NU Online News Service, May 29, 6:44 p.m. – Alaska Gov. Tony Knowles, a Democrat, is reviewing S.B. 37, a bill that would give physicians in Alaska the legal right to band together to negotiate with private health plans over issues other than fees.

S.B. 37 declares that there are instances in which “a health benefit plan dominates the market to the degree that fair negotiations between physicians and the health benefit plan are not possible.”

When such imbalances allow a health plan to “virtually dictate the terms of the contracts it offers to physicians,” the state should give competing physicians permission to engage in collective negotiations, according to the bill text.

The bill sets many limits on physicians’ collective negotiations.

A negotiator, or “authorized third party,” would have to get approval from the state attorney general for any deals negotiated through collective negotiations.

The negotiator could not represent more than 30% of the physicians practicing in a given geographic service area, could not negotiate over fees, and could not negotiate over measures that would shut out chiropractors, nurse midwives and other non-physician providers.

The bill would also forbid physicians from engaging in boycotts and strikes.

Health plans could refuse to do business with the negotiators. Even if plans worked with negotiators, they could offer different contract terms to different physicians represented by the same negotiator.

But the bill would let physicians join in negotiations over clinical practice guidelines, payment delays, patient referral procedures, quality assurance programs, and health plan procedures for resolving disputes.

S.B. 37 was introduced by Sen. Pete Kelly, R-Fairbanks, Alaska.

The bill passed 13-6 in the Senate and 29-10 in the House.

Knowles received the bill Tuesday and now has until June 20 to decide what to do with it, according to officials with the Alaska Legislature.

Kelly and many Alaskan physician groups argue that S.B. 37 will improve medical care.

“Our physicians need to be able to provide the best care for their patients without being hampered by unreasonable insurance restrictions, and S.B. 37 helps make that possible,” Kelly says.

But Alaskan insurance groups and officials with the Alaska Division of Insurance, the Alaska Department of Laws and the Federal Trade Commission say the bill raises antitrust concerns, even if it does not permit physicians to negotiate over fees or engage in strikes or boycotts.

The text of the bill is on the Web at http://www.legis.state.ak.us/basis/get_bill_text.asp?hsid=SB0037G&session=22