[Congressional Record Volume 140, Number 86 (Thursday, June 30, 1994)]
[Extensions of Remarks]
[Page E]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: June 30, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
               INTRODUCTION OF THREE RURAL MEDICAL BILLS

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                        HON. BLANCHE M. LAMBERT

                              of arkansas

                    in the house of representatives

                        Thursday, June 30, 1994

  Ms. LAMBERT. Mr. Speaker, I am pleased to take the floor today to 
describe three bills that I have introduced. Two of these bills will go 
a long way toward solving the lack of health care providers in rural 
areas. The other bill will assist countless of sick chronically ill 
children on Medicaid.
  The first bill, the Medicare Rural Physician Payment Equity Act, will 
provide doctors practicing in rural health professional shortage areas 
with incentives to locate in rural areas.
  Mr. Speaker, doctors in my district constantly describe the gross 
underpayment received on Medicare claims and as a result they have a 
difficult time remaining in rural areas such as my district. This bill 
will help solve that problem.
  The Medicare Rural Physician Payment Equity Act, will give doctors 
providing primary care services a 20-percent Medicare bonus payment and 
10 percent bonus for other services. In addition, the bill extends 
these benefits to nonphysician providers.
  Another provision of this legislation will write into law the 
recommendations of the physician payment review commission to update 
Medicare payments 10.7 percent for surgical services, 10.1 percent for 
primary care services, and 7.4 percent for all other services.
  The second bill is entitled ``The Rural Health Care Practitioners 
Revitalization Act of 1994.'' This legislation takes an innovative 
approach toward getting doctors into rural areas.
  First, this legislation provides a variety of tax credits to doctors 
who agree to practice in rural underserved areas. These tax credits 
range from tax-exemptions for interest on student loans, to credits 
given to doctors who agree to practice in rural areas for a specific 
time-frame.
  Second, the bill more than doubles the authorization for the National 
Health Service Corps. Such an increase will allow the program to bring 
even more doctors into rural areas. The bill also has a provision to 
provide more contracts to doctors with rural backgrounds.
  Third, the legislation establishes a State Health Service Corps 
Demonstration Project. Under this project, States will be allowed to 
establish programs to attract and train more doctors for service in 
health professional shortage areas. There is a Federal match for the 
program which is authorized through the year 2001.
  A final provision of the bill provides additional money for the Area 
Health Education Centers [AHECs]. These centers typically provide 
residency training programs for doctors in rural areas. It is widely 
recognized that without an expansion of AHEC assistance it will be 
extremely difficult to attract doctors into rural settings.
  Mr. Speaker, my third bill being introduced today is the Children's 
Health Equity Act of 1994. This bill seeks to provide protection to 
some of the most vulnerable enrollees, children, in the Medicaid 
Program.
  Today more and more States are moving into Medicaid-managed care 
programs. While this may not be bad in and of itself, the drive to 
managed care may leave chronically ill children with little or no 
access to pediatric specialists. Specifically HMO-type plans can 
systematically deny care to very sick children by not having enough or 
any pediatric specialists on contract.

  This bill seeks to protect children with special health care needs by 
requiring States who adopt Medicaid-managed care programs to keep 
chronically ill children enrolled in traditional fee for service 
programs. Most often, traditional Medicaid fee for service plans are 
the only way to provide necessary access to pediatric specialists for 
children with special health care needs.
  Another provision of this legislation requires the Secretary of 
Health and Human Services to develop and report to Congress on the 
viability of using pediatric risk adjustors for managed care plans. 
Risk adjustors, which balance profits between insurers who may be 
denying services rather than containing costs, provide great 
opportunities for intelligent management of the entire managed care 
industry, but we need to know just what concerns need consideration for 
children.
  Mr. Chairman, I believe this bills I have introduced today provide a 
great opportunity for us to improve the health of rural America and to 
better the lives of children. We must ensure that our vulnerable 
populations, specifically rural and children concerns, have access to 
health care. It is my belief that these pieces of legislation will help 
us achieve these goals.

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