[Congressional Record Volume 144, Number 11 (Thursday, February 12, 1998)]
[House]
[Pages H488-H489]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             THE MEDICARE VENIPUNCTURE FAIRNESS ACT OF 1997

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentlewoman from Texas (Ms. Sheila Jackson-Lee) is recognized for 5 
minutes.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, before I begin, I yield to my 
friend and colleague, the gentleman from Texas (Mr. Bentsen).


Supporting the Inclusion of the Dr. Martin Luther King, Jr. Birthday in 
                           the U.S. Flag Code

  Mr. BENTSEN. Mr. Speaker, I rise today to introduce legislation 
correcting an oversight that occurred in the 98th Congress during the 
establishment of the Federal holiday celebrating the birthday of our 
Nation's greatest civil rights leader, Dr. Martin Luther King, Jr.
  It is customary during the establishment of official Federal holidays 
to signify the importance of the date through recognition in the U.S. 
Flag Code. The U.S. Flag Code encourages all Americans to remember the 
significance of each Federal holiday through the display of our 
Nation's banner. The Flag Code reminds people that on certain days 
every year, displaying the flag will show respect for the people and 
events that have shaped our great Nation.
  I believe the American people should be afforded the opportunity to 
pay their respects to the memory of Dr. King and all his achievements 
through the display of our flag on the day we honor him. Of the ten 
permanent Federal holidays, only the King birthday lacks this honor, 
and I believe that as we celebrate Black History Month, it is 
appropriate to correct this emission.
  I would like to offer my appreciation to Mr. Charles Spain, a 
resident of Houston, which the gentlewoman and I come from. Mr. Spain 
brought this very important matter to my attention and I am grateful 
for his diligence and assistance in helping my office to introduce this 
legislation to correct this error.
  Mr. Speaker, I urge my colleagues to support this measure. Let us 
continue to honor the legacy of Dr. King and continue to move forward 
with his dream.
  Mr. Speaker, I thank the gentlewoman for yielding me this time.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I applaud the gentleman for 
his leadership on this issue, and I would join the gentleman in 
cosponsoring this legislation, which I think is an important correction 
for an honorable gentleman, Dr. Martin Luther King.
  I would like to as well, Mr. Speaker, to raise several issues that 
really are in keeping with Black History Month, in recognition of many 
of our tried-and-true men and women who served in the Vietnam war. I am 
certainly a product of that era and I could not find a better time to 
take a moment to salute those who lost their lives and sacrificed in 
order that we might be free.
  Many people had many things to say about the Vietnam war, but I have 
nothing to say other than for those who fought and those who lost limbs 
and were injured and those who lost lives and to their families and 
loved ones, I salute you, I applaud you, I honor you.
  In my district I work extensively with homeless veterans, many of 
whom are from the Vietnam era. They are no less diminished because of 
the tragedy of their life, because of some misstep that might have 
brought them to this point, but they are certainly a part of the honor 
of those who have served, and my hat is off to them.
  I salute those veterans of the 18th Congressional District who served 
in Vietnam. I certainly am grateful for the ending of that war, and I 
salute all of the veterans and all of the men and women all over this 
country who served in this Vietnam war.
  It is for this reason, Mr. Speaker, that I applaud the President 
today highlighting for America the Patient's Bill of Rights. And I will 
be supporting that legislation, along with the Venipuncture Fairness 
Act of 1997. In fact, many of my constituents, many veterans, are in 
home care, and the home care agencies are now being precluded from 
going to the homes of homebound individuals and taking vital signs that 
are necessary for prescription drugs and other various medications and 
physical needs. This H.R.

[[Page H489]]

2912 will correct an injustice by Medicare to prevent coverage for the 
venipuncture service that is needed.

                              {time}  1530

  So, Mr. Speaker, let me again thank the veterans of the Vietnam War 
and thank the families who gave through their loved ones the ultimate 
sacrifice. Let us never forget.
  And then as we proceed into this legislative agenda year, let us not 
forget those who need the patient bill of rights who now live with us 
today in America. Let us assure them of good health care and the rights 
of physicians and patients to make the decisions about life and death, 
not about good health care.
  And, as well, I ask my colleagues to support H.R. 2912 to correct the 
injustice of eliminating the venipuncture visitation by home care 
agencies. Let us support the Venipuncture Fairness Act of 1997.
  Mr. Speaker, I submit the following for the Record:
  Mr. Speaker, I rise this afternoon to urge this Congress to remedy a 
wrong we perpetrated upon America's home-bound seniors and disabled 
people when we passed one of the Medicare provisions in the Balanced 
Budget Act of 1997. As of February 5, 1998--last Thursday--home 
venipuncture services for individuals who do not receive any other 
skilled home health services are no longer covered by Medicare. H.R. 
2912, the Medicare Venipuncture Fairness Act of 1997, would reinstate 
Medicare coverage for this vital medical service.
  Venipuncture is simply the drawing of blood. Thousands of home-bound 
individuals rely on this service to ensure that their doctors are able 
to monitor their medication levels, particularly with the most 
complicated drugs such as heart medications, blood thinners, and 
insulin. Section 4615 of the Balanced Budget Act removed venipuncture 
from the list of prescribed services that qualify a Medicare 
beneficiary for other home health services. Therefore, unless a patient 
has been prescribed another skilled service, he or she will no longer 
be reimbursed for the cost of having blood drawn at home.
  There are several problems with this new approach. The reason most of 
these patients require their blood to be drawn at home is that they are 
unable to travel to their doctors' offices, either because they are 
located in a rural area, or because their health is such that leaving 
home is not feasible or safe. For those patients that are able to leave 
home, public transportation is often unavailable, and ambulance 
services to and from the doctor's office may cost up to $250 a trip. 
For those patients who cannot leave home, their only option may be 
placement in a nursing home. We are all acutely and unfortunately aware 
of the exorbitant cost of those facilities.
  In addition, this policy change may in fact be unnecessarily 
increasing the amount spent on skilled home health services. 
Essentially, we are forcing doctors to prescribe additional, costly 
services in order to ensure that their patients' medication levels are 
appropriately adjusted and safe.
  I voted for the Balanced Budget Act of 1997. I believe it is 
important to combat waste and fraud in the Medicare system. However, I 
have been presented with absolutely no evidence to support the 
contention that home venipuncture services were a source of either 
waste or fraud. There are no estimates as to either how much 
venipuncture services were costing the system before the Balanced 
Budget Act, or how much this dangerous change will save the Medicare 
system. In fact, the removal of coverage for home venipuncture may in 
fact end up increasing overall health costs by forcing seniors and 
disabled citizens into nursing homes when they otherwise could have 
stayed at home.

  I have, therefore, not heard anything to convince me that there was 
abuse of home venipuncture services, such that the change made by 
section 4615 was warranted. I have, however, heard much to convince me 
that this change is endangering the health and well-being of senior 
citizens and disabled people throughout this country. I have heard from 
people in my district who do not know how they are going to provide 
their elderly relatives' doctors with blood samples now that this 
policy change has been instituted. I have heard from one family that, 
faced with the discontinuation of Medicare reimbursement for 
venipuncture, sought to have someone continue to come to their home to 
draw their elderly mother's blood. However, they were unable to find 
any agency or organization that could provide this vital service, even 
it they scraped together the funds to pay for the service privately.
  What am I to tell these families, who are making personal sacrifices 
by caring for their loved ones at home? How can I tell them that we 
appreciate their devotion but that somebody had a suspicion, not 
apparently supported by any statistics, that this was a good service to 
discontinue so we did? I will not tell them that, without also telling 
them that we are trying to remedy this terrible error.
  I urge this Congress to support those Americans who need our help the 
most, our home-bound senior and disabled citizens, by supporting H.R. 
2912, the Medicare Venipuncture Fairness Act of 1997. We must, as 
representatives of the American people, be willing to admit when we 
have made a mistake and remedy it as soon as we possibly can.

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