NU Online News Service, March 12, 12:55 p.m. — Washington
Insurance companies and physicians are squaring off over legislation that could modify antitrust laws and allow physicians to form cooperatives that would jointly negotiate fees and other contract terms with health plans.
The legislation, H.R. 3897, says that efforts by physician cooperatives to negotiate terms on behalf of their members should not be deemed illegal per se, as is currently the case under the Clayton Antitrust Act.
Rather, the legislation says, legality of the arrangement should be judged on the basis of “reasonableness,” considering such factors as patient access to health care, the quality of health care and the proposed contract terms.
The legislation, which was introduced by Reps. Bob Barr, R-Ga., and John Conyers, D-Mich., says the antitrust protection is necessary because of the “concentration and exertion of market and economic power” exercised by health plans using such mechanisms as medical necessity determinations and delaying payments.
The American Medical Association, Chicago, is strongly supporting the legislation.