However, if otherwise competing payers were to agree among themselves not to purchase services from PAs, such an agreement could constitute an antitrust violation. Claims from chiropractors that the American Medical Association orchestrated a boycott by its member physicians against chiropractors were the basis of several governmental and private antitrust lawsuits. An agreement among professionals who compete with PAs, and who elicit collusion from a payer, could form the basis of an antitrust claim by the disadvantaged PAs. Unfortunately, the prerogative of a given payer or employer which elects to pay different types of providers different amounts for comparable services generally does not constitute an antitrust violation by the payer or employer. The payer has similar discretion with regard to the price and other terms in contracts it will enter.
Employers have similar discretion.
While claims have been made under laws prohibiting discrimination on the basis of gender for such conduct, such claims raise different issues outside the scope of antitrust analysis. As a general proposition, the merits of such gender-based claims depend upon the specific facts. Such claims have not frequently been successful. Price-fixing, probably the most serious of all antitrust violations, is nothing more than an agreement among competitors with regard to the prices at which they will sell their services. Price-fixing agreements are unlawful even if the otherwise competing PAs lack any ability to affect market prices.