Legislature(1999 - 2000)

04/18/2000 05:45 PM Senate RLS

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
       SB 256-PHYSICIAN NEGOTIATIONS WITH HEALTH INSURER                                                                        
                                                                                                                                
CHAIRMAN KELLY announced that two proposed amendments are before                                                                
the committee; one sponsored by Senator Pete Kelly and the other by                                                             
the Department of Law (DOL).                                                                                                    
                                                                                                                                
SENATOR MILLER moved to adopt the amendment proposed by Senator                                                                 
Pete Kelly.  That amendment reads as follows.                                                                                   
                                                                                                                                
                        A M E N D M E N T                                                                                       
                                                                                                                                
OFFERED IN THE SENATE                       BY SENATOR PETE KELLY                                                               
     TO:  CSSB 256(FIN)                                                                                                         
                                                                                                                                
  Page 4, lines 10 - 11:                                                                                                        
     Delete ", or a particular physician type or specialty"                                                                     
  Page 4, line 15:                                                                                                              
     Delete "and"                                                                                                               
     Insert a new paragraph to read:                                                                                            
               "(7)  the attorney general may limit the percentage                                                              
     of practicing physicians represented by an authorized third                                                                
     party; however, the limitation may not be less than 30 percent                                                             
     of the market of practicing physicians in the geographic                                                                   
     service area or proposed geographic service area; when                                                                     
     determining whether to impose a limitation described under                                                                 
     this paragraph, the attorney general shall consider the                                                                    
     provisions described under (h), (i), and (j) of this section;                                                              
     this paragraph does not apply if the market of practicing                                                                  
     physicians in the geographic service area or proposed                                                                      
     geographic service area consists of 40 or fewer individuals;                                                               
     and"                                                                                                                       
                                                                                                                                
  Renumber the following paragraph accordingly.                                                                                 
                                                                                                                                
SENATOR ELLIS objected to the adoption of the amendment.                                                                        
                                                                                                                                
CHAIRMAN KELLY noted that unless the DOL amendment to Senator                                                                   
Kelly's amendment is offered at this time, the vote will only                                                                   
pertain to Senator Kelly's amendment.                                                                                           
                                                                                                                                
SENATOR ELLIS moved to adopt the DOL amendment which reads as                                                                   
follows.                                                                                                                        
                                                                                                                                
                  A M E N D M E N T - VERSION 2                                                                                 
                                                                                                                                
OFFERED IN THE SENATE                        BY DEPARTMENT OF LAW                                                               
     TO:  CSSB 256(FIN)                                                                                                         
                                                                                                                                
  [Page 4, lines 10-11:                                                                                                         
     Delete ", or a particular physician type or specialty"]                                                                    
                                                                                                                                
  Page 4, line 15:                                                                                                              
     Delete "and"                                                                                                               
     Insert a new paragraph to read:                                                                                            
          "(7)  the attorney general may limit the percentage of                                                                
          practicing physicians or a particular physician type or                                                               
          specialty represented by an authorized third party;                                                                   
          [however, the limitation may not be less than 30 percent                                                              
          of the market of practicing physicians in the geographic                                                              
          service area or proposed geographic service area;] when                                                               
          determining whether to impose a limitation described                                                                  
          under this paragraph, the attorney general shall consider                                                             
          the provisions described under (h), [(i), and (j)] of                                                                 
          this section;  [this paragraph does not apply if the                                                                  
          market of practicing physicians in the geographic service                                                             
          area or proposed geographic service area consists of 40                                                               
          or fewer individuals;] and"                                                                                           
                                                                                                                                
  Renumber the following paragraph accordingly."                                                                                
                                                                                                                                
SENATOR MILLER objected to the adoption of DOL's amendment.                                                                     
                                                                                                                                
SENATOR PEARCE asked for an explanation of the amendment.                                                                       
                                                                                                                                
SENATOR PETE KELLY, sponsor of SB 256, explained that the problem                                                               
with DOL's amendment is that it essentially guts the bill.  It                                                                  
turns policy decisions over to DOL.  The wording of the amendment                                                               
will allow DOL to declare that no one is eligible to participate in                                                             
the negotiations.  DOL's amendment gives DOL way too much authority                                                             
over the negotiations.                                                                                                          
                                                                                                                                
MS. JULIA COSTER, Assistant Attorney General, Department of Law,                                                                
responded that the first part of DOL's amendment actually returns                                                               
the bill to what it was originally.  On page 4, subsection (6), the                                                             
bill originally allowed the number of physicians to be limited to                                                               
30 percent, both in the general and specialty markets.  The second                                                              
part of the DOL amendment allows the physician group to be limited                                                              
not only on the entire market but also with the specialty market                                                                
which was in subsection (6) also.  She thought that Senator Pete                                                                
Kelly was referring to the deletion of the limit in DOL's                                                                       
amendment. She did not agree that it guts the bill; it allows the                                                               
Attorney General to have the percentage of physicians be less than                                                              
30 percent if it meets the criteria under subsection (h), which                                                                 
means the Attorney General would determine whether or not the anti-                                                             
competitive effects of a larger group of people outweigh the                                                                    
benefit.  It would allow the Attorney General to engage in a                                                                    
balancing test.  That same provision is required under the Texas                                                                
legislation.                                                                                                                    
                                                                                                                                
Number 357                                                                                                                      
                                                                                                                                
SENATOR PETE KELLY asked that Mike Ford, the legal drafter of SB
256, address DOL's amendment.  He noted that Mr. Ford provided                                                                  
committee members with his analysis of DOL's objections to the                                                                  
bill.                                                                                                                           
                                                                                                                                
MR. MIKE FORD, Division of Legal Services, Legislative Affairs                                                                  
Agency, stated that after reading DOL's amendment, he cannot see                                                                
how one can maintain that it does not allow the Attorney General to                                                             
go to a zero percentage.  It does not set up a mechanism that would                                                             
limit the Attorney General's authority.  It removes the bottom cap                                                              
that prevents the limitation from being less than 30 percent.  He                                                               
agreed that it leaves in the consideration of subsection (h) but                                                                
that does not preclude the Attorney General from determining that                                                               
a percentage may be one or two percent.                                                                                         
                                                                                                                                
SENATOR MILLER continued to object to DOL's amendment.  The motion                                                              
to adopt DOL's amendment failed with Senators Leman, Miller and                                                                 
Pearce voting "nay," and Senators Ellis and Kelly voting "yea."                                                                 
                                                                                                                                
SENATOR LEMAN moved to adopt Senator Pete Kelly's amendment.  There                                                             
being no objection, the motion carried.                                                                                         
                                                                                                                                
SENATOR LEMAN moved to calendar all Senate versions of SB 276 at                                                                
the Chairman's discretion.  SENATOR ELLIS objected.                                                                             
                                                                                                                                
The motion to calendar all versions of SB 276 carried with Senators                                                             
Miller, Pearce, Leman and Kelly voting "yea," and Senator Ellis                                                                 
voting "nay."                                                                                                                   

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