The California Medical Association (CMA) has been made aware of a deceptive business practice by TRPN Direct Pay, Inc. (TRPN) in the form of a $15 check being delivered to California physician practices, accompanied by complicated, vague, and ambiguous “fine print” that purports to create a binding participation agreement if cashed by a physician practice.

TRPN claims that a physician who endorses and cashes the check has signed a unilateral provider participation contract of adhesion for consideration of a one-time $15 “license fee.” The contract includes onerous and burdensome terms that the vast majority of California physicians would not consider to be commercially reasonable.

“The utter lack of mutual and considered assent of contracting parties, the woefully inadequate consideration, the unfair terms of adhesion against physicians, the impossible and commercially impracticable obligations imposed, and the general deceptive nature of the $15 check scheme make any contract that TRPN wishes to enforce by this scheme completely null, void, and unenforceable,” CMA General Counsel and Senior Vice President Francisco Silva wrote in a letter to TRPN.

CMA believes this check scheme violates several important California laws designed to protect physicians against predatory silent PPO practices and has demanded that TRPN immediately cease engaging in its $15 check scheme in California. CMA has also demanded that, to the extent California physicians have cashed any checks as part of the scheme, TRPN immediately disavow and withdraw any efforts to recognize or enforce any participation agreement contemplated under the scheme.

CMA is informing California regulators and consumer protection agencies to alert them of TRPN’s $15 check scheme to ensure that all physicians and their patients are adequately protected.