Despite opposition from the governor and corporate hospitals, measures for medical workers are progressing


Camalot Todd, Nevada now
May 18, 2023

A bill proposed by the Patient Protection Board is about to pass Congress despite opposition from the governor’s office.

This bill, Congressional Bill 11, prohibits corporate hospitals and hospital systems from directly employing physicians. Nevada hospitals have long refrained from hiring doctors directly, opting instead to hire them as independent contractors. The bill formally enacts that practice.

The bill also prohibits hospitals from restricting nurses and other health care providers they employ or contract from discussing salaries, wages, and working conditions with others. The bill also prohibits hospitals from imposing non-compete agreements that prevent them from working with other medical facilities.

“While not all hospitals have enough doctors to hire, there is significant progress toward integration across hospitals and the healthcare industry to make hospitals and healthcare systems easier to operate, not just in Nevada, but across the country. There is a move “to increase market share,” said Bovet Bond, policy director at the Culinary Health Fund, at an earlier meeting on the bill.

Four companies—HCA, UHS, Renown, and Common Spirit—own most of Nevada’s acute care hospitals and generate more than 70 percent of hospital revenues and profits in the state, according to a bill presentation. But according to the Centers for Medicare and Medicaid Services, Nevada ranks first in the nation for the highest percentage of poorly rated acute care hospitals (those with 1 out of 5 stars). .

Across the United States, hospital and healthcare system ownership is becoming increasingly consolidated, resulting in higher costs for patients and lower remuneration for providers, according to the Health Care Pricing Project.

AB 11 is one of three bills introduced to Congress this week by the Patient Protection Board and endorsed by Democratic Gov. Steve Sisolak in 2019. At the beginning of this Congress, Republican Governor Joe Lombardo’s chief of staff wrote a letter. to the Commission to voice the Office of the Governor’s opposition to AB 11 and another bill they introduced.

However, AB 11 underwent a committee hearing last month and passed parliament as a whole by a vote of 26 to 16. Democrats Shea Backus and Shannon Billbrae-Axelrod joined the Republican opposition. The bill passed the Senate Health and Human Services Committee on Tuesday.

Hospitals that violate the bill’s provisions could be subject to administrative penalties, and repeated offenses could have their licenses revoked or suspended.

The bill also directs the Joint Interim Commission on Health and Welfare to investigate the employment of doctors by businesses during the 2023-2024 interim period and to issue one additional draft bill to address the findings of the Commission’s findings. required to be assigned to

The Nevada Hospital Association opposes AB 11, arguing it will keep the state on the back foot from national trends. In 2020, nearly 40% of doctors worked directly in hospitals or in clinics partially owned by hospitals or the health system, according to a report from the American Medical Association.

“There is a huge shortage of specialists in Nevada, and many doctors today are having a hard time opening up and paying rent, staffing issues, and malpractice issues,” state Senator Jeff said. Mr. Stone (Republican, Henderson) said: At a Senate committee hearing. “For many of them it is easier to work in an organization like a hospital.

Proponents of this measure would like to state that the law would affirm current practice in the state, would allow graduate medical education programs in the state to employ physicians, and would allow all hospitals where physicians have privileges or contracts claims to ensure that patients receive treatment at



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