238
operative venture for which an application for a
certificate of review is filed with the Attorney
General under section 453.
(B) CERTAIN VENTURES.—Any health care
cooperative venture meeting the following re-
quirements:
(i) The venture consists of a network
of non-institutional providers not greater
than—
(I) in the case of a nonexclusive
network in which the participating
members are permitted to create or
join other competing networks, 50
percent of the providers of health care
services in the relevant geographic
area and 50 percent of the members
of the provider specialty group in the
relevant market; or
(II) in the case of an exclusive
network in which the participating
members are not permitted to create
or join other competing networks, 35
percent of the providers of health care
services in the relevant geographic
area and 35 percent of the members
239
of the provider specialty group in the
relevant market.
(ii) Each member of the venture as-
sumes substantial financial risk for the op-
eration of the venture through risk-sharing
arrangements, including (but not limited
to)—
(I) the acceptance of capitation
contracts;
(II) the acceptance of contracts
with fee withholding mechanisms re-
lating to the ability to meet estab-
lished goals for utilization review and
management; and
(III) the holding by members of
significant ownership or equity inter-
ests in the venture, where the capital
contributed by the members is used to
fund the operational costs of the ven-
ture such as administration, market-
ing, and computer-operated medical
information, if the venture develops
and operates comprehensive programs
for utilization management and qual-
ity assurance that include controls
240
over the use of institutional, special-
ized, and ancillary medical services.
(3) SUBMISSION
OF
ADDITIONAL
INFORMA-
TION.—
(A) REQUEST OF ATTORNEY GENERAL.—
At any time after receiving a notification filed
under paragraph (1), the Attorney General may
require the submission of additional information
or documentary material relevant to the pro-
posed health care cooperative venture.
(B) PARTIES TO VENTURE.—Any party to
a health care cooperative venture may submit
such additional information on the venture’s be-
half as may be appropriate to ensure that the
venture will receive the protections provided
under subsection (b).
(C) REQUIRED SUBMISSION OF INFORMA-
TION
ON
CHANGES
TO
VENTURE.—A health
care cooperative venture for which a notification
is in effect under this section shall submit infor-
mation on any change in the membership of the
venture not later than 90 days after such
change occurs.
(4) PUBLICATION OF NOTIFICATION.—
241
(A) INFORMATION MADE PUBLICLY AVAIL-
ABLE.—Not later than 30 days after receiving
a notification with respect to a venture under
paragraph (1), the Attorney General shall pub-
lish in the Federal Register a notice with re-
spect to the venture that identifies the parties
to the venture and generally describes the pur-
pose and planned activity of the venture. Prior
to its publication, the contents of the notice
shall be made available to the parties to the
venture.
(B) RESTRICTION
ON
DISCLOSURE
OF
OTHER
INFORMATION.—All information and
documentary material submitted pursuant to
this section and all information obtained by the
Attorney General in the course of any investiga-
tion or case with respect to a potential violation
of the antitrust laws by the health care coopera-
tive venture (other than information and mate-
rial described in subparagraph (A)) shall be ex-
empt from disclosure under section 552 of title
5, United States Code, and shall not be made
publicly available by any agency of the United
States to which such section applies except in
242
a judicial proceeding in which such information
and material is subject to any protective order.
(5) WITHDRAWAL OF NOTIFICATION.—Any per-
son who files a notification pursuant to this section
may withdraw such notification before a publication
by the Attorney General pursuant to paragraph (4).
Any person who is deemed to have filed a notifica-
tion under paragraph (2)(A) shall be deemed to have
withdrawn the notification if the certificate of review
in question is revoked or withdrawn under section
454.
(6) NO
JUDICIAL
REVIEW
PERMITTED.—Any
action taken or not taken by the Attorney General
with respect to notifications filed pursuant to this
subsection shall not be subject to judicial review.
(b) PROTECTIONS FOR VENTURES SUBJECT TO NO-
TIFICATION.—
(1) IN GENERAL.—
(A) PROTECTIONS DESCRIBED.—The pro-
visions of paragraphs (2), (3), (4), and (5) shall
apply with respect to any action under the anti-
trust laws challenging conduct within the scope
of a notification which is in effect pursuant to
subsection (a)(1).