[Congressional Record (Bound Edition), Volume 147 (2001), Part 8]
[Senate]
[Pages 11374-11375]
[From the U.S. Government Publishing Office, www.gpo.gov]



                           TEXT OF AMENDMENTS

  SA 807. Mr. HUTCHINSON (for himself, Mr. Bond, Ms. Collins, Mr. 
Allen, Mr. Nickles, Mr. Burns, and Mr. Smith of New Hampshire) proposed 
an amendment to the bill S. 1052, to amend the Public Health Service 
Act and the Employee Retirement Income Security Act of 1974 to protect 
consumers in managed care plans and other health coverage; as follows:

       At the end, add the following:

     SEC.   . DEDUCTION FOR 100 PERCENT OF HEALTH INSURANCE COSTS 
                   OF SELF-EMPLOYED INDIVIDUALS.

       (a) In General.--Paragraph (1) of section 162(l) of the 
     Internal Revenue Code of 1986 is amended to read as follows:
       ``(1) Allowance of deduction.--In the case of an individual 
     who is an employee within the meaning of section 401(c)(1), 
     there shall be allowed as a deduction under this section an 
     amount equal to 100 percent of the amount paid during the 
     taxable year for insurance which constitutes medical care for 
     the taxpayer and the taxpayer's spouse and dependents.''.
       (b) Clarification of Limitations on Other Coverage.--The 
     first sentence of section 162(l)(2)(B) of the Internal 
     Revenue Code of 1986 is amended to read as follows: 
     ``Paragraph (1) shall not apply to any taxpayer for any 
     calendar month for which the taxpayer participates in any 
     subsidized health plan maintained by any employer (other than 
     an employer described in section 401(c)(4)) of the taxpayer 
     or the spouse of the taxpayer.''.
       (c) Effective Date.--The amendments made by this section 
     shall apply to taxable years beginning after December 31, 
     2001.
                                  ____

  SA 808. Mrs. FEINSTEIN submitted an amendment intended to be proposed 
by her to the bill S. 1052, to amend the Public Health Service Act and 
the Employee Retirement Income Security Act of 1974 to protect 
consumers in managed care plans and other health coverage; which was 
ordered to lie on the table; as follows:

       On page 97, between lines 13 and 14, add the following:

     SEC.   . PROMOTING GOOD MEDICAL PRACTICE.

       (a) Prohibiting Arbitrary Limitations or Conditions for the 
     Provision of Services.--
       (1) In general.--A group health plan, or a health insurance 
     issuer that is providing health insurance coverage, may not 
     arbitrarily interfere with or alter the decision of the 
     treating physician regarding the manner or setting in which 
     particular services are delivered if the services are 
     medically necessary or appropriate for treatment or diagnosis 
     to the extent that such treatment or diagnosis is otherwise a 
     covered benefit.
       (2) Construction.--Paragraph (1) shall not be construed as 
     prohibiting a plan or issuer from limiting the delivery of 
     services to one or more health care providers within a 
     network of such providers.
       (3) Manner or setting defined.--In paragraph (1), the term 
     ``manner or setting'' means the location of treatment, such 
     as whether treatment is provided on an inpatient or 
     outpatient basis, and the duration of treatment, such as the 
     number of days in a hospital. Such term does not include the 
     coverage of a particular service or treatment.
       (b) No Change in Coverage.--Subsection (a) shall not be 
     construed as requiring coverage of particular services the 
     coverage of which is otherwise not covered under the terms of 
     the plan or coverage or from conducting utilization review 
     activities consistent with this subsection.
       (c) Medical Necessity or Appropriateness Defined.--In 
     subsection (a), the term ``medically necessary or 
     appropriate'' means, with respect to a service or benefit, a 
     service or benefit which is consistent with generally 
     accepted principles of professional medical practice.
       (d) Application of Section.--This section shall supersede 
     any other provision of this title that conflicts with a 
     provision of this section.
       (e) Review.--Failure to meet the requirements of this 
     section shall constitute an appealable decision under 
     subtitle A and a cause of action relating to such shall be 
     deemed to arise by reason of a medically reviewable decision 
     for purposes of section 514(d) of the Employee Retirement 
     Income Security Act of 1974 (as added by section 302(b)).
                                  ____

  SA 809. Mr. McCAIN proposed an amendment to the bill S. 1052, to 
amend the Public Health Service Act and the Employee Retirement Income 
Security Act of 1974 to protect consumers in managed care plans and 
other health coverage; as follows:

       At the appropriate place, insert the following:

     SEC.   . SENSE OF SENATE WITH RESPECT TO PARTICIPATION IN 
                   CLINICAL TRIALS AND ACCESS TO SPECIALTY CARE.

       (a) Findings.--The Senate finds the following:
       (1) Breast cancer is the most common form of cancer among 
     women, excluding skin cancers.
       (2) During 2001, 182,800 new cases of female invasive 
     breast cancer will be diagnosed, and 40,800 women will die 
     from the disease.
       (3) In addition, 1,400 male breast cancer cases are 
     projected to be diagnosed, and 400 men will die from the 
     disease.
       (4) Breast cancer is the second leading cause of cancer 
     death among all women and the leading cause of cancer death 
     among women between ages 40 and 55.
       (5) This year 8,600 children are expected to be diagnosed 
     with cancer.
       (6) 1,500 children are expected to die from cancer this 
     year.
       (7) There are approximately 333,000 people diagnosed with 
     multiple sclerosis in the United States and 200 more cases 
     are diagnosed each week.
       (8) Parkinson's disease is a progressive disorder of the 
     central nervous system affecting 1,000,000 in the United 
     States.
       (9) An estimated 198,100 men will be diagnosed with 
     prostate cancer this year.
       (10) 31,500 men will die from prostate cancer this year. It 
     is the second leading cause of cancer in men.
       (b) Sense of the Senate.--It is the sense of the Senate 
     that--
       (1) men and women battling life-threatening, deadly 
     diseases, including advanced breast or ovarian cancer, should 
     have the opportunity to participate in a Federally approved 
     or funded clinical trial recommended by their physician;
       (2) an individual should have the opportunity to 
     participate in a Federally approved or funded clinical trial 
     recommended by their physician if--
       (A) that individual--
       (i) has a life-threatening or serious illness for which no 
     standard treatment is effective;
       (ii) is eligible to participate in a Federally approved or 
     funded clinical trial according to the trial protocol with 
     respect to treatment of the illness;
       (B) that individual's participation in the trial offers 
     meaningful potential for significant clinical benefit for the 
     individual; and
       (C) either--
       (i) the referring physician is a participating health care 
     professional and has concluded that the individual's 
     participation in the trial would be appropriate, based upon 
     the individual meeting the conditions described in 
     subparagraph (A); or
       (ii) the participant, beneficiary, or enrollee provides 
     medical and scientific information establishing that the 
     individual's participation in the trial would be appropriate, 
     based upon the individual meeting the conditions described in 
     subparagraph (A);
       (3) a child with a life-threatening illness, including 
     cancer, should be allowed to participate in a Federally 
     approved or funded clinical trial if that participation meets 
     the requirement of paragraph 2;
       (4) a child with a rare cancer should be allowed to go to a 
     cancer center capable of providing high quality care for that 
     disease; and

[[Page 11375]]

       (5) a health maintenance organization's decision that an 
     in-network physician without the necessary expertise can 
     provide care for a seriously ill patient, including a woman 
     battling cancer, should be appealable to an independent, 
     impartial body, and that this same right should be available 
     to all Americans in need of access to high quality specialty 
     care.

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