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






                                                 Union Calendar No. 342
106th CONGRESS
  2d Session
                                H. R. 1304

                          [Report No. 106-625]

 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

                              May 18, 2000

Additional sponsors: Mr. Nethercutt, Ms. Kilpatrick, Ms. Jackson-Lee of 
 Texas, Mr. Davis of Virginia, Ms. Lofgren, Mr. Norwood, Mr. Smith of 
 Texas, Ms. Woolsey, Mr. Bonior, Mr. Andrews, Mr. Whitfield, Mr. Wamp, 
Mr. Doolittle, Mr. Goode, Mr. Kildee, Mr. Barr of Georgia, Mr. Dickey, 
Mr. Bachus, Mr. Leach, Mr. Pickering, Mr. Rahall, Mr. Porter, Mr. Smith 
   of Michigan, Mr. Thornberry, Mr. Deal of Georgia, Mr. Baird, Mrs. 
McCarthy of New York, Mr. Diaz-Balart, Mr. George Miller of California, 
   Mr. Kolbe, Mr. Ackerman, Mr. McGovern, Mr. Walsh, Mr. McHugh, Mr. 
   Fletcher, Mr. Hansen, Mr. Weldon of Pennsylvania, Mr. Riley, Ms. 
   Baldwin, Mr. Thompson of Mississippi, Mr. Canady of Florida, Mr. 
Radanovich, Ms. DeLauro, Mr. Mica, Mr. Pascrell, Mr. Berman, Mr. Lucas 
 of Oklahoma, Mr. Weldon of Florida, Mr. Barton of Texas, Ms. Pelosi, 
    Mrs. Tauscher, Mr. Manzullo, Ms. Hooley of Oregon, Mr. Farr of 
    California, Mr. Weiner, Ms. Stabenow, Mr. Ford, Mr. Thompson of 
  California, Mr. Maloney of Connecticut, Mr. Forbes, Mr. Owens, Mr. 
 Smith of New Jersey, Mr. Boehlert, Mr. Cook, Mr. McNulty, Ms. Rivers, 
Mr. Peterson of Minnesota, Mr. Inslee, Mr. Ose, Mr. Graham, Mr. Turner, 
 Mr. Rothman, Mr. Dicks, Mr. Gary Miller of California, Mr. Holt, Mr. 
   LoBiondo, Mrs. Morella, Ms. Berkley, Mr. Pastor, Mr. Gilman, Mr. 
Barcia, Mr. Wu, Mr. Franks of New Jersey, Mrs. Kelly, Mr. Lampson, Mr. 
 Tiahrt, Mr. Snyder, Mr. Shaw, Mr. Abercrombie, Mr. Moran of Virginia, 
Ms. McCarthy of Missouri, Mr. Price of North Carolina, Mr. Isakson, Mr. 
Mascara, Mr. Scott, Mr. Kennedy of Rhode Island, Ms. Lee, Mr. Lewis of 
     California, Mr. Kind, Ms. Kaptur, Mr. Wicker, Mr. Holden, Mr. 
Gilchrest, Ms. Eshoo, Mr. Duncan, Mr. Clay, Mr. Tancredo, Mr. Ney, Mr. 
 McIntosh, Mr. Jones of North Carolina, Mr. Brady of Pennsylvania, Mr. 
    Clyburn, Mr. Saxton, Mr. Matsui, Ms. Danner, Mr. McIntyre, Mrs. 
Clayton, Ms. McKinney, Mr. Istook, Mr. Hill of Montana, Mr. Bishop, Mr. 
 Rodriguez, Mrs. Maloney of New York, Mr. Wynn, Mr. Lucas of Kentucky, 
Mr. Cummings, Mr. Ryun of Kansas, Mr. Udall of New Mexico, Mr. Vitter, 
 Mr. Gordon, Mr. Pickett, Mr. Watkins, Mr. Visclosky, Mrs. Lowey, Mr. 
 Weller, Mrs. Roukema, Mr. Moran of Kansas, Mrs. Emerson, Mr. Fattah, 
   Mr. Gibbons, Mr. Upton, Mrs. Cubin, Mr. Menendez, Mr. Phelps, Mr. 
 Kuykendall, Mr. Dixon, Mr. Udall of Colorado, Mr. Gillmor, Mr. Wise, 
   Mr. Payne, Mr. DeFazio, Mr. Sawyer, Mr. Rangel, Mr. Shimkus, Mr. 
Metcalf, Mr. Hall of Ohio, Mr. Skelton, Mr. Calvert, Mr. Kanjorski, Mr. 
 Borski, Mr. LaTourette, Mr. Engel, Mr. Pombo, Mr. Camp, Mrs. Wilson, 
Mr. Kucinich, Mr. Traficant, Mr. Hefley, Mr. Aderholt, Ms. DeGette, Mr. 
Gutierrez, Mr. Doyle, Mr. Hilliard, Mr. Evans, Mr. Cramer, Mr. Murtha, 
 Mr. Sanders, Mr. Everett, Mr. Hinojosa, Mr. McDermott, Mr. Gallegly, 
   Mrs. Jones of Ohio, Mrs. Napolitano, Mr. Stenholm, Mr. Baca, Ms. 
Carson, Mr. Boswell, Mr. Dingell, Mr. Meeks of New York, Mr. Petri, Mr. 
 Strickland, Mr. Coyne, Mr. Hastings of Florida, Mr. Lewis of Georgia, 
                            and Mr. English
Deleted sponsors: Mr. Coburn (added March 25, 1999; deleted October 14, 
 1999), and Mr. Delahunt (added March 25, 1999; deleted March 1, 2000)

                              May 18, 2000

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
 [For text of introduced bill, see copy of bill as introduced on March 
                               25, 1999]

_______________________________________________________________________

                                 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 
2000''.

SEC. 2. 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.--
            (1) No new right for collective cessation of service.--The 
        exemption provided in subsection (a) shall not confer any new 
        right to participate in any collective cessation of service to 
        patients not already permitted by existing law.
            (2) No change in national labor relations act.-- This 
        section applies only to health care professionals excluded from 
        the National Labor Relations Act. Nothing in this section shall 
        be construed as changing or amending any provision of the 
        National Labor Relations Act, or as affecting the status of any 
        group of persons under that Act.
    (d) 3-Year Sunset.--The exemption provided in subsection (a) shall 
only apply to conduct occurring during the 3-year period beginning on 
the date of the enactment of this Act and shall continue to apply for 1 
year after the end of such period to contracts entered into before the 
end of such period.
    (e) Limitation on Exemption.--Nothing in this section shall exempt 
from the application of the antitrust laws any agreement or otherwise 
unlawful conspiracy that excludes, limits the participation or 
reimbursement of, or otherwise limits the scope of services to be 
provided by any health care professional or group of health care 
professionals with respect to the performance of services that are 
within their scope of practice as defined or permitted by relevant law 
or regulation.
    (f) No Effect on Title VI of Civil Rights Act of 1964.--Nothing in 
this section shall be construed to affect the application of title VI 
of the Civil Rights Act of 1964.
    (g) No Application to Federal Programs.--Nothing in this section 
shall apply to negotiations between health care professionals and 
health plans pertaining to benefits provided under any of the 
following:
            (1) The medicare program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).
            (2) The medicaid program under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.).
            (3) The SCHIP program under title XXI of the Social 
        Security Act (42 U.S.C. 1397aa et seq.).
            (4) Chapter 55 of title 10, United States Code (relating to 
        medical and dental care for members of the uniformed services).
            (5) Chapter 17 of title 38, United States Code (relating to 
        Veterans' medical care).
            (6) Chapter 89 of title 5, United States Code (relating to 
        the Federal employees' health benefits program).
            (7) The Indian Health Care Improvement Act (25 U.S.C. 1601 
        et seq.).
    (h) General Accounting Office Study and Report.--The Comptroller 
General of the United States shall conduct a study on the impact of 
enactment of this section during the 6-month period beginning with the 
third year of the 3-year period described in subsection (d). Not later 
than the end of such 6-month period the Comptroller General shall 
submit to Congress a report on such study and shall include in the 
report such recommendations on the extension of this section (and 
changes that should be made in making such extension) as the 
Comptroller General deems appropriate.
    (i) 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 or a health insurance issuer that is 
                offering health insurance coverage.
                    (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)).
            (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.
                                                 Union Calendar No. 342

106th CONGRESS

  2d Session

                               H. R. 1304

                          [Report No. 106-625]

_______________________________________________________________________

                                 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.

_______________________________________________________________________

                              May 18, 2000

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed