Protecting Seniors' Access to Medicare Act of 2015

Floor Speech

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Mr. WENSTRUP. Mr. Speaker, let me take a couple of minutes to explain why Americans fear the Independent Payment Advisory Board, as it meddles with their health care.

As I stand here today, I will tell you that I am a physician, and I can tell you what is already taking place within private insurance with these peer reviews when you recommend something.

I recommended an MRI to a patient. That afternoon, I get on the phone. The woman says: I have had a problem for 10 years. I have had cortisone injections, physical therapy, blah, blah, blah.

I said: You need an MRI.

I am being denied the MRI by the insurance company because I have only seen her once. And I said to the gentleman, the doctor on the phone: How many times have you seen her?

None.

I said: What State do you have a license to practice in?

Not Ohio, which is where we were.

And so I said: Tell me your specialty.

My specialty is foot and ankle. This woman was in for a foot problem.

He said: I am an emergency room doctor.

I said: Well, then you would refer her to a specialist, which is where she is today.

He said: Well, I am not going to let you get that MRI.

I said: I hope this call is monitored for quality assurance, because I want someone to hear what you said to me today.

And then I asked the patient if she would go to her HR director and call the insurance company and say: We are going to drop the insurance because you are not letting the patients get the care their doctor recommends.

And then we got it. Within 3 weeks, I had her better because I knew what was wrong once I had the MRI.

Imagine trying to have that type of a discussion with the Independent Payment Advisory Board. If they pick up their phone, will they have a conversation with you about the patient?

This is a problem. This is what Americans are fearing today. And this is why the Independent Payment Advisory Board should go away.

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