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Code · BILL · 118th Congress · H.R. 10409 (Introduced in House) — To address the high costs of health care services, prescription drugs, and health insurance coverage in the United St... · Sec. 303

Sec. 303. Leveling the playing field between payers and providers

270 words·~1 min read·/bill/118/hr/10409/ih/section-303·

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It shall not be a violation of the antitrust laws for one or more private health insurer issuers or their designated agents to jointly negotiate prices of particular hospital services with a hospital provider with regards to the reimbursement policies of the insurers for those services. For purposes of this section: The term antitrust laws has the meaning given it in subsection
(a)of the 1st section of the Clayton Act ( 15 U.S.C. 12(a) ), except that such term includes section 5 of the Federal Trade Commission Act ( 15 U.S.C. 45 ) to the extent such section 5 applies to unfair methods of competition. The term health insurance issuer means an insurance company, insurance service, or insurance organization (including a health maintenance organization, as defined in subparagraph (C)) which is licensed to engage in the business of insurance in a State and which is subject to State law which regulates insurance (within the meaning of section 514(b)(2) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1144(b)(2) ). Such term does not include a group health plan. The term health maintenance organization means— a Federally qualified health maintenance organization (as defined in section 300e(a) of title 42 of the United States Code), an organization recognized under State law as a health maintenance organization, or a similar organization regulated under State law for solvency in the same manner and to the same extent as such a health maintenance organization. This section shall take effect on the date of the enactment of this Act but shall not apply with respect to conduct that occurs before such date.
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Sec. 303
Leveling the playing field between payers and providers
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