[Congressional Record Volume 142, Number 133 (Tuesday, September 24, 1996)]
[House]
[Pages H10907-H10909]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   MEDICAID CERTIFICATION ACT OF 1995

  Mr. BILIRAKIS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1791) to amend title XIX of the Social Security Act to make 
certain technical corrections relating to physicians' services, as 
amended.
  The Clerk read as follows:

                               H.R. 1791

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

     SECTION 1. TECHNICAL CORRECTIONS RELATING TO PHYSICIANS' 
                   SERVICES.

       (a) Correcting Reference to Unique Identifier System.--
       (1) In general.--Section 1902(a) of the Social Security Act 
     (42 U.S.C. 1396a(a)) is amended, in the paragraph 
     redesignated as paragraph (59) by section 13623(a)(6) of the 
     Omnibus Budget Reconciliation Act of 1993 and inserted by 
     section 4752(c)(1)(C) of the Omnibus Budget Reconciliation 
     Act of 1990, by striking ``subsection (v)'' and inserting 
     ``subsection (x)''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall be effective as if included in the enactment of the 
     amendments made by section 4752(c)(1) of the Omnibus Budget 
     Reconciliation Act of 1990.
       (b) Correction in Minimum Qualifications for Billing for 
     Physicians' Services to Children and Pregnant Women.--
       (1) In general.--Section 1903(i) of the Social Security Act 
     (42 U.S.C. 1396b(i)) is amended, in the paragraph 
     redesignated as paragraph (12) by section 13631(c)(3) of the 
     Omnibus Budget Reconciliation Act of 1993 and inserted by 
     section 4752(a)(2)(B) of the Omnibus Budget Reconciliation 
     Act of 1990--
       (A) in subparagraph (A)(i), by inserting ``or is certified 
     in family practice or pediatrics by the medical specialty 
     board recognized by the American Osteopathic Association'' 
     before the comma at the end;
       (B) in subparagraph (B)(i), by inserting ``or is certified 
     in family practice or obstetrics by the medical specialty 
     board recognized by the American Osteopathic Association'' 
     before the comma at the end; and
       (C) in each of subparagraphs (A) and (B)--
       (i) by striking ``or'' at the end of clause (v),
       (ii) in clause (vi), by inserting ``(or certified by the 
     State in accordance with policies of the Secretary)'' after 
     ``Secretary'',
       (iii) by redesignating clause (vi) as clause (vii), and
       (iv) by inserting after clause (v) the following new 
     clause:
       ``(vi) delivers such services in the emergency department 
     of a hospital participating

[[Page H10908]]

     in the State plan approved under this title, or''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall apply to physicians' services furnished on or after 
     January 1, 1992.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Florida [Mr. Bilirakis] and the gentleman from New York [Mr. Manton] 
each will control 20 minutes.
  The Chair recognizes the gentleman from Florida [Mr. Bilirakis].
  Mr. BILIRAKIS. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I am pleased that the House is considering H.R. 1791, 
the Medicaid Certification Act of 1995.
  This legislation makes technical corrections to title XIX of the 
Social Security Act relating to payments for physician serves in the 
Medicaid Program.
  In OBRA 1990, due to an unintentional omission, Osteopathic 
Physicians were not included in provisions concerning Medicaid 
reimbursement for services provided to pregnant women and children.
  The legislation before us today corrects this by adding that Medicaid 
may allocate funds for services to pregnant women and children when 
provided by physicians who are certified by the American Osteopathic 
Association.
  This bill also clarifies that services provided in emergency 
departments of a participating hospital will be covered as well.
  Finally, the legislation includes current HCFA practice that any 
physician certified by a State Medicaid plan will be allowed to 
participate in the Medicaid Program.
  Mr. Speaker, this bill has 60 cosponsors and broad bipartisan 
support. I urge my colleagues to support this legislation.
  Mr. Speaker, I thank the minority members of our committee, the 
gentleman from California [Mr. Waxman] and the gentleman from Michigan 
[Mr. Dingell], and, of course, the staffs on both sides for their hard 
work on this legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. MANTON. Mr. Speaker, I yield myself such time as I may consume, 
and I rise in support of H.R. 1791, the Medicaid Certification Act.
  Mr. Speaker, current Medicaid law establishes quality standards for 
physicians providing care for children and pregnant women in the 
Medicaid Program. When we passed that original legislation, we 
specified that physicians certified by the medical specialty board 
recognized by the American Board of Medical Specialties would meet the 
quality standards. But we failed to make specific mention as well of 
the medical specialty board recognized by the American Osteopathic 
Association.
  This legislation corrects that oversight. Clearly it was always the 
view of the committee that board-certified osteopaths are high quality 
providers, and should not be treated any differently than board-
certified allopathic physicians. This simply corrects any 
misunderstanding that may have been implied by our failure to mention 
them in the original legislation.
  I want to stress that in making this change we are in no way relaxing 
or stepping back from the original intention of the legislation to 
assure that quality standards are in effect for these providers of 
Medicaid services to pregnant women and children.
  We expect the Secretary of HHS to implement the original provision 
and this change to it with full attention to the basic purposes for the 
provision.
  I urge support of the legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield 5 minutes to the gentleman from 
Florida, I mean the gentleman from Texas [Mr. Barton], who is the chief 
sponsor--their loss would be our gain--the chief sponsor of this 
legislation. And certainly the American Osteopathic Association picked 
the right person to lead this legislation for them because he certainly 
is a doer.
  (Mr. BARTON of Texas asked and was given permission to revise and 
extend his remarks.)
  Mr. BARTON of Texas. Mr. Speaker, I am sure at one time Texas was 
part of Florida; today, though, we are an independent State of the 
great 50-State Union.
  Mr. Speaker, I do rise in support of H.R. 1791 as the chief sponsor 
in the Committee on Commerce. This legislation is required, quite 
frankly, because of an oversight in 1990 that both the gentleman from 
New York [Mr. Manton] and the gentleman from Florida [Mr. Bilirakis] 
have already referred to. Because of a series of missteps and oversight 
in subsequent Congresses in 1990, we have never been able to rectify 
that original mistake until this point in time.
  There is no opposition to this legislation. The American Medical 
Association supports it, the Clinton administration, the Health Care 
Finance Administration that implements Medicaid and oversees Medicaid 
supports it, the Rural Health Care Caucus supports it. It was reported 
by committee unanimously on a voice vote. The gentleman from Virginia, 
Chairman Bliley, has been very active, as has Chairman Bilirakis in 
subcommittee. The ranking member, the gentleman from Michigan, Mr. 
Dingell, and the gentleman from California, Mr. Waxman, have been very 
supportive. So there is no opposition.
  This rectifies a mistake. Osteopathic physicians are board certified.

                              {time}  1615

  There are 40,000 of them in the Nation. I have the fortune of having 
a cousin, Dr. Neil Gibson, who is an osteopathic physician licensed 
under the State of Texas, educated at the North Texas Health Science 
Center, Fort Worth, TX, in Mr. Pete Geren's district. He is a physician 
in west Texas, in a community where he is the only physician that is 
licensed to practice medicine. Osteopathic physicians conduct over 100 
million patient consultations per year. This legislation will make it 
possible for them to be reimbursed when they are caring for a pregnant 
woman or a child under the age of 21.
  This legislation is long overdue. I am sure and hope that it will 
pass unanimously in the House, and then we will pass it in the Senate, 
so that it rectifies past mistakes. I am pleased to be the chief 
sponsor. I want to thank again all the Members of the House on both 
sides of the aisle that have worked so hard in this Congress to correct 
a mistake, especially Chairman Bilirakis who has been very, very 
supportive.
  I urge unanimous adoption of the legislation.
  Mr. DINGELL. Mr. Speaker, I am pleased the House is considering today 
a bill to correct a legislative oversight regarding eligibility for 
Medicaid reimbursement of board-certified osteopathic physicians. The 
primary purpose of H.R. 1791 is to clarify this eligibility, which has 
been in question since the omnibus budget reconciliation bill was 
passed in 1990. At that time, purely through an oversight, board 
certification by the American Osteopathic Association was omitted from 
the amendments to the Medicaid statute. Unfortunately, because this 
just required a short, simple solution, it has fallen to the bottom of 
the in-box, so to speak, beneath other legislative business that has 
been viewed as more significant. In addition, since making this 
correction required opening the Medicaid statute, it has been a magnet 
for other controversial measures.
  In short, Mr. Speaker, this simple but important technical correction 
has spent an inordinate amount of time caught in the twists and turns 
of the legislative labyrinth. It is time to fix this problem once and 
for all, and I am pleased that my colleague from Virginia, the chairman 
of the Commerce Committee, was willing to include the bill as one of 
the committee's last items of business for the year. This clarification 
has been sought by osteopathic physicians and supported by many Members 
of Congress for a number of years.
  The Medicaid statute requires that physicians be certified for family 
practice or pediatrics by the American Board of Medical Specialties to 
provide care for pregnant women and children in the Medicaid Program. 
Except for a mistake during the drafting of that provision, it also 
would have included certification by a board recognized by the American 
Osteopathic Association. To address this oversight in part, the Health 
Care Financing Administration issued regulations stating that providers 
certified by a State Medicaid program may be reimbursed. However, those 
regulations are necessarily time-limited and thus do not correct the 
problem. Doing this permanently requires amendment of the Medicaid 
statute. This amendment is long overdue, and I support it.
  This bill may seem a small matter, but I know it is very important to 
many osteopathic physicians in my home State of Michigan and

[[Page H10909]]

across the country. It's time to correct the error in OBRA '90, and I 
hope we will pass this bill today and the Senate will complete the 
process quickly so that the legislation can be signed by the President 
soon.
  Mr. MANTON. Mr. Speaker, I yield back the balance of my time.
  Mr. BILIRAKIS. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Gunderson). The question is on the 
motion offered by the gentleman from Florida [Mr. Bilirakis] that the 
House suspend the rules and pass the bill, H.R. 1791, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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