[Congressional Record Volume 142, Number 138 (Monday, September 30, 1996)]
[Extensions of Remarks]
[Pages E1874-E1875]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




      SUPPORT OF H.R. 4012--MEDICARE WAIVER FOR THE WELLNESS PLAN

                                 ______
                                 

                            HON. FRED UPTON

                              of michigan

                    in the house of representatives

                       Monday, September 30, 1996

  Mr. UPTON. Mr. Speaker, I rise today to comment on legislation I 
introduced earlier this year to temporarily waive the Medicare 
enrollment composition rules for the Wellness Plan in Michigan. The 
bill enjoys bipartisan support in the House and Senate and passed the 
Commerce Committee on September 18 by a unanimous vote.
  H.R. 4012 would allow the Wellness Plan a waiver from the so-called 
50-50 rule, which requires that any plan which serves as a Medicare HMO 
have at least 50 percent of its enrollees as non-Medicare and non-
Medicaid recipients. The Wellness Plan is a Michigan-based 501(c)(3) 
federally qualified HMO which serves a predominately Medicaid-based 
population.
  This plan had begun to serve the Medicare population under a health 
care prepayment plan. However, HCPP contracts were effectively frozen 
as of January 1, 1996, as a result of changes made under the Social 
Security and Technical Corrections Act of 1994 which subjects HCPP 
contractors to MediGap laws. Because of this, the Wellness Plan has 
been unable to enroll any more Medicare beneficiaries.
  This plan has been recognized by two Secretaries of HHS and by 
Presidents Bush and Clinton. It serves a substantial portion of the 
Medicaid population in southeast Michigan and has been doing so for 
almost 25 years. It is financially sound and has an unblemished

[[Page E1875]]

record of providing health care to this population.
  Although the bill had passed the major committee of jurisdiction and 
enjoyed bipartisan support in the Senate, it became a victim of time 
constraints and was not able to be scheduled for a vote in the House 
before Congress adjourned for the year. Nonetheless, we made important 
progress this year and I believe we are in solid position to pass this 
bill early next year when Congress reconvenes for the 105th Congress. I 
look forward to working with my colleagues on the committee and the 
House leadership to achieve this goal.

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