[Congressional Record Volume 142, Number 117 (Friday, August 2, 1996)]
[Extensions of Remarks]
[Page E1502]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           MEDICARE WAIVER FOR THE WELLNESS PLAN OF MICHIGAN

                                 ______
                                 

                           HON. JOHN DINGELL

                              of michigan

                    in the house of representatives

                         Friday, August 2, 1996

  Mr. DINGELL. Mr. Speaker, today, I am joining with a number of my 
colleagues in introducing legislation to help the Medicare population 
in Michigan. This bill will make it possible for a longstanding, 
quality federally qualified health maintenance organization [HMO] that 
primarily has served the Medicaid population, to become available to 
Medicare beneficiaries. The Wellness Plan is a not-for-profit 501(c)(3) 
federally qualified HMO serving several counties in Michigan, including 
the Detroit MSA. The Wellness Plan currently has 150,000 enrollees, 
141,000 of whom are Medicaid, 12,000 commercial and 2,000 Medicare.
  The Wellness Plan is a nationally recognized leader in providing 
quality health services to this population. Since 1993, The Wellness 
Plan has had a Health Care Prepayment Plan [HCPP] contract with 
Medicare. Technical changes enacted by Congress and effective January 
1, 1996, unintentionally prevent the Wellness Plan from enrolling 
additional Medicare beneficiaries under the HCPP contract.
  The Wellness Plan is positioned to become a full Medicare risk 
contractor but currently is precluded from doing so due to the 50-50 
Medicare enrollment composition rule. Given that the Wellness Plan has 
an established managed care record with respect to both the Medicaid 
and Medicare populations, and that the Health Care Financing 
Administration supports The Wellness Plan receiving a plan-specific 5-
050 waiver at this time, this bill should be moved through the Congress 
as soon as practically possible.

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