The IPA is responsible to monitor the quality of the medical care provided and submit to periodic audits to verify that federal and state healthcare regulations are being met. The HMO requires that an IPA verify the credentials of each member physician regularly and pay for all of the medical services rendered by both member physicians and non-affiliated physicians as well. Without these contracts in place, services rendered by the IPA physicians to HMO patients would not be paid.
There is a similar contract between the individual physicians and the IPA. This contract between the IPA and the HMO is a critical document that allows patients to access physicians in the IPA and delineates the responsibilities the IPA must assume to comply with government and industry regulations. The HMO then lists the individual physicians in their directories and pay the IPA (not the individual physicians) a fixed monthly fee to provide all professional health related services for the patients that select doctors affiliated with that IPA. These independent physicians join together as an association for the purpose of contracting with Health Maintenance Organizations (HMO) such as Aetna, Blue Cross, Blue Shield, CIGNA, Health Net and PacifiCare. An Independent Practitioner Association (IPA) is a physician organization comprised of independently practicing physicians (as differentiated from Kaiser Permanente who employs and manages all of its physicians).
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