[Congressional Record (Bound Edition), Volume 148 (2002), Part 1]
[Senate]
[Pages 954-958]
[From the U.S. Government Publishing Office, www.gpo.gov]




         STATEMENTS ON INTRODUCTED BILLS AND JOINT RESOLUTIONS

      By Mr. WELLSTONE:
  S. 1928. A bill to amend section 222 of the Communications Act of 
1934 to require affirmative written consent by a customer to the 
release of customer proprietary network information; to the Committee 
on Commerce, Science, and Transportation.
  Mr. WELLSTONE. Mr. President, I rise today to introduce legislation 
to require telecommunications firms to receive explicit written consent 
from consumers prior to sharing their customer proprietary network 
information, or CPNI, with other entities. This is a simple bill that 
will provide consumers with the privacy protection that they deserve to 
have and that I believe should already be required under the 1996 
Telecommunications Act.
  The 1996 Communications Act established as law that CPNI is 
confidential personal information, requiring customer approval before 
its release or being shared with others. Congress and the American 
people count on the Federal Communications Commission, FCC, to carry 
out that mandate and to protect the privacy of American consumers who 
use the country's telecommunications system. Therefore, I believe it 
shouldn't really even be necessary to introduce this legislation, 
clarifying that approval should mean ``express written consent'' or, in 
other words, an ``opt-in'' approach to protecting privacy. But I share 
the concern of consumer advocates and 39 State attorneys general that 
the FCC, which is currently taking comment on the matter, could 
otherwise adopt an ``opt-out'' approach to privacy as it relates to 
CPNI. In my view, and in the view of the consumer advocates and the 
state attorneys general, an opt-out approach cannot adequately protect 
consumers' privacy and would not meet Congress's intent in passing the 
1996 Communications Act.
  An opt-out approach would put the unfair burden on consumers to 
protect their own confidential personal information that is in the 
possession of large telecommunications companies, protect it from being 
shared by those companies with other entities. This can be information 
of the most sensitive kind, including lists of phone numbers dialed and 
the duration and timing of calls. An opt-out approach presumes consumer 
consent that such information could be shared unless the customer goes 
through an unduly burdensome and uncertain process to request that the 
provider not share it.
  In recent months in Minnesota, for example, Qwest notified customers 
that the company would begin to share customer information unless the 
customers notified Qwest that they did not want it shared. The company 
notice was often overlooked by customers, and it was difficult to 
understand for many customers who did try to read it. Furthermore, 
numerous customers reported problems getting through to the company's 
800 number, or in navigating the options for opting out of the 
information sharing scheme. Due to customer complaints, and to the 
company's credit, Qwest recently reversed its position and will not 
share any customer information until the FCC issues a final CPNI rule. 
Meanwhile, however, Qwest and other telecommunications carriers have 
been advocating heavily for adoption by the FCC of an ``opt-out'' 
approach.
  I am not telling anyone whether they should want their CPNI shared 
and made available to marketers. That is up to consumers themselves. I 
do want to leave that choice to consumers. I believe that means that 
they must have the opportunity to give their express consent on what 
personal information and to whom it will be shared before such 
information is shared.
                                 ______
                                 
      By Mr. McCONNELL:
  S. 1929. A bill to amend title II of the Social Security to permit 
Kentucky to operate a separate retirement system for certain public 
employees; to the Committee on Finance.
  Mr. McCONNELL. Mr. President, I rise today to introduce legislation 
to add Kentucky to the list of States that are permitted to offer 
``divided retirement'' plans under the Social Security Act.

[[Page 955]]

  Three weeks ago, I was contacted by Brian James, president of the 
Louisville Fraternal Order of Police, FOP, and Tony Cobaugh, president 
of the Jefferson County FOP. These two law enforcement leaders called 
my attention to a problem that could jeopardize the retirement security 
of many of our community's police, fire, and emergency personnel.
  In November of 2000, the citizens of Jefferson County and the City of 
Louisville, KY voted to merge their communities and respective 
governments into a single entity, which will be known as Greater 
Louisville. As one might expect, combining two large metropolitan 
governments in such a short time frame cannot be done without 
encountering a few difficulties along the way. Jefferson County and the 
City of Louisville currently operate two very different retirement 
programs for their police officers. When these two governments merge on 
January 6, 2003, current Federal law will require the new government to 
offer a single retirement plan that could dramatically increase the 
cost of retirement for both our dedicated public safety officers and 
the new Greater Louisville government.
  Thankfully, when the FOP's leaders called this problem to my 
attention, they also suggested a simple solution, let the police 
officers and firefighters choose for themselves the retirement system 
which best meets their needs.
  I rise today to offer legislation that will provide retirement 
stability to our public safety officers by allowing Kentucky to operate 
what is known as a ``divided retirement system.'' I am pleased to be 
joined in this effort by Congressman Ron Lewis and Congresswoman Anne 
Northup who will soon introduce similar legislation in the House of 
Representatives.
  With passage of my legislation and similar legislation by the 
Kentucky General Assembly, Louisville's and Jefferson County's police 
officers would decide whether or not they want to participate in Social 
Security or remain in their traditional retirement plan. While future 
employees will be automatically enrolled in Social Security, no current 
officers would be forced into a new retirement system as a result of 
the merger without their approval.
  Current Federal law allows twenty-one states the option of offering 
divided retirement systems. Unfortunately, Kentucky is not one of these 
twenty-one States. The legislation I am offering today would change 
that by adding Kentucky to the list of states designated in the Social 
Security Act.
  It is critical that the Senate provide this retirement stability to 
the brave men and women who protect the citizens of Louisville and 
Jefferson County everyday. There is extensive precedent for granting 
Kentucky this authority, and my legislation enjoys the broad, bi-
partisan support of policemen, firefighters, local and state officials. 
I look forward to working with this coalition, as well as my colleagues 
in the Senate, to see that this urgently needed legislation is enacted 
into law this year.
  I ask unanimous consent that letters of support from the Louisville 
FOP, Jefferson County FOP, Louisville Firefighters Union, and State 
Finance and Administration Cabinet, be printed in the Record.
  There being no objection, the letters were ordered to be printed in 
the Record, as follows:

                                        Fraternal Order of Police,


                                           Louisville Lodge 6,

                                  Louisville, KY, January 7, 2002.
     Hon. Mitch McConnell,
     Louisville, KY.
       Dear Mr. McConnell: Following a referendum held 
     approximately one year ago the voters in our community 
     approved a government merger of the City of Louisville and 
     Jefferson County Kentucky. Currently officers employed by the 
     City of Louisville working for the Louisville Division of 
     Police do not pay into Social Security, due to having been 
     exempted from making such payments by a previous law. On 
     January 06, 2003 when our new government become effective the 
     Louisville Police Officers who I am elected to represent will 
     no longer be excused from Social Security participation.
       I would like to see our new government offer a ``Divided 
     Referendum'' vote that would allow each individual officer 
     the opportunity to choose his or her own preference in 
     participating in Social Security. This would make for a 
     smoother transition as it relates to our members and the new 
     government. For this to be possible there has to be federal 
     legislation sanctioning Kentucky as a ``Name State''. There 
     are currently twenty-one states that have such designation. 
     Also there has to be changes in the Kentucky. Revised 
     Statutes to allow for the ``Divided Referendum'' vote.
       It is my hope that you would assist our organization in 
     making the necessary changes at both the federal and state 
     levels during this years Congressional Session as well as 
     Kentucky's Legislative Session.
       If you have any questions regarding this issue please do 
     not hesitate to call me. Thank you in advance for any 
     consideration you can give this matter. I am looking forward 
     to seeing you in 2002.
           Respectfully,
                                                      David James,
     President.
                                  ____

                                        Fraternal Order of Police,


                                Jefferson County Lodge No. 14,

                                 Louisville, KY, January 15, 2002.
     Hon. Mitch McConnell,
     Louisville, KY.
       Dear Mr. McConnell: The voters of Louisville and Jefferson 
     County approved the referendum for a consolidated government 
     over one year ago. Now the monumental task of organizing that 
     future government is quickly upon us. As the leader of this 
     labor organization, I must focus on those labor-related 
     issues that affect my membership.
       The biggest issue raised to this point is the area of 
     social security. Louisville police officers do not 
     participate in Social Security. However, Jefferson County 
     police officers do participate. Both FOP lodges are working 
     closely on the very probable police merger that will most 
     likely follow the government merger.
       Both FOP lodges believe that the members should have the 
     opportunity to decide their futures in reference to Social 
     Security through a ``divided referendum''. It is our 
     understanding that a change must occur on the state and 
     federal level. Will you help us by changing Kentucky to a 
     ``Name State''? Hopefully, we can count on your support for 
     enabling changes at the state or federal level during the 
     2002 United States Congress or at the Kentucky General 
     Assembly.
           Respectfully,
     Anthony J. Cobaugh,
                                  ____

                                                        President.
                                      Louisville Professional Fire


                                     Fighters Union Local 345,

                                     Louisville, January 28, 2002.
     Hon. Mitch McConnell,
     Louisville KY.
       Dear Mr. McConnell: Following a referendum held 
     approximately one year ago, the voters in our community 
     approved a government merger of the city of Louisville and 
     Jefferson County, Kentucky. An issue has come up concerning 
     Social Security, involving police and fire fighters. Due to a 
     previous law exempting fire fighters, we do not pay into 
     social security. On January 6, 2003 when our new government 
     becomes effective, the members of the Louisville Professional 
     Fire Fighters, Local #345 will no longer be excused from 
     Social Security participation.
       I would like to see our newly formed metro government offer 
     a ``Divided Referendum'' vote that would allow each 
     individual the opportunity to choose his or her own 
     preference in participating in Social Security. For this to 
     be possible there has to be federal legislation sanctioning 
     Kentucky as a ``Name State''. There are currently twenty-one 
     states that have such legislation. In addition, there has to 
     be changes in the Kentucky Revised Statutes to allow for the 
     ``Divided Referendum'' vote. If ``Name State'' status is not 
     obtained, the new government will be forced to match the 
     Social Security, contribution made by more than 1,300 of its 
     employees, including the fire fighters, who currently do not 
     pay into the Social Security, System.
       It is my hope that you would assist the Louisville 
     Professional Fire Fighters in making the necessary changes at 
     both the federal and state levels during this year's US 
     Congressional Session as well as Kentucky's Legislative 
     Session.
       If you have any questions concerning this issue; please do 
     not hesitate to call me. Thank you in advance for any 
     consideration you can give this matter.
           Respectfully,
                                  Michael J. ``Howdy'' Kurtsinger,
     President.
                                  ____

                                         Commonwealth of Kentucky,


                                     Office of the Controller,

                                  Frankfort, KY, February 6, 2002.
     Hon. A.M. ``Mitch'' McConnell,
     U.S. Senate,
     Russell Senate Office Building, Washington, DC.
       Dear Senator McConnell: The Kentucky Division of Social 
     Security is responsible for administering the social security 
     and Medicare program for all public employees in the 
     Commonwealth. This includes not only state employees, but 
     also the employees of all political subdivisions such as 
     school boards, counties, cities, libraries, water districts, 
     etc.

[[Page 956]]

       Those public employees who are participating in an employer 
     provided retirement system and not covered for social 
     security and Medicare may join the program via an employee 
     referendum. There are several steps that must be taken during 
     this process, but, under current federal and state statutes, 
     it boils down to a simple majority of the eligible employees 
     approving coverage for all employees of a coverage group.
       There is, however, a second mechanism available to certain 
     states that are specifically named in the federal Social 
     Security Act. A referendum of the employees is also 
     conducted, but the outcome of the election differs in that 
     those employees voting for coverage become eligible for 
     participation in the social security and/or Medicare program. 
     Those employees voting against social security coverage are 
     exempt. This is referred as ``divided coverage''.
       Last November, the voters of Jefferson County voted to 
     merge the governments of the City of Louisville and Jefferson 
     County, effective January 6, 2003. The success of the merger 
     efforts, however, also present a problem that must be 
     resolved, that is, the social security and Medicare coverage 
     of several groups of public servants.
       Some of the City of Louisville Police and firefighters 
     contribute only the Medicare program, not social security. 
     Other city police and firefighters contribute to neither. The 
     Jefferson County Police and corrections employees contribute 
     to both social security and Medicare. When the merger become 
     effective next year all these coverage groups will be 
     considered as a single group for social security coverage 
     purposes.
       The new government, under the current legal situation, will 
     face the dilemma of adversely affecting the employee benefits 
     (eliminating social security coverage) of some of these 
     public servants or bring an additional financial burden on 
     the second group (forcing them to contribute to social 
     security) as well as on the new government (additional 
     employer contributions to social security).
       The preferred remedy to this situation is to utilize 
     divided coverage. This would allow each employee to decide 
     for his or herself whether to pay into social security. All 
     new employees hired after a divided referendum is conducted 
     would automatically be enrolled in social security.
       The Commonwealth of Kentucky is not included as a ``named'' 
     state in the Social Security Act and, therefore, its public 
     employers cannot utilize the divided coverage option. We are 
     requesting support for federal legislation amended 42 U.S.C. 
     418 to include Kentucky as a ``named'' state and enable 
     Greater Louisville and their employees to take advantage of 
     the divided coverage concept. This would add Kentucky to a 
     list of 21 states included in section 218(d)(6)(C) of the 
     Social Security Act that are currently permitted to conduct 
     divided referendums. The Kentucky General Assembly is 
     proceeding with amendments to the Kentucky Revised Statutes 
     to authorize a divided referendum, contingent upon federal 
     legislative changes.
       It should also be noted that providing the Commonwealth 
     with the ability to conduct divided coverage would in no way 
     effect the members of the Kentucky Teachers Retirement 
     System. State statutes prohibit social security coverage 
     under the Commonwealth Section 218 agreement with the Social 
     Security Administration to any individual covered by KTRS.
       The Commonwealth of Kentucky and the citizens of Jefferson 
     County need your support for designating Kentucky as a 
     ``Named State'' by the Congress. I will be glad to answer any 
     questions you may have.
           Sincerely,

                                             Patrick L. Doyle,

                                       Director, Kentucky Division
     of Social Security.
                                  ____

                                         Commonwealth of Kentucky,


                                      Office of the Secretary,

                                  Frankfort, KY, February 6, 2002.
     Senator Mitch McConnell,
     U.S Senate, Senate Russell Office Bldg., Washington, DC.
       Dear Senator McConnell: Last November, the voters of 
     Jefferson County voted to merge the governments of the City 
     of Louisville and Jefferson County, effective January 6, 
     2003. The success of the merger efforts, however, requires 
     that certain issues involving the social security and 
     Medicare coverage of several groups of public servants be 
     resolved.
       Some of the City of Louisville Police and firefighters 
     contribute only to the Medicare program, not social security. 
     Other city police and firefighters contribute to neither. The 
     Jefferson County Police and corrections employees contribute 
     to both social security and Medicare. When the merger becomes 
     effective next year all these coverage groups will be 
     considered as a single group for social security purposes.
       The preferred remedy to this situation is to utilize what 
     is termed a ``divided referendum''. This would allow each 
     employee to decide for his or herself whether to pay into 
     social security. All new employees hired after a divided 
     referendum is conducted would automatically be enrolled in 
     social security.
       Before the new government can conduct a divided referendum, 
     the federal Social Security Act must be amended to designate 
     Kentucky a ``Named State''. This would add Kentucky to a list 
     of 21 states included in section 218(d)(6)(C) of the Social 
     Security Act that are currently permitted to conduct divided 
     referendums. The Greater Louisville Merger Transition Office 
     has recommended this option and is pursuing legislation with 
     the Kentucky General Assembly to authorize divided 
     referendums, contingent on Federal legislative changes.
       We support the Greater Louisville Merger Transition Office 
     recommendation and the Commonwealth of Kentucky and the 
     citizens of Jefferson County need your support for 
     designating Kentucky as a ``Named State'' by the Congress. I 
     will be glad to answer any questions you may have.
           Sincerely,
                                                 T. Kevin Flanery,
                                                        Secretary.
                                 ______
                                 
      By Mr. CONRAD:
  S. 1930. A bill to promote the production of energy from wind; to the 
Committee on Finance.
  Mr. CONRAD. Mr. President, I am introducing legislation to promote 
the development of wind energy production across our Nation. My ``Wind 
Energy Promotion Act of 2002'' would provide incentives and clear 
regulatory hurdles to allow this economically feasible and 
environmentally friendly electricity source to help meet our National 
energy needs.
  As the Senate begins work to enact a comprehensive National energy 
policy, we must take advantage of the enormous potential that wind 
energy offers. Wind is an abundant an inexhaustible renewable resource 
across our country. North Dakota alone has the potential to produce 
more than 460,000 megawatts of electricity from wind annually, the 
highest potential in the Nation.
  Wind production costs have fallen dramatically over the last two 
decades, making production affordable, investment logical, and 
electricity consumption from wind economical for our Nation. Production 
costs have declined more than 80 percent since the 1980s, from an 
average of 38 cents per kilowatt-hour to an average of 3-6 cents per 
kilowatt-hour today. These costs are predicted to fall even lower in 
the near future. In addition, wind energy produces no pollution, 
providing a clean, environmentally friendly power option for the 
Nation.
  However, wind energy development faces a number of obstacles, which 
my legislation is designed to overcome. First, my bill will extend the 
valuable wind energy tax credit for five years. The credit expired at 
the end of last year, and renewal is simply crucial to the industry. 
Hundreds of millions of dollars of investment in wind energy in my 
State of North Dakota are on hold because the Senate has not yet acted 
to extend this credit. It is time to extend the credit now, for a full 
five years, in order to ensure substantial investment in the industry 
across the Nation.
  Further, my legislation makes it easier for farmers and ranchers to 
develop wind energy resources. It provides grants and loans to farmers 
and ranchers and allows producers to put wind turbines on CRP lands. 
And, because better technology will make investing in both large and 
small wind harnessing operations more attractive, my bill authorizes 
more than $500 million over the next four years for wind energy 
research. My bill also calls for breaking down federal regulatory 
barriers to wind energy development. The Federal Government should 
help, not hinder the development of the Nation's wind potential. 
Because North Dakota and other western States contain large tracts of 
public lands that contain great wind energy potential, my bill would 
allow for the development of facilities on public lands. Finally, my 
legislation would authorize studies on several aspects of developing 
the Nation's wind energy potential, including one to determine the best 
possible way to overcome the barriers to adequate transmission of power 
generated from wind.
  My bill is not only a key component to providing energy security for 
the country; it would provide a much-needed economic stimulus to rural 
America.
  According to the American Wind Energy Association, every 100 
megawatts

[[Page 957]]

of wind energy development will produce 500 job years of employment. In 
addition, payments to farmers and ranchers could equal $4 million for 
every 2,000 megawatts of wind energy production, money our Nation's 
producers would get simply for allowing wind development on their land. 
This would be a critical boost to our Nation's rural economy.
  Wind energy development would also play a key role in the economy of 
North Dakota. Extending the production tax credit alone will mean more 
than $100 million in sales for DMI Industries, LM Glasfiber, and other 
industry participants in my state in the next year. Using only 
conservative estimates, the wind industry has the potential to add a 
half billion dollars to North Dakota's economy in 2002, but only if the 
Senate acts soon to extend the wind energy production tax credit, the 
most important component of the legislation I am introducing today.
  The Senate will be taking up energy legislation this week. As this 
debate begins, I will be working to include the provisions of my wind 
energy legislation in a comprehensive energy policy that our Nation 
seriously needs. I urge my colleagues to join me in supporting the 
development of wind energy in the United States through the provisions 
of my Wind Energy Promotion Act.
                                 ______
                                 
      By Mr. LIEBERMAN (for himself, Ms. Collins, Mr. Torricelli, Ms. 
        Snowe, and Mr. Cochran):
  S. 1931. A bill to amend title XVIII of the Social Security Act to 
improve patient access to, and utilization of, the colorectal cancer 
screening benefit under the Medicare Program; to the Committee on 
Finance.
  Mr. LIEBERMAN. Mr. President, I rise to introduce the ``Colon Cancer 
Screen for Life Act of 2002.'' I am pleased that my colleagues Senators 
Collins, Torricelli, Snowe and Cochran have joined me in introducing 
this very important bill.
  As many of my colleagues know from personal experience, colon cancer 
is a devastating disease. Nearly 57,000 people die each year from colon 
cancer. It is the third most commonly diagnosed cancer in both men and 
women and the second most common cause of cancer-related death in 
America.
  But colon cancer can be combated, controlled and potentially 
conquered if it's caught in the earliest stages. In fact, colon cancer 
is a rare form of cancer in that it can even be prevented through 
screening, if pre-cancerous polyps are quickly identified and removed.
  The survival rate when colon cancer is detected at an early, 
localized stage is 90 percent. But only 37 percent of such cancers are 
discovered at that stage. The later the disease is caught, the lower 
the survival rate.
  That's why in 1997, Congress led the fight against colon cancer by 
making screening for the disease a covered benefit for every Medicare 
recipient. That is especially significant because the risk of colon 
cancer rises with age.
  Heightened awareness and greater access to treatment are working. 
Over the last 15 years, we've seen steady, if slow, annual declines in 
both incidence rates and mortality rates tied to colon cancer.
  But we can do more, because barriers to screening still exist. Modern 
technology has blessed us with extremely accurate screening tools, in 
particular the colonoscopy, which results in higher colon cancer 
identification rates and better long-term survival rates due to early 
detection. A consultation with a doctor before a colonoscopy is 
required to ensure that patients are properly prepared before they 
undergo the procedure.
  Unfortunately, Medicare does not pay for that consultation before a 
screening, creating an obvious obstacle to preventive treatment for 
many men and women. The Colon Cancer ``Screen for Life'' Act would 
cover these medical visits so that more Medicare beneficiaries will 
have easy access to screening.
  Further, with this legislation, just as Congress has done for 
screening mammography, screening colonoscopy will not count toward a 
senior's Medicare deductible. This will remove additional financial 
disincentives to screening.
  Finally, with this bill, we're breaking through another big barrier 
to early detection and treatment.
  The medical reality is that colonoscopy procedures are invasive and 
require sedation to perform, making it safer for them to be conducted 
in the hospital or an outpatient setting, where safety standards and 
emergency procedures are in place, rather than in a private doctor's 
office. But when doctors perform colonoscopies for Medicare patients in 
an outpatient setting, they take a hit on cost, because reimbursement 
for the procedure performed there has decreased by nearly 36 percent 
since 1997, while reimbursement for the procedure performed in a 
doctor's private office has increased by 52 percent.
  As a result, to balance their budgets, doctors and hospitals are 
typically forced to space out their Medicare patients, creating long 
waits for and limited access to these vital screenings. That financial 
incentive structure is indefensible.
  The job of medical services should be cutting cancer, not cutting 
costs. Unfortunately, today something as critical as colon cancer 
screening is moderated not by the real needs of patients and their 
medical doctors, but by market incentives.
  To address the problem, the ``Screen for Life'' Act would increase 
the payment rates for colonoscopies performed in hospitals and 
outpatient facilities by 30 percent. The result will be more access to 
early detection and treatment and thousands of lives saved.
  Colon cancer is a formidable foe, but we can make a difference in the 
fight against it. Early detection and treatment is our first line of 
defense.
  With the help of the Colon Cancer ``Screen for Life'' Act, I hope 
that in a decade we'll have fewer cancer cases to contend with and more 
survivors to celebrate the simple fact that screening saves lives.
  Ms. COLLINS. Mr. President, I am pleased to join Senators Lieberman, 
Torricelli, Snowe, and Cochran in introducing the Colon Cancer Screen 
for Life Act of 2002 to improve patients' access to the colorectal 
cancer screening benefit under Medicare.
  Colorectal cancer is the second leading cause of cancer-related 
deaths in the United States for both men and women: more than 57,000 
Americans will die from this disease this year, yet it is a disease 
that many of us feel uncomfortable discussing.
  The sad irony is that cancer of the colon is probably the most 
treatable and survivable of all cancers, but only if it is caught 
early. If detected and treated early, colon cancer is curable in more 
than 90 percent of diagnosed cases. Conversely, if the cancer is 
detected in an advanced stage, death rates are high. As many as 92 
percent of these patients will die within five years.
  Despite the fact that we have extremely effective screening tests for 
colon cancer, our screening rates for colon cancer, even among those 
Americans who are most at risk, are woefully low. Moreover, even the 
addition in 1998 of a new Medicare benefit covering these services has 
not improved the situation.
  In 2000, the General Accounting Office, GAO, conducted a review of 
claims data to determine the extent to which this new preventive health 
service has been used. According to the GAO, only 3.8 percent of 
Medicare patients received either a screening or diagnostic colonoscopy 
in 1999, far below the recommended use rates and just a one percent 
increase over the rate in 1995.
  Clearly we must find ways to heighten public awareness about the 
importance of colon cancer screening and remove any remaining barriers 
that may be preventing Medicare beneficiaries from receiving these 
critically important services. While the GAO identified a lack of 
patient awareness, understanding and inclination as the most 
significant factors inhibiting the use of colorectal cancer screening 
services, it also found that physician practices affect rates of 
screening. One factor is the inadequate Medicare reimbursement rates to 
cover the costs involved.
  Medicare reimbursement rates for this procedure have declined in 
recent years and are almost universally lower

[[Page 958]]

than reimbursements under private insurance. Moreover, in many States, 
the Medicare rates are lower than Medicaid rates. Our legislation will 
therefore increase the Medicare payment rates for colonoscopies 
performed both in hospitals and outpatient settings. Specifically, the 
payment rates in hospitals and outpatient facilities would be increased 
by 30 percent, while payment for procedures done in physicians' offices 
would be increased by 10 percent.
  Our legislation will also require Medicare to provide reimbursements 
for pre-procedure consultations to ensure that beneficiaries are 
properly prepared and educated before they undergo a screening 
colonoscopy. Medicare currently only pays for the pre-procedure 
appointment prior to a diagnostic colonoscopy. This pre-procedure visit 
is no less necessary in the case of a screening colonoscopy and should 
be covered.
  Finally, under our legislation, the normal Part B deductible will not 
apply for screening colonoscopy, just as it does not apply for 
screening mammography. This will remove a financial disincentive for 
seniors to seek screening and increase the likelihood that they will 
undergo screening colonoscopy.
  The Colon Cancer Screen for Your Life Act of 2002 will not only help 
to ensure the safety of colorectal cancer screenings, but it will also 
increase Medicare patients' access to this life-saving procedure, and I 
urge all of my colleagues to join us as cosponsors.

                          ____________________