FULL COMMITTEE ACTION

Thursday, June 20, 2002  -   Friday, June 21, 2002
(continuous session)
 

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Committee Print: Title I - Medicare Prescription Drug Benefit, was ordered favorably reported to the House, amended, on June 21, 2002, by a yea-nay vote: 30-23.  For further action see H.R. 4984.

The following amendments were offered:

An amendment in the nature of a substitute by Mr. Dingell, # 2, striking Title I and replacing it with Democratic plan that creates an affordable, comprehensive Medicare prescription drug benefit. The benefit under the Democratic plan is * $25 monthly premium; * $100 deductible; * 20% beneficiary co-insurance; * $2,000 stop-loss coverage. Senior citizens and individuals with disabilities whose incomes are under 150% of poverty will receive premium assistance on a sliding scale and pay only nominal cost-sharing, was defeated by a yea-nay vote: 24-30;

An amendment by Mr. Barton of Texas, # 3, re: permitting alternative use of prescription drug benefit account, was withdrawn by unanimous consent;

An amendment by Mrs. Capps and Mr. Pallone, # 4, re: a national Medicare plan ensuring stability and availability of prescription drug coverage under Medicare, requiring Medicare to offer the Republican "standard" benefit as guaranteed defined benefit with a uniform national premium, regardless of private plan presence, was defeated by a yea-nay vote: 24-31;

An amendment by Mr. Waxman, # 5, re: deleting the Tauzin amendment’s exemption from Medicaid "Best Price," was defeated by a voice vote;

An amendment by Mr. Waxman, # 6, re: requiring transparency in pricing, would require the Secretary to publish a clear and easily understandable comparison, for each Prescription Drug Plan sponsor and each Medicare+Choice organization, of the sponsor’s or organization’s negotiated price for each covered outpatient drug with the average manufacturer price, was defeated by a yea-nay vote: 25-31;

An amendment by Mr. Markey, # 7, re: medical privacy, providing adequate privacy protections for health information collected through the Prescription Drug Card program, was defeated by a yea-nay vote: 24-29, 1 voting "Present";

An amendment by Mr. Pallone, # 8, re: drug pricing, charges the Secretary of Health and Human Services to use the collective purchasing power of 40 million Medicare beneficiaries to negotiate lower drug prices, taking into account the goal of promoting the development of breakthrough drugs, was defeated by a yea-nay vote: 20-30;

An amendment by Mr. Pallone, # 9, re: average foreign price, allowing pharmacies to purchase prescription drugs for Medicare beneficiaries at the drugs’ low "average foreign price," meaning average price manufacturers realize on drugs sold in Canada, France, German, Italy, Japan, and the United Kingdom, was defeated by a voice vote;

An amendment by Mr. Pallone, # 10, re: Drug Reimportation from Canada, allowing U.S.-licensed pharmacists and drug wholesalers to import FDA-approved medications from Canada only, so that American consumers benefit from international price competition for prescription medicine, was ruled not germane;

An amendment by Mrs. Capps, # 11, re: filling the gap in the Republican bill’s standard benefit for individuals with amyotrophic lateral sclerosis (ALS); the amendment provides for a 20% co-payment between the $250 deductible and $3,700 limit in out-of-pocket spending, was defeated by a yea-nay vote: 19-28;

An amendment by Mr. Green of Texas, # 12, re: filling the gap in the Republican bill’s standard benefit; the amendment provides for a 20% co-payment between the $250 deductible and $3,700 limit in out-of-pocket spending, was defeated by a yea-nay vote: 22-30;

An amendment by Mr. Markey, # 13, re: filling the gap in the Republican bill’s standard benefit for widows; the amendment provides for a 20% co-payment between the $250 deductible and $3,700 limit in out-of-pocket spending, was defeated by a yea-nay vote: 21-28.

An amendment by Mr. Brown of Ohio, # 14, re: beneficiary access to comprehensive coverage, ensures that beneficiaries have access to prescription drug coverage that most closely approximates what most Members of Congress receive by requiring all private drug plans to offer coverage that mirrors that drug coverage currently in the Federal Employees Health Benefits Plan Blue Cross Standard Option, the most popular federal health plan, was defeated by a yea-nay vote: 20-27;

An amendment by Mr. Brown of Ohio, # 15, re: Greater Access to Affordable Pharmaceuticals, was ruled not germane;

An amendment by Mr. Green of Texas, # 16, re: Counting all out-of-pocket costs, improve beneficiaries’ access to stop-loss coverage in the Republican bill by eliminating language that counts only "true" out-of-pocket cost toward the cap, helping those in need of catastrophic coverage to count dollars spent by others to count toward the cap, was adopted, as amended by the Deal amendment, by a voice vote;

An amendment to the Green amendment by Mr. Deal, # 16A, only permitted dollars spent by individuals for a high-need beneficiary, not a third party such as group health insurance or other third-party payment arrangement for such costs, was adopted by a yea-nay vote: 31-22;

An amendment by Mr. John, # 17, re: Access to Pharmacies, strikes language and inserts language from the Democratic substitute that allows any pharmacy meeting the HHS Secretary’s standards to participate under the plan; Under the Republican bill, private drug plans may exclude certain pharmacies and limit the pharmacy network, as well as charge higher premiums for a point-of-service pharmacy benefit, was defeated by a yea-nay vote: 25-27;

An amendment by Mr. Stupak, # 18, re: minimum discount under the Prescription Drug Card, requires participating or "endorsed" discount cards to guarantee beneficiaries at least 35% off the Average Wholesale Price (AWP) per prescription, was defeated by a yea-nay vote: 20-32;

An amendment by Mr. Stupak, # 19, re: Federal Supply Schedule Prices, allowing seniors and those eligible for a Medicare prescription drug benefit to choose to pay Federal Supply Schedule prices for drugs, was defeated by a yea-nay vote: 20-32;

An amendment by Mr. Stupak, # 20, re: coal beneficiaries opt out, allows Coal Act beneficiaries to opt out of Medicare prescription drug coverage, and any steel workers whose legacy costs are covered in the future may opt out as well, was defeated by a yea-nay vote: 22-28;

An amendment by Mr. Sawyer, # 21, re: GAO study of the effectiveness of the new prescription drug program, was adopted by a voice vote;

An amendment by Mr. Sawyer, # 22, re: CMS data collection, allowing the Prescription Drug Plan sponsor to ensure timely access to appropriate data for the coordination and continuation of efforts at Center for Medicare and Medicaid Services (CMS) to monitor and improve quality, conduct related research, and for other purposes, was withdrawn by unanimous consent;

An amendment by Mr. Waxman, # 23, re: eliminate assets test for low income beneficiaries, was defeated by a yea-nay vote: 22-30;

An amendment by Mr. Green of Texas, # 24, re: inclusion of insulin syringes, was withdrawn by unanimous consent;

An amendment by Mr. Tauzin, # 25, re: lowering the limit on out-of-pocket costs to $3,700, was adopted by a voice vote.

Committee Print: Subtitle C - Promotion of Electronic Prescription, was ordered favorably reported to the House on June 20, 2002, by a voice vote.  For further action see H.R. 4989.

No amendments were offered to this Committee Print.

Committee Print: Sec. 942 - Certain Health Professions Programs Regarding Practice of Pharmacy, was ordered favorably reported to the House, amended, on June 20, 2002, by a voice vote.   For further action see H.R. 4992.

The following amendment was offered:

An amendment by Mr. Towns, #1, re: encouragement of people from disadvantaged backgrounds to become pharmacists, was adopted by a voice vote.

Committee Print: Title V - Provisions Relating to Part B, was ordered favorably reported to the House, amended,  on June 21, 2002, by a voice vote.  For further action see H.R. 4986.

The following amendments were offered:

An amendment by Mrs. Wilson, #1, re: physician fee schedule wage index revision, was adopted, as amended, by a voice vote;

An amendment by Mr. Barrett to the Wilson amendment, #1A, re: 2004 minimum work geographic index, was adopted by a voice vote;

An amendment by Mr. Dingell, #2, re: protecting fee-for-service Medicare by making permanent the adjustment to Medicare physician payment formula, was defeated by a yea-nay vote: 22-27;

An amendment by Mr. Ganske, #3, re: relief for certain non-teaching hospitals, was withdrawn by unanimous consent;

An amendment by Mr. Brown, #4, re: to strike provisions that establish competitive bidding for durable medical equipment, was defeated by a voice vote;

An amendment by Mr. Pallone, #5, re: to repeal the $1,500 cap put in place under the Balanced Budget Act of 1997 on outpatient rehabilitation services such as physical therapy, speech-language therapy and occupational therapy, was adopted, as amended, by a voice vote;

A substitute amendment for the Pallone amendment offered by Mr. Blunt, #5A, re: changing the expiration date of the moratorium on the outpatient therapy caps to January 2004, was adopted by a voice vote;

An amendment by Mr. Stupak, #6, re: ambulance fee adjustment (Based on H.R. 3109, "Medicare Rural Ambulance Service Improvement Act of 2001," this amendment would increase the reimbursement for ambulance services, with attention focusing on rural ambulance providers), was defeated by a yea-nay vote: 20-28;

An amendment by Mr. Engel, #7, re: coverage for home infusion therapy (based on H.R. 2750, "Medicare Home Infusion Therapy Act of 2001"), was withdrawn by unanimous consent;

An amendment by Mr. Engel, #8, re: increase funding for Outpatient PPS for clinic and emergency room visits, was defeated by a yea-nay vote: 18-29;

An amendment by Mr. Strickland, #9, re: providing for parity in treatment of outpatient mental health services (identical to H.R. 599, "Medicare Mental Illness Nondiscrimination Act of 2001"), was defeated by a yea-nay vote: 21-26;

An amendment by Mr. Towns, #10, re: increasing minimum payment for screening mammography to $90 for 2003, indexed to the Consumer Price Index in subsequent years, was adopted by a voice vote;

An amendment by Mr. Barrett, #11, re: requiring the Department of Health and Human Services to bring states with Medicare reimbursement rates well below the national average up to 95% of the national average, was defeated by a yea-nay vote: 19-28;

An amendment by Mr. Upton, #12, re: review of the application of absence of infrequent or short duration in establishing home confinement for purposes of eligibility for home health services, was adopted by a voice vote.

Committee Print: Title VI - Provisions Relating to Parts A and B, was ordered favorably reported to the House, amended, on June 21, 2002, by a voice vote.  For further action see H.R. 4987.

The following amendments were offered:

An amendment by Mr. Waxman, #1, re: establishment of reduced copayment for a home health service episode of care for certain beneficiaries, was defeated by a yea-nay vote: 0-44, 2 voting "Present";

An amendment by Mr. Stupak, #2, re: adjustment of labor costs relating to items and services furnished in a geographically re-classified hospital for which reimbursement under Medicare is provided on a prospective basis, was ruled not germane;

An amendment by Mr. Markey, #3, re: modification of the definition of homebound, was withdrawn by unanimous consent;

An amendment by Mr. Pickering, #4, re: increasing the updates for home health agencies, was adopted by a voice vote;

An amendment by Mr. Engel, #5, re: striking the extension beyond 2005 of the update reduction for hospitals above 140% of the national average per resident amount under graduate medical education, was defeated by a yea-nay vote: 18-27;

An amendment by Mr. Cox, #6, re: General Accounting Office study of Medicare payment for inhalation therapy, was adopted by a voice vote;

An amendment by Mr. Green of Texas, #7, re: permitting expansion of medical residency training programs in geriatric medicine and providing reimbursement for care coordination and assessment services provided under Medicare, was defeated by a voice vote;

An amendment by Ms. DeGette, #8, re: information on participation in clinical trials, was withdrawn by unanimous consent.

Committee Print: Title II - Medicare+Choice Revitalization and Medicare+Choice Competition Program, was ordered favorably reported to the House on June 21, 2002, by a yea-nay vote: 26-15.  For further action see H.R. 4985.

The following amendments were offered:

An amendment by Mr. Pallone, #1, re: preserving the new Medicare+Choice funding and other selected provisions, but striking the sections that (1) create a new premium support program (including the competitive demonstration), (2) preempt state laws for Medicare+Choice plans, and (3) make changes to Medicare MSAs. Under the Republican bill, Medicare+Choice is turned into a "competition" program starting in 2005 and a demonstration project is established to test premium support, was defeated by a yea-nay vote: 17-26;

An amendment by Mr. Luther, #2, re: increase in floor payment, was defeated by a yea-nay vote: 18-24, 1 voting "Present";

An amendment by Mr. Brown, #3, re: permanently eliminating the Medicare+Choice lock-in scheduled to go into effect in January 2005 based on the recently passed Bioterrorism bill; extending the existing Medigap protections that apply to people whose Medicare+Choice plan withdraws from the program to anyone whose Medicare+Choice plan changes benefits or whose doctor or hospital leaves the plan; prohibits Medicare+Choice plans from charging higher cost-sharing for a service than Medicare charges in the fee-for-service program (this provision is crafted to continue to allow reasonable flat-dollar co-payments), was defeated by a voice vote;

An amendment by Mrs. Capps, #4, re: adding to Section 201 of the bill a provision that directs the payment increases for Medicare+Choice go to areas that have been most affected by pull-outs and benefit cuts, in the opinion of the Secretary of Health and Human Services, was defeated by a voice vote;

An amendment by Mr. Pallone, #5, re: elimination of Medicare+Choice changes in Part B premium, was defeated by a yea-nay vote: 17-27;

An amendment by Mrs. Capps, #6, re: making the offering by Medicare+Choice plans of prescription drug coverage for brand name prescription drugs a condition of funding increase, was defeated by a voice vote.

Committee Print: Title VII - Medicare Benefits Administration, was ordered favorably reported to the House, amended, on June 21, 2002, by a yea-nay vote: 27-15.  For further action see H.R. 4988.

The following amendment was offered:

An amendment by Mr. Whitfield, #1, re: pharmacy grants, was adopted by a voice vote.

Committee Print: Subtitle B - Internet Pharmacies, was ordered favorably reported to the House on June 21, 2002, by a voice vote.  For further action see H.R. 4990.

The following amendment was offered:

An amendment by Mr. Waxman, #1, re: internet sales of prescription drugs, was defeated by a voice vote.

Committee Print: Sec. 903 - Disproportionate Share Hospital (DSH) Payments, was ordered favorably reported to the House on June 21, 2002, by a voice vote.  For further action see H.R. 4991.

The following amendments were offered:

An amendment by Ms. DeGette and Mr. Barrett, #1, re: eliminating the scheduled reduction in federal Medicaid DSH funding so that in 2003 and beyond each state DSH program can grow with inflation; additionally, the amendment will increase funding for low DSH states from 1% to 3%, was defeated by a yea-nay vote: 21-25;

An amendment by Mr. Barrett, #2, re: increase in floor for treatment as an extremely low DSH state to 3% in fiscal year 2002, was withdrawn by unanimous consent.

THE COMMITTEE ADJOURNED SUBJECT TO THE CALL OF THE CHAIR