[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[S. 493 Introduced in Senate (IS)]
103d CONGRESS
1st Session
S. 493
To amend the Public Health Service Act to facilitate the entering into
of cooperative agreements between hospitals for the purpose of enabling
such hospitals to share expensive medical or high technology equipment
or services, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 3, 1993
Mr. Cohen (for himself, Mr. Bond, Mr. Chafee, Mr. Simpson, Mr. Cochran,
Mr. Bingaman, Mr. Craig, Mr. Mack, Mr. McCain, Mr. Gorton, Mr.
Kempthorne, Mr. Burns, Mr. Domenici, Mr. Warner, Mr. Stevens, Mr.
Brown, Mr. Gregg, and Mr. Coats) introduced the following bill; which
was read twice and referred to the Committee on Labor and Human
Resources
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to facilitate the entering into
of cooperative agreements between hospitals for the purpose of enabling
such hospitals to share expensive medical or high technology equipment
or services, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Hospital Cooperative Agreement
Act''.
SEC. 2. PURPOSE.
It is the purpose of this Act to encourage cooperation between
hospitals in order to contain costs and achieve a more efficient health
care delivery system through the elimination of unnecessary duplication
and proliferation of expensive medical or high technology services or
equipment.
SEC. 3. HOSPITAL TECHNOLOGY AND SERVICES SHARING DEMONSTRATION PROGRAM.
Part D of title VI of the Public Health Service Act (42 U.S.C. 291k
et seq.) is amended by adding at the end thereof the following new
section:
``SEC. 647. HOSPITAL TECHNOLOGY AND SERVICES SHARING DEMONSTRATION
PROGRAM.
``(a) Establishment.--The Secretary shall establish a demonstration
program under which the Secretary shall award not to exceed 10 grants
to eligible applicants to facilitate collaboration among two or more
hospitals with respect to the provision of expensive, capital-embodied
medical technology or other highly resource-intensive services. Such
program shall be designed to demonstrate the extent to which such
agreements result in a reduction in costs, an increase in access to
care, and improvements in the quality of care with respect to the
hospitals involved.
``(b) Eligible Applicants.--
``(1) In general.--To be eligible to receive a grant under
subsection (a), an entity shall be a hospital and shall prepare
and submit to the Secretary an application at such time, in
such manner, and containing such information as the Secretary
may require, including--
``(A) a statement that such hospital desires to
negotiate and enter into a voluntary cooperative
agreement with at least one other hospital operating in
the State or region of the applicant hospital for the
sharing of medical technology or services;
``(B) a description of the nature and scope of the
activities contemplated under the cooperative agreement
and any consideration that may pass under such
agreement to any other hospital that may elect to
become a party to the agreement; and
``(C) any other information determined appropriate
by the Secretary.
``(2) Development of evaluation guidelines.--The
Administrator of the Agency for Health Care Policy and Research
shall develop evaluation guidelines with respect to
applications submitted under paragraph (1).
``(3) Evaluations of applications.--The Secretary, in
consultation with the Administrator of the Agency for Health
Care Policy and Research, shall evaluate applications submitted
under paragraph (1). In determining which applications to
approve for purposes of awarding grants under subsection (a),
the Secretary shall consider whether the cooperative agreement
described in each such application meets guidelines developed
under paragraph (2) and is likely to result in--
``(A) the enhancement of the quality of hospital or
hospital-related care;
``(B) the preservation of hospital facilities in
geographical proximity to the communities traditionally
served by such facilities;
``(C) improvements in the cost-effectiveness of
high-technology services by the hospitals involved;
``(D) improvements in the efficient utilization of
hospital resources and capital equipment; or
``(E) the avoidance of duplication of hospital
resources.
``(c) Use of Amounts.--
``(1) In general.--Amounts provided under a grant awarded
under this section shall be used only to facilitate
collaboration among hospitals and may not be used to purchase
facilities or capital equipment. Such permissible uses may
include reimbursements for the expenses associated with
specialized personnel, administrative services, support
services, and instructional programs.
``(2) Care in rural areas.--
``(A) In general.--Not less than three of the
grants awarded under subsection (a), shall be used to
demonstrate the manner in which cooperative agreements
of the type described in such subsection may be used to
increase access to or quality of care in rural areas.
``(B) Definition.--As used in subparagraph (A), the
term `rural areas' means those areas located outside of
metropolitan statistical areas.
``(d) Medical Technology and Services.--
``(1) In general.--Cooperative agreements facilitated under
this section shall provide for the sharing of medical or high
technology equipment or services among the hospitals which are
parties to such agreements.
``(2) Medical technology.--For purposes of this section,
the term `medical technology' shall include the drugs, devices,
and medical and surgical procedures utilized in medical care,
and the organizational and support systems within which such
care is provided.
``(3) Eligible services.--With respect to services that may
be shared under an agreement entered into under this section,
such services shall--
``(A) either have high capital costs or extremely
high annual operating costs; and
``(B) be services with respect to which there is a
reasonable expectation that shared ownership will avoid
a significant degree of the potential excess capacity
of such services in the community or region to be
served under such agreement.
Such services may include mobile clinic services.
``(e) Term.--The demonstration program established under this
section shall continue for a term of 5 years.
``(f) Report.--On the date that occurs 5 years after the
establishment of the demonstration program under this section, the
Secretary shall prepare and submit to the appropriate committees of
Congress, a report concerning the potential for cooperative agreements
of the type entered into under this section to--
``(1) contain health care costs;
``(2) increase the access of individuals to medical
services; and
``(3) improve the quality of health care.
Such report shall also contain the recommendations of the Secretary
with respect to future programs to facilitate cooperative agreements.
``(g) Relation to Other Laws.--
``(1) In general.--Notwithstanding any provision of the
antitrust laws, it shall not be considered a violation of the
antitrust laws for a hospital to enter into, and carry out
activities under, a cooperative agreement in accordance with
this section.
``(2) Definition.--For purposes of this subsection, the
term `antitrust laws' means--
``(A) the Act entitled ``An Act to protect trade
and commerce against unlawful restraints and
monopolies'', approved July 2, 1890, commonly known as
the ``Sherman Act'' (26 Stat. 209; chapter 647; 15
U.S.C. 1 et seq.);
``(B) the Federal Trade Commission Act, approved
September 26, 1914 (38 Stat. 717; chapter 311; 15
U.S.C. 41 et seq.);
``(C) the Act entitled ``An Act to supplement
existing laws against unlawful restraints and
monopolies, and for other purposes'', approved October
15, 1914, commonly known as the ``Clayton Act'' (38
Stat. 730; chapter 323; 15 U.S.C. 12 et seq.; 18 U.S.C.
402, 660, 3285, 3691; 29 U.S.C. 52, 53); and
``(D) any State antitrust laws that would prohibit
the activities described in paragraph (1).
``(h) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of the fiscal years 1994 through 1998.''.
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