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 orga-
nizations under the National Labor Relations
Act.
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 negotia-
tions 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 Representa-
tives 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 Rela-
tions 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, mana-
gerial employee, or supervisor.
(b) PROTECTION FOR GOOD FAITH ACTIONS.—Ac-
tions 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 be-
yond actual damages incurred.
(c) LIMITATION.—
(1) NO
NEW
RIGHT
FOR
COLLECTIVE
CES-
SATION
OF
SERVICE.—The exemption provided in
subsection (a) shall not confer any new right to par-
ticipate in any collective cessation of service to pa-
tients not already permitted by existing law.
(2) NO
CHANGE
IN
NATIONAL
LABOR
RELA-
TIONS ACT.— This section applies only to health
care professionals excluded from the National Labor
Relations Act. Nothing in this section shall be con-
strued 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 pro-
fessionals 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) EXEMPTION OF ABORTION AND ABORTION SERV-
ICES.—Nothing in this section shall apply to negotiations
specifically relating to requiring a health plan to cover
abortion or abortion services.
(i) GENERAL ACCOUNTING OFFICE STUDY AND RE-
PORT.—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 Comp-
troller General shall submit to Congress a report on such
study and shall include in the report such recommenda-
tions on the extension of this section (and changes that
should be made in making such extension) as the Comp-
troller General deems appropriate.
(j) 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 ap-
plies 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 insur-
ance issuer that is offering health insurance
coverage.
(B) 
HEALTH
INSURANCE
COVERAGE;
HEALTH
INSURANCE
ISSUER.—The 
terms
‘‘health insurance coverage’’ and ‘‘health insur-
ance issuer’’ have the meanings given such
terms under paragraphs (1) and (2), respec-
tively, of section 733(b) of the Employee Retire-
ment 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 Re-
tirement 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, as-
sistance 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.
(k) SENSE OF THE CONGRESS.—It is the sense of
the Congress that decisions regarding medical care and
treatment should be made by the physician or health care
professional in consultation with the patient.
Passed the House of Representatives June 30 (legis-
lative day, June 29), 2000.
Attest:
Clerk.