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105th Congress                                             Rept. 105-49
                        HOUSE OF REPRESENTATIVES

 1st Session                                                     Part 1
_______________________________________________________________________


 
  EXTENDING TERM OF APPOINTMENT OF CERTAIN MEMBERS OF THE PROSPECTIVE 
    PAYMENT ASSESSMENT COMMISSION AND THE PHYSICIAN PAYMENT REVIEW 
                               COMMISSION

                                _______
                                

                 April 10, 1997.--Ordered to be printed

_______________________________________________________________________


    Mr. Archer, from the Committee on Ways and Means, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1001]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Ways and Means, to whom was referred the 
bill (H.R. 1001) to extend the term of appointment of certain 
members of the Prospective Payment Assessment Commission and 
the Physician Payment Review Commission), having considered the 
same, report favorably thereon without amendment and recommend 
that the bill do pass.

                                CONTENTS

                                                                   Page
 I. Introduction......................................................2
        A. Purpose and Summary...................................     2
        B. Background and Need for Legislation...................     2
        C. Legislative History...................................     2
II. Explanation of the Bill...........................................2
III.Vote of the Committee.............................................3

IV. Budgets Effects of the Bill.......................................3
        A. Committee Estimate of Budgetary Effects...............     3
        B. Statement Regarding New Budget Authority and Tax 
          Expenditures...........................................     3
        C. Cost Estimate Prepared by the Congressional Budget 
          Office.................................................     3
 V. Other Matters to be Discussed under the Rules of the House........4
        A. Committee Oversight Findings and Recommendations......     4
        B. Summary of Findings and Recommendations of the 
          Committee on Government Reform and Oversight...........     5
        C. Constitutional Authority Statement....................     5

                            I. INTRODUCTION

A. Purpose and Summary

    H.R. 1001 would extend the terms of Commissioners on the 
Prospective Payment Assessment Commission (ProPAC) and the 
Physician Payment Review Commission (PPRC), whose appointments 
would otherwise expire during 1997 to expire as of May 1, 1998.

B. Background and Need for Legislation

    ProPAC and PPRC advise the Congress on Medicare payment 
policies. ProPAC consists of 17 individuals with expertise in 
health economics, health facility management, and reimbursement 
of health facilities. PPRC consists of 13 individuals with 
expertise in health economics, physician reimbursement, medical 
practice, and other related fields. ProPAC and PPRC 
commissioners are supposed to be appointed on April 1 and May 
1, respectively, by the Director of the Office of Technology 
Assessment (OTA). In 1995, the Congress eliminated funding for 
the OTA, so that currently there is not an OTA Director to 
appoint new ProPAC and PPRC commissioners. The terms of five 
ProPAC commissioners ended on April 1, 1997 and the terms of 
four PPRC commissioners will end on May 1, 1997. This bill will 
provide the Committees of jurisdiction time to consider the 
future structure of the two Commissions in order to develop 
legislation that would re-authorize their activities, as well 
as put in place a new process for membership

C. Legislative History

    H.R. 1001 was introduced March 10, 1997 by Chairman Thomas 
of California and Chairman Bilirakis of Florida, and referred 
to the Committee on Ways and Means, and in addition, to the 
Committee on Commerce. The bill, as introduced, contained a 
provision to extend the terms of Commissioners on the 
Prospective Payment Assessment Commission (ProPAC) and the 
Physician Payment Review Commission (PPRC), whose appointments 
would otherwise expire during 1997 to expire as of May 1, 1998. 
On March 18, 1997, the Subcommittee on Health ordered the bill 
favorably reported to the full Committee, without amendment, 
with a quorum present. The full Committee on Ways and Means 
considered the bill on April 9, 1997, and ordered the bill 
favorably reported, without amendment, by voice vote, with a 
quorum present.

                      II. EXPLANATION OF THE BILL

Extension of term of appointment of certain members of the Prospective 
        Payment Assessment Commission and the Physician Payment Review 
        Commission (Sec. 1)

            Present law
    ProPAC and PPRC commissions each serve a three-year term. 
The appointments are staggered so that each year approximately 
one-third of the commissioners' terms expire. On April 1, 1997 
the terms of five ProPAC commissioners expired. On May 1, the 
terms of four PPRC commissioners will expire. The new 
commissioners are supposed to be appointed by the Director of 
the Office of Technology Assessment (OTA). In 1995, the 
Congress eliminated funding of OTA. Therefore, there is not an 
OTA Director to appoint new ProPAC and PPRC commissioners.
            Explanation of provision
    This bill would extend the terms of ProPAC and PPRC 
commissioners which expire this year. It will provide the 
Subcommittee time to consider the future structure of the two 
Commissions, and pass legislation that would re-authorize their 
activities, as well as put in place a new process for 
membership appointment.
            Reasons for change
    ProPAC and PPRC are comprised of individuals with expertise 
in a wide variety of areas. The commissions would have 
difficulty completing their mission of providing the Congress 
with assistance and recommendations if one-third of their 
commissioners were eliminated.
            Effective date
    The provision is effective upon enactment.

                       III. VOTE OF THE COMMITTEE

    In compliance with clause 2(l)(2)(B) of rule XI of the 
Rules of the House of Representatives, the following statement 
is made concerning the vote of the Committee in its 
consideration of the bill, H.R. 1001:

Motion to report the bill

    The bill, H.R. 1001, was ordered favorably reported to the 
House by voice vote on April 9, 1997, with a quorum present.

                     IV. BUDGET EFFECTS OF THE BILL

A. Committee estimate of budgetary effects

    In compliance with clause 7(a) of rule XIII of the Rules of 
the House of Representatives, the following statement is made 
concerning the effects on the budget of this bill, H.R. 1001, 
as reported: The Committee agrees with the estimate prepared by 
CBO which is included below.

B. Statement regarding new budget authority and tax expenditures

    In compliance with subdivision (B) of clause 2(l)(3) rule 
XI of the Rules of the House of Representatives, the Committee 
states that the provisions of H.R. 1001 do not involve any new 
budget authority, or any increase or decrease in revenues or 
tax expenditures.

C. Cost estimate prepared by the Congressional Budget Office

    In compliance with subdivision (C) of clause 2(l)(3) of 
rule XI of the Rules of the House of Representatives, requiring 
a cost estimate prepared by the Congressional Budget Office, 
the following report prepared by CBO is provided.

                                     U.S. Congress,
                               Congressional Budget Office,
                                     Washington, DC, April 9, 1997.
Hon. Bill Archer,
Chairman, Committee on Ways and Means,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1001, a bill to 
extend the term of appointment of certain members of the 
Prospective Payment Assessment Commission and the Physician 
Payment Review Commission.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Tom Bradley.
            Sincerely,
                                         June E. O'Neill, Director.
    Enclosure.

H.R. 1001--To extend the term of appointment of certain members of the 
        Prospective Payment Assessment Commission and the Physician 
        Payment Review Commission

    CBO estimates that enacting this bill would have no 
significant effect on the federal budget. Because the bill 
would not affect direct spending or receipts, pay-as-you-go 
procedures would not apply. H.R. 1001 contains no 
intergovernmental or private-sector mandates as defined in the 
Unfunded Mandates Reform Act of 1995 and would not affect the 
budgets of state, local, or tribal governments.
    H.R. 1001 would extend for one year the terms of those 
members of the Prospective Payment Assessment Commission 
(ProPAC) and the Physician Payment Review Commission (PPRC) 
whose appointments expire during 1997. Under current law, 
members of these commissions are appointed by the Director of 
the Congressional Office of Technology Assessment. However, 
that agency was eliminated and the authority to appoint members 
of these Commissions has not been transferred.
    The terms of five ProPAC commissioners and four PPRC 
commissioners will expire during 1997. CBO expects that outlays 
of these commissions would not change significantly if the 
terms of the affected commissioners are extended.
    An identical version of H.R. 1001 was ordered reported by 
the House Committee on Commerce on March 13, 1997. CBO's 
estimate of that bill is identical to this estimate.
    The estimate was prepared by Tom Bradley. This estimate was 
approved by Paul N. Van de Water, Assistant Director for Budget 
Analysis.

     V. OTHER MATTERS TO BE DISCUSSED UNDER THE RULES OF THE HOUSE

A. Committee oversight findings and recommendations

    With respect to subdivision (A) of clause 2(l)(3) of rule 
XI of the Rules of the House of Representatives (relating to 
oversight findings), the Committee advises that it was as a 
result of its oversight activities with respect to the Medicare 
program that the Committee concluded that it is appropriate to 
enact the provision contained in the bill as reported.

B. Summary of findings and recommendations of the Committee on 
        Government Reform and Oversight

    With respect to subdivision (D) of clause 2(l)(3) of rule 
XI of the Rules of the House of Representatives (relating to 
oversight findings), the Committee advises that no oversight 
findings or recommendations have been submitted to this 
Committee by the Committee on Government Reform and Oversight 
with respect to the provisions contained in this bill.

C. Constitutional authority statement

    With respect to clause 2(l)(4) of rule XI of the Rules of 
the House of Representatives, relating to Constitutional 
Authority, the Committee states that the Committee's action in 
reporting the bill is derived from Article I of the 
Constitution, Section 8 (``The Congress shall have power to lay 
and collect taxes, duties, imposts and excises, to pay the 
debts and to provide for * * * the general Welfare of the 
United States * * *'').