[Congressional Record Volume 140, Number 19 (Monday, February 28, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: February 28, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
       OSTEOPATHIC PHYSICIANS' CERTIFICATION A MUST FOR MEDICAID

                                 ______


                           HON. MIKE KREIDLER

                             of washington

                    in the house of representatives

                       Monday, February 28, 1994

  Mr. KREIDLER. Mr. Speaker, I rise today to introduce a bill which 
amends title XIX of the Social Security Act to continue to permit 
Federal payment under the Medicaid Program for services to children and 
pregnant women performed by physicians certified by medical specialty 
boards recognized by the American Osteopathic Association [AOA]. This 
bill will make a technical correction to the Omnibus Budget 
Reconciliation Act of 1990 [OBRA90] by recognizing AOA certification.
  In an effort to prevent unqualified doctors from providing 
specialized treatment to Medicaid patients, Congress enacted a 
provision of OBRA90 which would require that physicians serving these 
populations be certified in family practice, pediatrics, or obstetrics 
by the medical specialty board recognized by the American Board of 
Medical Specialties [ABMS] for family practice, pediatrics, or 
obstetrics. While the goal of ensuring that the best-qualified 
providers serve these vulnerable Medicaid populations is appropriate, 
the language that passed directly subverts that goal.
  Specifically, the provision fails to recognize as eligible those 
physicians certified by the AOA. In so doing, the provision also fails 
to recognize that there are two types of physicians permitted to 
practice medicine and surgery, and recognized as such by the Federal 
Government and State governments across this Nation: allopathic 
physicians, to whom M.D. degrees are conferred, and osteopathic 
physicians, to whom D.O. degrees are conferred. Further, there are 
respective certifying bodies for each of these professions: the ABMS, 
which certifies physicians who have trained in allopathic post-graduate 
programs, and the AOA, which certifies those physicians who have 
trained in osteopathic post-graduate programs.
  At a time when this Nation is grappling with the need to reform its 
health care system, allowing this legislative omission to proceed, 
unchecked, would create a flagrant conflict with one of the primary 
goals of health care: ensuring quality care to the underserved. For 
more than a century osteopathic physicians have been filling a unique 
and vital niche in the delivery of health care in America. Despite the 
fact that osteopathic physicians constitute only 5.5 percent--about 
35,000 osteopathic physicians--of the Nation's physician-manpower, they 
serve approximately 1 out of every 4 Medicaid recipients in the United 
States. Indeed, the failure to recognize osteopathic certification in 
general/family practice, pediatrics, and obstetrics will deny a quarter 
of this Nation's Medicaid patients the quality health care they deserve 
and know.
  This is why I am introducing this measure, which I strongly urge my 
colleagues to support. It is my hope that this bill will provide a 
significant step toward ensuring that the vital services provided by 
osteopathic physicians remain available to any Medicaid beneficiary 
seeking them, particularly pregnant women and children under the age of 
21.
  The bill follows:

                               H.R. 3906

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

     SECTION 1. PERMITTING FEDERAL PAYMENT UNDER MEDICAID FOR 
                   SERVICES FURNISHED TO CHILDREN OR PREGNANT 
                   WOMEN BY INDIVIDUALS CERTIFIED BY BOARD 
                   RECOGNIZED BY AMERICAN OSTEOPATHIC ASSOCIATION.

       (a) In General.--Section 1903(i)(12) of the Social Security 
     Act (42 U.S.C. 1396b(i)(12)), as redesignated by section 
     13631(c)(3) of the Omnibus Budget Reconciliation Act of 1993, 
     is amended--
       (1) by amending clause (i) of subparagraph (A) to read as 
     follows:
       ``(i) is certified in family practice or pediatrics by the 
     medical specialty board recognized by the American Board of 
     Medical Specialties for family practice or pediatrics or is 
     certified in general practice or pediatrics by the medical 
     specialty board recognized by the American Osteopathic 
     Association,''; and
       (2) by amending clause (i) of subparagraph (B) to read as 
     follows:
       ``(i) is certified in family practice or obstetrics by the 
     medical specialty board recognized by the American Board of 
     Medical Specialties for family practice or obstetrics or is 
     certified in general practice or obstetrics by the Medical 
     Specialty Board recognized by the American Osteopathic 
     Association,''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect as if included in the enactment of the 
     Omnibus Budget Reconciliation Act of 1990.

                          ____________________