I 
111TH CONGRESS 
1ST SESSION H. R. 1493 
To ensure and foster continued patient safety and quality of care by exempt-
ing health care professionals from the Federal antitrust laws in their 
negotiations with health plans and health insurance issuers. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 12, 2009 
Mr. PAUL (for himself and Mr. PRICE of Georgia) introduced the following 
bill; which was referred to the Committee on the Judiciary 
A BILL 
To ensure and foster continued patient safety and quality 
of care by exempting health care professionals from the 
Federal antitrust laws in their negotiations with health 
plans and health insurance issuers. 
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 2009’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) According to a 2008 survey by the Henry 
J. Kaiser Family Foundation, 98 percent of Ameri-
cans who receive their health care through their em-
ployer are enrolled in some form of a managed 
health care plan, up from 27 percent in 1987. Seri-
ous questions have been raised about the quality of 
care patients are receiving under these plans. 
(2) Changes in the health care industry have 
led to an increased concentration of health care 
plans, including approximately 400 mergers in the 
last decade. This enhanced concentration has given 
health care plans significant leverage over health 
care providers and patients. 
(3) Antitrust laws which prohibit health care 
professionals from negotiating freely with health 
care plans infringe on the health care professionals’ 
constitutionally protected rights of freedom of asso-
ciation and contract. 
(4) Repealing Federal laws which prohibit med-
ical professionals from negotiating collectively with 
health care plans will create a more equal balance of 
negotiating power, will promote cooperation, and will 
enhance the quality of patient care. 
(5) Repealing Federal laws which prohibit med-
ical professionals from negotiating collectively with 
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health care plans will not change the professionals 
ethical duty to continue to provide medically nec-
essary care to their patients. 
SEC. 3. APPLICATION OF THE FEDERAL ANTITRUST LAWS 
TO HEALTH CARE PROFESSIONALS NEGOTI-
ATING 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
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 Re-
lations Act. Nothing in this section shall be con-
strued as changing or amending any provision of the 
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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 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.). 
(d) DEFINITIONS.—For purposes of this section: 
(1) FEDERAL
ANTITRUST
LAWS.—The term 
‘‘Federal antitrust laws’’ has the meaning the term 
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‘‘antitrust laws’’ 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 applies to unfair methods of competition. 
(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 
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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. 
Æ 
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