The HIPAA Recreational Injury Technical Correction Act

Mr. Speaker, I am pleased to join my colleagues Congressman Blunt and Congressman Strickland in introducing legislation that would prohibit insurers from denying payment to health plan participants for injuries sustained while engaged in certain recreational activities like horseback riding or motorcycling.

In January 2001, the Department of Labor, the Internal Revenue Service and the Health Care Financing Administration, issued a rule in accordance to the Health Insurance and Portability and Accountability Act of 1996 (HIPAA) that was designed to guard against discrimination in coverage in the group health market. These rules prohibited health plans from denying coverage to people who engage in recreational activities like horseback riding and motorcycling. However a loophole was created that allowed insurers to deny payment for services based upon the source of the injury.

The rule states that: ``While a person cannot be excluded from a plan for engaging in certain recreational activities, benefits for a particular injury can, in some cases, be excluded based on the source of the injury.'' A plan could, for example, include a general exclusion for injuries sustained while doing a specified list of recreational activities, even though treatment for those injuries, a broken arm for instance, would have been covered under the plan if the individual had tripped and fallen.

This loophole creates a situation that is especially unfair to people who ride motorcycles, horses, snowmobiles, or any other form of motorized recreation. Millions of Americans enjoy these activities safely every year within the framework of state laws and utilizing proper safety precautions. Should something extraordinary occur resulting in an injury, these individuals deserve the same consideration when it comes to their medical expenses as every other American. They should not be denied payment for health services for the mere fact that the injury occurred on horseback or on a motorcycle.

The legislation that we are introducing today will remove any ambiguity when it comes to participation in certain recreational activities or modes of transportation should an injury occur. I want to thank Mr. Blunt and Mr. Strickland for joining me on this legislation. I look forward to working with them along with the multitude of groups that have made this legislation such a high priority, especially the American Motorcyclist Association and the Motorcycle Industry Council. I urge all of our colleagues to join us as cosponsors and stand with America’s riders.

STATEMENT FOR THE RECORD - MICHAEL C. BURGESS

ENERGY AND AIR QUALITY SUBCOMMITTEE HEARING:

A HEARING ON THE ADMINISTRATION'S CLEAR SKIES INITIATIVE

May 26, 2005

Mr. Chairman, I would like to thank you for holding this important hearing.

I can't think of a better time to hold a hearing on clean air. My Congressional District, like the Chairman's, is located in the Dallas-Fort Worth Metroplex in North Texas. Each summer the Metroplex faces a serious public health problem in the form of ozone.

The hot Texas air combines with Volatile Organic Compounds and nitrogen oxides to form ground level ozone, which causes health problems for our elderly and children, and especially those with asthma.

I believe that clean air will be one of the North Texas region’s most important and challenging issues over the next decade. I support efforts to clean up our air - clean air is one of the most important legacies that we can leave our children.

In North Texas, there is a significant commitment to clean the air. The EPA, the State of Texas, the Cities of Fort Worth and Dallas, and the North Texas Clean Air Coalition, which is comprised of the North Texas Council of Governments and community leaders, are all working together to improve air quality in the North Texas region. They've done a good job so far - North Texas has grown rapidly over the last decade and the degree of air pollution has not increased, and has even improved.

The Dallas - Fort Worth Metroplex has been designated as in "moderate" non-attainment under the recently announced 8-Hour ozone designations, with an attainment date of 2010. This is an improvement over its 1-hour ozone designation, when Dallas - Fort Worth was classified as in "serious" non-attainment. I am pleased about the progress we have made over the last few decades on cleaning up our air, but there is a lot of work still to be done.

The Clean Air Act has helped to improve our air quality since it was enacted, but I believe that the time is right for Congress to examine whether or not it makes sense for the future.

The complexity alone makes it difficult for states and localities to comply. I do not believe that we should let states and cities "off the hook" for cleaning the air, as some have alleged.

But I think that it makes common sense to allow states and cities to spend their resources on cleaning up the air rather than complying with unnecessarily complex federal laws and regulations.

And, as a former member of the Transportation and Infrastructure Committee, I am also concerned about the transportation conformity provision in current law.

In conclusion, Mr. Speaker, I'd like to welcome Chairman Connaughton and Administrator Holmstead and thank them for testifying before us today. I look forward to learning more about the President's Clear Skies Initiative.

Opening Statement

Congressman Michael C. Burgess, M.D.

Pandemic Flu

May 25, 2005

Thank you Mr. Chairman. When looking at the historical incidences of pandemic flu, I think it is common for one to be overwhelmed by the challenges of preventing a devastating outbreak of influenza and dealing with its aftermath. The numbers tell a chilling story. In the last century, it is estimated that over 53 million people died due to periodic outbreaks of pandemic flu strains. Considering that the world’s population is more mobile today than at anytime in our history, public health officials are right in making the fight against communicable disease the highest priority. Factor in the adaptability of the influenza virus and it is understandable to see why we cannot consign the pandemic flu outbreaks of the 20^th century to the “never again” file.

There are several tools available to confront a possible outbreak, but I am concerned about the coordination of surveillance, prevention and containment strategies at the state, federal, and global levels--along with concerns about the availability of vaccine or anti-virals should an outbreak occur. While the severity of the next pandemic cannot be predicted, modeling by the CDC suggests that its effect in the United States could be severe. In the absence of any control measures (vaccination or drugs), it has been estimated that in the United States a “medium–level” pandemic could cause 89,000 to 207,000 deaths, between 314,000 and 734,000 hospitalizations, 18 to 42 million outpatient visits, and another 20 to 47 million people being sick. Between 15% and 35% of the U.S. population could be affected by an influenza pandemic, and the economic impact could range between $71.3 and $166.5 billion.

Not too long ago, we were concerned about another communicable disease, SARS. The SARS outbreak of 2003 exposed the capability of global surveillance and containment infrastructure and how an outbreak of an unknown disease can impact human interaction and commerce. Dr. Gerberding, I thank you for indulging my phone calls over this period, but even though the severity of the outbreak was largely isolated to East and South Asian countries, it did impact my district, which at the time was the home of Dallas/Fort Worth International Airport. A the local level at least, the SARS outbreak brought into sharp focus how fear can drive a containment response to an unknown illness in the absence of a workable containment strategy.

I look forward to hearing from our panels today. Understanding the current capabilities of our public health institutions and the vaccine industry will help improve our response to any future pandemic influenza outbreaks. Thank you and I yield back.

Opening Statement

Congressman Michael C. Burgess, M.D.

A Review of Community Health Centers: Issues and Opportunities

May 24, 2005

Mr. Chairman, I appreciate you convening this hearing on Community Health Centers today. Community Health Centers make up a critical part of our nation’s health care safety net for the poor and uninsured. Because of their proximity to the community and emphasis on primary and preventive care, Community Health Centers help relieve over-crowded emergency departments and improve the health of citizens in the community.

I am especially interested in hearing what our panel members have to say today because this issue is critically important to my home district. The 26^th District is a cross section of the United States. Within its boundaries you will find a mix of rich, poor and middle income; rural, suburban, and urban; black, Anglo, and Latino. You will also you see sharp differences in the health needs of different communities and how they are impacted by varying health disparities. For instance, in one part of my district, you see some of the highest rates of infant mortality anywhere in the country and indeed higher than even some Middle East and Caribbean countries. In other parts of my district, the population is healthier, but without ready access to health insurance.

A new Community Health Center in Denton, Texas is beginning to make a difference by giving community residents access to a physician at free or reduced cost. This will not only improve their short term health, but will help with the creation of a medical home.

I am also actively seeking out stakeholders in the City of Fort Worth to look at standing-up a clinic in South East Fort Worth to meet the needs of this community. This area of Fort Worth, having yet to really catch the wave of economic development that has benefited other areas of the city is crying out for just the type of assistance that a Community Health Center can provide. As we proceed from this hearing, I hope I am able to tap some of the expertise here in the room to assist my constituents in this area as they look to establish a Community Health Center. Thank you and I yield back.