[Congressional Record (Bound Edition), Volume 146 (2000), Part 17]
[House]
[Pages 25738-25739]
[From the U.S. 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. 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.

[[Page 25739]]


  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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