[Congressional Record (Bound Edition), Volume 153 (2007), Part 10]
[House]
[Pages 13674-13676]
[From the U.S. Government Publishing Office, www.gpo.gov]




      PROVIDING EXCEPTION TO LIMIT ON MEDICARE RECIPROCAL BILLING 
                              ARRANGEMENTS

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 2429) to amend title XVIII of the Social Security Act to 
provide an exception to the 60-day limit on Medicare reciprocal billing 
arrangements between two physicians during the period in which one of 
the physicians is ordered to active duty as a member of a reserve 
component of the Armed Forces.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2429

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

     SECTION 1. EXCEPTION TO 60-DAY LIMIT ON MEDICARE RECIPROCAL 
                   BILLING ARRANGEMENTS IN CASE OF PHYSICIANS 
                   ORDERED TO ACTIVE DUTY IN THE ARMED FORCES.

       (a) In General.--Section 1842(b)(6)(D)(iii) of the Social 
     Security Act (42 U.S.C. 1395u(b)(6)(D)(iii)) is amended by 
     inserting after ``of more than 60 days'' the following: ``or 
     are provided (before January 1, 2008) over a longer 
     continuous period during all of which the first physician has 
     been called or ordered to active duty as a member of a 
     reserve component of the Armed Forces''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to services furnished on or after the date of the 
     enactment of this section.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Texas (Mr. Barton) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days to revise and extend their remarks and 
include extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. I yield myself such time as I may consume.
  Mr. Speaker, I rise in strong support of this legislation. I thank my 
good friend from California (Mr. Thompson) for sponsoring it. This 
legislation is necessary to ensure that our Nation's doctors, who are 
brave enough to serve their country in a time of war, have a medical 
practice to serve in when they come home.
  Currently, Medicare allows for a physician who is ordered to active 
duty as a member of a reserve component of the Armed Forces to enter 
into a 60-day billing arrangement with another physician. These 
arrangements allow for physicians to maintain their practices while 
they go off to take care of our soldiers in combat.
  Unfortunately, what we are finding is that they are often away longer 
than 60 days, which puts them at odds with the current Medicare 
antifraud rules. This legislation fixes that problem by lifting the 60-
day limit currently in place, and allowing a physician who is called to 
active duty to find a substitute physician to watch over his patients 
for as long as he or she is deployed.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BARTON of Texas. Mr. Speaker, I yield myself such time as I may 
consume.
  Mr. Speaker, I rise in support of the bill on substance and in 
adamant opposition of the process.
  Now, there is absolutely nothing wrong with the substance of this 
bill. It has two distinguished cosponsors, one in the majority party, 
one in the minority party. The underlying substance is eminently fair, 
and we are not going to ask for a rollcall vote. If it passes on a 
voice vote, so be it.
  But having said that, I want to say in the strongest possible terms 
how extremely disappointed, and I mean extremely disappointed, that we 
have a bill that is in two committees of jurisdiction, the Ways and 
Means Committee and the Energy and Commerce Committee, and the bill had 
not even been introduced, had not even been introduced until this 
morning. There was no bill number.
  Now, when you put a bill on the Suspension Calendar, theoretically 
the majority party, the chairman or chairmen or chairwomen ask the 
ranking member of the minority party if there is any problem with the 
bill. If there is not, then they approve it. Then the Speaker of the 
House or the majority leader of the House calls the minority leader of 
the House and says, ``We want to put this bill on the Suspension 
Calendar.'' And you do it.
  Now, we have a bill before us that was not even introduced until the 
House convened this morning. There has been no hearing, there is no 
record, there has been no phone call. Chairman Dingell did not call me 
yesterday, he did not call me this morning. I don't know if Chairman 
Rangel called Ranking Member McCrery. I do know that Nancy Pelosi or 
Steny Hoyer did not call John Boehner.

[[Page 13675]]

  So we are now in a situation, we have a little extra time, let's 
introduce a bill and pass it in the next 30 minutes. We did not do that 
when we were in the majority.
  Now, this is a good bill. Mr. Thompson and Mr. Johnson deserve 
accolades for seeing a flaw in the current Social Security law, the 
Medicare law, and rectifying it. That is not the issue.
  The new majority campaigned on a platform of fairness and openness. 
Is this fair? Is this open?
  This happens to be a good bill. What if it weren't? What if it 
weren't?
  The only two Members that really know anything about it are the two 
cosponsors, and thankfully they are both decent, honorable men, and we 
have read the substance of the bill and it is okay. But this is not the 
way the House of Representatives should be run. It is just wrong, W-R-
O-N-G, wrong.
  So I support the substance of the bill, but I am adamantly opposed to 
the process. I hope this thing goes on a voice vote. If it is a 
rollcall vote, I am going to vote ``present'' and express, when I see 
Mr. Dingell, in the strongest possible terms how upset I am about the 
process.
  Mr. SAM JOHNSON of Texas. Mr. Speaker, will the gentleman yield?
  Mr. BARTON of Texas. I yield to the gentleman from Texas.
  Mr. SAM JOHNSON of Texas. Let me just correct one thing. The staff 
tells me Mr. Rangel did call our committee yesterday at 10 o'clock in 
the morning on this bill. So the Ways and Means Committee was informed.
  Mr. BARTON of Texas. Did he call Mr. McCrery?
  Mr. SAM JOHNSON of Texas. Yes.
  Mr. BARTON of Texas. Then I stand corrected.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Just in response, I understand where Mr. Barton is coming from. But I 
just want to point out that we do have bipartisan support in the House 
on the bill. And it is only a temporary measure that lasts for 1 year 
and provides immediate relief to these physicians that are going 
overseas and fighting for the country. It is a very special 
circumstance, which I don't think provides any real precedent here, 
because we do have these physicians who are going to serve their 
country in Iraq and we just don't want them to have a situation where 
they come back and they don't have any medical practice. I just don't 
think that is fair.
  I would mention to the ranking member that if we wanted to make a 
permanent change in this, we would be sure to spend more time and work 
with our Republican colleagues in accomplishing that goal. This is a 
temporary measure, and it is just because of the circumstances.
  Mr. Speaker, I yield to the gentleman from California (Mr. Thompson) 
such time as he may consume.
  Mr. THOMPSON of California. Mr. Speaker, I thank the gentleman for 
yielding.
  Mr. Speaker and Members, this is a very important bill. There are 
almost 3,000 physicians that are serving our country in the Reserves 
and the National Guard. And, as has been pointed out, when these folks 
are deployed and they leave, just like every other person in the Guard 
and Reserves that is deployed, they leave their families, they leave 
their businesses at home, and they go over and they serve their 
country. But there is just one thing different with these doctors; when 
they are deployed, they also leave behind their patients. And these are 
patients who depend upon the medical care they get from that great 
American who is now serving his or her country, and these patients 
can't go without a doctor.
  The way the rules are now, the physician has to line up someone to 
take their patients in their absence, and they can only do this for 60 
days. This doesn't work. It is bad for the doctors and it is bad for 
the patients. What we are trying to do is to waive that 60-day 
requirement so the physicians can line up one doctor to take their 
Medicare patients while they are serving our country in Afghanistan or 
in Iraq.

                              {time}  1130

  And it's a temporary measure. It's only good through this year. So we 
can, in fact, establish a permanent fix. And this bill has been vetted 
all through the different committees, and the Ways and Means Committee, 
both the chairman and the ranking member are very aware of this bill. 
And my good friend and committee colleague and war hero Sam Johnson has 
signed up on this as a coauthor, recognizing the plight of both the 
physicians who are serving, and their patients and their practices at 
home. And it's important that we fix this now and then continue to work 
on the permanent fix so we can make sure that no doctors and no 
patients who are caught in this vise go without medical care, or 
doctors, while serving their country, lose their practices.
  And I just want to say a special thank you to Dr. Bradley Clair of 
Lakeport, California, my constituent, who brought this to my attention. 
And he's ready to be deployed on his third tour. He'll be going to 
Iraq. So we need to fix it for him, for the other doctors, and patients 
who are exposed because of this problem. We need to fix it permanently. 
And this is the first step in doing so.
  Sam, thank you for your help and your friendship on this and other 
important issues.
  Mr. BARTON of Texas. Mr. Speaker, I yield such time as he may consume 
to the minority sponsor of this piece of legislation, the Honorable Sam 
Johnson of Plano, Texas.
  Mr. SAM JOHNSON of Texas. Mr. Speaker, you know, it's not every day 
the House gets to consider a bipartisan, commonsense bill that's 
affordable. This doesn't cost anything and supports our service men and 
women overseas. However, I'm happy to say this is one of those days.
  Right now the law prevents a Medicare physician from leaving his 
practice for more than 60 days at a time. And the regulation was 
created to prevent fraud, but it had the unintended effect of making 
life more difficult for someone that's called up to serve his country. 
And this bill eliminates the red tape by allowing our reservists to 
have one substitute doctor for their entire deployment.
  Not only will the bill help our reservists, it'll prevent Medicare 
beneficiaries from experiencing a gap in service or losing access to 
care altogether.
  And I want to thank my colleague from California for bringing this 
problem to my attention, I'm surprised we hadn't had it brought to our 
attention before, and for all the work you and your staff have done to 
get the bill to the floor today.
  Those who serve our country and their communities need and want our 
assistance, and it's time we helped our weekend warriors who happen to 
be doctors to keep their patients and keep their practice. This is a 
great bill, and I appreciate the time. I thank Mr. Kucinich for 
providing us the opportunity.
  Mr. PALLONE. Mr. Speaker, I have no further requests for time. I was 
going to inquire whether my colleague on the other side does.
  Mr. BARTON of Texas. No, Mr. Speaker. I yield myself such time as I 
may consume briefly.
  We support the underlying concept of the bill, and, as I said, if it 
passes on a voice vote, we won't ask for a roll call vote.
  I do stand by what I said, though, in terms of the committee process. 
We've got two bills on the suspension calendar from the Energy and 
Commerce Committee. Neither bill had a legislative hearing. Neither 
bill had a markup at subcommittee or full committee. Neither bill was 
introduced in its current form as of 2:45 yesterday afternoon. Both 
bills are on the floor today on the suspension calendar. That does call 
into question whether we even need an Energy and Commerce Committee, 
given that everything apparently comes to the floor without going 
through the committee process.
  But we support the underlying principles of this bill, and we 
certainly support the patriotism and courage of the two sponsors.
  Mr. Speaker, I yield back the balance of my time.

[[Page 13676]]


  Mr. PALLONE. Mr. Speaker, I would just say again, this is a temporary 
measure. We have these brave men and women who are leaving to care for 
our troops in Iraq, we're in a time of war, and I think it's just a 
very special circumstance right now. So I would urge my colleagues on 
both sides of the aisle to support passage.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 2429.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. THOMPSON of California. Mr. Speaker, on that I demand the yeas 
and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this question will 
be postponed.

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