HF 1812

as introduced - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to commerce; providing physician groups with 
  1.3             an exception from laws prohibiting the restraint of 
  1.4             trade; amending Minnesota Statutes 1994, sections 
  1.5             325D.50, by adding subdivisions; and 325D.55, by 
  1.6             adding a subdivision. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  [PURPOSE AND INTENT.] 
  1.9      The legislature finds that: 
  1.10     (a) physicians negotiating with dominant health benefits 
  1.11  third-party payers are in the same position as employees 
  1.12  negotiating over wages and terms of employment with their 
  1.13  employers; 
  1.14     (b) physicians do not have the resources with which to 
  1.15  resist inappropriate terms for the delivery of health care 
  1.16  services; 
  1.17     (c) permitting physicians to negotiate collectively with 
  1.18  health care benefits third-party payers will equalize the 
  1.19  bargaining position of physicians with dominant health care 
  1.20  benefits third-party payers, improving the delivery of health 
  1.21  care services; 
  1.22     (d) protection by law of the right of physicians to 
  1.23  organize and negotiate collectively with health benefits 
  1.24  third-party payers with market power is necessary to promote the 
  1.25  development of efficient health care delivery systems, 
  1.26  facilitate the delivery of health care services, and safeguard 
  2.1   commerce from injury, impairment, or interruption; and 
  2.2      (e) protection of the right of physicians to negotiate 
  2.3   collectively encourages practices fundamental to the amicable 
  2.4   adjustment of disputes relating to reimbursement and coverage 
  2.5   arrangements. 
  2.6      Sec. 2.  Minnesota Statutes 1994, section 325D.50, is 
  2.7   amended by adding a subdivision to read: 
  2.8      Subd. 7.  "Health benefits third-party payer" means a group 
  2.9   purchaser, as defined in section 62J.03, subdivision 6. 
  2.10     Sec. 3.  Minnesota Statutes 1994, section 325D.50, is 
  2.11  amended by adding a subdivision to read: 
  2.12     Subd. 8.  "Physician" is an individual licensed to practice 
  2.13  medicine pursuant to chapter 147. 
  2.14     Sec. 4.  Minnesota Statutes 1994, section 325D.50, is 
  2.15  amended by adding a subdivision to read: 
  2.16     Subd. 9.  "Reimbursement arrangement" means all the terms 
  2.17  and conditions relating to reimbursement by a health benefits 
  2.18  third-party payer for physician services, including but not 
  2.19  limited to conditions of coverage, reimbursement rates and 
  2.20  discounts, fee schedules, use of tests and second opinions, 
  2.21  utilization review, and risk sharing arrangements. 
  2.22     Sec. 5.  Minnesota Statutes 1994, section 325D.50, is 
  2.23  amended by adding a subdivision to read: 
  2.24     Subd. 10.  "Market power" shall be presumed to exist for 
  2.25  purposes of this statute whenever: 
  2.26     (a) any health benefits third-party payer provides coverage 
  2.27  for at least ten percent of the covered persons in any 
  2.28  geographical area; or 
  2.29     (b) has entered into reimbursement arrangements with at 
  2.30  least 25 percent of the physicians in any geographical area. 
  2.31     Sec. 6.  Minnesota Statutes 1994, section 325D.55, is 
  2.32  amended by adding a subdivision to read: 
  2.33     Subd. 4.  Nothing contained in sections 325D.49 to 325D.66, 
  2.34  shall apply to physicians practicing in groups of 20 or fewer 
  2.35  physicians who self-organize, form, join, or assist bargaining 
  2.36  organizations to bargain collectively through representatives of 
  3.1   their own choosing and engage in other concerted activities for 
  3.2   the purpose of negotiating reimbursement arrangements with 
  3.3   health benefits third-party payers with market power.  An 
  3.4   individual physician may participate in a bargaining 
  3.5   organization without regard to whether the physician is an 
  3.6   employee, independent contractor, or part of a group practice or 
  3.7   other arrangement.