The Council of the District of Columbia and Mayor Anthony Williams gave an overwhelming thumbs up in June to a bill that would allow self-employed physicians to negotiate their contracts as a group with managed care plans.

"This is truly a historic and positive outcome of the work done by an effective coalition," Eliot Sorel, M.D., president of the Washington Psychiatric Society (WPS), told Psychiatric News. "The WPS, the Medical Society of D.C., and the American Medical Association acted in the best interests of their patients and colleagues, and the community. Physicians and patients, not third-party payers, should determine the course of treatment."

Sorel emphasized the importance of collaborating with patient advocacy groups. "We listened to the advice given by the D.C. and National Alliance on Mental Illness."

Before it can become law, the bill must be approved by the U.S. Senate and the Financial Responsibility and Management Assistance Authority. The House of Representatives approved the bill last month.

"The war is not over yet," he noted. "But we anticipate that the D.C. delegate will support the bill in Congress." The District of Columbia is represented in Congress only by a nonvoting delegate.

The legislation allows physicians licensed to practice in the District of Columbia to negotiate with health plans on contract terms that are critical to delivering quality medical care. These include clinical practice, guidelines, and coverage criteria; patient-referral procedures; quality assurance programs; and utilization review procedures, according to a press release from the Medical Society of D.C.

Doctors are prohibited under the bill from striking or boycotting. In addition, doctors can negotiate these terms with health plans as long as they represent different specialties and 30 percent or less of the physicians in a health-plan service area, according to the press release.

The bill is modeled on Texas legislation that was enacted last June. A similar bill at the federal level was introduced in Congress by Representative Tom Campbell (R-Calif.) last year. It has yet to be passed by the House or Senate.