[Congressional Record Volume 144, Number 15 (Wednesday, February 25, 1998)]
[Extensions of Remarks]
[Page E219]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



   INTRODUCTION OF THE PRIVATE CONTRACTING CLARIFICATION ACT OF 1998

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                        HON. BENJAMIN L. CARDIN

                              of maryland

                    in the house of representatives

                      Wednesday, February 25, 1998

  Mr. CARDIN. Mr. Speaker, today I introduce the Medicare Private 
Contracting Clarification Act of 1998. This legislation clarifies a 
provision of the Balanced Budget Act which, for the first time, allows 
doctors to privately contract with Medicare beneficiaries for services 
normally covered by Medicare. My bill will make clear that nothing in 
this provision prevents Medicare beneficiaries from privately paying 
for services not covered by Medicare. This has always been true for our 
seniors, and it remains true under current law.
  Prior to passage of the Balanced Budget Act (BBA), federal law did 
not address the issue of private contracting between Medicare 
beneficiaries and their doctors. The Kyl amendment to BBA explicitly 
allows doctors to reject Medicare and privately contract with their 
patients for Medicare-covered services. For patients entering into 
private contracts, this means that they will be unable to use either 
their Medicare or Medigap coverage for their care.
  However, BBA includes assurances that private contracting will not 
destroy the balance billing limits and other patient protections of the 
Medicare program. Most importantly, BBA bars physicians who choose to 
privately contract from the Medicare program for two years. This means 
that patients will know in advance whether or not their Part B 
insurance is valid for a doctor's care. It means that Medicare patients 
can expect consistent and timely care from a physician, regardless of 
the patient's ability to pay out-of-pocket for a Medicare benefit under 
a private contract. In sum, seniors can rest assured that their 
Medicare coverage will be there for them when they need it.
  Unfortunately, false claims are being made about BBA's private 
contracting provisions. Proponents of private contracting are seeking 
to remove the two year exclusion period in BBA. In an effort to vastly 
expand doctors' ability to engage in private contracting, they claim 
that doctors will need private contracts for all services, even those 
not covered by Medicare. This is simply not true. Nothing in the 
Balanced Budget Act affects the ability of seniors to privately pay 
doctors for services that Medicare does not cover.
  Despite this fact, some groups continue to wage misinformation 
campaigns. My bill will put an end to this false rhetoric by clarifying 
that no private contract is required for a service that Medicare does 
not cover. It will eliminate the confusion surrounding this much-
debated issue, to assure seniors that their contract with Medicare, a 
public contract, will continue to be honored.
  Mr. Speaker, we have scarcely had time to understand the impact of 
the existing private contracting provisions on the Medicare program. 
The Congressional Budget Office has already stated that private 
contracting holds a ``serious potential for overbilling.'' Congress 
recently created a commission to examine ways to ensure the long-term 
financial stability of Medicare. To vastly expand the scope of this 
provision on the basis of inaccurate claims about its effect on doctors 
is a grave mistake, especially during this crucial period in the 
history of the program.
  If we must pass legislation on the private contracting issue, let us 
focus our attention on clarifying current law to assure seniors that 
their Medicare coverage will be there for them when they need it. BBA 
allows doctors to privately contract with Medicare beneficiaries, while 
preserving the balance billing limits, fraud and abuse controls, and 
patient protections of the Medicare program. I would hope our priority 
in Congress would be to preserve our commitment to our senior citizens 
and their health care. Let's keep the Medicare program in tact.

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