June 28, 2000 (3:00 p.m.)

Amendments Submitted to H.R. 1304, the Quality Health-Care Coalition Act of 2000

(in alphabetical order)

8. Ballenger: Adds the following patient protections to the bill: protects patients from increased costs and/or reduced benefits resulting from physician negotiations over fees; protects patients from physician efforts to negotiate terms allowing them to balance bill patients; helps protect patients from medical errors by not permitting physicians to collectively negotiate unless they have received federal approval of a patient safety plan; gives patients a right to know if their physicians are participating in collective negotiations; protects patients from physician boycotts; and gives patient a right to know if any of their physicians' treatment recommendations have been influenced by group boycott decisions, collective negotiations or political advocacy positions.

9. Ballenger: Prohibits collective negotiations involving fee-related terms.

1. Coburn: Exempts discussions regarding requiring abortion coverage from collective bargaining negotiations.

2. Coburn: Limits the scope of the anti-trust exemption for health care professionals to the State of California as a 5 year pilot program.

13. Cox: Provides that a physician may not be forced to join a union as a condition of employment by a health plan. LATE

14. Cox: Authorizes plan-wide unions and prohibits nation-wide bargaining. LATE

15. Cox: Strengthens prohibition on physician strikes; adds penalties for violations of ban on strikes. LATE

3. Davis (IL): Sense of Congress that medical decisions regarding treatment should be made by the physician or health care professional and the patient.

4. Davis (IL): Requires an annual report on the legislation's impact on "priority populations," which include the poor, the elderly, African-Americans, and other people of color who have experienced poor health outcomes.

17. Greenwood: Amends the Coburn amendment #1 by clarifying that the amendment does not require any health plan to cover any benefit or service not otherwise required under state or federal law, or require any individual who is a health care professional to provide a service that is contrary to his or her moral beliefs. The amendment also clarifies that the Coburn amendment does not preclude a religious entity from taking a position in collective bargaining in conformance with the principles of its affiliated religion. LATE

5. Johnson, Sam: Provides that the anti-trust exemption would not apply if the state appeals to the FTC on the grounds that the law has resulted in or is likely to result in negative consequences to patient care, access to care, and/or excessive increases in the cost of health care, and the FTC makes such a determination. WITHDRAWN

6. Johnson, Sam: Limits the anti-trust exemption to include only those areas in which the state's Attorney General certifies to the FTC that it is in the public interest. WITHDRAWN

7. Stearns: Exempts groups of health care professionals engaged in negotiations with health plans from federal antitrust laws if the FTC or the Department of Justice has certified that such negotiations would promote competition and enhance the quality of patient care. Groups representing fewer than 20% of the health care professionals in a specialty in a market area would get an antitrust exemption without having to obtain approval from the FTC or DOJ. Finally, the amendment clarifies that the bill does not create any legal right for such groups of health care professionals to engage in boycotts, coercive behavior or engage in a collective cessation of service to patients.

16. Terry: Prevents doctors, or any health care professional covered in the bill, from using the bill language to negotiate fees. LATE

10. Thomas: Sunsets the exemption provided in the bill if the Administrator of the Health Care Financing Administration determined that such exemption had resulted in increases, in excess of the rate of medical inflation, in fees for physician and other health professional services paid by Medicare+Choice plans. LATE

11. Thomas: Requires health professionals to report to the FTC information regarding any negotiations conducted with health plans under the exemption provided under the bill and instructs the FTC to report to the Congress periodically about the effects of such negotiations. LATE

12. Thomas: Provides that the exemption included in the bill not apply to: (1) negotiations between health professionals and health plans relating to fees, payments, reimbursements, or other compensation arrangements; or (2) negotiations with a health plan that would allow health professionals to balance bill patients of a health plan. The exemption would also not apply to a health professional if they had not submitted and received approval from the Sec. of HHS on a plan to reduce medical errors. Health professionals availing themselves of the exemption would also be required to notify patients and prospective patients of their participation in exempt negotiations. The exemption would not apply to health professional who engaged in boycotts of health plans. LATE

* Summaries derived from information submitted by the amendment sponsors.