Collective bargaining bill appears close to passing
Collective bargaining bill appears close to passing
A bill that would make Texas the first state to allow independent physicians to negotiate fees collectively with managed care organizations has become the subject of intense lobbying by national players on both sides of the issue.
The bill, called the Managed Care Freedom Act, passed with overwhelming support in the Texas Senate earlier this month. It subsequently was approved by the House Insurance Committee and currently resides in the Calendar Committee, where it’s due to be posted for floor debate in the House "any day now," says Ken Ortolon, spokesman for the Austin-based Texas Medical Association.
The bill is believed to have strong support in the House, which passed other managed care reform legislation two years ago by a wide margin. The wild card is Governor George W. Bush, who allowed the previous legislation to pass into law without his signature. Bush so far hasn’t offered any opinion about the collective bargaining bill.
Whatever happens in Texas must happen soon. The legislature adjourns May 31, and any bill not on Bush’s desk by that date dies. "So it will definitely come to a head sometime within the next week," Ortolon says.
Meanwhile, national interest groups are pushing hard to influence the house vote. Representatives from the Chicago-based American Medical Association have already testified before the Texas legislature in support of the bill, and last week the Federal Trade Commission’s (FTC) Bureau of Competition weighed in by urging the chair of the House Ways and Means Committee to oppose it.
"There’s a lot of tolerance in the antitrust laws for physicians who collaborate in forming a joint venture, because that collaboration is likely to help them deliver their product more efficiently," says Richard Feinstein, assistant director for health care at the FTC. "But when physicians are doing nothing more than collaborating on the negotiation, it’s a little hard to see how that does anything other than eliminate actual or potential competition."
But Ortolon says that under federal antitrust law, managed care companies already enjoy a number of exemptions that allow them to "get together and compare prices and contract provisions pretty much all they want." He adds that many managed care contracts aren’t in the best interest of health care consumers, whom the FTC says it wants to protect. "If [a managed care company] throws a contract down on the table and says, Doctor, sign this or you’re out of the plan,’ that’s not in the best interest of patients." (See related story on Trigon Blue Cross and Blue Shield, upper right.)
Ortolon adds that, under the bill, the state attorney general would have the authority to veto any fee agreement deemed harmful to consumers.
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