[Congressional Record Volume 142, Number 120 (Thursday, September 5, 1996)]
[Senate]
[Page S9967]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ABRAHAM (for himself and Mr. Levin):
  S. 2055. A bill to waive temporarily the Medicare enrollment 
composition rules for the Wellness Plan; to the Committee on Finance.


                  THE WELLNESS PLAN WAIVER ACT OF 1996

  Mr. ABRAHAM. Mr President, today I rise along with my distinguished 
colleague from Michigan, Senator Levin, to introduce legislation which 
will expand the number of health care choices available to residents of 
Michigan. This bill will provide Medicare beneficiaries in Michigan the 
opportunity to obtain health care from The Wellness Plan, a 
longstanding, federally qualified health maintenance organization. The 
Wellness Plan has been recognized by national leaders, including two 
former Secretaries of the Department of Health and Human Services, as a 
model managed care plan. In addition, the Wellness Plan has made 
significant contributions to improving the health and well-being of its 
enrollees, many of whom are poor women and children, by decreasing 
infant mortality, effectively reducing hypertension, and increasing 
mammography rates.
  The Wellness Plan has been serving the Medicaid population for over 
two decades. It currently has 150,000 enrollees, 141,000 of whom are 
Medicaid, 12,000 commercial and 2,000 Medicare. Since 1993, the 
Wellness Plan has had a health care prepayment plan contract with 
Medicare. However, technical changes enacted by Congress effective 
January 1, 1996, had the unintended effect of preventing 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/Medicaid enrollment composition rule. It must be emphasized 
that the Health Care Financing Administration supports the Wellness 
Plan receiving a plan-specific 50/50 waiver at this time.
  Allowing Medicare beneficiaries to participate in this program 
represents a small, but important step toward fulfilling Congress' 
commitment to improve the quality of this country's health care system. 
Given that the Wellness Plan has an established record with respect to 
both the Medicaid and Medicare programs, and that the Health Care 
Financing Administration supports the Wellness Plan receiving a plan-
specific 50/50 waiver, I urge Congress to move this bill before the end 
of this session so that Michigan Medicare beneficiaries will once again 
have the opportunity to participate in this plan beginning in 1997.
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