[Congressional Record Volume 156, Number 162 (Thursday, December 9, 2010)]
[House]
[Pages H8267-H8273]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MEDICARE AND MEDICAID EXTENDERS ACT OF 2010
Mr. STARK. Mr. Speaker, I move to suspend the rules and concur in the
Senate amendments to the bill (H.R. 4994) to amend the Internal Revenue
Code of 1986 to reduce taxpayer burdens and enhance taxpayer
protections, and for other purposes.
The Clerk read the title of the bill.
The text of the Senate amendments is as follows:
Senate amendments:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Medicare
and Medicaid Extenders Act of 2010''.
(b) Table of Contents.--The table of contents of this Act
is as follows:
Sec. 1. Short title; table of contents.
TITLE I--EXTENSIONS
Sec. 101. Physician payment update.
Sec. 102. Extension of MMA section 508 reclassifications.
Sec. 103. Extension of Medicare work geographic adjustment floor.
Sec. 104. Extension of exceptions process for Medicare therapy caps.
Sec. 105. Extension of payment for technical component of certain
physician pathology services.
Sec. 106. Extension of ambulance add-ons.
Sec. 107. Extension of physician fee schedule mental health add-on
payment.
Sec. 108. Extension of outpatient hold harmless provision.
Sec. 109. Extension of Medicare reasonable costs payments for certain
clinical diagnostic laboratory tests furnished to
hospital patients in certain rural areas.
Sec. 110. Extension of the qualifying individual (QI) program.
Sec. 111. Extension of Transitional Medical Assistance (TMA).
Sec. 112. Special diabetes programs.
TITLE II--OTHER PROVISIONS
Sec. 201. Clarification of effective date of part B special enrollment
period for disabled TRICARE beneficiaries.
Sec. 202. Repeal of delay of RUG-IV.
Sec. 203. Clarification for affiliated hospitals for distribution of
additional residency positions.
Sec. 204. Continued inclusion of orphan drugs in definition of covered
outpatient drugs with respect to children's hospitals
under the 340B drug discount program.
Sec. 205. Medicaid and CHIP technical corrections.
Sec. 206. Funding for claims reprocessing.
Sec. 207. Revision to the Medicare Improvement Fund.
Sec. 208. Limitations on aggregate amount recovered on reconciliation
of the health insurance tax credit and the advance of
that credit.
Sec. 209. Determination of budgetary effects.
[[Page H8268]]
TITLE I--EXTENSIONS
SEC. 101. PHYSICIAN PAYMENT UPDATE.
Section 1848(d) of the Social Security Act (42 U.S.C.
1395w-4(d)) is amended by adding at the end the following new
paragraph:
``(12) Update for 2011.--
``(A) In general.--Subject to paragraphs (7)(B), (8)(B),
(9)(B), (10)(B), and (11)(B), in lieu of the update to the
single conversion factor established in paragraph (1)(C) that
would otherwise apply for 2011, the update to the single
conversion factor shall be 0 percent.
``(B) No effect on computation of conversion factor for
2012 and subsequent years.--The conversion factor under this
subsection shall be computed under paragraph (1)(A) for 2012
and subsequent years as if subparagraph (A) had never
applied.''.
SEC. 102. EXTENSION OF MMA SECTION 508 RECLASSIFICATIONS.
(a) Extension.--
(1) In general.--Section 106(a) of division B of the Tax
Relief and Health Care Act of 2006 (42 U.S.C. 1395 note), as
amended by section 117 of the Medicare, Medicaid, and SCHIP
Extension Act of 2007 (Public Law 110-173), section 124 of
the Medicare Improvements for Patients and Providers Act of
2008 (Public Law 110-275), and sections 3137(a) and 10317 of
the Patient Protection and Affordable Care Act (Public Law
111-148), is amended by striking ``September 30, 2010'' and
inserting ``September 30, 2011''.
(2) Special rule for fiscal year 2011.--
(A) In general.--Subject to subparagraph (B), for purposes
of implementation of the amendment made by paragraph (1),
including (notwithstanding paragraph (3) of section 117(a) of
the Medicare, Medicaid, and SCHIP Extension Act of 2007
(Public Law 110-173), as amended by section 124(b) of the
Medicare Improvements for Patients and Providers Act of 2008
(Public Law 110-275)) for purposes of the implementation of
paragraph (2) of such section 117(a), during fiscal year
2011, the Secretary of Health and Human Services shall use
the hospital wage index that was promulgated by the Secretary
of Health and Human Services in the Federal Register on
August 16, 2010 (75 Fed. Reg. 50042), and any subsequent
corrections.
(B) Exception.--Beginning on April 1, 2011, in determining
the wage index applicable to hospitals that qualify for wage
index reclassification, the Secretary shall include the
average hourly wage data of hospitals whose reclassification
was extended pursuant to the amendment made by paragraph (1)
only if including such data results in a higher applicable
reclassified wage index. Any revision to hospital wage
indexes made as a result of this subparagraph shall not be
effected in a budget neutral manner.
(3) Adjustment for certain hospitals in fiscal year 2011.--
(A) In general.--In the case of a subsection (d) hospital
(as defined in subsection (d)(1)(B) of section 1886 of the
Social Security Act (42 U.S.C. 1395ww)) with respect to
which--
(i) a reclassification of its wage index for purposes of
such section was extended pursuant to the amendment made by
paragraph (1); and
(ii) the wage index applicable for such hospital for the
period beginning on October 1, 2010, and ending on March 31,
2011, was lower than for the period beginning on April 1,
2011, and ending on September 30, 2011, by reason of the
application of paragraph (2)(B);
the Secretary shall pay such hospital an additional payment
that reflects the difference between the wage index for such
periods.
(B) Timeframe for payments.--The Secretary shall make
payments required under subparagraph (A) by not later than
December 31, 2011.
(b) Conforming Amendment.--Section 117(a)(3) of the
Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public
Law 110-173) is amended by inserting ``in fiscal years 2008
and 2009'' after ``For purposes of implementation of this
subsection''.
SEC. 103. EXTENSION OF MEDICARE WORK GEOGRAPHIC ADJUSTMENT
FLOOR.
Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C.
1395w-4(e)(1)(E)) is amended by striking ``before January 1,
2011'' and inserting ``before January 1, 2012''.
SEC. 104. EXTENSION OF EXCEPTIONS PROCESS FOR MEDICARE
THERAPY CAPS.
Section 1833(g)(5) of the Social Security Act (42 U.S.C.
1395l(g)(5)) is amended by striking ``and ending on'' and all
that follows through ``2010'' and inserting ``and ending on
December 31, 2011''.
SEC. 105. EXTENSION OF PAYMENT FOR TECHNICAL COMPONENT OF
CERTAIN PHYSICIAN PATHOLOGY SERVICES.
Section 542(c) of the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000 (as enacted
into law by section 1(a)(6) of Public Law 106-554), as
amended by section 732 of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (42 U.S.C. 1395w-4
note), section 104 of division B of the Tax Relief and Health
Care Act of 2006 (42 U.S.C. 1395w-4 note), section 104 of the
Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public
Law 110-173), section 136 of the Medicare Improvements for
Patients and Providers Act of 2008 (Public Law 110-275), and
section 3104 of the Patient Protection and Affordable Care
Act (Public Law 111-148) is amended by striking ``and 2010''
and inserting ``2010, and 2011''.
SEC. 106. EXTENSION OF AMBULANCE ADD-ONS.
(a) Ground Ambulance.--Section 1834(l)(13)(A) of the Social
Security Act (42 U.S.C. 1395m(l)(13)(A)) is amended--
(1) in the matter preceding clause (i), by striking
``2011'' and inserting ``2012,''; and
(2) in each of clauses (i) and (ii), by striking ``January
1, 2011'' and inserting ``January 1, 2012'' each place it
appears.
(b) Air Ambulance.--Section 146(b)(1) of the Medicare
Improvements for Patients and Providers Act of 2008 (Public
Law 110-275), as amended by sections 3105(b) and 10311(b) of
Public Law 111-148, is amended by striking ``December 31,
2010'' and inserting ``December 31, 2011''.
(c) Super Rural Ambulance.--Section 1834(l)(12)(A) of the
Social Security Act (42 U.S.C. 1395m(l)(12)(A)) is amended by
striking ``2011'' and inserting ``2012''.
SEC. 107. EXTENSION OF PHYSICIAN FEE SCHEDULE MENTAL HEALTH
ADD-ON PAYMENT.
Section 138(a)(1) of the Medicare Improvements for Patients
and Providers Act of 2008 (Public Law 110-275), as amended by
section 3107 of the Patient Protection and Affordable Care
Act (Public Law 111-148), is amended by striking ``December
31, 2010'' and inserting ``December 31, 2011''.
SEC. 108. EXTENSION OF OUTPATIENT HOLD HARMLESS PROVISION.
Section 1833(t)(7)(D)(i) of the Social Security Act (42
U.S.C. 1395l(t)(7)(D)(i)), as amended by section 3121(a) of
the Patient Protection and Affordable Care Act (Public Law
111-148), is amended--
(1) in subclause (II)--
(A) in the first sentence, by striking ``2011''and
inserting ``2012''; and
(B) in the second sentence, by striking ``or 2010'' and
inserting ``2010, or 2011''; and
(2) in subclause (III), by striking ``January 1, 2011'' and
inserting ``January 1, 2012''.
SEC. 109. EXTENSION OF MEDICARE REASONABLE COSTS PAYMENTS FOR
CERTAIN CLINICAL DIAGNOSTIC LABORATORY TESTS
FURNISHED TO HOSPITAL PATIENTS IN CERTAIN RURAL
AREAS.
Section 416(b) of the Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 (42 U.S.C. 1395l-
4), as amended by section 105 of division B of the Tax Relief
and Health Care Act of 2006 (42 U.S.C. 1395l note), section
107 of the Medicare, Medicaid, and SCHIP Extension Act of
2007 (42 U.S.C. 1395l note), and section 3122 of the Patient
Protection and Affordable Care Act (Public Law 111-148), is
amended by striking ``the 1-year period beginning on July 1,
2010'' and inserting ``the 2-year period beginning on July 1,
2010''.
SEC. 110. EXTENSION OF THE QUALIFYING INDIVIDUAL (QI)
PROGRAM.
(a) Extension.--Section 1902(a)(10)(E)(iv) of the Social
Security Act (42 U.S.C. 1396a(a)(10)(E)(iv)) is amended by
striking ``December 2010'' and inserting ``December 2011''.
(b) Extending Total Amount Available for Allocation.--
Section 1933(g) of such Act (42 U.S.C. 1396u-3(g)) is
amended--
(1) in paragraph (2)--
(A) by striking ``and'' at the end of subparagraph (M);
(B) in subparagraph (N), by striking the period at the end
and inserting a semicolon; and
(C) by adding at the end the following new subparagraphs:
``(O) for the period that begins on January 1, 2011, and
ends on September 30, 2011, the total allocation amount is
$720,000,000; and
``(P) for the period that begins on October 1, 2011, and
ends on December 31, 2011, the total allocation amount is
$280,000,000.''; and
(2) in paragraph (3), in the matter preceding subparagraph
(A), by striking ``or (N)'' and inserting ``(N), or (P)''.
SEC. 111. EXTENSION OF TRANSITIONAL MEDICAL ASSISTANCE (TMA).
Sections 1902(e)(1)(B) and 1925(f) of the Social Security
Act (42 U.S.C. 1396a(e)(1)(B), 1396r-6(f)) are each amended
by striking ``December 31, 2010'' and inserting ``December
31, 2011''.
SEC. 112. SPECIAL DIABETES PROGRAMS.
(1) Special diabetes programs for type i diabetes.--Section
330B(b)(2)(C) of the Public Health Service Act (42 U.S.C.
254c-2(b)(2)(C)) is amended by striking ``2011'' and
inserting ``2013''.
(2) Special diabetes programs for indians.--Section
330C(c)(2)(C) of the Public Health Service Act (42 U.S.C.
254c-3(c)(2)(C)) is amended by striking ``2011'' and
inserting ``2013''.
TITLE II--OTHER PROVISIONS
SEC. 201. CLARIFICATION OF EFFECTIVE DATE OF PART B SPECIAL
ENROLLMENT PERIOD FOR DISABLED TRICARE
BENEFICIARIES.
Effective as if included in the enactment of Public Law
111-148, section 3110(a)(2) of such Act is amended to read as
follows:
``(2) Effective date.--The amendment made by paragraph (1)
shall apply to elections made on and after the date of the
enactment of this Act.''.
SEC. 202. REPEAL OF DELAY OF RUG-IV.
Effective as if included in the enactment of Public Law
111-148, section 10325 of such Act is repealed.
SEC. 203. CLARIFICATION FOR AFFILIATED HOSPITALS FOR
DISTRIBUTION OF ADDITIONAL RESIDENCY POSITIONS.
Effective as if included in the enactment of section
5503(a) of Public Law 111-148, section 1886(h)(8) of the
Social Security Act (42 U.S.C. 1395ww(h)(8)), as added by
such section 5503(a), is amended by adding at the end the
following new subparagraph:
``(I) Affiliation.--The provisions of this paragraph shall
be applied to hospitals which are members of the same
affiliated group (as defined by the Secretary under paragraph
(4)(H)(ii)) and the reference resident level for each such
hospital shall be the reference resident level with respect
to the cost reporting period that results in the smallest
difference between the reference resident level and the
otherwise applicable resident limit.''.
[[Page H8269]]
SEC. 204. CONTINUED INCLUSION OF ORPHAN DRUGS IN DEFINITION
OF COVERED OUTPATIENT DRUGS WITH RESPECT TO
CHILDREN'S HOSPITALS UNDER THE 340B DRUG
DISCOUNT PROGRAM.
(a) Definition of Covered Outpatient Drug.--
(1) Amendment.--Subsection (e) of section 340B of the
Public Health Service Act (42 U.S.C. 256b) is amended by
striking ``covered entities described in subparagraph (M)''
and inserting ``covered entities described in subparagraph
(M) (other than a children's hospital described in
subparagraph (M))''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect as if included in the enactment of section
2302 of the Health Care and Education Reconciliation Act of
2010 (Public Law 111-152).
(b) Technical Amendment.--Subparagraph (B) of section
1927(a)(5) of the Social Security Act (42 U.S.C. 1396r-
8(a)(5)) is amended by striking ``and a children's hospital''
and all that follows through the end of the subparagraph and
inserting a period.
SEC. 205. MEDICAID AND CHIP TECHNICAL CORRECTIONS.
(a) Repeal of Exclusion of Certain Individuals and Entities
From Medicaid.--Section 1902(a) of the Social Security Act
(42 U.S.C. 1396a(a)) is amended by striking paragraph (78).
(b) Income Level for Certain Children Under Medicaid.--
Section 1902(l)(2)(C) of the Social Security Act (42 U.S.C.
1396a(l)(2)(C)) is amended by striking ``133 percent'' and
inserting ``100 percent (or, beginning January 1, 2014, 133
percent)''.
(c) Calculation and Publication of Payment Error Rate
Measurement for Certain Years.--Section 601(b) of the
Children's Health Insurance Program Reauthorization Act of
2009 (Public Law 111-3) is amended by adding at the end the
following: ``The Secretary is not required under this
subsection to calculate or publish a national or a State-
specific error rate for fiscal year 2009 or fiscal year
2010.''.
(d) Corrections to Exceptions to Exclusion of Children of
Certain Employees.--Section 2110(b)(6) of the Social Security
Act (42 U.S.C. 1397jj(b)(6)) is amended--
(1) in subparagraph (B)--
(A) by striking ``per person'' in the heading; and
(B) by striking ``each employee'' and inserting
``employees''; and
(2) in subparagraph (C), by striking ``, on a case-by-case
basis,''.
(e) Electronic Health Records.--Effective as if included in
the enactment of section 4201(a)(2) of the American Recovery
and Reinvestment Act of 2009 (Public Law 111-5), section
1903(t) of the Social Security Act (42 U.S.C. 1396b(t)) is
amended--
(1) in paragraph (3)(E), by striking ``reduced by any
payment that is made to such Medicaid provider from any other
source (other than under this subsection or by a State or
local government)'' and inserting ``reduced by the average
payment the Secretary estimates will be made to such Medicaid
providers (determined on a percentage or other basis for such
classes or types of providers as the Secretary may specify)
from other sources (other than under this subsection, or by
the Federal government or a State or local government)''; and
(2) in paragraph (6)(B), by inserting before the period the
following: ``and shall be determined to have met such
responsibility to the extent that the payment to the Medicaid
provider is not in excess of 85 percent of the net average
allowable cost''.
(f) Corrections of Designations.--
(1) Section 1902 of the Social Security Act (42 U.S.C.
1396a) is amended--
(A) in subsection (a)(10), in the matter following
subparagraph (G), by striking ``and'' before ``(XVI) the
medical'' and by striking ``(XVI) if'' and inserting ``(XVII)
if'';
(B) in subsection (a)(23), by striking ``(ii)'' and
inserting ``(kk)'';
(C) in subsection (a)(77), by striking ``(ii)'' and
inserting ``(kk)'';
(D) in subsection (ii)(2), as added by section 2303(a)(2)
of Public Law 111-148, by striking ``(XV)'' and inserting
``(XVI)''; and
(E) by redesignating subsection (ii), as added by section
6401(b)(1)(B) of Public Law 111-148, as subsection (kk) and
transferring such subsection so as to appear after subsection
(jj) of that section.
(2) Section 2107(e)(1) of the Social Security Act (42
U.S.C. 1397gg(e)(1)) is amended--
(A) in subparagraph (D), as added by section 6401(c) of
Public Law 111-148, by striking ``(ii)'' and inserting
``(kk)''; and
(B) by redesignating the subparagraph (N) of that section
added by 2101(e) of Public Law 111-148 as subparagraph (O).
SEC. 206. FUNDING FOR CLAIMS REPROCESSING.
For purposes of carrying out the provisions of, and
amendments made by, this Act that relate to title XVIII of
the Social Security Act, and other provisions of, or relating
to, such title that ensure appropriate payment of claims,
there are appropriated to the Secretary of Health and Human
Services for the Centers for Medicare & Medicaid Services
Program Management Account, from amounts in the general fund
of the Treasury not otherwise appropriated, $200,000,000.
Amounts appropriated under the preceding sentence shall be in
addition to any other funds available for such purposes,
shall remain available until expended, and shall not be used
to implement changes to title XVIII of the Social Security
Act made by Public Laws 111-148 and 111-152.
SEC. 207. REVISION TO THE MEDICARE IMPROVEMENT FUND.
Section 1898(b)(1)(B) of the Social Security Act (42 U.S.C.
1395iii(b)(1)(B)) is amended by striking ``$550,000,000'' and
inserting ``$275,000,000''.
SEC. 208. LIMITATIONS ON AGGREGATE AMOUNT RECOVERED ON
RECONCILIATION OF THE HEALTH INSURANCE TAX
CREDIT AND THE ADVANCE OF THAT CREDIT.
(a) In General.--So much of section 36B(f)(2)(B) of the
Internal Revenue Code of 1986 as precedes clause (ii) thereof
is amended to read as follows:
``(B) Limitation on increase.--
``(i) In general.--In the case of a taxpayer whose
household income is less than 500 percent of the poverty line
for the size of the family involved for the taxable year, the
amount of the increase under subparagraph (A) shall in no
event exceed the applicable dollar amount determined in
accordance with the following table (one-half of such amount
in the case of a taxpayer whose tax is determined under
section 1(c) for the taxable year):
------------------------------------------------------------------------
``If the household income (expressed as a percent of The applicable
poverty line) is: dollar amount is:
------------------------------------------------------------------------
Less than 200%....................................... $600
At least 200% but less than 250%..................... $1,000
At least 250% but less than 300%..................... $1,500
At least 300% but less than 350%..................... $2,000
At least 350% but less than 400%..................... $2,500
At least 400% but less than 450%..................... $3,000
At least 450% but less than 500%..................... $3,500''.
------------------------------------------------------------------------
(b) Conforming Amendment.--Section 36B(f)(2)(B)(ii) of such
Code is amended by inserting ``in the table contained'' after
``each of the dollar amounts''.
(c) Effective Date.--The amendments made by this section
shall apply to taxable years beginning after December 31,
2013.
SEC. 209. DETERMINATION OF BUDGETARY EFFECTS.
(a) In General.--The budgetary effects of this Act, for the
purpose of complying with the Statutory Pay-As-You-Go Act of
2010, shall be determined by reference to the latest
statement titled ``Budgetary Effects of PAYGO Legislation''
for this Act, submitted for printing in the Congressional
Record by the Chairman of the Senate Budget Committee,
provided that such statement has been submitted prior to the
vote on passage.
(b) Emergency Designation for Congressional Enforcement.--
In the House of Representatives, this Act, with the exception
of section 101, is designated as an emergency for purposes of
pay-as-you-go principles.
Amend the title so as to read: ``An Act to extend certain
expiring provisions of the Medicare and Medicaid programs,
and for other purposes.''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
California (Mr. Stark) and the gentleman from California (Mr. Herger)
each will control 20 minutes.
The Chair recognizes the gentleman from California (Mr. Stark).
Mr. STARK. Mr. Speaker, I rise in support of H.R. 4994, the Medicare
and Medicaid Extenders Act, a bill that was passed by unanimous consent
in the Senate yesterday because of the critical importance to our
senior citizens and military families.
The legislation does the bare minimum of what is needed to ensure
that Medicare runs smoothly for the next year. Because the military's
TRICARE system operates by many of Medicare's rules, it also protects
the health care of our military families.
Importantly, the bill prevents a nearly 25 percent pay cut to
Medicare and TRICARE physicians that would otherwise go into effect on
January 1, 2011. Giving physicians a year of certainty in their pay is
important to protect Medicare beneficiaries' access to their
physicians. The bill extends a host of other key policies to protect
the health of seniors and people with disabilities.
In the long run, we all know we need to do much better by Medicare
than continued 1-year patches on the physician payment formula. The
House passed a permanent solution in November of 2009, but the Senate
was unable to move it. We need to work together across party lines to
reach a permanent solution. In the meantime, H.R. 4994 is the
appropriate short-term measure.
I urge my colleagues to join us in protecting the Medicare
beneficiaries by voting ``yes.''
Mr. Speaker, I reserve the balance of my time.
Mr. HERGER. Mr. Speaker, I yield myself such time as I may consume.
When the Democrats passed their massive health care overhaul, they
didn't spend one cent to resolve a longstanding problem and ensure
seniors have continued access to their physician. As a result, for the
fourth time since Obamacare passed, we are forced to take emergency
action to prevent physicians from having their Medicare payments
slashed. This time, the looming cut is 25 percent. The brinkmanship
where this Democrat Congress has walked physicians up to the cliff,
only to back away at the last minute, is unacceptable.
My friends on the other side of the aisle are quick to remind us that
they
[[Page H8270]]
offered to address Medicare physician payments last fall. This is true.
They put a bill on the floor which had already failed to pass the
Senate. This bill would have expanded our already record deficit by an
astounding $210 billion, a crippling debt load on top of the $1
trillion health bill. Rather than responsibly manage the Medicare
program, they chose instead to cut Medicare by one half trillion
dollars to fund their government takeover of health care.
The good news is that today we are finally starting to address this
problem in a bipartisan way. We're stopping these cuts not for 1 month
or 2 months but for a full year. We're ensuring that physicians will be
able to keep their doors open and that seniors will have continued
access to their doctors. And we are doing this in a fiscally
responsible manner without adding a dime to the deficit. We are doing
it by taking aim at the irresponsible overspending that was created by
the new health care law.
Let it be known on this day, in the people's House, that dismantling
of Obamacare begins. Once the House passes this bill and the President
signs it into law, we will have landed the first blow to the Democrats'
massive health care overhaul. Today we begin by removing $19 billion
from their risky $1 trillion experiment; a risky experiment that CBO
predicts will force health insurance premiums for millions of families
to increase by $2,100 in 2016 alone; a risky experiment that the Obama
administration predicts could force 117 million Americans out of their
health plans; a risky experiment that Medicare officials have
repeatedly warned could jeopardize seniors' access to care; a risky
experiment that Medicare officials predict will force millions of
seniors out of their current Medicare and retiree health coverage; a
risky experiment that increases taxes by more than one-half trillion
dollars at a time when unemployment is nearly 10 percent.
{time} 1020
A risky experiment that would spend an additional $1 trillion on
health care when every respective economist tells us in order to
improve our country's fiscal health, we must get control of health care
spending.
My friends on the other side of the aisle repeatedly said a doctor's
fix couldn't be paid for, that it shouldn't be paid for. Yet with
bipartisan work, we have before us a fully offset bill that gives
physicians 1 year of certainty while Congress works to reform physician
payments in a fiscally responsible manner once and for all.
So here we are today, Mr. Speaker, pulling at the thread that will
begin to unravel ObamaCare. Rest assured, America, we are taking $19
billion today, but we will continue to fight to get the rest next year.
Mr. Speaker, I reserve the balance of my time.
General Leave
Mr. STARK. Mr. Speaker, I ask unanimous consent that all Members may
have 5 legislative days in which to revise and extend their remarks on
this matter.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from California?
There was no objection.
Mr. STARK. I would like to remind my distinguished friend that health
reform was 100 percent paid for, and the party that wants to spend $700
billion on the richest Americans for their tax cuts certainly shouldn't
lecture anyone on the deficit.
Mr. Speaker, I yield such time as he may consume to the gentleman
from New Jersey (Mr. Pallone).
Mr. PALLONE. Mr. Speaker, first of all let me say, as I did the other
day, as you know, about a week ago we passed an extension to eliminate
the cut in the SGR, the doctor's fix, until the end of this month. This
bill before us today would take this for another year, until the end of
December of 2011.
And at the time, the gentleman from California (Mr. Herger) also got
on the floor and made statements which I think totally do not represent
what we were doing. First of all, I would say with regard to the
doctor's fix, nobody wants a 25 percent cut in doctor's reimbursement
rate, and that is why we were here last week for the extension to
eliminate that cut until the end of this year, and that is why we are
today, to eliminate that cut until the end of 2011.
But the fact of the matter is it is the Republican Party and it is
the party of the gentleman from California (Mr. Herger) in the House
that refused to vote for a permanent fix when we passed it in the
Democratic majority over a year ago. As I said that day, only one
person, Dr. Burgess who is a physician on our committee, voted with the
Democrats for the permanent fix. It is as a result of the inability and
the unwillingness of the Republicans to do anything about this doctor's
cut or reimbursement cut that we had to pass, I guess, five different
short-term fixes.
Now granted today we are going to have a year extension, and I am
certainly happy that the Republicans have agreed to a year extension,
but they still have not come along to a permanent fix and they have not
helped us in our efforts to achieve a permanent fix. So for the
gentleman to suggest that somehow the Republicans have been helpful and
they wanted to deal with this problem is, in my opinion, simply not
accurate.
Now, let me dispel another thing. There is nothing in this bill that
would in any way disrupt or repeal the health care reform, the landmark
legislation that the Democrats passed again this year without any
support from the other side of the aisle. If there was any remote
suggestion that we were repealing or this was the beginning of the
repeal, as the gentleman suggested, of the health care reform, not one
Democrat would support that; and I certainly would not.
The fact of the matter is that the health care reform was fully paid
for. And the fact of the matter is that it did not in any way affect
Medicare beneficiaries. We actually improved benefits for Medicare
beneficiaries in the health care reform. We basically filled up and
eliminated the doughnut hole. We also provided more money for copays so
seniors who are poor or lower income would not have to do copays for
preventative care. And the list of additional benefits for Medicare
beneficiaries under the larger health care reform goes on and on. I
could list more.
So the suggestion that we somehow were cutting Medicare benefits is
simply not true. The fact of the matter is that benefits were
increased; the bill was paid for; and this bill today in no way takes
away from that larger health care reform.
Now we have paid for the health care reform. We have paid for the
doctor's fix for an additional year in this legislation by making sure
that people who were going to get a subsidy and who didn't qualify
would have to pay it back. That is the only change. That is the way it
is paid for here today.
I just want to say, Mr. Speaker, this is a very important bill. It is
a vital piece of legislation for America's seniors, persons with
disabilities, and military families. Without this legislation,
physician fees in Medicare and TRICARE would be reduced by 25 percent
on January 1, just 3 weeks from now, and that kind of cut would
threaten the ability of enrollees in Medicare and TRICARE to see their
doctors. We can't allow that to happen.
As I mentioned before, we have passed some short-term fixes. This is
another short-term fix. But, thankfully, it is at least for another
year until we can work out a permanent solution. The Democrats already
passed that permanent solution without Republican help; but,
unfortunately, therefore, it did not become law and we will have to
address it again.
The bill also provides help in 2011 to low-income Medicare
beneficiaries in paying their part B premiums which are nearly $100 per
month for many people. The legislation extends several important
Medicare policies, including an exceptions process for therapy caps
that allows Medicare beneficiaries to access medically needed therapy
treatment. And it extends an important program that helps Medicaid
beneficiaries work more hours without losing their Medicaid benefits.
It is completely paid for over 10 years. It moved through the Senate
by unanimous consent. It is really not controversial at all, and so I
urge Members of the House to vote ``yes'' on this bill that provides
stability to the Medicare program.
Mr. HERGER. Mr. Speaker, I yield the balance of my time to the
ranking
[[Page H8271]]
member of the Energy and Commerce Committee, the gentleman from Texas
(Mr. Barton).
The SPEAKER pro tempore. Without objection, the gentleman from Texas
will control the time.
There was no objection.
Mr. BARTON of Texas. I thank the gentleman from California for his
courtesy.
I would ask the Chair how much time I have remaining.
The SPEAKER pro tempore. The gentleman has 15 minutes remaining.
Mr. BARTON of Texas. May I ask the Chair how much time my friends on
the majority have remaining?
The SPEAKER pro tempore. The gentleman from California (Mr. Stark)
has 13 minutes remaining.
Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may
consume.
The Republicans do rise in support of this 1-year fix for the
reimbursement rate for physicians. Having said that, I think I was able
to listen to some of what my distinguished subcommittee chairman of the
Energy and Commerce Committee, Mr. Pallone, was saying as I was waiting
for the tram to come over here. It is time, Mr. Speaker, for Members on
both sides of the aisle to put aside partisan politics and in the
upcoming year or years, if it takes more than 1 year, sit down and
let's really come up with a new formula to fix permanently how we pay
our physicians.
The current formula is based on an index that is based on inflation;
and under the score keeping, any year in which medical expenses go up
more rapidly than the general inflation rate, I am simplifying the
index but this is the basic part of it, you have to find savings in
that particular year or there is a negative balance created in the
physician reimbursement fund. The current system is not sustainable. It
doesn't work. It doesn't reflect the practice of medicine. But because
of our score keeping, we keep getting further and further behind and so
each year the 1-year cut gets bigger and bigger. This year it would be
25 percent.
Now obviously when most of our physician community claims, and I
think with justification, that they are not being adequately reimbursed
for treating Medicare patients, you have the situation as you have in
my district, and I am sure each of us can say in our own districts, in
their districts, physicians are not taking Medicare patients. In my
home county of Ellis County, the county seat is a community of about
30,000, Waxahachie, Texas. The mayor of Waxahachie is a personal friend
of mine, and I have known him for over 20 years.
{time} 1030
His existing doctor retired. He is on Medicare. He is over 65. He
went to find a new doctor who would treat him, and he couldn't find a
doctor. Here is the mayor of Waxahachie, Texas, who at least
temporarily cannot find a Medicare doctor who will accept him as a
patient. That doesn't make sense. You can have the best health care
system in the world, and if you don't have the doctors to implement it,
you don't have a health care system.
So it is my strong recommendation that Republicans--the current
minority, soon to be majority--vote for this 1-year fix, knowing that
it is really not a fix, that it is another kick-the-can, kick-the-
problem down the road. But in this case, at least it is for a year.
In the upcoming Congress and when the majorities switch, I am going
to be a member of the committee of primary jurisdiction, the Energy and
Commerce Committee. It will be my strong recommendation to our new
chairman, Fred Upton of Michigan; to our new Speaker, Mr. Boehner of
Ohio; and to our new majority leader, Mr. Cantor of Virginia, that we
sit down with our stakeholders and with our friends on the soon-to-be
minority side of the aisle to come up with a system that adequately
reflects the will of both parties, that also gets buy-in from the
stakeholders and reflects the cost of practicing medicine as it is
today.
I know it is going to be expensive. I know it is going to be
difficult, but it will be possible, and I hope that we can do that. I
would ask for a ``yes'' vote when it comes time to vote for this under
the suspension calendar.
I reserve the balance of my time.
The SPEAKER pro tempore. Without objection, the gentleman from New
Jersey will control the time.
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
California (Mr. Farr).
(Mr. FARR asked and was given permission to revise and extend his
remarks.)
Mr. FARR. Thank you very much for yielding.
Mr. Speaker, I rise in support of this bill but with real dismay.
First, it is ludicrous that Congress continues to pass the SGR
instead of to fix it once and for all. This bill, though necessary,
doesn't fix what is broken, and we will just find ourselves back here
again next year, trying to find a way forward. It is time to ``repeal
and replace'' the doctor payment formula and to come up with something
new.
Second, this bill contains special ``pork'' favors for certain
Midwest Senators which will pay their doctors more than the doctors in
other parts of the country--in particular, my State of California.
Section 103 of this bill provides an arbitrary ``floor'' for certain
doctors' payments in Iowa and in other Midwest States that will boost
their Medicare reimbursements, but this provision does not extend to
all doctors in the United States. Iowa will get an additional $17
million in FY 2011, on top of regular Medicare reimbursements, which
other States will not get. Over the 2-year cycle of FY 2010-2011, Iowa
doctors will be reimbursed over $34 million because of this special
``floor'' in payments inserted by Senator Grassley and by others in
that body.
In a bill that is supposed to be ``clean'' and that is supposed to
simply advance a moratorium on reductions in the sustained growth rate,
section 103 is an abomination. It is plain unfair to doctors in other
States.
My doctors in California and especially in my district have suffered
for more than a decade under a misaligned doctor payment formula due to
outdated geographic locality designations. Despite numerous government
reports by the GAO and CMS and despite numerous times that the House
has passed legislation to fix this problem, the Senate has refused to
accept the fix in favor of tipping the scales in order to satisfy
Senator Grassley's whims.
If Congress really wants to do right by doctors, it needs to do right
by all doctors. This bill does not do that.
Mr. BARTON of Texas. Mr. Speaker, I yield 3 minutes to a
distinguished member of the Energy and Commerce Committee and of the
Health Subcommittee, the current ranking member of the Oversight and
Investigations Subcommittee, Dr. Michael Burgess of Lewisville, Texas.
Mr. BURGESS. I thank the gentleman, my ranking member, for yielding.
Mr. Speaker, this is an important bill that is going to be before us
today. Ordinarily, I would not support something this large being done
on a suspension calendar, but this truly is an emergency for our
Nation's patients and for our Nation's physicians.
I support the passage of this bill. It does also give us some time in
this body and in the other body to work on a permanent solution. There
is plenty of blame to go around on both sides of the aisle and in both
Houses of this Capitol as to why we are in this fix.
The fact is that it began back in 1998 with the Omnibus Budget
Reconciliation Act. It was extended under the Republican watch for 12
years. Now we have had 4 years under the Democrats, and it has not been
fixed. In fact, most of the doctors you talk to have just come through
the worst year ever in trying to manage their practices.
Stop and think about it for a minute.
You've got a small medical practice of two, three, four, five
doctors. They don't do all Medicare work--maybe it's only 5 or 10
percent of their actual book of business. But in April and in June, we
asked the administrator of the Centers for Medicare and Medicaid
Services to hold the checks for a few weeks until Congress could get
back from a recess and take up yet another fix for this problem.
The practical effect of doing this was that we cut 10, 15 percent off
of the operating budget for every small practice that did Medicare,
that saw our Medicare patients in this country that we asked them to
see. Most physician offices run very close to the margin
[[Page H8272]]
every month. The consequence of this was that they had to go out and
borrow the money to meet cash flow in April and in June. I dare say
most of those practices have not yet fully recovered from that insult
to the cash flow that occurred.
So it is extremely important for us to pass a 1-year extension that
gives them the stability to be able to plan, that gives patients the
ability to be able to find doctors under the Medicare system and that
gives physician offices the ability to plan for the future.
Now, during this year that comes up, we are obligated--both sides of
the aisle and both Houses in this Capitol--to fix this problem. Shame
on us if it continues after this fix has expired. There is the
political will to do it. We have heard it this morning from both sides.
I will commit myself to working with, yes, my side, with the other side
of the aisle and with the other House in this Capitol to work on a
permanent solution to this. It is out there. It depends on how we want
it to look. It depends on where we are going to get the pay-fors.
One of the most egregious things in this health care bill that the
President signed last March was, even though you took $500 billion out
of the Medicare system, you used that to fund a new entitlement for the
middle class in subsidies in the exchange. Not one dime--not one dime--
was sequestered to pay down the problem that we have with the
sustainable growth rate formula.
Here is the real bad news.
The Independent Payment Advisory Board is coming up in 2015, also
part of the health care bill that was signed into law last March.
Doctors now, perhaps, face double jeopardy from cuts in the sustainable
growth rate formula and from cuts within the Independent Payment
Advisory Board.
The time to fix it is now. It stretches out ahead of us for 12
months. We've got time to do it. Let's dedicate ourselves to getting
this done for our Nation's seniors.
Mr. PALLONE. I reserve the balance of my time.
Mr. BARTON of Texas. Mr. Speaker, I think all that needs to be said
has been said; so let me simply say that this is a problem that needs
to be dealt with.
I compliment those who negotiated the 1-year fix. Hopefully, in the
next Congress, we will work together--and I mean that seriously--in a
bipartisan fashion to replace the existing formula with one that
doesn't have to be updated and fixed in every session of Congress. Yet,
for today, I would urge all of those in the current minority to vote
for the bill under suspension.
I yield back the balance of my time.
Mr. PALLONE. Mr. Speaker, let me associate myself completely with the
remarks that the gentleman from Texas just made.
I do think that it is significant that we are able to negotiate on a
bipartisan basis a 1-year extension to avoid these cuts to the doctors,
and I do believe we need to work together on a bipartisan basis to
achieve a permanent fix in the next Congress.
Ms. JACKSON LEE of Texas. Mr. Speaker, today I rise in support of the
Senate amendment to H.R. 4994, the ``Medicare and Medicaid Extenders
Act,'' which makes certain that our seniors and military families are
able to continue seeing their doctors.
Scheduled for January 1 and through 2011, this bipartisan legislation
stops the 25 percent cut in Medicare payments to doctors. This very
important legislation protects and supports our doctors who are serving
Medicare recipients and active duty military, their families, the
Reserve members and military retirees whose access to healthcare is
tied to Medicare through the TRICARE system. If we fail to pass this
legislation we are doing an extreme injustice to numerous Americans who
depend on these doctors and this Congress for their healthcare.
In my Congressional District, Riverside General Hospital (RGH), a
member of the TRICARE network can ensure military families will be able
to continue to see their doctors. Riverside General Hospital, formerly
The Houston Negro Hospital was erected in 1926 in memory of Lieutenant
John Halm Cullinan, 344th FA., 90th Div. AEP.
St. Joseph Medical Center, in Houston, Texas, in my district, the
only hospital in the inner city of Houston, can now continue to provide
access to Medicare beneficiaries to Houston's most needy patient
population as a result of this legislation in its current form.
Currently, St. Joseph's provides $14 million in uninsured care in the
Houston Market.
St. Joseph Medical Center provides a full range of comprehensive
medical and surgical services, such as, cardiology, cancer care,
behavioral health, intensive care/critical care, emergency care,
neurosurgery, orthopedics and pediatrics. St. Joseph Women's Medical
Center, Houston's only full service women's hospital attached to a
general acute care hospital, provides women's medical and surgical
services, a family birthing center for moms and newborns, labor/
delivery/recovery suites and a neonatal intensive care unit for
premature or seriously ill newborns. The Level III Neonatal Intensive
Care Unit is staffed by the Small Wonders Team of specially trained
doctors, nurses and staff who provide the smallest patients with the
best chance at life. Specialty services provided by St. Joseph include
an advanced wound care center, behavioral medicine, blood conservation
and management services, occupational medicine, sports medicine and
rehabilitation, inpatient and outpatient diagnostic imaging, and
Corporate Healthcare Connection, a partnership with Houston's corporate
businesses that provides expedited care to their employees. A Houston
institution for 120 years, St. Joseph Medical Center is also a major
provider of psychiatric beds as it currently operates 102 of the 800
licensed beds in Houston.
For an entire year, this legislation provides thousands with a
practical, invaluable, and stable solution for deserving patients and
doctors. These doctors deserve payment for the aid they render and we
would be doing an intensely unjust service to them by not ensuring
their repayment. Furthermore, we would be building a shaky platform for
our constituents by not ensuring healthcare and medicine to the
elderly, unfortunate, or those who so altruistically serve or served
our country.
Moreover, the bill is fully paid for according to the Congressional
Budget Office. Furthermore, the CBO reports that it would serve to
reduce the deficit by $2.8 billion over the next 10 years if the bill
is passed. This is made possible by modifying the Affordable Care Act
in the area of overpayments of tax credits to help individuals afford
insurance. It is important to note that this bill's provision will in
fact protect income based tax credits. Specifically, this provision
would change the way individuals pay back overpayments when they
receive a larger tax credit than they were eligible for based on their
actual income for the year. Also, this legislation is highly supported
by AARP and the American Medical Association.
Other extensions include:
The Transitional Medical Assistance (TMA), which allows low-income
families to keep their Medicaid coverage as they move into employment
and their income increases. Which is extremely important for those who
are struggling to get on the their feet and make a way for themselves
and their families. If we take away their assistance just as they are
beginning to earn more money then we force those individuals to
struggle to pay for more costly healthcare they cannot afford
subsequently reducing their total income.
Extension of the Qualifying Individual (Q1) Program which allows
Medicaid to pay the Medicare premiums for those with incomes 120-135
percent below the poverty line who are Medicare recipients.
Mr. Speaker, I urge my colleagues to support the passage of H.R.
4994, which greatly assists our countrymen and helps those who are
elderly, poverty stricken, and those brave individuals who serve and
served in our armed forces and their family members.
Further, however the major component to keeping our health care
system working is to not reduce doctors' payments from medicare by 25%
as of January 1, 2011. This bill will fix that inequity and extend
current medicare payments to doctors. Until December, 2012.
This is good advice. I urge a ``yea'' vote.
Ms. SCHAKOWSKY. Mr. Speaker, I rise today in support of the Senate
amendments to H.R. 4994.
I continue to believe that we need to make permanent reforms to
Medicare's physician payment rules. Senior citizens and persons with
disabilities need to know that they will be able to get high quality
and timely care and that their doctors will be paid fairly and in a
timely fashion. There is never really any question that Congress will
act to prevent double-digit cuts in Medicare and TRICARE physician
payments, but we should not have to debate these issues on a monthly
basis.
The bill before us today does not provide a permanent solution as I
would like, but it does provide a one-year fix, eliminating the
confusion and concern that is created by very short-term measures to
prevent cuts. I am pleased that it also includes an extension of the
Medicare physician payment add-on for mental health, since we know that
access to mental health services continues to be a problem in our
communities.
While much of the focus has been on the physician payment issue,
there are other provisions in the Medicare and Medicaid Extenders Act
that will improve access to care
[[Page H8273]]
through December 31, 2011. Those include an extension of the exceptions
process for Medicare therapy caps so that individuals who need
additional services will not be forced to go without. It extends the
Special Diabetes Programs, which are so important in dealing with the
impacts of this terrible disease. The bill clarifies that orphan drugs
are included in the 340B drug discount program for children's
hospitals. It continues Medicare's Quality Individual program to help
pay for Medicare Part B premiums for low-income seniors and people with
disabilities and it extends Transitional Medical Assistance so low-
income families don't lose critical Medicaid coverage as they move into
employment.
Passage of the Medicare and Medicaid Extenders Act will make sure
that the end of this year won't bring with it cutbacks in access to
health care for millions of Americans. It gives us all of 2011 to make
these year-long extensions permanent, and I will work hard to make sure
that we use next year to do so.
Mr. WAXMAN. Mr. Speaker, I speak today in support of H.R. 4994, the
``Medicare and Medicaid Extenders Act of 2010.''
This legislation blocks a 25 percent fee cut that is scheduled for
Medicare physician payments on January 1, 2011. A cut of that magnitude
would jeopardize the access of seniors and people with disabilities to
their doctors.
Likewise, military families who rely on TRICARE need this
legislation, because TRICARE uses Medicare rates and would also face a
huge fee cut on January 1.
The recent practice of Congress to legislate on physician payments
several times per year needs to stop. Upon enactment, this will make
the fifth SGR bill Congress has passed in 13 months.
I am pleased that this legislation, unlike other recent SGR bills,
would address the problem for an entire year.
However, a 1-year solution is far less than the Medicare program
ultimately needs. Congress must eventually confront the SGR
permanently. The House has previously passed a permanent solution to
the SGR problem. I hope that the next Congress is able to follow up on
that work and fix this problem once and for all.
This bill also ensures the continued ability of Medicare
beneficiaries to access therapy benefits to help them recover from
illness. And it contains other important technical changes to maintain
the smooth functioning of the Medicare and Medicaid programs.
Other provisions of this bill help low income Medicare and Medicaid
beneficiaries. One provision helps low-income Medicare beneficiaries
cover the cost of their Medicare Part B premiums. Another extends the
transitional medical assistance program to help Medicaid beneficiaries
as they work more hours and increase their earnings.
This legislation is completely paid for, and it is necessary. It
passed the Senate by unanimous consent, and I hope that all Members of
the House will support it as well.
One further note for purposes of interpretation. Section 204 of this
bill contains a technical amendment to Section 340B of the Public
Health Services Act. This language corrects an error in P.L. 111-152,
the Health Care and Education Reconciliation Act of 2010, that
inadvertently caused children's hospitals to lose access to orphan
drugs at 340B prices. The language in Section 204 restores full access
to orphan drugs at 340B prices for these hospitals. This amendment is
retroactive as if included in P.L. 111-152. The intent of this
retroactivity is to clarify congressional intent that there be no
discontinuity in access to orphan drugs at 340B prices for childrens'
hospitals. To the extent that drug manufacturers have not provided
these discounts at any point between the enactment of P.L. 111-152 and
the enactment of this legislation, they should do so retroactively,
subject to HRSA or any other compliance and enforcement authority.
Mr. CONYERS. Mr. Speaker, I rise today in support of Senate
amendments to H.R. 4994, the Medicare and Medicaid Extenders Act.
One of the most important priorities of Congress, regardless of our
current economic downturn, is the financial well-being of our nation's
hospitals, and the ability of patients to have access to medically
necessary care when they need it.
Passage of the Senate amendments to H.R. 4994 accomplishes both goals
by blocking a scheduled 25 percent cut in Medicare payments to doctors
and extending current Medicare payment rates through December 31, 2011.
Passage of the bill today by the House will send this legislation to
the President's desk for his signature.
In order to have world class hospitals in the United States, we must
have the needed funding to ensure that our nation's hospitals can
provide the highest quality care possible. Passage of the Senate
amendments to H.R. 4994 will help strengthen our hospitals, especially
those located in our inner cities and rural areas. These hospitals are
experiencing serious funding shortages, and are at risk of losing much
needed doctors and medical staff.
This bill is fully paid for, and according to CBO, the bill would
reduce the deficit by $2.8 billion over the next 10 years. This
legislation also helps to protect access to doctors for Medicare
beneficiaries and military families, given that payment rates for
doctors in TRICARE, the health care program for active-duty
servicemembers, National Guard and Reserve members, military retirees,
and their families are tied to Medicare rates. Passage of the Senate
amendments to H.R. 4994 is a good example of how Members of Congress
working together in a spirit of bipartisan unity can improve the health
and well being of all Americans.
I do want to raise some concerns with the way this bill is going to
be paid for, which is to decrease the affordability credits for
Americans that are needed to defray the costs of purchasing private
insurance under the soon to be established health exchanges in 2014. I
believe that this is tantamount ``to robbing Peter to pay Paul.'' This
Congress should not get into the habit of viewing future benefits for
low-income Americans as a source of funding for today's legislative
initiatives. There are other more fair minded and progressive offsets
which could have been utilized for this payment fix--such as taxing
Wall Street or our nation's billionaires.
If we are going to make sure that Medicare doctors and hospitals are
reimbursed at an appropriate rate over the next several years, we are
going to have to be more serious and pragmatic about how to implement
efficiencies in the Medicare program.
Medicare is a highly successful and efficient program, but it can't
keep feeding the ``corporate medical monster'' forever. The time has
come for the Federal Government to rein in the costs of for-profit
hospital care by taking a more serious look at how we can reduce the
costs of prescription drugs and medical technology--two of the most
costly expenditures for hospitals and doctors.
Furthermore, we must pass H.R. 676, ``The U.S. National Health Care
Act,'' so that all Americans can enjoy the benefits of a universal
single payer system, which has successfully worked in every major
industrialized country to contain the rising costs of health care and
provide quality health care for all. If we created this system, then we
would be able to pay our nation's physicians at optimal levels and
provide America's hospitals and clinics with a more financially stable,
predictable, and efficient health care payment system for years to
come.
In the meantime, today's physician payment bill will allow today's
Medicare beneficiaries to enjoy the care they have earned. I urge my
colleagues to support the bill.
Mr. PALLONE. I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from California (Mr. Stark) that the House suspend the rules
and concur in the Senate amendments to the bill, H.R. 4994.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds
being in the affirmative, the ayes have it.
Mr. HERGER. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
____________________