Quality Health Care Coalition Act of 2015

To ensure and foster continued patient safety and quality of care by clarifying the application of the antitrust laws to negotiations between groups of health care professionals and health plans and health care insurance issuers. 1. Short title This Act may be cited as the Quality Health Care Coalition Act of 2015 2. Application of the Federal 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 exempt from the Federal antitrust laws. (b) 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. (c) 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 (5) Chapter 17 (6) Chapter 89 (7) The Indian Health Care Improvement Act 25 U.S.C. 1601 et seq. 3. Definitions In this Act, the following definitions shall apply: (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) Federal Trade Commission Act 15 U.S.C. 45 (B) includes any State law similar to the laws referred to in subparagraph (A). (2) Group health plan The term group health plan (3) Group health plan, health insurance issuer The terms group health plan health insurance issuer (4) Health care services The term health care services (5) Health care professional The term health care professional (6) Health insurance coverage The term health insurance coverage (7) Health insurance issuer The term health insurance issuer (8) Health maintenance organization The term health maintenance organization (A) a federally qualified health maintenance organization (as defined in section 1301(a) of the Public Health Service Act 42 U.S.C. 300e(a) (B) an organization recognized under State law as a health maintenance organization; or (C) a similar organization regulated under State law for solvency in the same manner and to the same extent as such a health maintenance organization. (9) Health plan The term health plan (10) Medical care The term medical care (A) the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body; and (B) transportation primarily for and essential to receiving items and services referred to in subparagraph (A). (11) Person The term person (12) State The term State 4. Effective date This Act shall take effect on the date of the enactment of this Act and shall not apply with respect to conduct occurring before such date.

Summary: Quality Health Care Coalition Act of 2015 Exempts health care professionals, including individuals and entities, from federal and state antitrust laws in connection with negotiations with a health plan regarding contract terms under which the professionals provide health care items or services for which plan benefits are provided. Declares that this Act: (1) applies only to health care professionals excluded from the National Labor Relations Act; and (2) does not apply to negotiations relating to Medicare or Medicaid programs, the Children's Health Insurance Program, medical and dental care for members of the uniformed services, veterans' medical care, the federal employees health benefits program, or the Indian Health Care Improvement Act.