[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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