A coalition of 11 physicians in rural east Texas became the first to receive state approval for a special antitrust exemption that permits collective negotiations with health plans.
Jubilant officials with the Texas Medical Association, which worked for years to win passage of the statute, said they believe the decision will trigger requests across the state for similar exemptions and help foster renewed efforts for similar laws across the U.S.
"This will get the attention of health plans," said Michael Cushman, director of the association's department of healthcare delivery.
Yet, the landmark decision by state Attorney General John Cornyn became something of a hollow victory when Blue Cross and Blue Shield of Texas immediately said it would not bargain collectively with the doctors in Henderson, a rural outpost of about 12,000 people 100 miles east of Dallas.
"We are certainly willing to continue negotiations with the physicians," the state's largest, not-for-profit health insurer said in a written statement. "However, we have declined to participate in the collective-bargaining negotiation process with the Henderson physician group."
Ken Ortolon, a spokesman for the medical association, said his group was "disappointed" by the Blues' decision. Despite the health plan's unwillingness to bargain collectively, Ortolon said, the law will provide the 11 doctors, all of whom are now in at least one Blues network, with some additional freedom to communicate about contract terms.
The plan serves more than 2.7 million customers in all 254 counties in Texas. It is the largest private insurer in Rusk County.
The attorney general's decision was the first of its kind since the 1999 passage of a state law providing an antitrust exemption for competing doctors who want to negotiate with health plans.