PRINTER'S NO. 2519
No. 1997 Session of 1999
INTRODUCED BY KENNEY AND BELFANTI, OCTOBER 25, 1999
REFERRED TO COMMITTEE ON LABOR RELATIONS, OCTOBER 25, 1999
AN ACT 1 Amending the act of June 1, 1937 (P.L.1168, No.294), entitled 2 "An act to protect the right of employes to organize and 3 bargain collectively; creating the Pennsylvania Labor 4 Relations Board; conferring powers and imposing duties upon 5 the Pennsylvania Labor Relations Board, officers of the State 6 government, and courts; providing for the right of employes 7 to organize and bargain collectively; declaring certain labor 8 practices by employers to be unfair; further providing that 9 representatives of a majority of the employes be the 10 exclusive representatives of all the employes; authorizing 11 the board to conduct hearings and elections, and certify as 12 to representatives of employes for purposes of collective 13 bargaining; empowering the board to prevent any person from 14 engaging in any unfair labor practice, and providing a 15 procedure for such cases, including the issuance of a 16 complaint, the conducting of a hearing, and the making of an 17 order; empowering the board to petition a court of common 18 pleas for the enforcement of its order, and providing a 19 procedure for such cases; providing for the review of an 20 order of the board by a court of common pleas on petition of 21 any person aggrieved by such order, and establishing a 22 procedure for such cases; providing for an appeal from the 23 common pleas court to the Supreme Court; providing the board 24 with investigatory powers, including the power to issue 25 subpoenas and the compelling of obedience to them through 26 application to the proper court; providing for service of 27 papers and process of the board; prescribing certain 28 penalties," further providing for the rights, duties and 29 responsibilities of medical professional employees and health 30 care financing firms. 31 The General Assembly of the Commonwealth of Pennsylvania
1 hereby enacts as follows: 2 Section 1. Section 3(c) and (d) of the act of June 1, 1937 3 (P.L.1168, No.294), known as the Pennsylvania Labor Relations 4 Act, amended June 5, 1947 (P.L.410, No.188), are amended and the 5 section is amended by adding clauses to read: 6 Section 3. Definitions. When used in this act-- 7 * * * 8 (c) The term "employer" includes any person acting, directly 9 or indirectly, in the interest of an employer, but shall not 10 include the United States or the Commonwealth, or any political 11 subdivision thereof, or any municipal authority, or any person 12 subject to the Federal Railway Labor Act or any labor 13 organization (other than when acting as an employer), or anyone 14 acting in the capacity of officer or agent of such labor 15 organization. The term "employer" shall also include a health 16 care financing firm. 17 (d) The term "employe" shall include any employe, and shall 18 not be limited to the employes of a particular employer, unless 19 the act explicitly states otherwise, and shall include any 20 individual whose work has ceased as a consequence of, or in 21 connection with, any current labor dispute, or because of any 22 unfair labor practice, and who has not obtained any other 23 regular and substantially equivalent employment, but shall not 24 include any individual employed as an agricultural laborer, or 25 in the domestic service of any person in the home of such 26 person, or any individual employed by his parent or spouse. The 27 term "employe" shall also include any medical professional 28 employe. 29 * * * 30 (i.1) The term "medical professional employe" means an 19990H1997B2519 - 2 -
1 individual who is licensed, certified or otherwise regulated to 2 provide health care services under the laws of this 3 Commonwealth, including, but not limited to, a physician, 4 dentist, podiatrist, optometrist, pharmacist, psychologist or 5 chiropractor, who receives compensation or reimbursement from a 6 health care financing firm by virtue of a provider contract, 7 participation in a provider network, and a practice which 8 consists of patients who are enrollees of a health care 9 financing firm and such patients constitute fifteen per centum 10 or more of the individual's patient caseload. 11 (i.2) The term "health care financing firm" includes a firm 12 that offers health care insurance or similar coverage for health 13 care services, including, but not limited to, a health insurance 14 plan or a self-funded health benefit plan. For the purposes of 15 this act, a third-party administrator shall be considered a 16 health care financing firm when it interacts with medical 17 professional employes on behalf of a health care financing firm. 18 (i.3) The term "health care services" includes services for 19 the diagnosis, prevention, treatment, cure or relief of a health 20 condition, injury, disease or illness, including, but not 21 limited to, the professional and technical component of 22 professional services, supplies, drugs and biologicals, 23 diagnostic X-ray, laboratory and other diagnostic tests, 24 preventive screening services and tests (e.g. pap smears, 25 mammograms), X-ray, radium and radioactive isotope therapy, 26 surgical dressings, devices for the reduction of fractures, 27 durable medical equipment, braces, trusses and artificial limbs 28 and eyes, dialysis services and facility services. 29 (i.4) The term "health insurance plan" includes an entity, 30 subject to the insurance laws of this Commonwealth or otherwise 19990H1997B2519 - 3 -
1 subject to the jurisdiction of the Insurance Commissioner or the 2 Department of Labor and Industry, which contracts or offers to 3 contract to provide, deliver, arrange for, pay for or reimburse 4 any of the costs of health care services, including, but not 5 limited to, an entity licensed under any of the following: 6 (1) The act of May 17, 1921 (P.L.682, No.284), known as "The 7 Insurance Company Law of 1921," including section 630. 8 (2) The act of December 29, 1972 (P.L.1701, No.364), known 9 as the "Health Maintenance Organization Act." 10 (3) The act of December 14, 1992 (P.L.835, No.134), known as 11 the "Fraternal Benefit Societies Code." 12 (4) 40 Pa.C.S. Ch. 61 (relating to hospital plan 13 corporations). 14 (5) 40 Pa.C.S. Ch. 63 (relating to professional health 15 services plan corporations). 16 (i.5) The term "Insurance Commissioner" means the Insurance 17 Commissioner of the Commonwealth. 18 (i.6) The term "provider contract" includes an agreement 19 between a medical professional employe and a health care 20 financing firm which sets forth the terms and conditions under 21 which the medical professional employe is to deliver health care 22 services to enrollees of health insurance plan or self-funded 23 health benefit plan. 24 (i.7) The term "provider network" includes medical 25 professional employes who have provider contracts with a health 26 care financing firm. 27 (i.8) The term "self-funded health benefit plan" includes a 28 plan that provides for the assumption of the cost of or 29 spreading risk of loss resulting from health care services of 30 the covered lives by any employer, union or other sponsor, 19990H1997B2519 - 4 -
1 substantially out of the current revenues, assets or any other 2 funds of the sponsor. 3 (i.9) The term "third-party administrator" includes an 4 entity that provides utilization review, provider network 5 credentialing, or other administrative services for a health 6 insurance plan or a self-funded health benefit plan. 7 * * * 8 Section 2. Section 6(2) of the act is amended by adding a 9 clause to read: 10 Section 6. Unfair Labor Practices.--* * * 11 (2) It shall be an unfair labor practice for a labor 12 organization, or any officer or officers of a labor 13 organization, or any agent or agents of a labor organization, or 14 any one acting in the interest of a labor organization, or for 15 an employe or for employes acting in concert-- 16 * * * 17 (f) In regard to medical professional employes, to call, 18 institute, maintain or conduct a strike or boycott against any 19 health care financing firm. 20 Section 3. This act shall be applicable when permitted by 21 Federal law as certified by the Department of Labor and 22 Industry, such certification to be published as a notice in the 23 Pennsylvania Bulletin. 24 Section 4. This act shall take effect in 60 days. J18L43RZ/19990H1997B2519 - 5 -