Legislation Permitting Healthcare Providers to Negotiate Jointly with Health Insurers Introduced in Congress

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Legislation was recently introduced by Representative John Conyers (D-Michigan) that would permit healthcare providers to negotiate jointly with health insurers concerning contract terms without running afoul of the antitrust laws. The bill, the “Quality Health Care Coalition Act of 2014,” (H.R. 4077), has been referred to the House Judiciary’s Subcommittee on Regulatory Reform, Commercial and Antitrust Law for further action.
In introducing the legislation, Representative Conyers stated that “over the last several decades, the health insurance market has become exceedingly concentrated, dominated by a few large insurers offering a limited number of health insurance plans. This has occurred in large part because of insurers’ immunity from federal antitrust laws. In contrast, our nation’s physicians and health care providers are afforded no comparable protections. This unbalanced playing field ultimately means consumers lose out with higher healthcare costs and poorer care. H.R. 4077 allows for physicians to negotiate with insurers on a level playing field, ensuring heightened quality standards for patient care.”
Notably, Representative Conyers has introduced similar legislation in the past, without success. However, the legislation enjoys a degree of bipartisan support this Congress, with Republicans in both the House and Senate having also introduced legislation containing provisions similar to those in Representative Conyers’s bill. Specifically, H.R. 2300, which was introduced by Representative Tom Price (R-Georgia) last June, would permit healthcare providers to negotiate jointly with insurers, as does S. 1851, which was introduced by Senator John McCain (R-Arizona) last December. However, both H.R. 2300 and S. 1851 are much larger bills that also seek to repeal the Affordable Care Act, and thus those bills are unlikely to garner Democrat support in the House or Senate.
Nonetheless, the fact that these Republican-sponsored bills contain language that is virtually identical to that in Representative Conyers’s bill suggests that the prospects for H.R. 4077 are probably brighter this year than they have been at any time since 2000, when similar legislation was passed in the House but failed to get acted upon in the Senate. Will Representative Conyers’s legislation finally “cross the finish line” this Congress? Time will tell; stay tuned.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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