[Congressional Record Volume 143, Number 155 (Friday, November 7, 1997)]
[Extensions of Remarks]
[Page E2216]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         INTRODUCTION OF THE MEDICARE VENIPUNCTURE FAIRNESS ACT

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                         HON. NICK J. RAHALL II

                            of west virginia

                    in the house of representatives

                        Friday, November 7, 1997

  Mr. RAHALL. Mr. Speaker, I rise today to introduce a bill titled the 
Medicare Venipuncture Fairness Act of 1997, to reinstate payment under 
Medicare for home health services consisting of venipuncture based 
solely on blood monitoring, and to require the Secretary of Health and 
Human Services to study the appropriate use of venipuncture under the 
Medicare Program. This essential Medicare home health benefit was 
denied in the recently passed Balanced Budget Act, and will affect 
literally thousands of vulnerable Medicare beneficiaries.
  Over the past 3 weeks, I have received more than 234 letters from 
concerned Medicare patients, or their family members and caregivers in 
my District expressing their grave concern over the devastating impact 
this provision will have on seriously ill and disabled seniors.
  As I introduce this legislation today, I am pleased to be joined in 
sponsoring the bill by my friends and distinguished colleagues, 
Representatives Poshard, Mollohan, Clayton, Kilpatrick, McIntyre, 
Frost, Costello, Clement, Baesler, Aderholt, Boucher, and Cramer.
  Of the 38 million Medicare recipients in the United States, we know 
that approximately 4 million receive some type of home health benefit--
this is the only number HCFA has available. Speaking of HCFA--the 
Health Care Financing Administration, it is useful and telling to note 
that while the agency claims the venipuncture prohibition was put into 
law to fight fraud and abuse in the Medicare home health benefit, there 
are no studies or reports that exist, either from HCFA, the HHS 
Inspector General or the General Accounting Office [GAO], linking blood 
monitoring in home care to fraud, waste, or abuse. Removing blood 
monitoring as a qualifying service for the Medicare home health benefit 
was a vast overreaction--indeed it was a solution in search of a 
problem in my view.
  Mr. Speaker, if we start down that slippery slope of denying or 
withdrawing services because some unscrupulous provider decides to 
defraud or abuse the system, we will have to terminate nearly every 
federally supported benefit program that exists today.
  Another important point to remember is that the need for blood 
monitoring does not automatically result in eligibility for home health 
care. An individual must meet all of the very detailed and specific 
eligibility requirements for home health care and services must be 
prescribed by a physician. Currently, nearly 1 million home health 
beneficiaries need blood monitoring.
  In rural communities where nearly 38 percent of residents are 
unserved by public transportation, Medicare beneficiaries who need 
blood monitoring will face special problems. In these areas, travel by 
the elderly, sick or disabled seniors is nearly impossible. Ambulance 
services would cost as much as $250 a trip--much, much more costly than 
paying for blood monitoring at home. Moreover, if these beneficiaries 
cannot get proper blood monitoring services, they will end up in 
institutions like hospitals or nursing homes at a much higher cost to 
Medicare.
  One of the senior citizens from my congressional district who wrote 
to me says that he suffers from Black Lung disease, is confined to a 
wheelchair on 24-hour oxygen, and suffers from heart problems for which 
he takes medication plus blood thinners. How vulnerable can you get? 
How can this man or his caregiver get to a doctor's office or a 
laboratory for timely and medically necessary blood monitoring?
  My colleagues, it is one thing to penalize unscrupulous providers by 
cutting off reimbursement under Medicare, but to penalize the sick, 
disabled elderly who have not committed fraud or abused the system is 
quite another. The 234 Medicare beneficiaries in my district who have 
contacted me concerning this loss in their benefit, are confused and 
afraid--confused because they've done nothing wrong, afraid because 
they can't get to an outside facility, physician, or laboratory to get 
blood samples taken. They do not know what will happen to them, the 
stability of their health, or their peace of mind. They believe their 
ability to remain in their own homes, as opposed to a hospital or 
nursing home, hangs in the balance.
  In the name of fairness, I urge my colleagues to cosponsor the 
Medicare Venipuncture Fairness Act so that we can rectify this 
injustice to Medicare beneficiaries. The legislation not only repeals 
the provision in the BBA that denies home health services based solely 
on blood monitoring, but mandates a study to look at past abuses in the 
benefit and to recommend standards for the appropriate use of 
venipuncture services.
  Time is of the essence. I call upon my colleagues to join with me 
quickly so that we can defeat this proposal before it becomes effective 
on February 5, 1998, leaving thousands of needy Americans without a 
vital health care benefit.
  If you wish to cosponsor, please call me or Mrs. Kyle on my staff at 
X53452.

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