[Congressional Record Volume 144, Number 10 (Wednesday, February 11, 1998)]
[House]
[Page H409]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       IN SUPPORT OF MEDICARE VENIPUNCTURE SENIORS PROTECTION ACT

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Alabama (Mr. Aderholt) is recognized for 5 minutes.
  Mr. ADERHOLT. Mr. Speaker, first let me say that I would like to 
commend my colleague, the gentleman from West Virginia (Mr. Rahall), 
for his leadership on the issue of Medicare coverage for venipuncture.
  Since Christmas, I have received hundreds of letters and numerous 
phone calls at both my home and office on home care and the health of 
our elderly. Most of these people calling and writing are scared. They 
are afraid for themselves and for their loved ones. Why are they 
afraid? Because the recently passed Balanced Budget Act will change 
their lives in a way that could be devastating.
  This change in coverage under Medicare for a service known as 
venipuncture or, more simply, the drawing of blood, was made without 
even a score from the Congressional Budget Office. No hearings were 
held; no specific clinical examples were used. We are being told that 
this will not have a strong impact on the lives of those who receive 
this service because they can qualify in some other way for 
venipuncture services.
  But what if they cannot? What if even a handful cannot get the 
services they need anymore? People could die. People could actually die 
if we are not sure about the impact of this change which became 
effective last week. In the court system in this country the jury must 
have evidence that can leave no reasonable doubt of guilt to make a 
decision. How can we sentence our seniors to this harsh change if we do 
not have assurance that they will be protected from harm?
  For this reason I have introduced H.R. 3137, the Medicare 
Venipuncture Seniors Protection Act, which will delay the 
implementation of this legislation for 18 months, giving us more time 
to study the impact of this change in coverage on our elderly and 
frail. This bill will also request specific information from Health and 
Human Services on the hardships of those in rural areas and what they 
will endure due to the effect of this new law.
  I fear that those who recommended this change were thinking more of 
places like New York City than rural parts of Alabama, West Virginia 
and Texas, where people may not be physically able to get to a doctor's 
office or to have their blood drawn. This small 29-word provision that 
was inserted into the Balanced Budget Act rather hastily did not take 
into account the situation of States like Tennessee, for instance, 
where under their State law lab technicians by law cannot leave the 
health care facility, leaving any home-bound person truly in need of 
venipuncture with very limited options.
  We are all in favor of cutting out waste, fraud and abuse, but let us 
not throw the baby out with the bathwater by punishing the elderly and 
the frail who have come to depend on these services. Waste, fraud and 
abuse in a Medicare system that has just been saved from the brink of 
bankruptcy cannot be tolerated, but a truly home-bound elderly Medicare 
recipient should not be punished for the fraud their health care 
provider is engaged in.
  I ask my colleagues to join with me in fighting to protect our 
seniors.
  Mr. THOMPSON. Mr. Speaker, I rise today as the representative of 
Mississippi 2nd Congressional District in support of H.R. 2912, the 
Medicare Venipuncture Fairness Act of 1997. This bill will delay the 
implementation of the Venipuncture provision in the Balanced Budget Act 
1997, Section 4615. The service is greatly needed for elderly people 
who utilize home health services solely for venipuncture. Patients on 
Coumadin, a blood thinning agent, need repetitive blood sampling and 
monitoring to determine if their treatment is effective. The loss of 
this venipuncture service for patients on certain medications such as 
Coumadin could result in life threatening episodes.
  The Mississippi Association for Home Care estimates that eliminating 
the venipuncture provision will affect Ten to Twelve thousand patients 
in Mississippi alone. Punishing the frail and elderly recipients who 
depend upon home health services is not the intent of this change, but 
will be the ultimate effect.
  According to the Health Care Financing Agency (HCFA), the 
venipuncture provision was placed into law under the Balanced Budget 
Act of 1997 (BBA) in order to fight fraud and abuse of the Medicare 
system. Mr. Speaker, I am committed to ending fraud and abuse. However, 
I do not support fighting fraud and abuse to the detriment of the 
Nation's elderly. I am also greatly concerned about this provision due 
to the fact that: There were no hearings on the inclusion of this 
provision in the Balanced Budget Act, there was no Congressional Budget 
Office estimate given on the venipuncture provision, and the provision 
was based on anecdotal evidence and there were no specific clinical 
examples used as a justification for the provision.
  Therefore, I am in full support of H.R. 2912, which calls for the 
Secretary of Health and Human Services to delay the implementation of 
Section 4615 of the Balanced Budget Act for 18 months from the date of 
the enactment. This delay will also allow further study on the impact 
of the provision on the homebound frail and elderly.
  As I close, I would like to once again express my support for H.R. 
2912 and thank Representative Rahall and Representative Aderholt for 
their work in bringing this legislation forth to protect the interests 
of venipuncture patients. I urge my colleagues to support this bill.

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