Before recessing for the Independence Day holiday, the U.S. House and Senate took action on differing bills designed to address perceived HMO abuses.

Collective Bargaining: On June 30, 2000, the House of Representatives passed a bill to allow health care professionals engaged in contractual negotiations with HMOs and other health insurers to bargain collectively without running afoul of Federal antitrust statutes. The bill, H.R.1304, passed by a vote of 276 to 136, with 20 of the 31 New York members of the House voting for the bill. Under the bill, "health care professional" is defined as "an individual who provides health care items or services, treatment, assistance with activities of daily living, or medications to patients and who, to the extent required by State or Federal law, possesses specialized training that confers expertise in the provision of such items or services, treatment, assistance, or medications." No action is scheduled in the Senate on H.R.1304.

Patients' Bill of Rights: On June 29, 2000, the Senate passed along party lines a Republican version of a Patients' Bill of Rights. Republican leaders claimed that the bill contained a number of provisions that had been worked out in a bipartisan conference committee charged with reconciling differences between HMO reform legislation passed by the House and Senate earlier in this Congress. Democrats have refused to continue negotiations, arguing that the conference committee was not making sufficient progress. One provision of the legislation that passed the Senate on June 29 has caused great concern for GNYHA. Under the provision, a hospital would be required to notify a health plan with which it does not have a contractual relationship within two hours of stabilizing a health plan enrollee who has presented for emergency care. If the hospital notifies the plan in time and the plan does not respond within two hours, the plan will be obligated to pay for the services provided. On the other hand, if the hospital does not notify within two hours of stabilization, the plan will not be obligated to pay. GNYHA is concerned that the two-hour notification requirement does not give hospitals adequate time to notify a plan, particularly a plan with which the hospital does not interact on a regular basis. In addition, emergency physicians at busy urban or suburban emergency departments cannot spend time on the phone when more and more patients are in need of care. GNYHA is working with the American Hospital Association and the Healthcare Association of New York State on developing alternatives to this provision. No New York members of Congress are assigned to the HMO reform conference committee.