I

104TH CONGRESS

2D SESSION H. R. 3770

To make the antitrust laws inapplicable to the negotiations between a coalition

of health-care professionals and a health-care service plan regarding

the wages, rates of pay, hours of work, and other terms and conditions

of a contract between a member of such health-care professionals coalition and a health-care service plan, and to their carrying out such

terms and conditions.

IN THE HOUSE OF REPRESENTATIVES

JULY 10, 1996

Mr. CAMPBELL introduced the following bill; which was referred to the

Committee on the Judiciary

A BILL

To make the antitrust laws inapplicable to the negotiations

between a coalition of health-care professionals and a

health-care service plan regarding the wages, rates of

pay, hours of work, and other terms and conditions of

a contract between a member of such health-care professionals coalition and a health-care service plan, and to

their carrying out such terms and conditions.

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

2 This Act may be cited as the ‘‘Health-Care Profes3 sionals Coalition Act of 1996’’.

4 SEC. 2. DEFINITIONS.

5 For purposes of this Act—

6 (1) the term ‘‘antitrust laws’’ has the meaning

7 given to it in subsection (a) of the first section of

8 the Clayton Act (15 U.S.C. 12(a)), except that such

9 term includes section 5 of the Federal Trade Com10 mission Act (15 U.S.C. 45) to the extent that sec11 tion 5 applies to unfair methods of competition,

12 (2) the term ‘‘presumption of market power’’

13 shall be defined as a ‘‘Herfindahl-Hirschman Index

14 (‘HHI’)’’ of greater than 2,000,

15 (3) the term ‘‘health-care professional’’ means

16 an individual who—

17 (A) is engaged in the delivery of health18 care services in a State,

19 (B) is required by State law or State regu20 lation to be licensed or certified by the State to

21 engage in the delivery of health-care services in

22 the State, and

23 (C) has a valid license or certification from

24 the State to engage in the delivery of health25 care services in the State,
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1 (4) the term ‘‘health-care professionals coali2 tion’’ means an organization or association whose

3 membership consists exclusively of health-care pro4 fessionals or health-care professionals groups, or

5 both,

6 (5) the term ‘‘health-care professionals group’’

7 means a group of health-care professionals that is le8 gally organized as a partnership, corporation, foun9 dation, nonprofit corporation, faculty practice plan,

10 or similar association,

11 (6) the term ‘‘health-care service plan’’ means

12 a person or governmental entity that agrees to pay

13 (directly or by reimbursement) any part of the cost

14 for health-care services provided to recipients of

15 such services, in return for a prepaid or periodic

16 payment made by or for the benefit of such recipi17 ents,

18 (7) the term ‘‘home health agency’’ has the

19 meaning given to it in section 1395x(o) of the Social

20 Security Act (42 U.S.C. 1395x(o)),

21 (8) the term ‘‘hospice program’’ has the mean22 ing given to it in section 1395x(dd)(2) of the Social

23 Security Act (42 U.S.C. 1395(dd)(2)),
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1 (9) the term ‘‘hospital’’ has the meaning given

2 to it in section 1395x(e) of the Social Security Act

3 (42 U.S.C. 1395x(e)),

4 (10) the term ‘‘person’’ has the meaning given

5 it in subsection (a) of the first section of the Clayton

6 Act (15 U.S.C. 12(a)), and

7 (11) the term ‘‘skilled nursing facility’’ has the

8 meaning given to it in section 1395i(3)(A) of the So9 cial Security Act (42 U.S.C. 1395i(3)(A)).

10 SEC. 3. PURPOSE.

11 The purpose of this Act is to create a more equal

12 balance of negotiating power between health-care profes13 sionals and health-care service plans.

14 SEC. 4. APPLICATION OF ANTITRUST LAWS TO HEALTH15 CARE PROFESSIONALS COALITIONS.

16 (a) EXEMPTION.—Subject to subsection (b), it shall

17 not be unlawful under the antitrust laws for a health-care

18 professionals coalition—

19 (1) to negotiate with a health-care service plan

20 regarding the wages, rates of pay, hours of work,

21 and other terms and conditions of a contract that

22 require members of the coalition to provide health23 care services to beneficiaries of the plan, or

24 (2) to carry out such terms and conditions.
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1 (b) LIMITATION ON EXEMPTION.—The exemption es2 tablished in subsection (a) shall apply only to a line of

3 service—

4 (1) of health-care professionals and health care

5 professionals groups who are members of a health6 care professionals coalition, and

7 (2) with respect to which there is in the rel8 evant market a presumption of market power held

9 by health-care service plans with which the coalition

10 negotiates terms and conditions described in such

11 subsection.

12 SEC. 5. EFFECTIVE DATE.

13 This Act shall take effect on the date of the enact14 ment of this Act, but shall not apply with respect to con15 duct occurring before such date.

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