29736 Federal Register / Vol. 63, No. 104 / Monday, June 1, 1998 / Notices

Number of Petitions Filed: 1.

Federal Communications Commission.

Magalie Roman Salas,

Secretary.

[FR Doc. 98–14375 Filed 5–29–98; 8:45 am]

BILLING CODE 6712–01–M

FEDERAL RESERVE SYSTEM

Formations of, Acquisitions by, and

Mergers of Bank Holding Companies

The companies listed in this notice

have applied to the Board for approval,

pursuant to the Bank Holding Company

Act of 1956 (12 U.S.C. 1841 et seq.)

(BHC Act), Regulation Y (12 CFR Part

225), and all other applicable statutes

and regulations to become a bank

holding company and/or to acquire the

assets or the ownership of, control of, or

the power to vote shares of a bank or

bank holding company and all of the

banks and nonbanking companies

owned by the bank holding company,

including the companies listed below.

The applications listed below, as well

as other related filings required by the

Board, are available for immediate

inspection at the Federal Reserve Bank

indicated. The application also will be

available for inspection at the offices of

the Board of Governors. Interested

persons may express their views in

writing on the standards enumerated in

the BHC Act (12 U.S.C. 1842(c)). If the

proposal also involves the acquisition of

a nonbanking company, the review also

includes whether the acquisition of the

nonbanking company complies with the

standards in section 4 of the BHC Act.

Unless otherwise noted, nonbanking

activities will be conducted throughout

the United States.

Unless otherwise noted, comments

regarding each of these applications

must be received at the Reserve Bank

indicated or the offices of the Board of

Governors not later than June 17, 1998.

A. Federal Reserve Bank of Atlanta

(Lois Berthaume, Vice President) 104

Marietta Street, N.W., Atlanta, Georgia

30303-2713:

1. Compass Bancshares, Inc.,

Birmingham, Alabama; Compass Banks

of Texas, Inc., Birmingham, Alabama;

and Compass Bancorporation of Texas,

Inc., Wilmington, Delaware; to acquire

100 percent of the voting shares of Hill

Country Bank, Austin, Texas.

Board of Governors of the Federal Reserve

System, May 27, 1998.

Jennifer J. Johnson,

Deputy Secretary of the Board.

[FR Doc. 98–14441 Filed 5–29–98; 8:45 am]

BILLING CODE 6210–01–F

FEDERAL TRADE COMMISSION

[File No. 961–0005]

Institutional Pharmacy Network, et al.;

Analysis to Aid Public Comment

AGENCY: Federal Trade Commission.

ACTION: Proposed Consent Agreement.

SUMMARY: The consent agreement in this

matter settles alleged violations of

federal law prohibiting unfair or

deceptive acts or practices or unfair

methods of competition. The attached

Analysis to Aid Public Comment

describes both the allegations in the

draft complaint that accompanies the

consent agreement and the terms of the

consent order—embodied in the consent

agreement—that would settle these

allegations.

DATES: Comments must be received on

or before July 31, 1998.

ADDRESSES: Comments should be

directed to: FTC/Office of the Secretary,

Room 159, 6th St. and Pa. Ave., NW,

Washington, DC 20580.

FOR FURTHER INFORMATION CONTACT:

William Baer or Willard Tom, FTC/H–

374, Washington, DC 20580. (202) 326–

2032 or 326–2786.

SUPPLEMENTARY INFORMATION: Pursuant

to Section 6(f) of the Federal Trade

Commission Act, 38 Stat. 721, 15 U.S.C.

46 and Section 2.34 of the Commission’s

Rules of Practice (16 CFR 2.34), notice

is hereby given that the above-captioned

consent agreement containing a consent

order to cease and desist, having been

filed with and accepted, subject to final

approval, by the Commission, has been

placed on the public record for a period

of sixty (60) days. The following

Analysis to Aid Public Comment

describes the terms of the consent

agreement, and the allegations in the

complaint. An electronic copy of the

full text of the consent agreement

package can be obtained from the FTC

Home Page (for May 21, 1998), on the

World Wide Web, at ‘‘http://

www.ftc.gov/os/actions97.htm.’’ A

paper copy can be obtained from the

FTC Public Reference Room, Room H–

130, Sixth Street and Pennsylvania

Avenue, NW, Washington, DC 20580,

either in person or by calling (202) 326–

3627. Public comment is invited. Such

comments or views will be considered

by the Commission and will be available

for inspection and copying at its

principal office in accordance with

Section 4.9(b)(6)(ii) of the Commission’s

Rules of Practice (16 CFR 4.9(b)(6)(ii)).

Analysis of Proposed Consent Order To

Aid Public Comment

The Federal Trade Commission has

accepted, subject to final approval, an

agreement to a proposed consent order

from Institutional Pharmacy Network

(IPN) and its five members: Evergreen

Pharmaceutical, Inc.; NCS Healthcare of

Oregon, Inc.; NCS Healthcare of

Washington, Inc.; United Professional

Companies, Inc.; and White, Mack and

Wart, Inc.

The proposed consent order has been

placed on the public record for sixty

(60) days for reception of comments by

interested persons. Comments received

during this period will become part of

the public record. After sixty (60) days,

the Commission will again review the

agreement and the comments received

and will decide whether it should

withdraw from the agreement or make

final the agreement’s proposed order.

The purpose of this analysis is to

facilitate public comment on the

proposed order, and it is not intended

to constitute an official interpretation of

the agreement and proposed order or to

modify in any way their terms. The

proposed consent order has been

entered into for settlement purposes

only and does not constitute an

admission by any proposed respondent

that the law has been violated as alleged

in the complaint.

Description of the Draft Complaint

A complaint that the Commission

prepared for issuance along with the

proposed order alleges the following:

Evergreen Pharmaceutical, Inc.; NCS

Healthcare of Oregon, Inc.; NCS

Healthcare of Washington, Inc.; United

Professional Companies, Inc.; and

White, Mack and Wart, Inc., are

institutional pharmacies that compete to

serve institutional care facilities, such as

nursing homes. Institutional pharmacies

provide specialized services, including

providing medications in single dose

packages, maintaining an ‘‘emergency

box’’ at the client facility with drugs for

use in emergency situations, and

providing consulting and quality

assurance services to institutional care

facilities. The institutional pharmacy/

respondents together provide pharmacy

services for approximately 80 percent of

the patients that receive institutional

pharmacy services in Oregon.

The State of Oregon created the

Oregon Health Plan (‘‘OHP’’) in 1994 to

provide health care to Medicaid

recipients and other needy Oregonians.

Under OHP, the state contracts with

Fully Capitated Health Plans (‘‘Plans’’),

which are managed care organizations

that receive a fixed payment to care for
Federal Register / Vol. 63, No. 104 / Monday, June 1, 1998 / Notices 29737

OHP patients. The Plans in turn contract

with providers, including nursing

homes, hospitals, physicians, retail

pharmacies, and institutional

pharmacies. OHP covers about half of

all institutional care patients in Oregon.

The institutional pharmacy

respondents formed IPN to offer their

services jointly. Their purpose to

negotiate collectively has been to

maximize their resulting leverage in

bargaining over reimbursement rates

with the Plans. Indeed, even before

forming IPN, they saw ‘‘an advantage to

negotiate from strength for

reimbursement’’ because they

recognized that competition among

themselves would drive down

reimbursement rates. IPN neither

provides new or efficient services, nor

enables its members to provide new or

efficient services. Moreover, IPN

members do not share risk.

IPN has contracted with three Plans.

Pursuant to each of those contracts, each

Plan pays IPN members a higher rate

than it pays institutional pharmacies

that are not IPN members and that did

not negotiate collectively with that Plan.

IPN also attempted to contract with at

least four other Plans. Clinical,

Evergreen, IPAC, ProPac, and UPC

agreed that, before conducting

individual negotiations, each member

would give IPN time to attempt to

negotiate a contract. Pursuant to this

agreement, the pharmacies negotiated

separately with three of the Plans only

after IPN failed to reach an agreement

on behalf of the group. IPN also

negotiated with a fourth Plan that is by

far the largest purchaser of institutional

pharmacy services for OHP patients.

Although this Plan sought to deal with

the pharmacies individually, they

largely refused to respond and instead

approached the Plan as a group. After

months of attempting to negotiate

individually with the institutional

pharmacy members of IPN, and under

pressure to implement pharmacy

arrangements for institutional care

patients under OHP, the Plan began

negotiating with IPN. As a result of

these negotiations, the Plan agreed to

pay higher rates to IPN members than it

had agreed to pay other institutional

pharmacies.

The institutional pharmacy members

of IPN have agreed among themselves,

and used IPN, to engage in collective

negotiations over price and other terms

with the Plans and thereby to fix the

fees they charge the Plans. In so doing,

IPN and its institutional pharmacy

members have fixed, stabilized, or

increased the price of institutional

pharmacy services and otherwise

restrained competition among

institutional pharmacies in Oregon and

thereby deprived the State of Oregon,

the Plans, nursing homes and other

long-term care facilities, and OHP

beneficiaries of the benefits of

competition among providers of

institutional pharmacy services in

Oregon.

Description of the Proposed Consent

Order

The proposed order would prohibit

IPN and the institutional pharmacy

respondents from entering into,

maintaining, or enforcing any agreement

with any pharmacy concerning fees or

fixing, raising, stabilizing, maintaining,

or tampering with any fees. The

proposed order contains a number of

provisos.

Proviso (1) allows each respondent to

engage in conduct (including

collectively determining reimbursement

and other terms of contracts with

payers) that is reasonably necessary to

operate (a) any ‘‘qualified risk-sharing

joint arrangement,’’ or (b) upon prior

notice to the Commission, any

‘‘qualified clinically integrated joint

arrangement.’’ The proviso addresses

the arrangements that the respondents

may enter into, rather than the overall

nature of the group, because a pharmacy

network may enter into legitimate

arrangements with some third-party

payers but engage in illegal conduct

with respect to others. For the purposes

of the order, a ‘‘qualified risk-sharing

joint arrangement’’ must satisfy two

conditions: (a) participating pharmacies

must share substantial financial risk and

(b) the arrangement must be nonexclusive. The order lists ways in which

pharmacies might share financial risk.

These track the four types of financial

risk sharing set forth in the Joint FTCDepartment of Justice Statements of

Antitrust Enforcement Policy in Health

Care. 4 Trade Reg. Rep. (CCH) ¶ 13,153

(August 29, 1996). To be a ‘‘qualified’’

risk sharing arrangement, the

arrangement must also be nonexclusive, both in name and in fact. An

arrangement that either restricts the

ability of participating pharmacies to

contract outside the arrangement

(individually or through other networks)

with third-party payers, or facilitates

refusals to deal outside the arrangement

by participating pharmacies, does not

fall within the proviso. Although

exclusive joint arrangements are not

necessarily anticompetitive, they can

impair competition, particularly when

they include a large portion of the

pharmacies in a market. In light of the

IPN members’ large share of the Oregon

institutional pharmacy market, this

definition does not permit the

respondents to form or participate in

exclusive arrangements.

A qualified clinically integrated joint

arrangement includes arrangements in

which the pharmacies undertake

cooperative activities to achieve

efficiencies in the delivery of clinical

services, without necessarily sharing

substantial financial risk. For purposes

of the order, such arrangements are ones

in which the participating pharmacies

have a high degree of interdependence

and cooperation through their use of

programs to evaluate and modify their

clinical practice patterns, in order to

control costs and assure the quality of

pharmacy services provided through the

arrangement. As with risk-sharing

arrangements, the definition of

clinically integrated arrangements

reflects the analysis in the 1996 FTC/

DOJ Statements of Antitrust

Enforcement Policy in Health Care and

the arrangement must be non-exclusive.

Because the definition of a clinically

integrated arrangement is by necessity

less precise than that of a risk sharing

arrangement, the order imposes prior

notification requirements. Such prior

notification will allow the Commission

to evaluate the likely competitive

impact of a specific proposed

arrangement and thereby help guard

against the recurrence of acts and

practices that have restrained

competition and consumer choice.

The remaining provisos allow

business arrangements typical to

pharmacy markets. Proviso (2)(a) allows

the proposed respondents to contract

with pharmacy benefit managers that

own or are affiliated with retail

pharmacies. Provisos (2)(b) and (3)

together permit price agreements

between a pharmacy and a nursing

home even if the nursing home is

affiliated with a pharmacy. Provisio

(2)(c) permits a pharmacy to enter into

subcontracting agreements where it is

not reasonable for a pharmacy with an

agreement with a nursing home or thirdparty payer to provide services by itself.

Such agreements are common among

both retail and institutional pharmacies.

Proviso (2)(c) also allows for such

subcontracts where the respondent that

operates a long-term care network (as

UPC does) enters into an agreement

with the incumbent pharmacy provider

for an institutional facility within that

network. Finally, Proviso (4) permits

pharmacy agreements to operate or

manage a pharmacy.

Parts III.A and III.B of the proposed

order require the respondents to

distribute the order to the Fully

Capitated Health Plans and to certain

officers, directors, and managers. Parts

III.C, III.D, and III.E require each
29738 Federal Register / Vol. 63, No. 104 / Monday, June 1, 1998 / Notices

respondent to file compliance reports,

retain certain documents, and notify the

Commission of certain changes in its

corporate structure.

By direction of the Commission.

Donald S. Clark,

Secretary.

[FR Doc. 98–14420 Filed 5–29–98; 8:45 am]

BILLING CODE 6750–01–M

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

National Committee on Vital and Health

Statistics; Meetings

Pursuant to the Federal Advisory

Committee Act, the Department of

Health and Human Services announces

the following advisory committee

meetings.

Name: National Committee on Vital and

Health Statistics (NCVHS), Subcommittee on

Health Data Needs, Standards, and Security.

Times and Dates: 10:00 a.m.-5:00 p.m.,

June 15, 1997.

Place: Room 505A, Hubert H. Humphrey

Building, 200 Independence Avenue, SW,

Washington, DC 20201.

Status: Open.

Purpose: Under the Administrative

Simplification provisions of Pub. L. 104–191,

the Health Insurance Portability and

Accountability Act of 1996 (HIPAA), the

Secretary of Health and Human Services is

required to adopt standards for specified

transactions to enable health information to

be exchanged electronically. The law

requires that, within 24 months of adoption,

all health plans, health care clearinghouses,

and health care providers who choose to

conduct these transactions electronically

must comply with these standards. The law

also requires the Secretary to adopt a number

of supporting standards including standards

for code sets and classifications systems. The

Secretary is required to rely upon the

recommendations of the National Committee

on Vital and Health Statistics (NCVHS) in

complying with these provisions. The

NCVHS is the Department’s federal advisory

committee on health data, privacy and health

information policy.

On June 15, 1998, the NCVHS

Subcommittee on Health Data Needs,

Standards, and Security will hold a meeting

to review the progress of its work and plan

future activities. The Subcommittee will

discuss plans for addressing 1) the HIPAA

requirements relating to electronic data

interchange standards for claims attachments

and 2) NCVHS recommendations for

standards for clinical data and its electronic

interchange. The Subcommittee also will

consider possible comments on the

published Notices of Proposed Rulemaking

relating to the adoption of EDI standards for

health care administrative transactions. In

addition, the Subcommittee will discuss

approaches to the development of a

framework for procedure classification

systems, as well as plans for public hearings

on unique individual identifiers for use in

the health system. All topics and times are

tentative and subject to change. Please check

the NCVHS website, where a detailed agenda

will be posted prior to the meeting.

Contact Person for More Information:

Substantive program information as well as

summaries of NCVHS meetings and a roster

of committee members may be obtained by

visiting the NCVHS website (http://

aspe.os.dhhs/gov/ncvhs). You may also call

James Scanlon, NCVHS Executive Staff

Director, Office of the Assistant Secretary for

Planning and Evaluation, DHHS, Room 440–

D. Humphrey Building, 200 Independence

Avenue SW, Washington, DC 20201,

telephone (202) 690–7100, or Marjorie S.

Greenberg, Executive Secretary, NCVHS,

NCHS, CDC, Room 1100, Presidential

Building, 6525 Belcrest Road, Hyattsville,

Maryland 20782, telephone (301) 436–7050.

Note: In the interest of security, the

Department has instituted stringent

procedures for entrance into the Hubert H.

Humphrey Building by non-government

employees. Thus, individuals without

government identification cards may need to

have the guard call for an escort to the

meeting room.

Dated: May 26, 1998.

James Scanlon,

Director, Division of Data Policy, Office of

the Assistant Secretary for Planning and

Evaluation.

[FR Doc. 98–14291 Filed 5–29–98; 8:56 am]

BILLING CODE 4151–04–M

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Food and Drug Administration

[Docket No. 96N–0373]

Agency Information Collection

Activities; Submission for OMB

Review; Comment Request

AGENCY: Food and Drug Administration,

HHS.

ACTION: Notice.

SUMMARY: The Food and Drug

Administration (FDA) is announcing

that the proposed collection of

information listed below has been

submitted to the Office of Management

and Budget (OMB) for review and

clearance under the Paperwork

Reduction Act of 1995 (the PRA).

DATES: Submit written comments on the

collection of information by July 1,

1998.

ADDRESSES: Submit written comments

on the collection of information to the

Office of Information and Regulatory

Affairs, OMB, New Executive Office

Bldg., 725 17th St. NW., rm. 10235,

Washington, DC 20503, Attn: Desk

Officer for FDA.

FOR FURTHER INFORMATION CONTACT:

Margaret R. Schlosburg, Office of

Information Resources Management

(HFA–250), Food and Drug

Administration, 5600 Fishers Lane,

Rockville, MD 20857, 301–827–1223.

SUPPLEMENTARY INFORMATION: In

compliance with section 3507 of the

PRA (44 U.S.C. 3507), FDA has

submitted the following proposed

collection of information to OMB for

review and clearance.

Request for Information From U.S.

Processors that Export to the European

Community (OMB Control Number

0910–0320—Reinstatement)

European Community (EC) is a group

of 15 European countries that have

agreed to harmonize their commodity

requirements to facilitate commerce

among member States. EC legislation for

intra-EC trade has been extended to

trade with non-EC countries, including

the United States. For certain food

products, including those listed below,

EC legislation requires assurances from

the responsible authority of the country

of origin that the processor of the food

is in compliance with applicable

regulatory requirements.

With the assistance of trade

associations and State authorities, FDA

requests information from processors

that export certain animal-derived

products (e.g., shell eggs, dairy

products, game meat, game meat

products, and animal casings) to EC.

FDA uses the information to maintain

lists of processors that have

demonstrated current compliance with

U.S. requirements and provides the lists

to EC quarterly. Inclusion on the list is

voluntary. EC member countries refer to

the lists at ports of entry to verify that

products offered for importation to EC

from the United States are from

processors that meet U.S. regulatory

requirements. Products processed by

firms not on the list are subject to

detention and possible refusal at the

port. FDA requests the following

information from each processor:

(1) Business name and address;

(2) Name and telephone number of

person designated as business contact;

(3) Lists of products presently being

shipped to EC and those intended to be

shipped in the next 6 months;

(4) Name and address of

manufacturing plants for each product;

(5) Names and affiliations of any

Federal, State, or local governmental

agencies that inspect the plant,

government-assigned plant identifier,

such as plant number, and last date of

inspection; and

(6) Assurance that the firm or

individual representing the firm and