Committee hears broad debate over bill to let rural hospitals collaborate and limit antitrust review

The State Senate Health and Human Services Committee held a hearing on House Bill 1393, a measure that would allow rural public hospital authorities to coordinate purchasing, staffing and contract negotiations and would create a limited state-action immunity from antitrust liability for some collaborative arrangements.

Representative Werkhauser (author) said the bill aims to preserve rural hospitals by permitting tightly defined collaboration among rural hospital authorities, restoring authority the legislature intended after courts limited immunity in the Phoebe Putney litigation. He framed the bill as a narrow tool to let small, geographically proximate hospitals share resources and negotiate more effectively with insurers.

Bill Lee, CEO of Evans Memorial Hospital in Claxton, testified that many rural hospitals operate with fewer than 50 beds, thin margins and low negotiating leverage. "We can't recruit talent because we can't pay for it," Lee said, urging the committee to consider collaboration as a way to achieve parity with larger systems and avoid closures.

Legal and industry voices cautioned that the bill as drafted could be broader than its sponsors intend. Josh Belenfani, representing a government-relations client, told the committee the bill's definitions and cross-references could allow larger hospital systems to affiliate with a rural authority and gain antitrust protections by virtue of where a transaction occurs rather than who the parties are. "That opens the door to transactions that would bypass antitrust review," he said.

The Georgia Association of Health Plans and consumer advocates echoed that concern. Jesse Wellington, president and CEO of the Georgia Association of Health Plans, said the measure could reduce competition and increase prices if not tightly limited. Whitney Griggs of Georgians for a Healthy Future warned that past consolidation (the Phoebe Putney case) led to higher costs in affected markets and urged explicit oversight mechanisms, suggesting the Department of Insurance, the Attorney General and the Department of Public Health play oversight roles.

Sponsor and supporters acknowledged the concerns and proposed drafting fixes and guardrails; the author said he wants to preserve the bill’s rural-collaboration goals while tightening language. Committee members asked for follow-up on how federal rural-health transformation grants and directed-payment plans intersect with the bill’s aims and asked parties to return with suggested amendments.

No final action was taken; the hearing was meant for discussion only. The committee adjourned and asked stakeholders to continue working on statutory language and oversight options.