[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2784 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2784

To amend title XVIII of the Social Security Act to limit the ability of 
   physicians to demand more money through private contracts during 
        periods in which the patient is in an exposed condition.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 30, 1997

  Mr. Stark introduced the following bill; which was referred to the 
   Committee on Ways and Means, and in addition to the Committee on 
Commerce, for a period to be subsequently determined by the Speaker, in 
   each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To amend title XVIII of the Social Security Act to limit the ability of 
   physicians to demand more money through private contracts during 
        periods in which the patient is in an exposed condition.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``No Private Contracts To Be 
Negotiated When the Patient Is Buck Naked Act of 1997''.

SEC. 2. FINDINGS.

    Whereas the Kyl amendment on private contracting gives the patient 
and the doctor freedom to negotiate payment rates higher than 
Medicare's payment rates;
    Whereas most normal patients do not particularly want to pay more 
for a service and therefore the Kyl amendment is really an amendment to 
let doctors charge more;
    Whereas ability of doctors to pick when and where to force patients 
to give up their Medicare benefits will create such uncertainty as to 
destroy Medicare as an insurance program that citizens can rely on;
    Whereas, in light of a recent Wall Street Journal article detailing 
how a doctor whose income declined from $400,000 a year to $300,000 a 
year resorted to selling Amway products to his patients to increase his 
income (despite ethical questions about the practice raised by the 
American Medical Association), it is likely that some doctors will do 
anything to make more money and will want to charge more than the 
Medicare fee schedule;
    Whereas the negotiation of a private contract--to be fair--should 
be between two reasonably equal parties; and
    Whereas there are moments in a doctor's office when it is difficult 
for the average patient to feel reasonably equal;
    Therefore it is appropriate to limit the situations in which a 
negotiated private contract may be discussed in order to avoid turning 
the negotiation into an extortion.

 SEC. 3 CERTAIN SITUATIONS WHERE IT IS NOT APPROPRIATE TO NEGOTIATE A 
              PRIVATE CONTRACT

    To promote equality in the negotiation of private contracts, the 
Secretary of the Department of Health and Human Services shall issue 
regulations prohibiting the discussion or signing of private contracts 
at any time--
            (a) the patient is buck naked and the doctor is fully 
        clothed (and conversely, to protect the rights of doctors, when 
        the patient is fully clothed and the doctor is naked);
            (b) the patient is wearing one of those short, flimsy 
        little hospital gowns that don't close in the back;
            (c) during any sigmoidoscopic or proctoscopic examination 
        of the gastrointestinal tract or a digital rectal examination 
        of the prostate;
            (d) during any testicular examination;
            (e) at any time the patient's legs are in a stirrup device;
            (f) at any time the patient is using a bedpan or in the 
        middle of the administration of an enema (or awaiting the 
        outcome of such administration);
            (g) at any time one has been asked to give a urine or stool 
        sample; and
            (h) at any other time that the Secretary determines that a 
        normal human being would find it awkward to negotiate a 
        contract with his or her physician.
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