,i #aac? ,,congress #b;d ,session ,h4 ,r4 #djgg ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,febru>y #be1 #bjad ,mr4 ,cony]s 7= himself & ,mr4 ,b5i%ek7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ! ,judici>y ,a ,,bill ,to ensure & fo/] cont9u$ pati5t safety & quality ( c>e by cl>ify+ ! application ( ! antitru/ laws to negotiations betwe5 gr\ps ( heal? c>e pr(essionals & heal? plans & heal? c>e insurance issu]s4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,quality ,heal? ,c>e ,coalition ,act ( #bjad4 #b4 ,application ( ! ,f$]al antitru/ laws to heal? c>e pr(essionals negotiat+ ) heal? plans 7a7 ,9 g5]al ,any heal? c>e pr(essionals :o are engag$ 9 negotiations ) a heal? plan reg>d+ ! t]ms ( any contract "u :i* ! pr(essionals provide heal? c>e items or s]vices = :i* b5efits are provid$ "u su* plan %all1 9 connection ) su* negotiations1 be exempt f ! ,f$]al antitru/ laws4 7b7 ,limitation 7#a7 ,no new "r = collective cessation ( s]vice ,! exemption provid$ 9 subsection 7a7 %all n conf] any new "r to p>ticipate 9 any collective cessation ( s]vice to pati5ts n already p]mitt$ by exi/+ law4 7#b7 ,no *ange 9 ,national ,labor ,relations ,act ,?is section applies only to heal? c>e pr(essionals exclud$ f ! ,national ,labor ,relations ,act4 ,no?+ 9 ?is section %all be con/ru$ z *ang+ or am5d+ any provision ( ! ,national ,labor ,relations ,act1 or z affect+ ! /atus ( any gr\p ( p]sons "u t ,act4 7c7 ,no application to ,f$]al programs ,no?+ 9 ?is section %all apply to negotiations betwe5 heal? c>e pr(essionals & heal? plans p]ta9+ to b5efits provid$ "u any ( ! foll[+3 7#a7 ,! ,m$ic>e ,program "u title ,,xviii ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7#b7 ,! ,m$icaid program "u title ,,xix ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 7#c7 ,! ,,s*ip program "u title ,,xxi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq474 7#d7 ,*apt] #ee ( title #aj1 ,unit$ ,/ates ,code 7relat+ to m$ical & d5tal c>e = memb]s ( ! uni=m$ s]vices74 7#e7 ,*apt] #ag ( title #ch1 ,unit$ ,/ates ,code 7relat+ to ,vet]ans' m$ical c>e74 7#f7 ,*apt] #hi ( title #e1 ,unit$ ,/ates ,code 7relat+ to ! ,f$]al employees' heal? b5efits program74 7#g7 ,! ,indian ,heal? ,c>e ,improvem5t ,act 7#be ,u4,s4,c4 #afja et seq474 #c4 ,def9itions ,9 ?is ,act1 ! foll[+ def9itions %all apply3 7#a7 ,antitru/ laws ,! t]m antitru/ laws-- 7,a7 has ! mean+ giv5 x 9 subsection 7a7 ( ! fir/ section ( ! ,clayton ,act 7#ae ,u4,s4,c4 #ab7;a771 except t su* t]m includes section #e ( ! ,f$]al ,trade ,commission ,act 7#ae ,u4,s4,c4 #de7 to ! ext5t su* section applies to unfair me?ods ( competition2 & 7,b7 includes any ,/ate law simil> to ! laws ref]r$ to 9 subp>agraph 7,a74 7#b7 ,gr\p heal? plan ,! t]m gr\p heal? plan means an employee welf>e b5efit plan to ! ext5t t ! plan provides m$ical c>e 7includ+ items & s]vices paid = z m$ical c>e7 to employees or _! dep5d5ts 7z def9$ "u ! t]ms ( ! plan7 directly or ?r\gh insurance1 reimbursem5t1 or o!rwise4 7#c7 ,gr\p heal? plan1 heal? insurance issu] ,! t]ms gr\p heal? plan & heal? insurance issu] include a ?ird-p>ty adm9i/rator or o!r p]son act+ = or on behalf ( su* plan or issu]4 7#d7 ,heal? c>e s]vices ,! t]m heal? c>e s]vices means any s]vices = :i* paym5t may be made "u a heal? plan1 includ+ s]vices relat$ to ! deliv]y or adm9i/ration ( su* s]vices4 7#e7 ,heal? c>e pr(essional ,! t]m heal? c>e pr(essional means any individual or entity t provides heal? c>e items or s]vices1 treatm5t1 assi/ance ) activities ( daily liv+1 or m$ications to pati5ts & :o1 to ! ext5t requir$ by ,/ate or ,f$]al law1 possesses specializ$ tra9+ t conf]s exp]tise 9 ! provision ( su* items or s]vices1 treatm5t1 assi/ance1 or m$ications4 7#f7 ,heal? insurance cov]age ,! t]m heal? insurance cov]age means b5efits consi/+ ( m$ical c>e 7provid$ directly1 ?r\gh insurance or reimbursem5t1 or o!rwise & includ+ items & s]vices paid = z m$ical c>e7 "u any hospital or m$ical s]vice policy or c]tificate1 hospital or m$ical s]vice plan contract1 or heal? ma9t5ance organization contract (f]$ by a heal? insurance issu]4 7#g7 ,heal? insurance issu] ,! t]m heal? insurance issu] means an insurance company1 insurance s]vice1 or insurance organization 7includ+ a heal? ma9t5ance organization7 t is lic5s$ to engage 9 ! bus9ess ( insurance 9 a ,/ate & t is subject to ,/ate law regulat+ insurance4 ,su* t]m does n include a gr\p heal? plan4 7#h7 ,heal? ma9t5ance organization ,! t]m heal? ma9t5ance organization means-- 7,a7 a f$]ally qualifi$ heal? ma9t5ance organization 7z def9$ 9 section #acja7;a7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;e7a7772 7,b7 an organization recogniz$ "u ,/ate law z a heal? ma9t5ance organization2 or 7,c7 a simil> organization regulat$ "u ,/ate law = solv5cy 9 ! same mann] & to ! same ext5t z su* a heal? ma9t5ance organization4 7#i7 ,heal? plan ,! t]m heal? plan means a gr\p heal? plan or a heal? insurance issu] t is (f]+ heal? insurance cov]age4 7#aj7 ,m$ical c>e ,! t]m m$ical c>e means am\nts paid =-- 7,a7 ! diagnosis1 cure1 mitigation1 treatm5t1 or prev5tion ( disease1 or am\nts paid = ! purpose ( affect+ any /ructure or function ( ! body2 & 7,b7 transportation prim>ily = & ess5tial to receiv+ items & s]vices ref]r$ to 9 subp>agraph 7,a74 7#aa7 ,p]son ,! t]m p]son includes a ,/ate or unit ( local gov]nm5t4 7#ab7 ,/ate ,! t]m ,/ate includes ! sev]al ,/ates1 ! ,di/rict ( ,columbia1 ,pu]to ,rico1 ! ,virg9 ,isl&s ( ! ,unit$ ,/ates1 ,guam1 ,am]ican ,samoa1 & ! ,commonweal? ( ! ,nor!rn ,m>iana ,isl&s4 #d4 ,effective date ,?is ,act %all take effect on ! date ( ! enactm5t ( ?is ,act & %all n apply ) respect to conduct occurr+ be=e su* date4