[Congressional Record (Bound Edition), Volume 162 (2016), Part 2]
[House]
[Pages 2559-2561]
[From the U.S. Government Publishing Office, www.gpo.gov]




     PROVIDING FOR CONSIDERATION OF H.R. 3716, ENSURING REMOVAL OF 
            TERMINATED PROVIDERS FROM MEDICAID AND CHIP ACT

  Mr. BURGESS. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 632 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 632

       Resolved, That at any time after adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 3716) to amend title XIX of the Social 
     Security Act to require States to provide to the Secretary of 
     Health and Human Services certain information with respect to 
     provider terminations, and for other purposes. The first 
     reading of the bill shall be dispensed with. All points of 
     order against consideration of the bill are waived. General 
     debate shall be confined to the bill and shall not exceed one 
     hour equally divided and controlled by the chair and ranking 
     minority member of the Committee on Energy and Commerce. 
     After general debate the bill shall be considered for 
     amendment under the five-minute rule. In lieu of the 
     amendment in the nature of a substitute recommended by the 
     Committee on Energy and Commerce now printed in the bill, it 
     shall be in order to consider as an original bill for the 
     purpose of amendment under the five-minute rule an amendment 
     in the nature of a substitute consisting of the text of Rules 
     Committee Print 114-45. That amendment in the nature of a 
     substitute shall be considered as read. All points of order 
     against that amendment in the nature of a substitute are 
     waived. No amendment to that amendment in the nature of a 
     substitute shall be in order except those printed in the 
     report of the Committee on Rules accompanying this 
     resolution. Each such amendment may be offered only in the 
     order printed in the report, may be offered only by a Member 
     designated in the report, shall be considered as read, shall 
     be debatable for the time specified in the report equally 
     divided and controlled by the proponent and an opponent, 
     shall not be subject to amendment, and shall not be subject 
     to a demand for division of the question in the House or in 
     the Committee of the Whole. All points of order against such 
     amendments are waived. At the conclusion of consideration of 
     the bill for amendment the Committee shall rise and report 
     the bill to the House with such amendments as may have been 
     adopted. Any Member may demand a separate vote in the House 
     on any amendment adopted in the Committee of the Whole to the 
     bill or to the amendment in the nature of a substitute made 
     in order as original text. The previous question shall be 
     considered as ordered on the bill and amendments thereto to 
     final passage without intervening motion except one motion to 
     recommit with or without instructions.

  The SPEAKER pro tempore. The gentleman from Texas is recognized for 1 
hour.
  Mr. BURGESS. Mr. Speaker, for the purpose of debate only, I yield the 
customary 30 minutes to the gentleman from Florida (Mr. Hastings), 
pending which I yield myself such time as I may consume. During 
consideration of this resolution, all time yielded is for the purpose 
of debate only.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, House Resolution 632 provides for a rule to 
consider a commonsense, bipartisan piece of legislation that will 
address waste, fraud, and abuse within the Medicaid program.
  The rule provides for 1 hour of debate, equally divided between the 
majority and the minority of the Committee on Energy and Commerce. The 
Committee on Rules made in order four amendments that were submitted to 
the committee, three Democratic amendments and one bipartisan offering.
  Finally, the rule affords the minority the customary motion to 
recommit, a final opportunity to amend the legislation should the 
minority choose to exercise that option.
  H.R. 3716, the Ensuring Access to Quality Medicaid Providers Act, 
combines two bipartisan bills that were unanimously reported out of the 
Energy and Commerce Committee: H.R. 3716, the Ensuring Terminated 
Providers Are Removed from Medicaid and CHIP Act that was introduced by 
Dr. Larry Bucshon, a member of the committee; and H.R. 3821, the 
Medicaid DOC Act authored by Representative Chris Collins, also on the 
committee.
  Not only is this bill bipartisan, it has received support of the 
administration, and it is an important illustration of the work we are 
doing in the House right now to improve health care for all Americans.
  The Medicaid program continues to suffer from fraud, waste, and 
abuse. These issues cause direct harm to the beneficiaries and waste 
billions of taxpayer dollars.
  Medicaid beneficiaries frequently end up in the emergency room, not 
because they need emergency care, but because they cannot find a 
physician participating in their Medicaid program. This is an 
inefficient and ineffective way to access health care.
  H.R. 3716 is commonsense legislation that resolves both of these 
problems and improves beneficiary access to quality providers. Not only 
is this bill good for patients, it is fiscally responsible.
  According to the Congressional Budget Office, this package would 
reduce Federal outlays by $15 million over the budget window because 
the Medicaid program would no longer be paying providers who had been 
terminated for reasons of fraud, integrity, or quality.
  Although the Congressional Budget Office does not estimate State-
specific savings, this bill would also save State Medicaid programs 
from several million dollars over the same timeframe.
  The Office of Inspector General at the Department of Health and Human 
Services has previously found that 12 percent of terminated providers 
were participating in a State Medicaid program as of January 1, 2012, 
after the same provider was terminated for reasons of integrity or 
quality from another State Medicaid program.

                              {time}  1230

  The base bill, H.R. 3716, will ensure that we put an end to this 
problem.
  State Medicaid and State CHIP programs will be required to report 
terminated providers to the Centers for Medicare & Medicaid Services 
within 21 business days. The Centers for Medicare & Medicaid Services 
will then be required to include that data and Medicare provider 
terminations in its Termination Notification database within 21 
business days. In addition, State Medicaid and State CHIP managed care 
contracts will be required to include a provision that providers 
terminated for reasons of integrity or quality from Medicare, Medicaid, 
or SCHIP be terminated from participation in their provider networks. 
Where Medicaid or CHIP payments are made to providers for services 
performed more than 60 days after the provider's termination, those 
States will be required to pay back the Federal portion of the Medicaid 
match of those payments.
  The bill will also ensure that State Medicaid agencies have a current 
and complete list of providers serving Medicaid patients by requiring 
providers to enroll with the State agency. To streamline reporting 
requirements and eliminate duplication, the Centers for Medicare & 
Medicaid Services will be required to develop uniform terminology for 
terminations related to fraud, integrity, or quality.
  These simple reforms will ensure that we stop paying millions of 
Federal taxpayer dollars for fraudulent and wasteful care and that 
beneficiaries are not receiving care from providers who

[[Page 2560]]

have failed to adhere to basic standards of quality or integrity.
  The second key issue this bill tackles is one of access to care. 
Beneficiaries in the Medicaid program have historically struggled to 
find a physician who will accept Medicaid and can provide treatment. 
H.R. 3716 includes H.R. 3821, introduced by Representative Chris 
Collins of New York, to empower beneficiaries with better information 
that will arm them with the information that they need to access care 
without first going to an emergency room.
  While Medicaid beneficiaries enrolled in managed care plans have a 
defined network of providers, about half of States use delivery systems 
other than risk-based managed care, and those served under a fee-for-
service or primary care case management program include some of the 
most vulnerable Medicaid enrollees, such as the elderly and disabled 
children. Unfortunately, these enrollees may have limited assistance in 
identifying physicians who participate in the Medicaid program.
  Specifically, the policy would require State Medicaid programs to 
publish an electronic directory of physicians who have billed Medicaid 
in the prior year--an indication that the physician has or likely still 
accepts Medicaid patients. That directory would include the physician's 
name, specialty, address, telephone number, and, where relevant, 
information on whether the physician is accepting new patients and 
linguistic capabilities.
  Medicaid is estimated to cover 83 million people this year, and it is 
growing. H.R. 3716 makes two targeted but important reforms to 
strengthen the integrity of the Medicaid program and to improve access 
to quality care. This legislation is another example of the Energy and 
Commerce Committee's record of success on bipartisan reform to improve 
the state of health care in America. I encourage my colleagues to vote 
for this package.
  Mr. Speaker, I reserve the balance of my time.
  Mr. HASTINGS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I thank the gentleman from Texas for yielding me the 
customary 30 minutes for debate.
  Mr. Speaker, I rise today to debate the rule for H.R. 3716, Ensuring 
Removal of Terminated Providers from Medicaid and CHIP Act. Among other 
things, this bill requires State Medicaid and CHIP programs to report 
providers terminated for reasons of fraud, integrity, or quality to CMS 
within 21 business days.
  The requirements in this legislation are straightforward and have 
achieved broad bipartisan support. I find myself strangely in the 
position of agreeing with all of what my colleague from Texas had to 
say. I listened to him intently. So it only leaves the question: Why is 
this bill being presented here today instead of under the suspension 
calendar?
  Rather than taking the time to debate a rule for a bill that could be 
passed without the need for a special rule, would it not be a better 
use of this body's valuable legislative time to debate and pass a 
budget resolution and get the appropriations process started?
  Mr. Speaker, I applaud Speaker Ryan's promises to end Republican 
obstruction and dysfunction and return to regular order, but I cannot 
see how what is unfolding now is a step in that direction.
  Last fall, Republicans and Democrats came together to pass a 
bipartisan budget agreement. Now Republicans, appeasing the most 
extreme fringe of their party, are considering breaking that agreement. 
Breaking this agreement will not be without consequences for this 
Nation, including deeper cuts to seniors and working families.
  Mr. Speaker, the majority's fumble on the budget has ushered in a new 
level of dysfunction for this institution. My Republican friends' 
inability to govern has gotten so bad that they can't even agree to 
follow through on an agreement they have already agreed to and has been 
signed into law.
  As we debate today, it is still not clear how the majority plans to 
move forward on one of this body's most basic constitutional 
obligations: appropriating funds to run the country.
  I told the young people working with me that I thought of a metaphor 
last night about when I first learned to swim. I grew up in an area 
where there were a lot of lakes, so it was automatic that all of us 
would learn how to swim, and we did. In learning to swim, among the 
things that the young boys taught me was there were times when you just 
tread water, where you don't move forward or backward. If you are 
backstroking, just tread water. Some learned to float. I didn't. But 
apparently my Republican friends have learned to float and have learned 
to tread water because we are not going anywhere fast in this 
institution of dysfunction.
  The inability to fulfill this obligation is truly astounding and 
reveals a Republican majority that may wish upon every star in the sky 
to return to regular order but has no earthly idea of how to do so. 
Indeed, the only regularity we see coming out of today's Republican 
leadership is one dedicated to disorder.
  The inability to even begin a fruitful discussion of a budget process 
is but one among many pieces of evidence that prove that the Republican 
hopes of regular order are as elusive as is their ability to put forth 
a plan that will benefit working class Americans, strengthen our 
infrastructure, and provide for the least among us. It would be comical 
if it were not so dire.
  Let's recap how we have arrived at this point of Republican inability 
to govern. For the first time in 40 years, Republicans refuse to even 
invite a representative from the administration to testify on the 
President's budget proposal. Then, Republican leaders failed to hold a 
committee markup on a budget resolution last week and fumbled their 
plans to present their conference with a promised budget blueprint. 
Now, in order to appease the insatiable radical fringe of his party, 
Speaker Ryan is threatening to break the terms of the bipartisan budget 
agreement passed into law last year--totally unbelievable.
  Mr. Speaker, the American people deserve better. They want us to work 
together to fund their government and solve the problems of this 
country. This whole Republican budget process has shown that the 
majority and the radical fringe rightwing of their party are simply not 
up to that task.
  I might add that I read last night that the majority leader in the 
other body has made it very clear that he is not going to play along 
with House Republican functionaries who would send stuff to the Senate 
that is not going to pass. I predict that we will one day have the 
usual omnibus at the end of this process, and that is tragic.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I have no further speakers, so pending Mr. 
Hastings' conclusion, I will reserve the balance of my time.
  Mr. HASTINGS. Mr. Speaker, I have no further speakers as well, and I 
am prepared to close.
  I yield myself the balance of my time.
  Mr. Speaker, if we defeat the previous question, I am going to offer 
an amendment to the rule to bring up a resolution that would require 
the Republican majority to stop its partisan games and finally hold 
hearings on the President's budget proposal.
  Mr. Speaker, I ask unanimous consent to insert the text of the 
amendment in the Record, along with extraneous material, immediately 
prior to the vote on the previous question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. HASTINGS. Mr. Speaker, I urge my colleagues to vote ``no'' and 
defeat the previous question.
  Mr. Speaker, the bill underlying this rule institutes a number of 
proposals that have broad bipartisan support. So again I ask: Why are 
we here debating a rule for such a bill? Quite obviously, it is because 
Republicans have no choice but to tread water. In doing so, they have 
called a time-out on helping the American people; they have called a 
time-out on doing their job.
  They have done so, so that they may make haste in putting Humpty 
Dumpty back together again.

[[Page 2561]]

  Good luck, my friends. Truly, truly, I wish you good luck.
  In the meantime, rest assured that those of us on this side of the 
aisle stand ready in getting to the people's business once you can pull 
yourselves together and put forth a budget plan. I am, of course, 
suspect of whether our friends on the other side of the aisle will be 
able to do so.
  Mr. Speaker, I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, I do want to point out today is March 2, significant for 
many of us in Texas because that is Texas Independence Day, a date that 
is recognized across the Nation as one that brought independence to the 
State of Texas.
  I would point out it seems like oftentimes, in my role here 
presenting the Republican case for the rule from the Rules Committee, 
it also becomes my duty to provide some historical perspective for the 
House of Representatives, and today is no exception.
  March 2, today, the first year that the Democrats had the majority in 
recent memory was calendar year 2007. When was a budget passed in 
calendar year 2007? It was passed on March 29. I would point out that 
the only thing bipartisan about that budget resolution was the 
opposition.
  Calendar 2008, a bit better, the budget passed on March 13, the 
middle of the month, about 2 weeks from where we are today. Once again, 
on that budget, 212 yeas and 207 nays. But the nays were bipartisan. 
The yeas, of course, were of a single party.
  Calendar year 2009, the budget didn't pass until the month of April, 
and, once again, the only thing bipartisan about the budget that year 
was its opposition.
  Then, finally, I would point out that the following calendar year, 
2010, there was no budget submitted.
  So, Mr. Speaker, my understanding from the chairman of the Budget 
Committee is they are actively working on the budget. I wish them 
Godspeed. I am thankful that I don't have to be in the room while it is 
being done, but I have every confidence that they will produce a budget 
document that the House will then consider. But today--today--Mr. 
Speaker, today's rule provides for consideration of an important fix to 
the Nation's Medicaid program.
  I certainly want to thank Dr. Larry Bucshon and Mr. Collins of New 
York--both, of the Energy and Commerce Committee, two important members 
of the Committee on Energy and Commerce--for their work on this 
legislation.
  Mr. Speaker, I urge my colleagues to vote ``yes'' on the rule and 
``yes'' on the underlying bill.
  The material previously referred to by Mr. Hastings is as follows:

     An amendment to H. Res. 632 Offered by Mr. Hastings of Florida

       At the end of the resolution, add the following new 
     sections:
       Sec. 2. Immediately upon the adoption of this resolution it 
     shall be in order without intervention of any point of order 
     to consider in the House the resolution (H. Res. 624) 
     Directing the Committee on the Budget to hold a public 
     hearing on the President's fiscal year 2017 budget request 
     with the Director of the Office of Management and Budget as a 
     witness. The resolution shall be considered as read. The 
     previous question shall be considered as ordered on the 
     resolution and preamble to adoption without intervening 
     motion or demand for division of the question except one hour 
     of debate equally divided and controlled by the chair and 
     ranking minority member of the Committee on the Budget.
       Sec. 3. Clause 1(c) of rule XIX shall not apply to the 
     consideration of H. Res. 624.
                                  ____


        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Republican majority agenda and a vote to allow 
     the Democratic minority to offer an alternative plan. It is a 
     vote about what the House should be debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives (VI, 308-311), describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       The Republican majority may say ``the vote on the previous 
     question is simply a vote on whether to proceed to an 
     immediate vote on adopting the resolution. . . . [and] has no 
     substantive legislative or policy implications whatsoever.'' 
     But that is not what they have always said. Listen to the 
     Republican Leadership Manual on the Legislative Process in 
     the United States House of Representatives, (6th edition, 
     page 135). Here's how the Republicans describe the previous 
     question vote in their own manual: ``Although it is generally 
     not possible to amend the rule because the majority Member 
     controlling the time will not yield for the purpose of 
     offering an amendment, the same result may be achieved by 
     voting down the previous question on the rule. . . . When the 
     motion for the previous question is defeated, control of the 
     time passes to the Member who led the opposition to ordering 
     the previous question. That Member, because he then controls 
     the time, may offer an amendment to the rule, or yield for 
     the purpose of amendment.''
       In Deschler's Procedure in the U.S. House of 
     Representatives, the subchapter titled ``Amending Special 
     Rules'' states: ``a refusal to order the previous question on 
     such a rule [a special rule reported from the Committee on 
     Rules] opens the resolution to amendment and further 
     debate.'' (Chapter 21, section 21.2) Section 21.3 continues: 
     ``Upon rejection of the motion for the previous question on a 
     resolution reported from the Committee on Rules, control 
     shifts to the Member leading the opposition to the previous 
     question, who may offer a proper amendment or motion and who 
     controls the time for debate thereon.''
       Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Republican 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.

  Mr. BURGESS. Mr. Speaker, I yield back the balance of my time, and I 
move the previous question on the resolution.
  The previous question was ordered.
  The resolution was agreed to.
  A motion to reconsider was laid on the table.

                          ____________________