The legislation was introduced in the Senate as bill number S 644 and in the House of Representatives as bill number HR 1415. Initial drafts were developed by the Coalition for Health Care Choice and Accountability. The Coalition, initially formed by the American Chiropractic Association, includes 31 different health care provider associations of all types, including nurses, surgeons, MDs and dentists. The ACA has maintained a leadership role in the Coalition.
The two most important elements of the proposed legislation are that all U.S. employees have access to a point of service plan (POS), and the prohibition against discrimination of providers "solely based on their license." POS plans have only been available over the last 10 years, but are becoming very popular, primarily because they allow enrollees the option of accessing a provider outside the network for a reasonable additional cost.
Introduction of the PARCA bill in the House was headed by Congressman Charlie Norwood (R-GA). At press time, there were 80 House members co-sponsoring the bill, including three important House committee chairmen: Bob Livingston, House Appropriations Committee (R-LA); Floyd Spence, House Armed Services Committee (R-SC); and Gerald Solomon, House Rules Committee (R-NY).
In the Senate, Alphonse D'Amato (R-NY) is sponsoring the legislation. The work over the past several weeks has been aimed toward obtaining original sponsors for the PARCA bill in the House, and the organizations that support the legislation are still in the early stages of building support for it in the Senate.
Key Points for Patients
Besides access to POS plans, the PARCA legislation would allow patients to:- have prompt delivery of health services; select a health professional within a plan, change that selection if they feel it necessary, and be guaranteed continuity for health care services they receive;
- have access to specialized treatment when that treatment is "medically necessary in the professional judgment of the treating health professional";
- participate in a plan regardless of "race, gender, language, age, disability, health status, or anticipated need for services";
- have their views "considered in developing health plan policies, including policies governing coverage for treatment, utilization review, quality, and management of medical procedures";
- have access to clearly understandable information about the plan, including: benefits; the number and mix of network health professionals; out of network costs; grievance/appeals procedures; and to have that information published in a uniform format for easy comparison across all health plans.
Key Points for Health Professionals
Besides the prohibition against discrimination of providers "solely based on their license," the PARCA legislation mandates that health professionals:- must be allowed to apply as a provider, and use meaningful standards in reviewing applications;
- cannot be discriminated against participation in a plan because of race, gender, age, disability (if disability does not impair the professional's ability to provide services), or lack of affiliation with a hospital;
- "must be considered in developing health plan policies, including policies governing coverage for treatment, utilization review, quality, and management of medical procedures";
- must be given a reasonable notice of termination from a plan, and allow for appeal;
- cannot be prohibited or limited from engaging in "medical communications regarding the patient's health status, medical care, treatment options, utilization review requirements, or financial incentives to deny or limit care";
- be given "fair and accountable utilization reviews, and timely payment of claims," and prevents plans from compensating utilization reviewers for denying care.
Enforcement of PARCA
PARCA will be enforced in the same way as the Kennedy-Kassebaum Health Insurance Portability Act. This bill allows states to enforce the provisions of this act for all non-self-insured plans. Because self-insured plans avoid state laws and to ensure single unified guidelines in the spirit of ERISA, guidelines for self-insured plans will be enforced by the federal government. States will be given the authority to pass additional requirements than are included in this bill for non-ERISA plans.In addition to the impact the PARCA bill will have on health care plans if passed, it will likely be the only broadly-drafted managed care standards bill introduced in the GOP-controlled Congress which has Republican members of Congress as the legislation's principal sponsors.
What You Can Do
The House version of the bill is headed for the House Commerce Committee and the House Education and the Workforce Committee. The Senate version goes to the Senate Labor and Human Resources Committee.Below is a state listing of the members of those committees and how to contact them. Take a moment to call, fax or e-mail your representatives with a message of your support, and encourage your family, friends and patients to do the same.
- = co-sponsor of the PARCA bill
HOUSE EDUCATION AND WORKFORCE COMMITTEE
Phone: (202) 225-4527 Fax: (202) 225-9571http://www.house.gov/eeo/
California
Matthew D. Martinez (D-31)
Howard "Buck" McKeon (R-25)
George Miller (D-7)
Frank Riggs (R-1)
Loretta L. Sanchez (D-46)
Lynn Woolsey (D-6)
Colorado
Bob Schaffer (R-4)
Delaware
Michael Castle (R-at large)
Florida
Joe Scarborough (R-1)
Georgia
Nathan Deal (R-9)
Charles Norwood (R-10)
Hawaii
Patsy Mik (D-2)
Illinois
Harris W. Fawell (R-13)
Indiana
David McIntosh (R-2)
Tim J. Roemer (D-3)
Mark Souder (R-4)
Massachusetts
John F. Tierney (D-6)
Michigan
Peter Hoekstra (R-2)
Dale E. Kildee (D-9)
Joseph Knollenberg (R-11)
Fred Upton (R-6)
Missouri
William "Bill" Clay (D-1), Rnk. Mem.
James Talent (R-2)
Nebraska
Bill Barrett (R-3)
New Jersey
Robert E. Andrews (D-1)
Marge Roukema (R-5)
New York
Carolyn McCarthy (D-4)
Major R. Owens (D-11)
Donald M. Payne (D-10)
North Carolina
Cass Ballenger (R-10)
Ohio
Dennis J. Kucinich (D-10)
Pennsylvania
Chaka Fattah (D-2)
William F. Goodling (R), Chair
Jim Greenwood (R-8)
John E. Peterson (R-5)
Puerto Rico
Carlos Romero-Barcelo (D)
South Carolina
Lindsey Graham (R-3)
Tennessee
Harold E. Ford, Jr. (D-9)
Van Hilleary (R-4)
Texas
Ruben E. Hinojosa (D-15)
Sam Johnson (R-3)
Ron E. Paul (R-14)
Virginia
Robert "Bobby" C. Scott (D-3)
Wisconsin
Ronald J. Kind (D-3)
Thomas E. Petri (R-6)
HOUSE COMMERCE COMMITTEE
Phone: (202) 225-2927 Fax: (202) 225-1919
http://www.house.gov/commerce/
California Brian Bilbray (R-49)
Christopher Cox (R-47)
Anna Eshoo (D-14)
James E. Rogan (R-27)
Henry A. Waxman (D-29)
Colorado
Diana L. DeGette (D-1)
Dan Schaefer (R-6)
Florida
Michael Bilirakis (R-9)
Cliff Stearns (R-6)
Georgia
Nathan Deal (R-9)
Charles Norwood (R-10)
Idaho
Michael Crapo (R-2)
Illinois
Elizabeth Furse (D-1)
J. Dennis Hastert (R-14)
John M. Shimkus (R-20)
Iowa
Greg Ganske (R-4)
Kentucky
Edward Whitfield (R-1)
Louisiana
W.J. "Billy" Tauzin (R-3)
Maryland
Albert Wynn (D-4)
Massachusetts
Edward J. Markey (D-7)
Michigan
John D. Dingell (D-16), Rnk. Mem.
Bart Stupak (D-1)
Fred Upton (R-6)
Missouri
Karen McCarthy (D-5)
New Jersey
Frank Pallone, Jr. (D-6)
New York
Eliot Engel (D-17)
Rick Lazio (R-2)
Thomas J. Manton (D-7)
Bill Paxon (R-27)
Edolphus Towns (D-10)
North Carolina
Richard M. Burr (R-5)
Ohio
Sherrod Brown (D-13)
Paul E. Gillmor (R-5)
Michael G. Oxley (R-4)
Thomas C. Sawyer (D-14)
Ted Strickland (D-6)
Oklahoma
Tom Coburn (R-2)
Steve Largent (R-1)
Pennsylvania
Jim Greenwood (R-8)
Ron Klink (D-4)
Tennessee
Bart Gordon (D-6)
Texas
Joe Barton (R-6)
Gene Green (D-29)
Ralph M. Hall (D-4)
Virginia
Thomas J. Bliley, Jr. (R-7), Chair
Rick Boucher (D-9)
Washington
Rick White (R-1)
Wisconsin
Scott Klug (R-2)
Wyoming
Barbara Cubin (R-at large)
SENATE LABOR AND HUMAN RESOURCE COMMITTEE
Phone: (202) 224-5375 Fax (202) 228-5044
Arkansas Tim Hutchinson (R)
Conecticut
Christopher J. Dodd (D)
Indiana
Dan Coats (R)
Bill Frist (R)
Iowa
Tom Harkin (D)
Kentucky
Mitch McConnell (R)
Maine
Susan M. Collins (R)
Maryland
Barbara A. Mikulski (D)
Massachusetts
Edward M. Kennedy (D), Rnk. Mem.
Minnesota
Paul David Wellstone (D)
New Hampshire
Judd Gregg (R)
New Mexico
Jeff Bingaman (D)
Ohio
Mike Dewine (R)
Rhode Island
Jack Reed (D)
Vermont
Jim M. Jeffords (R), Chair
Virginia
John W. Warner (R)
Washington
Patty Murray (D)
Wyoming
Michael B. Enzi (R)
Thanking Our Friends
Listed alphabetically below are the congressional representatives who have introduced and sponsored the PARCA bill. Telephone numbers and e-mail addresses (not all representatives have e-mail!), have been included so that you may contact your representative and voice your appreciation of their support for this vitally important legislation. Please take the time to review this list, your voice is important.Bill's Sponsers:
Rep. Charlie Norwood (R-GA)
Tel: (202) 225-4101
E-mail:
Sen. Alphonse D'Amato (R-NY)
Tel: (202) 224-6542
E-mail:
Bill's Co-Sponsors:
Rep. Spencer Bachus (R-AL)
Tel: (202) 225-4921
Rep. Richard H. Baker (R-LA)
Tel: (202) 225-3901
Rep. James A. Barcia (D-MI)
Tel: (202) 225-8171
Rep. Bob Barr (R-GA)
Tel: (202) 225-2931
E-mail:
Rep. Thomas M. Barrett (D-WI)
Tel: (202) 225-3571
E-mail:
Rep. Sanford D. Bishop, Jr. (D-GA)
Tel: (202) 225-3631
Rep. Sherrod Brown (D-OH)
Tel: (202) 225-3401
E-mail:
Rep. Charles T. Canady (R-FL)
Tel: (202) 225-1252
E-mail:
Rep. Saxby Chambliss (R-GA)
Tel: (202) 225-6531
E-mail:
Rep. Jon Christensen (R-NE)
Tel: (202) 225-4155
E-mail:
Rep. Howard Coble (R-NC)
Tel: (202) 225-3065
Rep. Tom A. Coburn (R-OK)
Tel: (202) 225-2701
Rep. Michael "Mac" Collins (R-GA)
Tel: (202) 225-5901
E-mail:
Rep. Larry Combest (R-TX)
Tel: (202) 225-4005
Rep. John Cooksey (R-LA)
Tel: (202) 225-8490
Rep. Robert E. "Bud" Cramer, Jr. (D-AL)
Tel: (202) 225-4801
E-mail:
Rep. Danny K. Davis (D-IL)
Tel: (202) 225-5006
Rep. Thomas M. Davis (R-VA)
Tel: (202) 225-1492
E-mail:
Rep. Nathan Deal (R-GA)
Tel: (202) 225-5211
Rep. Peter A. Defazio (D-OR)
Tel: (202) 225-6416
E-mail:
Rep. Jay Dickey (R-AR)
Tel: (202) 225-3772
E-mail:
Rep. John J. Duncan, Jr. (R-TN)
Tel: (202) 225-5435
E-mail:
Rep. Bob Filner (D-CA)
Tel: (202) 225-8045
Rep. Mark Foley (R-FL)
Tel: (202) 225-5792
Rep. John D. Fox (R-PA)
Tel: (202) 225-6111
E-mail:
Rep. Martin Frost (D-TX)
Tel: (202) 225-3605
E-mail:
Rep. Benjamin A. Gilman (R-NY)
Tel: (202) 225-3776
Rep. Lindsey O. Graham (R-SC)
Tel: (202) 225-5301
Rep. Gene Green (D-TX)
Tel: (202) 225-1688
E-mail:
Rep. Tony P. Hall (D-OH)
Tel: (202) 225-6465
Rep. Van Hilleary (R-TN)
Tel: (202) 225-6831
E-mail:
Rep. Earl F. Hilliard (D-AL)
Tel: (202) 22-2665
Rep. Maurice D. Hinchey (D-NY)
Tel: (202) 225-6335
E-mail:
Rep. William L. Jenkins (R-TN)
Tel: (202) 225-6356
Rep. Walter B. Jones (R-NC)
Tel: (202) 225-3415
Rep. Sue W. Kelly (R-NY)
Tel: (202) 225-5441
E-mail:
Rep. Patrick J. Kennedy (D-RI)
Tel: (202) 225-4911
Rep. Ron Kind (D-WI)
Tel: (202) 225-5506
Rep. Gerald D. Kleczka (D-WI)
Tel: (202) 225-4572
E-mail:
Rep. Ray LaHood (R-IL)
Tel: (202) 225-6201
Rep. Ron Lewis (R-KY)
Tel: (202) 225-3501
Rep. John Linder (R-GA)
Tel: (202) 225-4272
E-mail:
Rep. Bob Livingston (R-LA)
Tel: (202) 225-3015
Rep. Carolyn B. Maloney (D-NY)
Tel: (202) 225-7944
Rep. Paul McHale (D-PA)
Tel: (202) 225-6411
E-mail:
Rep. John M. McHugh (R-NY)
Tel: (202) 225-4611
Rep. David M. McIntosh (R-IN)
Tel: (202) 225-3021
E-mail:
Rep. Constance A. Morella (R-MD)
Tel: (202) 225-5341
Rep. Sue Myrick (R-NC)
Tel: (202) 225-1976
E-mail:
Rep. George R. Nethercutt, Jr. (R-WA)
Tel: (202) 225-2006
Rep. Frank Pallone, Jr. (D-NJ)
Tel: (202) 225-4671
Rep. Charles W. "Chip" Pickering (R-MS)
Tel: (202) 225-5031
Rep. Charles B. Rangel (D-NY)
Tel: (202) 225-4365
E-mail:
Rep. Frank Riggs (R-CA)
Tel: (202) 225-3311
E-mail:
Rep. Marge Roukema (R-NJ)
Tel: (202) 225-4465
Rep. Bernie Sanders (I-VT)
Tel: (202) 225-4115
Rep. Joe Scarborough (R-FL)
Tel: (202) 225-4136
Rep. F. James Sensenbrenner, Jr. (R-WI)
Tel: (202) 225-5101
E-mail:
Rep. John B. Shadegg (R-AZ)
Tel: (202) 225-3361
Rep. Gerald B.H. Solomon (R-NY)
Tel: (202) 225-5614
Rep. Floyd Spence (R-SC)
Tel: (202) 225-2452
Rep. Fortney Pete Stark (D-CA)
Tel: (202) 225-5065
E-mail:
Rep. Ted Strickland (D-OH)
Tel: (202) 225-5705
Rep. Edolphus Towns (D-NY)
Tel: (202) 225-5936
Rep. James T. Walsh (R-NY)
Tel: (202) 225-3701
E-mail:
Rep. Zach Wamp (R-TN)
Tel: (202) 225-3271
Rep. J.C. Watts, Jr. (R-OK)
Tel: (202) 225-6165
E-mail:
Rep. Robert A. Weygand (D-RI)
Tel: (202) 225-2735
Rep. Roger F. Wicker (R-MS)
Tel: (202) 225-4306
E-mail:
Rep. Robert E. Wise, Jr. (D-WV)
Tel: (202) 225-2711
E-mail:
Rep. Lynn C. Woolsey (D-CA)
Tel: (202) 225-5161
E-mail:
As we go to press, nine more representatives have come onboard as co-sponsors of the PARCA bill:
Rep. John Elias Baldacci (D-ME)
Tel: (202) 225-6306
E-mail:
Rep. Barbara Cubin (R-WY)
Tel: (202) 225-2311
Rep. John T. Doolittle (R-CA)
Tel: (202) 225-2511
Rep. Bart Gordon (D-TN)
Tel: (202) 225-4231
E-mail:
Rep. Jim McDermott (D-WA)
Tel: (202) 225-3106
Rep. Susan Molinari (R-NY)
Tel: (202) 225-3371
E-mail:
Rep. Nick J. Rahall II (D-WV)
Tel: (202) 225-3452
E-mail:
Rep. William M. "Mac" Thornberry (R-TX)
Tel: (202) 225-3706
Rep. Jim Turner (D-TX)
Tel: (202) 225-2401
E-mail:
For further information on the PARCA bill and the impact it will have on the nation's health care system, please contact the American Chiropractic Association's government relations department at (703) 276-8800.
Dynamic Chiropractic editorial staff members research, investigate and write articles for the publication on an ongoing basis. To contact the Editorial Department or submit an article of your own for consideration, email
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