[Congressional Record Volume 147, Number 58 (Wednesday, May 2, 2001)]
[Extensions of Remarks]
[Page E705]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                ACCESS TO EMERGENCY MEDICAL SERVICES ACT

                                 ______
                                 

                           HON. MARGE ROUKEMA

                             of new jersey

                    in the house of representatives

                         Wednesday, May 2, 2001

  Mrs. ROUKEMA. Mr. Speaker, today I am introducing the Access to 
Emergency Medical Services Act with my colleague, Mr. Cardin of 
Maryland. I would first like to thank Mr. Cardin for taking the 
initiative on this issue and continually bringing this bill to 
Congress's attention.
  This important legislation is an effort to allow medical 
professionals to make decisions in the emergency room, not the 
insurance company bureaucrats.
  Insurance companies reportedly have refused to pay emergency room 
bills when patients did not obtain prior authorization for emergency 
treatment. It is inappropriate and dangerous for insurance companies to 
require pre-authorization for emergency services. Indeed, emergency 
conditions are by definition problems that require immediate medical 
attention without delay.
  Patients are also being financially punished for taking precautionary 
action and admitting themselves to the emergency room for a critical 
situation. We should not attach a high personal risk to seeking out 
emergency care. I have heard many stories of individuals who go to the 
emergency room with symptoms that indicate a serious illness, perhaps a 
heart attack. They undergo a battery of tests and find out that the 
heart attack was something else, perhaps a bad case of heartburn. That 
should be good news. However, weeks later they find out that those 
tests cost hundreds, maybe thousands of dollars, and their insurance 
companies refuse to pay.
  This legislation will put an end to bottom-line medicine and keep 
insurance companies out of the emergency room. Decisions on the medical 
treatment of the ill and injured should be placed back in the hands 
trained to save lives, not dollars. The Access to Emergency Medical 
Services Act of 2001 would require insurers to pay for emergency room 
visits based on a ``prudent layperson'' definition of an emergency and 
a patient's symptoms, rather than the final diagnosis. An individual 
seeking medical attention for what they ``prudently'' determine to be a 
medical emergency should not be penalized for that decision. This bill 
would also prohibit insurance companies' pre-authorization requirements 
for emergency care. Finally, the bill requires that health care plans 
and emergency physicians work jointly to coordinate follow-up care.
  This bill does not replace the need for comprehensive health 
insurance reform. The initiatives proposed by Congressmen Ganske and 
Dingell are essential for a broad reform of our health insurance 
system. That being said, this is a necessary bill to pass to protect 
citizens from physical injury caused by paperwork delays from their 
insurance carriers.
  I strongly urge my colleagues to support this important legislation 
which ensures that an insurance company's response will not make the 
difference between life and death in emergency room.

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