106TH CONGRESS

2D SESSION H. R. 1304

AN ACT

To ensure and foster continued patient safety and

quality of care by making the antitrust lawsapply to negotiations between groups of healthcare professionals and health plans and healthinsurance issuers in the same manner as suchlaws apply to collective bargaining by labor organizations under the National Labor RelationsAct.

106TH CONGRESS

2D SESSION H. R. 1304

AN ACT

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.
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1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Quality Health-Care

5 Coalition Act of 2000’’.

6 SEC. 2. APPLICATION OF THE ANTITRUST LAWS TO HEALTH

7 CARE PROFESSIONALS NEGOTIATING WITH

8 HEALTH PLANS.

9 (a) IN GENERAL.—Any health care professionals who

10 are engaged in negotiations with a health plan regarding

11 the terms of any contract under which the professionals

12 provide health care items or services for which benefits

13 are provided under such plan shall, in connection with

14 such negotiations, be entitled to the same treatment under

15 the antitrust laws as the treatment to which bargaining

16 units which are recognized under the National Labor Rela17 tions Act are entitled in connection with such collective

18 bargaining. Such a professional shall, only in connection

19 with such negotiations, be treated as an employee engaged

20 in concerted activities and shall not be regarded as having

21 the status of an employer, independent contractor, mana22 gerial employee, or supervisor.

23 (b) PROTECTION FOR GOOD FAITH ACTIONS.—Ac24 tions taken in good faith reliance on subsection (a) shall

25 not be the subject under the antitrust laws of criminal
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1 sanctions nor of any civil damages, fees, or penalties be2 yond actual damages incurred.

3 (c) LIMITATION.—

4 (1) NO NEW RIGHT FOR COLLECTIVE CES5 SATION OF SERVICE.—The exemption provided in

6 subsection (a) shall not confer any new right to par7 ticipate in any collective cessation of service to pa8 tients not already permitted by existing law.

9 (2) NO CHANGE IN NATIONAL LABOR RELA10 TIONS ACT.— This section applies only to health

11 care professionals excluded from the National Labor

12 Relations Act. Nothing in this section shall be con13 strued as changing or amending any provision of the

14 National Labor Relations Act, or as affecting the

15 status of any group of persons under that Act.

16 (d) 3-YEAR SUNSET.—The exemption provided in

17 subsection (a) shall only apply to conduct occurring during

18 the 3-year period beginning on the date of the enactment

19 of this Act and shall continue to apply for 1 year after

20 the end of such period to contracts entered into before

21 the end of such period.

22 (e) LIMITATION ON EXEMPTION.—Nothing in this

23 section shall exempt from the application of the antitrust

24 laws any agreement or otherwise unlawful conspiracy that

25 excludes, limits the participation or reimbursement of, or
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1 otherwise limits the scope of services to be provided by

2 any health care professional or group of health care pro3 fessionals with respect to the performance of services that

4 are within their scope of practice as defined or permitted

5 by relevant law or regulation.

6 (f) NO EFFECT ON TITLE VI OF CIVIL RIGHTS ACT

7 OF 1964.—Nothing in this section shall be construed to

8 affect the application of title VI of the Civil Rights Act

9 of 1964.

10 (g) NO APPLICATION TO FEDERAL PROGRAMS.—

11 Nothing in this section shall apply to negotiations between

12 health care professionals and health plans pertaining to

13 benefits provided under any of the following:

14 (1) The Medicare Program under title XVIII of

15 the Social Security Act (42 U.S.C. 1395 et seq.).

16 (2) The Medicaid Program under title XIX of

17 the Social Security Act (42 U.S.C. 1396 et seq.).

18 (3) The SCHIP program under title XXI of the

19 Social Security Act (42 U.S.C. 1397aa et seq.).

20 (4) Chapter 55 of title 10, United States Code

21 (relating to medical and dental care for members of

22 the uniformed services).

23 (5) Chapter 17 of title 38, United States Code

24 (relating to Veterans’ medical care).
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1 (6) Chapter 89 of title 5, United States Code

2 (relating to the Federal employees’ health benefits

3 program).

4 (7) The Indian Health Care Improvement Act

5 (25 U.S.C. 1601 et seq.).

6 (h) EXEMPTION OF ABORTION AND ABORTION SERV7 ICES.—Nothing in this section shall apply to negotiations

8 specifically relating to requiring a health plan to cover

9 abortion or abortion services.

10 (i) GENERAL ACCOUNTING OFFICE STUDY AND RE11 PORT.—The Comptroller General of the United States

12 shall conduct a study on the impact of enactment of this

13 section during the 6-month period beginning with the

14 third year of the 3-year period described in subsection (d).

15 Not later than the end of such 6-month period the Comp16 troller General shall submit to Congress a report on such

17 study and shall include in the report such recommenda18 tions on the extension of this section (and changes that

19 should be made in making such extension) as the Comp20 troller General deems appropriate.

21 (j) DEFINITIONS.—For purposes of this section:

22 (1) ANTITRUST LAWS.—The term ‘‘antitrust

23 laws’’—

24 (A) has the meaning given it in subsection

25 (a) of the first section of the Clayton Act (15
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1 U.S.C. 12(a)), except that such term includes

2 section 5 of the Federal Trade Commission Act

3 (15 U.S.C. 45) to the extent such section 5 ap4 plies to unfair methods of competition; and

5 (B) includes any State law similar to the

6 laws referred to in subparagraph (A).

7 (2) HEALTH PLAN AND RELATED TERMS.—

8 (A) IN GENERAL.—The term ‘‘health plan’’

9 means a group health plan or a health insur10 ance issuer that is offering health insurance

11 coverage.

12 (B) HEALTH INSURANCE COVERAGE;

13 HEALTH INSURANCE ISSUER.—The terms

14 ‘‘health insurance coverage’’ and ‘‘health insur15 ance issuer’’ have the meanings given such

16 terms under paragraphs (1) and (2), respec17 tively, of section 733(b) of the Employee Retire18 ment Income Security Act of 1974 (29 U.S.C.

19 1191b(b)).

20 (C) GROUP HEALTH PLAN.—The term

21 ‘‘group health plan’’ has the meaning given that

22 term in section 733(a)(1) of the Employee Re23 tirement Income Security Act of 1974 (29

24 U.S.C. 1191b(a)(1)).
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1 (3) HEALTH CARE PROFESSIONAL.—The term

2 ‘‘health care professional’’ means an individual who

3 provides health care items or services, treatment, as4 sistance with activities of daily living, or medications

5 to patients and who, to the extent required by State

6 or Federal law, possesses specialized training that

7 confers expertise in the provision of such items or

8 services, treatment, assistance, or medications.

9 (k) SENSE OF THE CONGRESS.—It is the sense of

10 the Congress that decisions regarding medical care and

11 treatment should be made by the physician or health care

12 professional in consultation with the patient.

Passed the House of Representatives June 30 (legislative day, June 29), 2000.

Attest:

Clerk.