107th Congress

Antitrust Exemptions for Health Care Professionals

Message to Congress As a registered nurse, I am concerned that passage of anti-trust exemptions for physicians and other health care providers will raise the cost of health care and give physicians the legal means to limit the services provided by advance practice nurses. It could erect new barriers to practice for non-physician providers by giving an unprecedented exemption to physicians from antitrust law – without adequate regulatory oversight. I urge you to oppose this anti-competitive legislation.

The Issues Surrounding Anti Trust:

• Legislation may soon be introduced that would exempt physicians and health care professionals from the federal antitrust laws. Last year, physician groups attempted a similar effort, but were not successful.

• The American Nurses Association, along with other associations representing the nursing profession and especially advanced practice nurses, remains strongly opposed to any legislation that would remove antitrust protections and exempt physicians and other health care professionals from the federal antitrust laws.

• The federal antitrust laws serve to protect consumers and providers from anticompetitive behavior. This includes maintaining the ability for nurses, particularly advanced practice nurses, to be viable providers in health plans. In the market for health services, fair competition among professional groups should be encouraged and defended to ensure that the public continues to receive the best health care services at a reasonable price. Advanced practice nurses serve both on medical teams and as independent providers receiving direct reimbursement. In both areas, advanced practice nurses (certified nurse-midwives, certified registered nurse anesthetists, certified nurse practitioners and clinical nurse specialists) need to be free from market place discrimination and as independent contractors to negotiate the best price for their services with different health care entities.

• Over the years, there have been numerous federal antitrust violations by physicians who have acted against nurses to restrict competition. The Federal Trade Commission and Antitrust Division of the Justice Department have entered into a number of consent decrees to stop anticompetitive practices by physicians that have resulted in higher costs for consumers (refer to attachment). Enactment of an antitrust exemption will essentially legalize these illegal practices, giving physicians the ability to negotiate unfair and exclusionary agreements with health plans that make it difficult or impossible for advanced practice nurses to directly provide heath care services.

• Physicians who are employees already have the right to collectively bargain under America's labor laws, just as other employees do. Passing legislation that will weaken antitrust protections by granting physicians a special exemptions from the antitrust laws will only serve to encourage further monopolistic practices by physicians.

• Permitting physicians to collude on prices would increase health care costs. The Congressional Budget Office (CBO) reported in 1999 that exempting physicians from antitrust laws for just three years would reduce tax revenues through higher tax-exempt health insurance premiums, and increase government expenditures for Medicare, Medicaid and other health benefits programs by $6.1 billion over ten years, and would increase health premiums by 1.5 percent by 2003.

Return to U.S. Federal Affairs.

Search	Contact ANA	Join/Renew Membership	Members Only	Online CE
NursingInsiderSpecial Offersnursesbooks.org © 2008 The American Nurses Association, Inc. All Rights Reserved Copyright Policy | Privacy Statement