The investigation
The AdC ordered the opening of an investigation in September 2021, following well-substantiated indications of the existence of practices prohibited by article 9 of the Portuguese Competition Act and article 101 TFEU in public tenders for the provision of teleradiology services to hospitals and hospital centres in Portugal, and carried out unannounced inspections in the premises of several companies, during September and October of the same year, in order to collect evidence of such infringements.
Settlement decisions
In 20/09/2022, the AdC adopted a settlement decision, imposing ITM - Instituto de Telemedicina, Lda. a fine of €202,300, for participating in a cartel established for the supply of teleradiology services to public hospitals and other public health centers in Portugal, at least between November 2015 and December 2017.
In 14/10/2022, the AdC adopted a second settlement decision, imposing Dr. Campos Costa – Consultório de Tomografia Computorizada, S.A. a fine of € 5.038.200, for participating in the same cartel, between November 2015 and August 2021, with higher incidence and frequency between the years 2015 and 2018.
The AdC has concluded the case in advance in relation to these two companies due to their cooperation, since they decided to participate in a settlement procedure, admitting their participation in the cartel and renouncing to litigate in court. The fines imposed by the AdC were subject to a reduction in comparison to the those that would be imposed if the companies had not participated in the settlement procedure.
The Decision against three other undertakings
In December 2023, the AdC adopted a condemnatory decision regarding the three other undertakings for participating in this cartel.
The AdC's investigation revealed that those three undertakings - together with the two undertakings which had already been subject to a final sanctioning decision in a settlement procedure - implemented an agreement and/or concerted practice, under which they jointly defined which companies would submit the winning bids in public tenders for the provision of teleradiology services.
Through these contacts, the companies involved in the cartel would disclose to each other the prices they would bid in the future, to ensure that the best bid would be that of the company they defined. They also agreed that others would be excluded as a result of submitting bids that failed to meet eliminatory tender criteria.
The contacts that were established allowed the companies involved in the cartel to share among themselves the national market for the provision of teleradiology services in public procurement procedures.
On the other hand, the companies jointly implemented strategies aimed at a general price increase in the market under consideration.
The AdC's Final Decision may be appealed.
Teleradiology services
Teleradiology allows diagnostic tests to be carried out in a health care facility without the physical presence of a radiologist or neuroradiologist. The medical specialists receive the images and results of the diagnostic tests performed at the health care facility remotely afterwards, interpret them, and draw up a report, which they then transmit to the health care facility concerned.
These services are provided by companies to entities of the National Healthcare System by means of public tenders. The use of teleradiology is especially relevant in cases where healthcare facilities do not have teams that include radiology and/or neuroradiology specialists to meet local needs, making it possible to make up for such shortfalls and help interpret complex diagnoses.