[Congressional Record Volume 144, Number 71 (Thursday, June 4, 1998)]
[Extensions of Remarks]
[Page E1026]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


          THE MEDICARE CONSUMER BILL OF RIGHTS CONFORMING ACT

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                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                         Thursday, June 4, 1998

  Mr. STARK. Mr. Speaker, earlier this year, President Clinton issued 
an Executive Memorandum directing all Federal health plans, which serve 
over 85 million Americans, to come into substantial compliance with the 
Consumer Bill of Rights recommended by the President's Quality 
Commission.
  The Advisory Commission on Consumer Protection and Quality in the 
Health Care Industry recommended: Consumer information disclosure; 
choice of providers and plans; access to emergency services; consumer 
participation in treatment decisions; nondiscrimination protections; 
confidentiality of health information; access to complaints and appeals 
processes; and, a recognition of consumer responsibilities.
  The Medicare program is already meeting most of these standards, but 
there are two specific components of the Consumer Bill of Rights that 
cannot be enforced in Medicare without a statutory fix. Both provisions 
affect the choice of plans and providers. The first would grant women 
direct access to obstetricians and gynecologists, the second would 
grant transitional care protections to patients who are undergoing a 
course of treatment and faced with an involuntary change in health 
plans or their doctor leaving the plan.
  Today, I rise with my Democratic colleagues from the Ways and Means 
Health Subcommittee to introduce ``The Medicare Consumer Bill of Rights 
Conforming Act'' which creates statutory authority for Medicare to 
fully enforce the President's Quality Commission's Consumer Bill of 
Rights.
  The Medicare Consumer Bill of Rights Conforming Act would require 
health plans to allow a Medicare beneficiary to select an OB-GYN as her 
primary care provider if she so chooses. It would also prohibit health 
plans from requiring women to obtain prior authorization before 
obtaining routine gynecological care.
  An issue of real concern to people in managed care plans, and those 
thinking of joining them, is that doctors come and go from health 
plans, resulting in a loss of continuity of care for patients during 
those transitional times. The Medicare Consumer Bill of Rights 
Conforming Act would create short-term protections for Medicare 
patients in such situations. Patients undergoing a course of treatment 
when a health care provider is terminated from the plan would be able 
to continue that care with the same provider for up to 90 days. Cases 
involving institutionalization, pregnancy or terminal illness could 
have longer periods of transitional coverage. In all instances, the 
provider would need to accept the payment rate of the patient's health 
plan in order to qualify for continued participation.
  The Medicare Consumer Bill of Rights Conforming Act is a small but 
important piece of legislation that would ensure Medicare beneficiaries 
of a basic set of consumer protections. These protections are not 
controversial. They were endorsed by the President's Quality 
Commission, which included representatives of big business, insurers, 
small business, labor, consumers, seniors, and the managed care 
industry. This is a very small step for Congress to take to provide 
Medicare with the authority to enact these protections for our nation's 
seniors and disabled population. I look forward to working with my 
colleagues to enact this sensible, non-controversial legislation.

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