[Congressional Record Volume 144, Number 2 (Wednesday, January 28, 1998)]
[House]
[Pages H67-H68]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               MEDICARE PRESERVATION AND RESTORATION ACT

  (Mr. KLECZKA asked and was given permission to address the House for 
1 minute and to revise and extend his remarks.)
  Mr. KLECZKA. Mr. Speaker, today I rise to introduce the Medicare 
Preservation and Restoration Act in response to the concerns of many 
seniors in my district and around the country about the recent changes 
of the Medicare program.
  As my colleagues know, the Balanced Budget Amendment of 1997 contains 
the Kyl amendment, which permits private contracting between doctors 
and Medicare beneficiaries for medical services that otherwise would be 
covered under the Medicare program.
  Know full well that private contracts will increase medical expenses 
for America's seniors and substantially weaken the integrity of the 
program. Beneficiaries who establish private

[[Page H68]]

contracts with physicians are obligated to pay 100 percent of the bill 
out of their own pocket. By circumventing the Medicare system, private 
contracts will create a two-tiered health care system where the elderly 
of modest means are forced to receive second rate care or bankrupt 
themselves to pay high prices under private contracts.
  Repealing the Kyl amendment and placing an outright prohibition on 
any private contracts for services currently covered in the Medicare 
program is the only way to guarantee seniors access to affordable 
medical care now and in the future.
  Mr. Speaker, I urge my colleagues to review this legislation and join 
me in restoring the commitment that Medicare made to senior citizens 
more than 30 years ago.
  The Medicare Preservation and Restoration Act will repeal the 
Medicare private contracting provision of the Balanced Budget Act of 
1997 and clarify that private contracts are prohibited under Medicare 
for Medicare covered services.
  The legislation I am introducing is simple. First, it requires that 
providers submit a Medicare claim whenever Medicare-covered services 
are provided to a beneficiary. Second, it requires that a provider, 
when treating a Medicare beneficiary, charge no more than Medicare's 
balance billing limits allow. My legislation will settle the issue of 
private contracting once and for all. It will explicitly prohibit 
providers from circumventing the Medicare system, it will preserve 
beneficiary billing protections, and it will restore the promise of 
quality and affordable health care for every American senior citizen. 
My legislation has the support and endorsement of the National 
Committee to Preserve Social Security and Medicare and the National 
Council of Senior Citizens. The Medicare Rights Center also has spoken 
out in opposition to Medicare private contracts.
  Mr. Speaker, this legislation is the only way we can continue to 
guarantee every senior citizen in America the right to affordable 
health care under Medicare. The private contracts allowed under the 
Balanced Budget Act represent a dangerous first-step towards 
dismantling the Medicare program as a whole. They are ill-conceived and 
unnecessary. These contracts will allow doctors to disregard Medicare's 
most important protection--balanced billing limits. These limits 
guarantee that all seniors regardless of their income or their health 
status will have access to affordable health care. Private contracts 
destroy these protections and allow doctors the ability to decide 
patient-by-patient which senior will be forced to pay more than 
Medicare's set rates for needed medical care.
  During debate on the budget bill last October, Senator John Kyl of 
Arizona included this private contracting provision to allow any doctor 
to treat Medicare patients outside of the program and bill the patient 
privately at any rate the doctor sets. During negotiations on the final 
package, the provision was altered to protect beneficiaries and to 
prevent physicians from moving back and forth between billing some 
patients privately and others through the Medicare program. The final 
bill stated that if the doctor wanted to treat seniors under private 
contract, then the doctor had to forgo Medicare participation entirely 
for two years.
  This two-year restriction was designed to protect the program against 
fraud, guard against a massive exit of physicians from the Medicare 
program, and ensure that doctors would not create a two-tiered Medicare 
system--one waiting room for private pay patients who are served first, 
and one for non-private Medicare beneficiaries who are served last. 
Now, a movement is underway to remove this two-year limitation and give 
doctors the right to decide not only patient-by-patient, but procedure-
by-procedure, which services will be billed through Medicare and which 
will be billed privately.
  Many of you have probably seen the mailings certain interest groups 
have been sending to our senior constituents in an attempt to distort 
the facts about private contracts. These mailings are falsely scaring 
seniors and attempting to trick seniors into giving up Medicare's 
balanced billing protections.
  These groups are not telling the truth when they say that Medicare 
won't pay for seniors' health care. They are not telling the truth when 
they say that seniors are going to be left with no doctors that will 
treat Medicare beneficiaries. The truth is virtually any doctor 
anywhere in the country today will treat a Medicare beneficiary. 
Currently, fewer than five percent of doctors decline to participate in 
Medicare, and of all the doctors' bills submitted to the Medicare 
program, over 90 percent are paid at a fixed rate set by the program.
  These groups are not telling the truth when they say that if Medicare 
won't pay for a senior's health or medical needs then that senior will 
have to go without treatment. The truth is seniors have always been 
able to purchase medical care that Medicare does not pay for by paying 
for the service out of their own pocket. This has always been the case 
and has not changed.
  These groups are not telling the truth when they say that private 
contracting will increase options for seniors. The truth is the only 
thing that private contracts will increase is seniors' health care 
costs. Unless we repeal this private contract provision and restore 
Medicare balanced billing limits, seniors will be forced to negotiate 
with their doctor on their own for needed medical care. Unless we 
eliminate private contracts, seniors will be forced to pay out of their 
own pockets for medical care at whatever rate the doctor decides to 
charge.
  Let's restore Medicare's balanced billing limits for all Medicare 
beneficiaries by eliminating these dangerous private contracts. These 
billing limits are the only way we can guarantee that all seniors 
receive the health care they need at reasonable and fair prices.
  I urge my colleagues to strip away the rhetoric and conjecture, to 
examine this issue closely and in its entirety. And, I believe you will 
come to the same conclusion that I have that private contracts are 
unnecessary and have the potential to destroy the Medicare program. I 
urge you to cosponsor the Medicare Preservation and Restoration Act--a 
sensible and responsible solution which will guarantee Medicare for all 
elderly Americans.

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