[Congressional Record (Bound Edition), Volume 148 (2002), Part 8]
[Extensions of Remarks]
[Page 11089]
[From the U.S. Government Publishing Office, www.gpo.gov]




 INTRODUCTION OF THE HEALTH BENEFITS CLAIMS PROMPT PAYMENT ACT OF 2002

                                 ______
                                 

                            HON. MAX SANDLIN

                                of texas

                    in the house of representatives

                         Friday, June 21, 2002

  Mr. SANDLIN. Mr. Speaker, our nation's doctors and hospitals face 
funding challenges. Today, to help address these challenges, I 
introduced the Health Benefits Claims Prompt Payment Act of 2002.
  We have heard a lot about the need to stop the declining payments 
from Medicare, especially since the proportion of patients on Medicare 
continues to grow. Further, doctors and hospitals face great 
uncertainty as to when they will be paid by health care plans for 
services rendered. As a result of this uncertainty, doctors and 
hospitals have no guarantee that they can pay their own obligations in 
a timely manner. That's unfair. That's bad business.
  This week, several congressional committees began the arduous process 
of considering Medicare legislation. Among the provisions that have 
received widespread bipartisan support in that legislation are payment 
updates for hospitals, doctors, and other health care providers. These 
provisions attempt to address the decrease in Medicare payments to 
doctors and other providers by 5.4 percent this year. They also help to 
address similar hospital funding shortfalls, especially in rural areas 
where hospitals are paid less than their urban and suburban 
counterparts due to the use of a biased and outdated formula. While 
these changes will not fully address the decline in payments and the 
funding shortages from Medicare that our providers face, they are a 
good first step.
  But, addressing the Medicare funding problems is not enough. Doctors 
and hospitals need to be paid, and paid on time, by the private group 
and individual health plans. On-time payments are critical for doctors 
to pay their own bills and for the longterm financial survival of 
medical practices and hospitals.
  Several states have passed legislation to ensure prompt payment for 
health care claims. However, the shortsightedness of politicians in 
some states--as in my home state of Texas--has prevented such 
legislation from becoming law. Even in states where laws are on the 
books, doctors and hospitals face possible federal ERISA preemption of 
state laws--meaning that without a federal ``prompt pay'' law, health 
plans will continue to be able to manage their cash flow on the backs 
of doctors and hospitals.
  Today, I introduced the Health Benefits Claims Prompt Payment Act of 
2002. This legislation will ensure that doctors and hospitals are paid 
``promptly'' for the health care services they provide to participants 
in private health care plans. Failure to pay such claims on time would 
result in interest penalties being imposed on health plans.
  This bill also specifically protects a state's right to provide 
doctors and hospitals with even more certainty--allowing states to 
impose harsher penalties or stricter standards on the payment of 
claims.
  The Health Benefits Claims Prompt Payment Act of 2002 is one way to 
help ensure that doctors and hospitals can focus on what they do best--
treating patients and practicing medicine.

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