[Congressional Record (Bound Edition), Volume 151 (2005), Part 21]
[House]
[Pages 29264-29268]
[From the U.S. Government Publishing Office, www.gpo.gov]




              PROFICIENCY TESTING IMPROVEMENT ACT OF 2005

  Mr. DEAL of Georgia. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 4568) to improve proficiency testing of clinical 
laboratories, as amended.
  The Clerk read as follows:

                               H.R. 4568

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Proficiency Testing 
     Improvement Act of 2005''.

     SEC. 2. IMPROVEMENT OF PROFICIENCY TESTING OF CLINICAL 
                   LABORATORIES.

       Notwithstanding any other provision of law, the Secretary 
     of Health and Human Services--
       (1) may not, during the one-year period beginning on the 
     date of the enactment of this Act, conduct (or cause an 
     entity with which the Secretary contracts to conduct) the 
     proficiency testing referred to in section 353(f)(4)(B)(iv) 
     of the Public Health Service Act (42 U.S.C. 
     263a(f)(4)(B)(iv));
       (2) shall revise such proficiency testing (or cause such 
     testing to be revised)--
       (A) to reflect the collaborative clinical decision-making 
     of laboratory personnel involved in screening or interpreting 
     cytological preparations;
       (B) to revise grading or scoring criteria to reflect 
     current practice guidelines;
       (C) to provide for such testing to be conducted no more 
     often than every 2 years; and
       (D) to make such other revisions to the standards for such 
     testing as may be necessary to reflect changes in laboratory 
     operations and practices since such standards were 
     promulgated in 1992; and
       (3) shall make the revisions required by paragraph (2) 
     within one year after the date of the enactment of this Act 
     and before resuming proficiency testing referred to in such 
     section.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Georgia (Mr. Deal) and the gentleman from Ohio (Mr. Brown) each will 
control 20 minutes.
  The Chair recognizes the gentleman from Georgia.


                             General Leave

  Mr. DEAL of Georgia. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days within which to revise and extend 
their remarks and include extraneous material on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Georgia?
  There was no objection.
  Mr. DEAL of Georgia. Mr. Speaker, I yield myself such time as I may 
consume.
  Each year, the licensed physicians and cytotechnologists who screen 
and interpret Pap tests save the lives of thousands of women by 
detecting the earliest signs of cervical cancer, a common cancer in 
women. Without question, these professionals serve a vital role in the 
health care delivery system of this Nation, and we owe them our sincere 
admiration and appreciation for the services they perform.
  However, our Federal bureaucracy has let these professionals and 
their patients down by neglecting to develop an effective and 
appropriate proficiency test for these individuals as required by the 
Clinical Laboratory Improvement Amendments of 1998, commonly referred 
to as CLIA. Instead, the Centers for Medicare and Medicaid Services 
have recently chosen to implement an outdated and flawed testing system 
that was finalized over 13 years ago.
  This situation is unacceptable, and these professionals who are 
performing vital services deserve better.
  And that is why I have introduced this legislation. H.R. 4568 will 
place a hold on the current CMS testing system and require that a new 
rule be developed that accomplishes the following four goals: First, to 
reflect the collaborative clinical decision-making of laboratory 
personnel involved in screening or interpreting cytological 
preparations; second, to revise grading or scoring criteria to reflect 
current practice guidelines; and, third, to provide for such testing to 
be conducted no more often than every 2 years; and, fourth, to make 
such revisions to the standards for such testing as may be necessary to 
reflect changes in the laboratory operations and practices since the 
standards were promulgated originally in 1992.
  This is the least we can do for these professionals. And I want to 
thank my colleagues Sue Myrick, Tom Price, John Shimkus and Sherrod 
Brown for joining me in sponsoring this legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Joining my friend from Georgia, Mr. Deal, I rise in support of H.R. 
4568, the Proficiency Testing Improvement Act.
  It makes perfect sense to take steps to ensure that women are 
receiving accurate results after they have had a Pap test. But it makes 
no sense to take false steps in that direction. Proficiency testing can 
be extremely useful, or it can make a bad situation worse. If the 
proficiency test itself is inaccurate, then both competence and 
incompetence get lost in the shuffle. It is almost worse than not 
knowing.
  H.R. 4568 gives the Secretary of Health and Human Services authority 
to revise a 13-year-old regulation that CMS has only recently acted on. 
The regulation calls for a Federal program to test the proficiency of 
individual laboratory individuals who read Pap tests.
  Since this rule was first proposed in 1992, significant advances, 
such as computer-assisted screening, location-guided screening, digital 
imaging, have made a positive impact on screening for cervical cancer.
  The proficiency testing system embedded in the agency's rule has not 
been modified to reflect these significant advances. As a result, the 
system is rooted in outdated and obsolete medical standards and 
practices. In fact, the testing scheme adopted 13 years

[[Page 29265]]

ago but just implemented by the Federal Government this year is based 
upon standards that go back to the late 1960s.
  H.R. 4568 delays implementation of this testing program for 1 year so 
the agency can review and revise the program to reflect current medical 
practice. One can look at it from a quality perspective, a safety 
perspective, an access perspective or a fiscal perspective. From any of 
those angles, it is in no one's best interest to use the wrong test to 
evaluate proficiency. All they end up with are more questions.
  I want to make clear the bill does not repeal this testing program. 
It simply puts the program on pause while the agency makes changes to 
reflect valid and up-to-date medicine and laboratory working 
conditions.
  In September, I joined over 100 Members of the House, from both 
parties, in sending a letter to Secretary Leavitt, urging him to update 
the testing program before implementing it. The Secretary of HHS, for 
whatever reason, has not responded.
  In February, the Clinical Laboratory Improvement Advisory Committee, 
which advises the Department of Health and Human Services, unanimously 
recommended that the agency revise and update this 13-year-old 
regulation; yet the agency continues to move forward with a January 1, 
2006, implementation date.
  If we are serious in this body about promoting quality health care, 
we should ensure that the Federal Government's regulations are keeping 
pace with 21st Century medicine. This bill will help do that. I urge my 
colleagues to support it.
  Mr. Speaker, I reserve the balance of my time.
  Mr. DEAL of Georgia. Mr. Speaker, I yield 2 minutes to the gentleman 
from Illinois (Mr. Shimkus), a member of the Energy and Commerce 
Committee that has jurisdiction over this issue.
  Mr. SHIMKUS. Mr. Speaker, I want to thank Chairman Deal of the 
subcommittee for his work on this legislation, also Ranking Member 
Brown, and I think they accurately have mentioned what this legislation 
does.
  It wants to hold off these regulations that are decades old for new 
science and new technology and for safety and cost and efficiency and 
all those things.
  I just want to take this time to thank Dr. James Miller, who runs a 
lab in Fayette County Hospital in Vandalia, Illinois, for always 
keeping me updated on issues facing the laboratory community.
  In my district and across the country, we already have a shortage of 
medical lab technicians. These proficiency testing regulations would 
further reduce access to cytology services.
  I urge my colleagues to support this legislation, H.R. 4568.

                              {time}  1530

  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentlewoman 
from South Dakota (Ms. Herseth), who has been a terrific advocate for 
women's health in our country.
  Ms. HERSETH. Mr. Speaker, I thank my friend from Ohio for yielding 
and for his long-standing commitment for health care issues facing this 
country.
  Mr. Speaker, I rise today in support of H.R. 4568, the Proficiency 
Testing Improvement Act of 2005, because this legislation reflects a 
thoughtful compromise, and I am extremely pleased we are going to have 
an opportunity to address the underlying issues concerning the clinical 
laboratory proficiency testing regime currently being implemented by 
the Centers for Medicare and Medicaid Services.
  As I toured laboratories in South Dakota earlier this year and 
discussed the proficiency test with pathologists in my State, it has 
become clear to me that the science and practice guidelines for 
cytology have advanced substantially in the 13 years since the initial 
design of the proficiency testing program.
  I have serious concerns with the possibility of qualified physicians 
and lab personnel being penalized as a result of a test based on 
outdated standards, and I have concerns about the access problems this 
may create in rural areas.
  The Clinical Laboratory Improvement Advisory Committee, which is 
charged with advising the Secretary of Health and Human Services on the 
standards governing clinical laboratories, has recommended that the 
Department of Health and Human Services revise the outdated regulation 
to reflect the advances in the practice of cytology.
  When it became clear that Secretary Leavitt intended to proceed with 
the January 1 implementation date, as Mr. Brown indicated, I joined 
with him and many others of this body to urge the Secretary to suspend 
the current testing program and make the necessary revisions to reflect 
the advances in science, technology and practice. But time grows short, 
and without any assurances that the flaws in the current regime will be 
addressed, it is necessary for us to act.
  This legislation delays implementation of proficiency testing for 1 
year to allow the Secretary to make the appropriate revisions and 
ensure a testing program that reflects medically and scientifically 
current standards for the practice of cytology. This step is necessary 
to protect access to clinical laboratory services and to ensure the 
high quality of those services.
  I want to express my sincere thanks to all those who have worked so 
hard in the last few weeks to bring this legislation to the floor 
before the end of the session. Ranking Members Dingell and Brown, 
Chairman Deal, Mr. Price, have all been diligent and thoughtful 
throughout this process. And I also want to extend my thanks to 
Chairman Barton for his flexibility and offer my prayers for his speedy 
recovery during the Christmas season.
  I encourage my colleagues in the House to support H.R. 4568 and our 
colleagues in the Senate to act swiftly to pass this important 
legislation before we adjourn.
  Mr. DEAL of Georgia. Mr. Speaker, I am pleased to yield 4 minutes to 
my colleague, the gentleman from Georgia (Mr. Price), and to thank him 
for his efforts in shepherding this bill to the floor today.
  Mr. PRICE of Georgia. Mr. Speaker, first, I want to thank Chairman 
Deal for his leadership on this issue and Chairman Barton as well for 
allowing this to go forward and thank particularly Mr. Brown and Ms. 
Herseth and Mr. Dingell for working together to make certain that this 
issue is brought forward before we go home for the holiday.
  Any testing, any testing, for quality in health care, must recognize 
and be tailored to real-life situations and the actual practice of 
medicine. As a physician, I have a real concern about quality health 
care and about how often government decisions may adversely affect that 
care.
  In our State of Georgia, as the chairman knows, 40 percent of the 
pathologists in our State no longer read Pap smears. They no longer 
read Pap smears. The reason is not that they forgot how to read Pap 
smears. The reason is that the liability, the risk for reading a Pap 
smear at this point is greater than the benefit that they can derive 
themselves, and it is not worth putting their families at that personal 
financial risk to do so. If we go ahead with current CMS policy, I fear 
all across this Nation, we will see the remainder of the pathologists 
will no longer be able to read Pap smears, and consequently, the 
quality of care will be further diminished.
  The reason that this test that has been proposed to move forward is 
flawed is because the practice of pathology is a collegial practice. If 
a pathologist is reading a slide to determine a diagnosis and he or she 
may have a question about it, they do not simply put it aside and not 
do anything about it. They call over Dr. Smith or Dr. Jones or one of 
the other personnel and ask them, what do you think? And they come to a 
decision together. Sometimes they may even take the specimen, that 
slide and the specimen they have, to a professor, to a university 
nearby or to a seminar that is being held and get other opinions. It is 
a collegial practice.
  The test that is on the books right now and being proposed to be 
implemented January 1 on a mandatory basis does not recognize any of 
the

[[Page 29266]]

collegiality of the practice of pathology or medicine for that matter.
  So I believe that any testing that ought to be approved must be 
approved by the specialty society. The College of American Pathologists 
has wonderful individuals, scientists, individuals who understand the 
practice of medicine and also understand the science, and they must, 
they must, approve any test before it goes forward.
  I also believe that any test that would be of benefit to us as 
citizens and truly increase the quality of care would be a test that 
measured the quality of the facility which recognizes the collegiality 
of the practice of pathology, and not be necessarily physician-
specific, because that does not recognize how these things are done.
  So, this bill, I commend the chairman once again for bringing it 
forward. I believe it is a commonsense measure. It is a measure that, 
ultimately, I believe, will result in a better rule and a better 
ability of pathologists and other physicians across this Nation to 
practice. I urge adoption of this bill.
  Mr. BROWN of Ohio. Mr. Speaker, I reserve the balance of my time.
  Mr. DEAL of Georgia. Mr. Speaker, I am pleased to yield 4 minutes to 
the gentleman from Florida (Mr. Weldon), a physician familiar with this 
issue.
  Mr. WELDON of Florida. Mr. Speaker, I thank the subcommittee chairman 
for his leadership on this issue.
  I am not an OB/GYN, but as a general internist, I performed numerous 
Pap smears. I was not here in 1992 when this statute was put in place. 
If I had been, I would have voted against it. I do not think the 
Federal Government has any business being in this process.
  I have to ask everybody in the Chamber a question: Why do we want to 
have a special test only for the pathologists? Why not a Federal test 
for the doctor performing the Pap smear? I frequently did breast exams 
at the same time. Why not a special test, a Federal test, for that? 
What about the mammogram? Why not a Federal exam for a mammogram?
  We obviously do not do that for obvious reasons. Professional 
societies govern these issues. State statutes govern them, and this is 
just a huge area.
  Physicians of various specialties perform a multitude of different 
tests. They review and do a multitude of different procedures, and it 
would virtually be impossible; it would involve a colossal expansion of 
the Federal Government into essentially an area traditionally of 
commerce.
  Now, understanding, as I do, that this is in the law, another reason 
why this is a bad law is just the way it has played out. Thirteen years 
for the regulatory agency to finally bring regulations to the process, 
to put them forward, and, lo and behold, surprise, surprise, they are 
completely outdated. They are completely inconsistent with what has 
been going on.
  Litigation forces and the College of American Pathology's policies 
have changed the landscape, and now you essentially have many 
pathologists, as my physician colleague Dr. Price said earlier, and I 
commend him for his leadership on this, many pathologists have 
abandoned this. And you literally have certain pathologists who are 
specializing in this. They read them all the time. They go to seminars 
all the time. When they get difficult smears, they take them to the 
university. They bring their colleagues in the room.
  To me, this is a wasteful and inappropriate involvement of the 
Federal Government, and I am very, very pleased that the other side of 
the aisle is willing to go along with this 1-year delay. Hopefully, the 
Senate will approve this.
  What I hope is, ultimately, we repeal this, because I believe it is 
completely unnecessary, and it is inserting the Federal Government in a 
place that I do not think the American public would really want us to 
be, and that is into the details of the practice of medicine, carving 
out one specific area of pathology. Why are we not credential-
ing pathologists who read thyroid biopsies? That can be very, very 
important. What about breast biopsies? So to single this out, to me it 
is almost bizarre.
  Mr. Speaker, I commend the chairman of the subcommittee. I am 
certainly looking forward to working with him in the year ahead. I 
certainly commend the ranking member for his willingness to allow this 
to move forward, and I do hope the Senate concurs, and we are able to 
pass this.


                          What the bill does?

  In 1992 CMS, HCFA, proposed regulations that would require 
proficiency testing of pathology labs for pap tests.
  Those regs sat on the shelf for the past 13 years, until earlier this 
year CMS decided to implement these 13-year-old regs.
  This bill simply delays for one more year the implementation of these 
regulations and asks CMS to update their regulations to reflect the 
practice of medicine today both within the pathology labs and in how 
clinicians respond to those lab tests.


                      Why is this bill necessary?

  CMS dusted off 13-year-old regs that do not reflect the current 
practice of medicine.
  CMS is requiring that pathologists examine these test exams in a 
vacuum; however, pathologists and cytologist practice in a team today. 
The CMS regulations don't reflect this change in practice; they are 
testing in a manner that does not reflect how a pathology is practiced 
today.
  The test asks pathologists/cytologists to distinguish between high- 
and low-grade lesions.
  In 1992 the standard of practice for low-grade lesions was to 
continue repeat cytology testing while colposcoply and biopsy were 
ordered for high-grade lesions.
  The standard of practice today is to order colposcopy and biopsy for 
both high- and low-grade lesions.
  The exam also applies a double standard for scoring--one test for 
cytologists and another higher standard for pathologists.


                 Who Has Asked CMS to Delay These Regs

  Ten national pathology and cytology organizations; 49 State pathology 
medical societies; over 120 Members of Congress wrote CMS in October 
asking CMS to delay this testing; even CMS's own Clinical Laboratory 
Improvement Advisory Committee, CLIAC, unanimously moved that CMS 
revise the cytology PT regulations to reflect current practice, 
evidence based guidelines and antipated changes in technology.


                               Conclusion

  This bill will provide for only a 1-year delay of these regulations 
so that CMS can update the regulations that they left sitting on the 
shelf for the past 13 years.
  Mr. BROWN of Ohio. Mr. Speaker, I yield 3 minutes to the gentleman 
from Maryland (Mr. Cummings).
  Mr. CUMMINGS. Mr. Speaker, I was just listening to the last speaker, 
and I just wanted to bring something to the attention of the House.
  In Maryland, we had a situation where we had Maryland General 
Hospital, which is in my district, as a matter of fact, within 6 blocks 
of my house, and one of the things that we discovered was that the 
hospital was providing tests whereby personnel in the hospital knew 
that these HIV and hepatitis tests, the results were the wrong results. 
In other words, there was some faulty machinery. There was some problem 
within the lab itself. And when the whistleblower went to blow the 
whistle, the whistleblower was fired.
  Government does have a role in this. The government must have a role. 
Almost, not almost, every single person in this country at some point 
is subjected to some type of medical test. As a matter of fact, we in 
the State of Maryland, it was of such significance that we got the 
College of American Pathologists to revise their entire program so as 
to protect whistleblowers, to make sure that if there was retaliation 
against a whistleblower, that that clinical lab could lose its 
accreditation.
  They also are spending $9 million over the next 2 years to revamp 
their whole process, because here is the College of American 
Pathologists who oversees some 6,000 clinical labs all around the 
world, and they realized that it was important that they give proper 
results and protect whistleblowers, have a better system. But I can 
tell you the thing that pushed them to do that was government 
intervention.
  So I understand this particular piece of legislation. I think it 
makes sense. I wish we had a little bit more time to consider it. The 
fact is, I am not going to stand in the way of it, but I refuse to 
accept an argument that says that government has no role in this, 
because, again, the American public

[[Page 29267]]

must, must, have confidence in medical tests, must be able to rely on 
them.
  When we are talking about such subjects as medical malpractice, Mr. 
Speaker, if someone has the wrong results on a test, my God, it may 
result in all kinds of very unfortunate circumstances and expenses and 
pain and suffering to a family.
  Mr. DEAL of Georgia. Mr. Speaker, I yield myself 15 seconds just to 
respond to the gentleman and assure him that we understand his concerns 
with the whistleblower, but this is a situation in which government 
does have a role, but we are trying to make sure that government does 
not impose outdated regulations that are 13 years old and do not 
associate themselves with the current realities of the practice.
  Mr. Speaker, I yield 2 minutes to the gentleman from Pennsylvania 
(Mr. Shuster).
  Mr. SHUSTER. Mr. Speaker, I thank the gentleman for yielding me the 
time.
  Mr. Speaker, I rise today in support of H.R. 4568. This legislation 
will put in place a 1-year delay of a problematic cytology testing 
program and will allow HHS to review and revise the program in order to 
better reflect current medical practice.
  Numerous pathologists from my district in central and western 
Pennsylvania have expressed great concern over this testing program. I 
would like to share a portion of a letter I received from a well-
respected pathologist from Roaring Springs, Pennsylvania, Dr. Bill 
Kirsch, regarding this issue. And I think it is extremely important to 
hear the words of a practicing pathologist and not just legislators on 
the floor of the House.
  Dr. Kirsch first contacted me in August of this year saying the 
following:
  ``Although I have not received the survey material at this time, it 
was apparent when I read the initial introduction of this new testing 
procedure that it had little merit and was only vaguely related to the 
actual practice of cytopathology.
  ``My contention is this supposed proficiency examination will do 
little or nothing to improve the quality of the cytopathology services 
and only add to hospital expenses through fee and the paid time for the 
cytology tech staff and the pathologist forced to participate. There 
are other proficiency tests that I have subscribed to for a number of 
years and have helped me to become a better cytopathologist.
  ``The current proficiency testing by MIME has, in my opinion, no 
merit and does not deserve to be continued. It does not have the 
support of pathology or cytopathologist professionals and should not 
have even been initiated.''
  Mr. Speaker, I respect the wisdom and experience of many of the 
doctors and laboratory professionals that have contacted me asking that 
we please ask HHS to step back and review this testing program. A vote 
for the commonsense legislation is just what the doctor ordered.

                              {time}  1545

  Mr. BROWN of Ohio. Mr. Speaker, I reserve the balance of my time.
  Mr. DEAL of Georgia. Mr. Speaker, I yield 2 minutes to the gentleman 
from Texas (Mr. Burgess), my colleague on the Health Subcommittee of 
Energy and Commerce.
  Mr. BURGESS. Mr. Speaker, I thank the chairman and the ranking member 
for bringing this relevant and important piece of legislation to the 
floor today.
  It is probably the cervical cytology that has been more responsible 
than any other medical test for the foundation of preventative medicine 
in the United States.
  I cannot tell you of the change that has taken place in the science 
of cervical cytologies from 1988, when this language was first written, 
until the time I left practice in 2002. The change has been so rapid in 
the science of cytology; and the language in this legislation being 
over 10 years old, over a decade old, is inappropriate for the 21st 
century.
  In this day and time, we now have thin-layer cytologies. We have 
liquid-based cytologies, none of which were available in the late 80s 
or early 90s. The accuracy of these tests is light years ahead of what 
it was. If you add to that the ability to do DNA typing on abnormal 
cells, a lot of problems with false negatives have been eliminated. The 
CLIA standards to affect this language at this point would be 
inappropriate. They would be draconian. In fact, they would be a big 
step backward.
  I look forward to working with my chairman. I look forward to working 
with the committee with my fellow members to develop language that more 
accurately measures the performance of cytopathologists and 
pathologists.
  Mr. BROWN of Ohio. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I was just looking through the CMS informational 
supplement on this whole issue, and I just wanted to read the reason 
that CMS could not get its act together through Secretary Thompson and 
now Secretary Leavitt, that they have delayed this so much longer than 
it needed to, and this is their sort of double speak, if you will:
  ``Implementation of cytology proficiency testing has taken an 
extended period of time due to the absence of qualified national 
proficiency testing organizations and insufficient number of reference 
cytology testing materials and significant technical difficulties. 
Currently, there are two CMS-approved cytology proficiency testing 
programs in the country for 2005, and we anticipate the approval of 
additional programs in 2006.''
  So the last 5 years both Secretary Thompson and Secretary Leavitt 
have not been able to get this whole program up and running. Now we 
have this same cast of characters telling the country that we have got 
to implement the Medicare bill right now when plenty of people in this 
body, led by Ms. Schakowsky of Illinois and Mr. Stark from California, 
it said on the Medicare bill that we should push back the deadline for 
people who want to benefit from the Medicare prescription drug benefit 
program, who want to benefit but cannot yet make their minds up because 
of the complexity of it. And they will be actually financially 
penalized if they do not make that decision more quickly than many 
seniors feel that they are capable of making.
  At the same time, we are also doing nothing to allow the Secretary of 
CMS to bring down the price of prescription drugs. In fact, this 
institution, this body, prohibited the government from negotiating 
lower prices. So while Secretary Thompson and now Secretary Leavitt 
could not get their act together on this, they seem to want to move 
forward too quickly on Medicare, forcing seniors to make a choice 
prematurely in the minds of many seniors or pay an economic financial 
penalty for every month they delay, and at the same time doing nothing 
to bring the price of prescription drugs down.
  It all fits together in a peculiar way, Mr. Speaker. That does not 
mean this bill is not important. I join my colleague, Mr. Deal, in 
support of it. As always, there is a little bigger picture here.
  Mr. Speaker, I yield back the balance of my time.
  Mr. DEAL of Georgia. Mr. Speaker, I yield myself such time as I may 
consume.
  While my colleague, Mr. Brown of Ohio, is my copartner in the issue 
of health care and he and I share many things in common, this bill 
being one of them, and I would disagree with his comments with regard 
to Medicare part D, I for one am pleased that we are finally offering 
senior citizens of this country the opportunity to have a prescription 
drug benefit plan.
  We can disagree on that, and we will probably have some disagreements 
in the future; but I do want to thank Mr. Brown of Ohio and his staff 
and the others on the minority side for their cooperation in dealing 
with this issue that is before us today on pathology licensure.
  I think that it is a bill that we need to act on quickly, and 
hopefully our colleagues across the way will do likewise.
  Mr. DINGELL. Mr. Speaker, I support H.R. 4568, the ``Proficiency 
Testing Improvement

[[Page 29268]]

Act of 2005,'' which requires the Secretary of the Department of Health 
and Human Services to update the federal program to test the 
proficiency of individual laboratory professionals who read Pap tests. 
This bill delays implementation of the program first proposed in 1992 
so that revisions, including those recommended by the Clinical 
Laboratory Improvement Advisory Committee, can be made. Importantly, 
these revisions are required to be made within one year, and must be 
made before proficiency testing can resume.
  This is a commonsense measure that will assure that regulations 
implemented by the Federal Government reflect current science, 
technology, and medical practice. I urge my colleagues to support it.
  Mr. DEAL of Georgia. Mr. Speaker, I yield back the balance of my 
time.
  The SPEAKER pro tempore (Mr. McHugh). The question is on the motion 
offered by the gentleman from Georgia (Mr. Deal) that the House suspend 
the rules and pass the bill, H.R. 4568.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

                          ____________________