In response to inquiries from independent rheumatologists regarding the new MedicalRx Specialty Provider Network (MSPN) from OptumRx, CSRO has engaged Mark Watson, a healthcare attorney with Hancock, Daniel & Johnson, P.C. to provide a summary of one version of their agreement. A webinar was hosted on December 16 to review the summary and answer follow up questions.
Note: The summary provided is based on, and specific to, the draft OptumRx Agreement included with these materials. All agreements for participation in the OptumRx network may not be identical. As such, this summary may not address the specific features of an OptumRx Agreement you may be considering. In addition, the content represents an objective summary of key terms in the OptumRx agreement, but in no way represents an opinion by the Coalition of State Rheumatology Organizations (“CSRO”) as to any specific term or CSRO’s views on whether to accept or decline a proposal from OptumRx.
Each practice should consult with its advisors and make its own, independent assessment and decision on whether to join the OptumRx network. Each practice should also avoid sharing its decision on whether to join the OptumRx network with CSRO or other practices. Note that if independent practices discuss the terms of the draft OptumRx Agreement, particularly the reimbursement rates, with each other or coordinate their responses to OptumRx, such activities could raise antitrust concerns.