[Congressional Record Volume 146, Number 34 (Thursday, March 23, 2000)]
[Extensions of Remarks]
[Page E398]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                RURAL HEALTH CARE PROTECTION ACT OF 2000

                                 ______
                                 

                            HON. MATT SALMON

                               of arizona

                    in the house of representatives

                        Thursday, March 23, 2000

  Mr. SALMON. Mr. Speaker, I rise to introduce the Rural Health Care 
Protection Act of 2000. Among other things, the bill mandates that 
Medicare+Choice enrollees cannot be held liable by contracted or non-
contracted providers for any claims that are unpaid by a 
Medicare+Choice plan. It also allows the insurance commissioner of a 
state to apply to the Secretary of HHS for reimbursement for all valid, 
unpaid provider claims. And, the legislation establishes HCFA as a 
creditor for Medicare+Choice Amos that go bankrupt.
  The need for this legislation is clear. In Arizona, Premier HMO 
recently announced it was insolvent. Roughly 20,000 seniors have left 
Premier to return to traditional Medicare (which provides no 
prescription drug benefit) or have enrolled in an alternative Medicare 
HMO. Unfortunately, nine Arizona counties no longer have an HMO option. 
We need to make sure that Medicare+Choice enrollees are not held 
responsible when bankrupt HMOs fail to pay providers' claims.
  Under current law, the Health Care Financing Administration (HCFA) 
has the discretion, but is not required, to provide direct 
reimbursement to health care providers when an HMO fails to make 
payments for providers' claims. Quite often HCFA makes payments only 
where Medicare+Choice HMOs continue to operate. If an HMO becomes 
insolvent, doctors, hospitals, and others are often left unpaid for 
services already rendered.
  In 1997 Congress passed the Balanced Budget Act which included a 
provision to expand choices for Medicare beneficiaries through the new 
Medicare+Choice program. It was anticipated that the program would lead 
to a wider variety of health plan choices for beneficiaries in all 
areas of the country--particularly in rural counties. Unfortunately, 
there was never a plan to deal with organizations who could not 
maintain financial solvency. And HCFA has not recognized the need to 
protect Medicare beneficiaries from defunct health plans--even though 
they are the financing arm for Medicare.
  Even worse, HCFA's regulations have added to the problem by making it 
more difficult for HMOs and other like organizations to enter the 
Medicare Choice program. They make it tough to get in the program and 
do little for beneficiaries once the HMOs leave. As of last year, there 
were only 262 health plans across the Nation that participated in the 
Medicare+Choice program, 84 less than 1998. According to the American 
Association of Health Plans, nearly 700,000 beneficiaries have had 
their Medicare+Choice coverage disrupted since the program's inception.
  Seniors shouldn't be left holding the bag when health plans go 
bankrupt. The Rural Health Care Protection Act would ensure that the 
government fulfills its promise to those seniors who have chosen to 
participate in the Medicare+Choice program. I urge my colleagues to 
cosponsor this legislation.

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