By next year, a handful of HMOs will control two-thirds of the commercial market in Texas, constituting an insurmountable advantage in negotiating with physicians. Independent physicians are prohibited from sharing information. If they communicate with each other, they face six-figure legal fees, potential treble damages and criminal charges. Physicians will be herded into tightly controlled groups, restricting competitive choices for employers. Physicians who stay in smaller or solo practices will be powerless to stand up to the plans' demands, further consolidating the market and hampering meaningful competition over those business practices that compromise the quality of care.
Negotiations are voluntary and non-binding.
Prohibits union-like activities by physicians, including boycotts, strikes or the collective cessation of patient care. Allows fees to be negotiated only in limited cases when the Attorney General determines that a managed care plan wields substantial market power, in which case fee negotiations may be permitted to ensure adequate access to care. Permits local control by having the Texas Attorney General referee antitrust concerns instead of the federal government.