2007 -- H 6502

Enacted 07/07/07



J O I N T  R E S O L U T I O N






     Introduced By: Representatives Murphy, and Mumford

     Date Introduced: June 06, 2007



     WHEREAS, A substantial amount of health care services in this state are purchased for

the benefit of patients by health care insurers engaged in the provision of health care financing

services or it otherwise delivered subject to the terms and agreements between health care

insurers and providers of the services; and

     WHEREAS, Health care insurers also manage the health care services rendered to

patients through utilization review programs and other managed care tools and associated

coverage and payment policies; and

     WHEREAS, Health care insurers are often able to dictate the terms of the provider

contracts that they offer primary care physicians and other health care providers, and will

commonly offer provider contracts on a take-it-or-leave-it basis; and

     WHEREAS, Current federal anti-trust enforcement policy restricts health care providers'

ability to collectively negotiate fee-for-service arrangements with payers. The large majority of

primary care physicians and other health care providers do not have sufficient market power to

negotiate or reject provider contract terms; and

     WHEREAS, Health care insurers have significant influence by virtue of their market

power, economic resources and control over payments. In response, health care providers seek a

method to assert their appropriate balancing influence on health care issues; and

     WHEREAS, It is the intention of the general assembly to determine the public benefit or

consequences associated with authorizing primary care providers to jointly discuss with health

care insurers topics of concern regarding the provision of quality health care, or to jointly

negotiate with health care insurers and to qualify such joint negotiations and related joint

activities for the state-action exemption to the federal and state anti-trust laws through the

articulated state policy and active supervision of the state attorney general; now, therefore be it

     RESOLVED, That a special legislative commission be and the same is hereby created

consisting of five (5) members: one of whom shall be the Health Care Advocate of the

Department of Attorney General, or designee; one of whom shall be the Director of the

Department of Health, or designee; one of whom shall be the Commissioner of the Office of the

Health Insurance Commissioner, or designee, who shall be the chair; and two (2) of whom shall

be primary care practitioners or their representatives, of whom one shall be appointed by the

President of the Senate, and one shall be appointed by the Speaker of the House.

     The purpose of the Commission shall be to develop recommendations for strengthening

the role of the state's primary care providers within the health care system, including, legislative

recommendations regarding the creation of a state-authorized and state-monitored mechanism

allowing primary care providers to jointly negotiate health care provider and participation

agreements with health insurers.

     Forthwith upon passage of this resolution, the members of the commission shall meet at

the call of the Health Insurance Commissioner who shall provide suitable quarters and staff for

said commission. Vacancies in said commission shall be filled in like manner as the original


     The membership of said commission shall receive no compensation for their services.

     RESOLVED, That the commission shall report its findings and recommendations to the

General Assembly no later than January 1, 2008 and said commission shall expire on May 1,