[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1304 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 1304

 To ensure and foster continued patient safety and quality of care by 
   making the antitrust laws apply to negotiations between groups of 
health care professionals and health plans and health insurance issuers 
in the same manner as such laws apply to collective bargaining by labor 
         organizations under the National Labor Relations Act.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 25, 1999

  Mr. Campbell (for himself, Mr. Conyers, Mr. Miller of Florida, Mr. 
Hoeffel, Mr. Baker, Mr. LaFalce, Mr. Cooksey, Mr. Pallone, Mr. Nadler, 
     Mr. Horn, Mr. Frost, Mr. Filner, Mr. Boucher, Mr. Wexler, Mr. 
  Scarborough, Ms. Schakowsky, Mr. Shows, Mr. Sandlin, Mr. Towns, Mr. 
 Blagojevich, Mr. Brown of Ohio, Mr. Paul, Mr. Coburn, Mr. Ganske, Mr. 
Delahunt, Mr. Rohrabacher, Mr. McCollum, and Mr. Klink) introduced the 
  following bill; which was referred to the Committee on the Judiciary

_______________________________________________________________________

                                 A BILL


 
 To ensure and foster continued patient safety and quality of care by 
   making the antitrust laws apply to negotiations between groups of 
health care professionals and health plans and health insurance issuers 
in the same manner as such laws apply to collective bargaining by labor 
         organizations under the National Labor Relations Act.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Quality Health-Care Coalition Act of 
1999''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) A large number of Americans receive their health care 
        coverage from managed health care plans. This represents a 10-
        fold increase over the last 20 years. Serious questions have 
        been raised about the quality of care patients are receiving 
        under these plans.
            (2) Changes in the health care industry have led to an 
        increased concentration of health care plans, including more 
        than 162 mergers in the last 10 years.
            (3) The McCarran-Ferguson Act has created an enhanced 
        opportunity for market power of insurance companies in health 
        care and has given such companies significant leverage over 
        health care providers and patients.
            (4) Permitting health care professionals to negotiate 
        collectively with health care plans will create a more equal 
        balance of negotiating power, will promote competition, and 
        will enhance the quality of patient care.
            (5) Allowing health care professionals to negotiate 
        collectively with health care plans will not change the 
        professionals' ethical duty to continue to provide medically 
        necessary care to their patients.

SEC. 3. APPLICATION OF THE ANTITRUST LAWS TO HEALTH CARE PROFESSIONALS 
              NEGOTIATING WITH HEALTH PLANS.

    (a) In General.--Any health care professionals who are engaged in 
negotiations with a health plan regarding the terms of any contract 
under which the professionals provide health care items or services for 
which benefits are provided under such plan shall, in connection with 
such negotiations, be entitled to the same treatment under the 
antitrust laws as the treatment to which bargaining units which are 
recognized under the National Labor Relations Act are entitled in 
connection with such collective bargaining. Such a professional shall, 
only in connection with such negotiations, be treated as an employee 
engaged in concerted activities and shall not be regarded as having the 
status of an employer, independent contractor, managerial employee, or 
supervisor.
    (b) Protection for Good Faith Actions.--Actions taken in good faith 
reliance on subsection (a) shall not be the subject under the antitrust 
laws of criminal sanctions nor of any civil damages, fees, or penalties 
beyond actual damages incurred.
    (c) Limitation.--The exemption provided in subsection (a) shall not 
confer any right to participate in any collective cessation of service 
to patients not otherwise permitted by law.
    (d) Definitions.--For purposes of this section:
            (1) Antitrust laws.--The term ``antitrust laws''--
                    (A) has the meaning given it in subsection (a) of 
                the first section of the Clayton Act (15 U.S.C. 12(a)), 
                except that such term includes section 5 of the Federal 
                Trade Commission Act (15 U.S.C. 45) to the extent such 
                section 5 applies to unfair methods of competition, and
                    (B) includes any State law similar to the laws 
                referred to in subparagraph (A).
            (2) Health plan and related terms.--
                    (A) In general.--The term ``health plan'' means a 
                group health plan, a health insurance issuer that is 
                offering health insurance coverage, a Medicare+Choice 
                organization that is offering a Medicare+Choice plan, 
                or a Medicaid managed care entity offering benefits 
                under title XIX of the Social Security Act.
                    (B) Health insurance coverage; health insurance 
                issuer.--The terms ``health insurance coverage'' and 
                ``health insurance issuer'' have the meanings given 
                such terms under paragraphs (1) and (2), respectively, 
                of section 733(b) of the Employee Retirement Income 
                Security Act of 1974 (29 U.S.C. 1191b(b)).
                    (C) Group health plan.--The term ``group health 
                plan'' has the meaning given that term in section 
                733(a)(1) of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1191b(a)(1)).
                    (D) Medicare+choice organization; medicare+choice 
                plan.--The terms ``Medicare+Choice organization'' and 
                ``Medicare+Choice plan'' have the meanings given such 
                terms in subsections (a)(1) and (b)(1) of section 1859 
                of the Social Security Act (42 U.S.C. 1395w-28).
                    (E) Medicaid managed care entity.--The term 
                ``Medicaid managed care entity'' has the meaning given 
                the term ``managed care entity'' under section 
                1932(a)(1)(B) of the Social Security Act (42 U.S.C. 
                1396u-2(a)(1)(B)).
            (3) Health care professional.--The term ``health care 
        professional'' means an individual who provides health care 
        items or services, treatment, assistance with activities of 
        daily living, or medications to patients and who, to the extent 
        required by State or Federal law, possesses specialized 
        training that confers expertise in the provision of such items 
        or services, treatment, assistance, or medications.
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