[Congressional Record Volume 146, Number 141 (Tuesday, October 31, 2000)]
[House]
[Pages H11682-H11683]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 OPPOSING MOTION TO INSTRUCT CONFEREES

  Mr. BILIRAKIS. Mr. Speaker, I thank the gentleman for allowing us the 
opportunity.
  Mr. Speaker, this motion actually reverses a policy set in 
legislation enacted only 3 years ago, at the bipartisan request of our 
Nation's governors. Provisions to repeal the Boren Amendment were 
included in the 1997 Balanced Budget Act. That measure was approved by 
the House with the support of 193 Republicans and 153 Democrats, and it 
was signed into law by President Clinton.
  I would also refer to remarks made by the President of the National 
Governors Association on August 8 of last year in St. Louis, Missouri, 
when he said, we have waived or eliminated scores of laws and 
regulations on Medicaid, including one we all wanted to get rid of, the 
so-called Boren Amendment.
  As I intended to explain earlier, the proposal, Mr. Speaker, is 
unnecessary.

[[Page H11683]]

The Medicaid statute already includes provisions which address the 
gentleman's concern. Under title 19, States are specifically required 
to provide adequate reimbursement. Section 1902(a)30(A) requires States 
plans to, and I quote, ``provide such methods and procedures relating 
to the utilization of and the payment for care and services available 
under the plan as may be necessary to safeguard against unnecessary 
utilization of such care and services, and to ensure that payments are 
consistent with efficiency, economy and quality of care, and are 
sufficient to enlist enough providers so that care and services are 
available under the plan, at least to the extent that such care and 
services are available to the general population in the geographic 
area.''
  Mr. Speaker, this has been true in regulation for years, Mr. Speaker, 
but it was also codified in statute by the 1989 omnibus budget 
reconciliation act. Imposing additional mandates on the States would 
not accomplish any justifiable public policy purpose.
  The other interpretation of the gentleman's motion to instruct is 
that in the spirit of Halloween, he is attempting to breathe life into 
the now-dead Boren Amendment. History has shown us that the use of such 
general terms as ``adequate reimbursement'' and ``suppliers furnishing 
items and services'' will lead to litigation.
  Mr. PALLONE. Regular order, Mr. Speaker.
  The SPEAKER pro tempore. The House is proceeding under regular order.
  Mr. PALLONE. Mr. Speaker, the gentleman asked for 1 minute.
  The SPEAKER pro tempore. The gentleman asked for 5 minutes. The 
gentleman will suspend. The gentleman from Florida has the time.
  Mr. BILIRAKIS. Mr. Speaker, the gentleman from Florida asked for 5 
minutes.
  The SPEAKER pro tempore. The gentleman was recognized for 1 minute.
  Mr. BILIRAKIS. Mr. Speaker, the original Boren Amendment was intended 
to serve as a ceiling for State reimbursement decisions, but over many 
years of judicial interpretation, it became a tool to create an ever-
increasing floor.
  Mr. Speaker, I would urge all to vote against this motion, and I 
thank the gentleman for his courtesy.

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