is trying to do, independent of anything that happens within UAS, is really improve access."
Noam Fischman, outside counsel for the primary care group, said the group is not seeking monetary damages but an injunction to keep anti-competitive conduct from continuing.
There is a smaller scale legal precedent for such action.
Last year, a lawsuit against the Texas Allergy, Asthma & Immunology Society in state court there led to an injunction on its members approaching insurance companies and defaming primary care physicians, the San Antonio Express-News reported.
A representative for the ACAAI said the organization only just found out about the suit through a press release it received.
"ACAAI has not yet been served with a complaint and, obviously, has not yet had the opportunity to review the charges," a statement to MedPage Today said. "However, based on the press release, we believe the charges have no merit and ACAAI intends to defend itself vigorously."
The AAAAI declined to comment, pending more information.
By Crystal Phend
January 16, 2014