[Congressional Record Volume 140, Number 1 (Tuesday, January 25, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: January 25, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                             SENIORS BEWARE

                                 ______


                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                            January 25, 1994

  Mr. STARK. Mr. Speaker, throughout the land, the push is on to get 
people to sign up in managed care health plans.
  In many cases, that is a good and healthy movement that can improve 
service and save money. In other cases, it is greedy marketing that is 
the equivalent of malpractice and fraud. Of particular concern is the 
marketing being done to the Nation's disabled and elderly.
  The enclosed letter from a community health clinic in Berkeley 
describes the kind of problem that can occur and why we need to do more 
to educate and protect the elderly and disabled.


                                     Over Sixty Health Center,

                                   Berkeley, CA, November 2, 1993.
     Health Plans,
     Claims Division,
     San Francisco, CA
     Re: Mary Smith.
       To Whom It May Concern: Today, I had the unfortunate duty 
     of informing the above patient that she could no longer come 
     to us for Medical services. As a member of Over 60 since 
     1992, she was unaware that she had signed her Medicare 
     benefits over to you and had to see a physician over 10 miles 
     away in Orinda, California. She remembered signing up for 
     your coverage but was totally oblivious to the implications 
     of its restrictions. She had never heard of an Orinda 
     Physician Dr. ------ which your records show as her primary 
     provider. I asked your telephone representative why a senior 
     female who has had two hip replacements surgeries, who does 
     not drive and who lives so far away would select a doctor in 
     Orinda, CA? Her reply was ``That's the doctor she selected 
     and I can't do anything about it.''
       Mrs. Smith was admitted to Alta Bates Hospital in August, 
     1993. Since she believed that your insurance was Medi-Gap 
     coverage, she continued to see and be followed by Physicians 
     from our office. Attached are our claims for the services 
     provided to your member.
                                                    ------ ------,
     Billing Systems Manager.

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