IB
Union Calendar No. 342
106TH CONGRESS
2D SESSION
H. R. 1304
[Report No. 106–625]
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.
IN THE HOUSE OF REPRESENTATIVES
MARCH 25, 1999
Mr. CAMPBELL (for himself, Mr. CONYERS, Mr. MILLER of Florida, Mr.
HOEFFEL, Mr. BAKER, Mr. LAFALCE, Mr. COOKSEY, Mr. PALLONE, Mr.
NADLER, Mr. HORN, Mr. FROST, Mr. FILNER, Mr. BOUCHER, Mr.
WEXLER, Mr. SCARBOROUGH, Ms. SCHAKOWSKY, Mr. SHOWS, Mr.
SANDLIN, Mr. TOWNS, Mr. BLAGOJEVICH, Mr. BROWN of Ohio, Mr.
PAUL, Mr. COBURN, Mr. GANSKE, Mr. DELAHUNT, Mr. ROHRABACHER,
Mr. MCCOLLUM, and Mr. KLINK) introduced the following bill; which was
referred to the Committee on the Judiciary
MAY 18, 2000
Additional sponsors: Mr. NETHERCUTT, Ms. KILPATRICK, Ms. JACKSON-LEE
of Texas, Mr. DAVIS of Virginia, Ms. LOFGREN, Mr. NORWOOD, Mr.
SMITH of Texas, Ms. WOOLSEY, Mr. BONIOR, Mr. ANDREWS, Mr.
WHITFIELD, Mr. WAMP, Mr. DOOLITTLE, Mr. GOODE, Mr. KILDEE, Mr.
BARR of Georgia, Mr. DICKEY, Mr. BACHUS, Mr. LEACH, Mr. PICK-
ERING, Mr. RAHALL, Mr. PORTER, Mr. SMITH of Michigan, Mr. THORN-
BERRY, Mr. DEAL of Georgia, Mr. BAIRD, Mrs. MCCARTHY of New York,
Mr. DIAZ-BALART, Mr. GEORGE MILLER of California, Mr. KOLBE, Mr.
ACKERMAN, Mr. MCGOVERN, Mr. WALSH, Mr. MCHUGH, Mr. FLETCH-
ER, Mr. HANSEN, Mr. WELDON of Pennsylvania, Mr. RILEY, Ms. BALD-
WIN, Mr. THOMPSON of Mississippi, Mr. CANADY of Florida, Mr. RADAN-
OVICH, Ms. DELAURO, Mr. MICA, Mr. PASCRELL, Mr. BERMAN, Mr.
LUCAS of Oklahoma, Mr. WELDON of Florida, Mr. BARTON of Texas, Ms.
PELOSI, Mrs. TAUSCHER, Mr. MANZULLO, Ms. HOOLEY of Oregon, Mr.
FARR of California, Mr. WEINER, Ms. STABENOW, Mr. FORD, Mr.
THOMPSON of California, Mr. MALONEY of Connecticut, Mr. FORBES,
Mr. OWENS, Mr. SMITH of New Jersey, Mr. BOEHLERT, Mr. COOK, Mr.
MCNULTY, Ms. RIVERS, Mr. PETERSON of Minnesota, Mr. INSLEE, Mr.
OSE, Mr. GRAHAM, Mr. TURNER, Mr. ROTHMAN, Mr. DICKS, Mr. GARY
MILLER of California, Mr. HOLT, Mr. LOBIONDO, Mrs. MORELLA, Ms.
BERKLEY, Mr. PASTOR, Mr. GILMAN, Mr. BARCIA, Mr. WU, Mr. FRANKS
of New Jersey, Mrs. KELLY, Mr. LAMPSON, Mr. TIAHRT, Mr. SNYDER,
Mr. SHAW, Mr. ABERCROMBIE, Mr. MORAN of Virginia, Ms. MCCARTHY
of Missouri, Mr. PRICE of North Carolina, Mr. ISAKSON, Mr. MASCARA,
Mr. SCOTT, Mr. KENNEDY of Rhode Island, Ms. LEE, Mr. LEWIS of Cali-
fornia, Mr. KIND, Ms. KAPTUR, Mr. WICKER, Mr. HOLDEN, Mr.
GILCHREST, Ms. ESHOO, Mr. DUNCAN, Mr. CLAY, Mr. TANCREDO, Mr.
NEY, Mr. MCINTOSH, Mr. JONES of North Carolina, Mr. BRADY of
Pennsylvania, Mr. CLYBURN, Mr. SAXTON, Mr. MATSUI, Ms. DANNER,
Mr. MCINTYRE, Mrs. CLAYTON, Ms. MCKINNEY, Mr. ISTOOK, Mr. HILL
of Montana, Mr. BISHOP, Mr. RODRIGUEZ, Mrs. MALONEY of New York,
Mr. WYNN, Mr. LUCAS of Kentucky, Mr. CUMMINGS, Mr. RYUN of Kan-
sas, Mr. UDALL of New Mexico, Mr. VITTER, Mr. GORDON, Mr. PICK-
ETT, Mr. WATKINS, Mr. VISCLOSKY, Mrs. LOWEY, Mr. WELLER, Mrs.
ROUKEMA, Mr. MORAN of Kansas, Mrs. EMERSON, Mr. FATTAH, Mr.
GIBBONS, Mr. UPTON, Mrs. CUBIN, Mr. MENENDEZ, Mr. PHELPS, Mr.
KUYKENDALL, Mr. DIXON, Mr. UDALL of Colorado, Mr. GILLMOR, Mr.
WISE, Mr. PAYNE, Mr. DEFAZIO, Mr. SAWYER, Mr. RANGEL, Mr.
SHIMKUS, Mr. METCALF, Mr. HALL of Ohio, Mr. SKELTON, Mr. CAL-
VERT, Mr. KANJORSKI, Mr. BORSKI, Mr. LATOURETTE, Mr. ENGEL, Mr.
POMBO, Mr. CAMP, Mrs. WILSON, Mr. KUCINICH, Mr. TRAFICANT, Mr.
HEFLEY, Mr. ADERHOLT, Ms. DEGETTE, Mr. GUTIERREZ, Mr. DOYLE,
Mr. HILLIARD, Mr. EVANS, Mr. CRAMER, Mr. MURTHA, Mr. SANDERS,
Mr. EVERETT, Mr. HINOJOSA, Mr. MCDERMOTT, Mr. GALLEGLY, Mrs.
JONES of Ohio, Mrs. NAPOLITANO, Mr. STENHOLM, Mr. BACA, Ms. CAR-
SON, Mr. BOSWELL, Mr. DINGELL, Mr. MEEKS of New York, Mr. PETRI,
Mr. STRICKLAND, Mr. COYNE, Mr. HASTINGS of Florida, Mr. LEWIS of
Georgia, and Mr. ENGLISH
Deleted sponsors: Mr. COBURN (added March 25, 1999; deleted October 14,
1999), and Mr. DELAHUNT (added March 25, 1999; deleted March 1, 2000)
MAY 18, 2000
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed in italic]
[For text of introduced bill, see copy of bill as introduced on March 25, 1999]
A BILL
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 pro-
vide health care items or services for which benefits are pro-
vided under such plan shall, in connection with such nego-
tiations, be entitled to the same treatment under the anti-
trust laws as the treatment to which bargaining units which
are recognized under the National Labor Relations Act are
entitled in connection with such collective bargaining. Such
a professional shall, only in connection with such negotia-
tions, be treated as an employee engaged in concerted activi-
ties and shall not be regarded as having the status of an
employer, independent contractor, managerial employee, or
supervisor.
(b) PROTECTION FOR GOOD FAITH ACTIONS.—Actions
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 beyond actual
damages incurred.
(c) 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 al-
ready permitted by existing law.
(2) NO CHANGE IN NATIONAL LABOR RELATIONS
ACT.— This section applies only to health care profes-
sionals 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.
(d) 3-YEAR SUNSET.—The exemption provided in sub-
section (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 sec-
tion shall exempt from the application of the antitrust laws
any agreement or otherwise unlawful conspiracy that ex-
cludes, limits the participation or reimbursement of, or oth-
erwise limits the scope of services to be provided by any
health care professional or group of health care professionals
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 af-
fect the application of title VI of the Civil Rights Act of
1964.
(g) NO APPLICATION TO FEDERAL PROGRAMS.—Noth-
ing 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 (re-
lating to the Federal employees’ health benefits pro-
gram).
(7) The Indian Health Care Improvement Act
(25 U.S.C. 1601 et seq.).
(h) 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 Comptroller Gen-
eral shall submit to Congress a report on such study and
shall include in the report such recommendations on the
extension of this section (and changes that should be made
in making such extension) as the Comptroller General
deems appropriate.
(i) 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 sec-
tion 5 of the Federal Trade Commission Act (15
U.S.C. 45) to the extent such section 5 applies 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 insurance
issuer that is offering health insurance coverage.
(B) 
HEALTH
INSURANCE
COVERAGE;
HEALTH INSURANCE ISSUER.—The terms ‘‘health
insurance coverage’’ and ‘‘health insurance
issuer’’ have the meanings given such terms
under paragraphs (1) and (2), respectively, of
section 733(b) of the Employee Retirement In-
come 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.
Union Calendar No. 342
106TH CONGRESS
2D SESSION
H. R. 1304
[Report No. 106–625]
A BILL
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.
MAY 18, 2000
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union,
and ordered to be printed