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tv   Politics and Public Policy Today  CSPAN  July 6, 2016 11:00am-1:01pm EDT

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the 91 people who die every day from gun violence, on behalf of our colleagues we give you this pledge. we will not stop until our job is done to pass this legislation. and what better leader could we have to enforce this value, to make this legislative change, than our american hero and icon, congressman john lewis. >> thank you, leader pelosi. for bringing us all here today. i want to take just a moment to thank all of the victims of gun violence for being here. for speaking up, for speaking out, and finding a way to get in
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the way. thank you for never giving up, for never giving in, for keeping the faith. we're going to win a victory. it will be a victory. we have the power. we have the capacity, we have the abilities to disarm hate. hate is a heavy burden to bear. by coming here, you have been witness to the truth. our colleagues on the other side of the house will get the message. the american people are with us. they're with you. so hang in there. keep your faith. it's going to work out. in atlanta, in my own direct district, and around the south and around america, i have seen
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too much violence. too much gun violence. too many victims. we've lost too many of our babies, our children. our brothers and sisters. our mothers and fathers. our friends. we cannot give up now. we cannot be quiet. we cannot be patient. we have come to the point where we're trying to say to members of congress, all of our members, you must do something. you must act, and act now. not tomorrow, but now. never ever before in the history of the congress we had a sit-in. but by sitting in, by sitting down, we were really standing up. so continue to stand up. we're going to have some more
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action. we don't know what form it's going to take, but stay tuned. stay tuned. be restless. stay with us. hang in there. i'm all fired up and i'm ready to go. let's go. let's win. thank you very much for being here.
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if you missed any of this event with house democrats and gun control advocates you can watch it any time online at our
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website, c-span.org. as members head to the house chamber to join their colleagues on more debate on gun policy, we have this article from the hill. paul ryan facing defections on the right about a gun bill that conservatives claim is unconstitutional. a handful of naysayers have raised doubts about whether he can raise enough votes to pass the gun provision. backed by the national riefrl administration. congressman thomas massie, an opponent of the republican provision, said i think it's dead. the gun provision was part of a larger anti-terrorism package that was set to hit the floor today. that vote was postponed to allow republican lawmakers returning from their week-long july fourth recess more time to study the package. >> and the gun provision could come up in today's house rules committee hearing. they're scheduled to take up the defense spending bill due on the floor later this week.
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we'll have live coverage at 3:00 p.m. eastern. and now to a house senate confrenco conference committee meeting on an opioid bill to address grants for opioid abuse and heroin abuse. this started about 10:00 this morning. we join it now. >> and you have heard the statistics, and frankly, i don't agree with my colleague. this isn't about statistics. this is about families all across our country. alex from buffalo grove, high school student, had his life in front of him. a good student. a good athlete. lots of friends. when he went off to college actually ended up dying from a heroin overdose. we have an epidemic on our hands in our country. and this legislation that we're working on today is really talking about hopefully giving a second chance at recovery for literally millions of people across our nation. every single community is at
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risk. and so as someone that serves as the co-chair of the illinois suburban anti-heroin task force, i have seen first-hand what this is doing to families right back at home. no mother should have to walk into a child's bedroom to find them overdosed from heroin. and prescription drugs. and so there is very meaningful pieces of legislation. mr. chairman, i'm going to submit the rest of my remarks for the record, but i do think that this is an incredibly important piece of legislation that requires our attention and requires that we step up and meaningfully attack what's going on right now across our country. i yield back. >> gentleman yields back. i would now ask unanimous consent that all statements be made part of the record. without objection, so ordered. i believe all members that are here have given an opening statement or submitted them to the record. so i now call up the conference draft and ask the clerk to
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report. >> conference draft of the comprehensive addiction and recovery act of 2016. >> so the conference draft will be considered as read. excuse me. and i want to remind members of our amendment process. so the coniferees of the sponsors house will first discover the amendment for five minutes. each for the majority and then for the minority. and then that house will vote on the amendment. if the amendment is agreed to, the process will repeat for the conferees of the other body. the chair recognizes himself for the amendment and the clerk will report the amendment. >> amendment to the conference report on s-524, offered by chairman upton. >> the amendment will be considered as read, the chair will recognize himself briefly in support of the amendment. this amendment provides technical edits to the conference report.
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specifically, the edits insure the grants authorized in the bill are carried out by the secretary of hhs. if an authorization of appropriations is included in that section. amendment also makes minor classifications to section 303. the opioid use disorder treatment expansion and modernization. and i would ask my colleagues to support the amendment. are there members on the majority side that would wish to speak in support of the amendment? i see none. i will yield back the balance of my time. are there members of the minority that would like to speak for or against the amendment? see none. the vote occurs on the upton amendment. those in favor will say aye. those opposed say no. the ayes have it, the opinion is agreed to. at this point, we yield to mr. grassley to see if the senate will accept the house amendment.
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>> i support -- i support the manager's amendment. i could take a moment to thank senator upton and members -- what? >> you said senator upton. >> okay. i apologize. i support chairman upton and thank him for this opportunity. we ought to thank also members of staff of both chambers on both sides of the aisle for their work finalizing the report in preparation for today. it was truly bipartisan, bicameral team effort. does anybody on the senate minority want to speak? then i'll yield back my time. those in favor shall signify by saying aye. all opposed, no. the ayes have it. the amendment is agreed to.
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the senate has accepted the house offer on the upton amendment, and the amendment is adopted. >> with that, the conference accepts the upton amendment. mr. leahy's amendment was next in line. he will be back shortly. so when he returns, we'll take his amendment up. at this point, the gentleman from new jersey has an amendment at the desk. >> thank you, mr. chairman. i do have an amendment at the desk. >> and clerk will report the title of the amendment. >> discussion dropped amendment to the conference report for s-524 offered by mr. pallone. >> and the amendment will be considered as read. the staff will distribute the amendment. and the gentleman from new jersey is recognized, his side is recognized for five minutes in support of the amendment. >> thank you, mr. chairman. this amendment would provide critical funding for opioid and heroin abuse treatment that is fully paid for with vetted bipartisan off sets. as we made clear, we're here today because we're in the midst of an unprecedented opioid and
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heroin crisis. sadly, 2014 saw the highest number of drug overdose deaths than any other year on record. our public health and treatment systems have not kept pace with the expanding epidemic. those struggling with heroin or opioid addictions suffer from shortages of treatment access. only 1 in 10 individuals suffering from abuse disorders receive any treatment. given the tremendous gap between supply and demand for treatment, it's hard to believe we can mount a forceful response without providing additional resources to our communities and public health systems. that's why i'm offering this amendment which provides $920 million in immediate funding to provide critical tools to attack theode identity epidemic head on and further expand the type of providers who can treat opioid dependence. mr. chairman, the funding would go directly to the states to enable them to increase treatment capacity, to
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cooperative agreements to expand access to medication assisted treatment for opioid use disorders. this provides for a targeted response where funding is allocated to the areas hit hardest by the epidemics. it will empower states to increase treatment capacity as well as make treatment more affordable for those seeking services. and the amendment is fully offset with bipartisan commonsense offsets we have all agreed to in the past, including, one, rolling back the start date on a policy that is currently enacted law to make sure that were applicable, medicaid statements are no mare than what we pay for the same items in medicare. two, changing the way medicare pays for part b infusion drugs to the, quote, asb plus 6% methodology that would result in a payment amount that better reflects the actual transaction prices. three, reducing payments made to fraudulent providers in our federal health programs through
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a requirement that states report any provider terminated from one state's medicaid program into a uniform and central database that is accessible to all states, and fourth, better protecting our medicare and medicate program integrity alcorhythms and insuring the savings from the policy we have agreed to allowing for the creation of the drug prescription management programs to beneficiaries in the part d program, and that goes towards the opioid crisis in this country. mr. chairman, i would urge my colleagues to vote in favor of this amendment. these are all policies we voted on before, and funding is needed to address this crisis in a meaningful way. make no mistake about it, if we do not bring resources to the table in our fight against the opioid epidemic, we will fail. anything less than a robust response to address this crisis will result in increased deaths. deaths, and plays tremendous emotional and financial burdens on our individuals and
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communities. the need for action is now. we can't wait until the normal appropriations psychotool provide funding necessary to respond to this crisis. additionally, mr. chairman, if congress doesn't take a proactive approach in providing the necessary resources to combat this crisis, we will pay for it later through the collateral consequences of this epidemic. such as through our emergency departments and through the criminal justice system. meaning that we save money today at the expense of lives lost and incroesused spending later. mr. chairman, it's time for congress to step up and provide safe communities and families with funding they need to fight this epidemic. i urge my colleagues to support this critical amendment, and i yield back. >> gentleman yields back. i will claim the time in opposition. i want to thank -- i want to say i thank all members on this conference committee believe that resources to fight the opioid epidemic are an important component in our strategy to help communities that indeed and
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families that are suffering. i would note that just this morning, the house appropriations committee announced they'll be providing some $581 million to address opioid and heroin abuse. that's $525 million increase above the 2016 enacted level in some $490 million above the president's budget request. so this conference report includes many bipartisan priorities addressing the prevention, education, treatment, and recovery of opioid use disorders aimed at strengthening our nation's response to this epidemic. one example is an important provision in the bill to provide pregnant and post partum women with proper treatment for substance abuse disorders. the amendment before us, it's not a bipartisan attempt at finding resources for opioid programs. in fact, at no point was this amendment discussed during the
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months of negotiations in the house and the senate. instead, the ideas included in the amendment were included in a letter that the democratic conferees released yesterday afternoon. so i would agree with our appropriators we have to devote significant resources to combat this epidemic, which they have done, announced this morning, but this amendment is not the right way to do it. i would note that s-524 passed the senate with 94 senators voting in support in the house package of opioids passed 400-5. yesterday, over 100 groups voiced their support for the legislation. i think we have to allow this bill. we must not allow the bill to be weighed down with last-minute objection to major bipartisan priorities, so i would urge my conferees in the house to oppose the amendment and would ask if any members of the majority side
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would also like to speak against it. if not, i would yield back to balance of my time. roll call is being requested, right? five minutes on each side. so the clerk will call the roll. i would note that on this amendment, the conferees from energy and commerce, the general conferees, judiciary and ways and means members will be voting and the clerk will call the roll. >> mr. pitts? mr. pitts votes no. mr. lance. mr. lance votes no. mr. guthrie. mr. guthrie votes no. mr. kinsinger. he votes no. mr. bushaun, mr. bushaun votes no. mrs. brooks, mrs. brooks votes no. mr. goodlatte, mr. goodlatte
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votes no. mr. sensenbrenner. mr. smith. mr. murano. mr. collins. mr. collins votes no. mr. trot. mr. trot votes no. mr. bishop. mr. bishop votes no. mr. mccarthy. mr. pallone. mr. pallone votes aye. mr. lujan. mr. sarbanes. mr. sarbanes votes aye. mr. green. mr. conyers. ms. jackson-lee. ms. jackson lee votes aye. ms. chu, she votes aye. mr. cohen. mr. cohen votes aye. ms. etsy. ms. etsy votes aye. ms. custer. ms. custer votes aye. mr. courtney.
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mr. courtney votes aye. mr. men. mr. men votes no. mr. told votes no. mr. mcdermott. mr. mcdermott votes aye. chairman upton? >> votes no. >> chairman upton votes no. >> that's the -- we have proxies for i think all of these members. how is mr. sensenbrenner reported. >> he's not recorded. >> i have a proxy. he votes no. >> mr. sensenbrenner votes no. >> how is mr. moreno reported? >> he's not recorded. >> i have a proxy. he votes no. >> mr. moreno votes no. >> how is mr. mccarty. >> not recorded. >> i have a proxy, he votes no. >> mr. mccarthy votes no. >> mr. chairman. >> how is mr. smith recorded?
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>> mr. smith is not recorded. >> he has a proxy, right? >> i believe the only proxies i have is mr. conyers just returned. >> how is mr. conyers recorded? >> i vote aye. >> mr. conyers votes aye. >> how is mr. lujan recorded. >> he's not recorded. mr. lujan records aye. >> how is mr. green recorded? >> he is not recorded. >> i do not have a proxy for mr. green. >> so are there other members that are not recorded? yes, you may. yes, the conference -- it's my understanding the conference
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allows conferences allow for proxy voting, which is -- and we told all members that earlier, at an earlier point. proxies would be included. are there members that were called that have not voted or wish to vote or changed their vote? if not, the clerk will report the tally. >> you know, i might ask, how is congressman lamar smith recorded? >> he is not recorded. >> i have a proxy for him. so he votes no. >> mr. smith votes no. >> now the clerk will report the tally. >> mr. chairman, on that vote, there are 17 ayes, there are 11 ayes and 17 nays. >> 11 ayes, 17 nays.
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the amendment is not agreed to. next amendment. next amendment, gentle lady from washington state. ms. murray. >> thank you. i call up my amendment, number four. >> clerk will report the title of the amendment. >> amendment to the conference report of s-524, offered by ms. murray. >> thank you. >> the amendment will be considered as read. the staff will dwint the amendment and the gentle lady is recognized for five minutes in support of her amendment. >> thank you. as i said in my opening statement, i'm very glad we have been able to reach some important bipartisan agreement on this issue, but our states need more to tackle the opioid crisis head on. they need new investments. this amendment will provide $920 million in funding for states to expand access to prevention and treatment services, especially for those who cannot afford it. there is no reason we can't all support this amendment. we all agree the funding is desperately needed to help our
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communities stop the wave of overdose deaths and to properly treat addiction to prescription opioids and heroin. and specifically, we know that without more funding to expand access to medication assisted treatments, states will not have the resources they need to put people on the path to recovery and save lives. we're debating a bill to address theo opioid epidemic. it should include the funding necessary to actually fight that epidemic. this amendment would provide funding to states for medicaid assisted treatment, allow nurse practitioners and physicians assistance to provide the drug to help their patients cope with and recover from addiction and importantly, the bill empowers these providers to treat patients while deferring to state scope of practice laws. this is critical for many of our rural communities that have been hit hard by this epidemic. the amendment is also fully paid for by a set of offsets that
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both parties have supported in previous votes and would not add a single dollar to the deficit. the bottom line is when someone is ready for treatment, we need to make sure health care system is ready to treat them. i'm very concerned that if we pass a bill that changes our nation's opioid policies but completely ignores the funding, that would enable cities and states to put those policies into practice, that funding might never come. for far too many families, there is no later. there is no next time. this is the opioid bill this year. and frankly, people across the country are running out of time. so let's make the tough choices. let's vote for this amendment. and let's make sure this bill takes an absolute necessary step forward in expanding access to the life-saving treatments that families across the country need. mr. chairman, i yield my additional time to senator
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wideman. >> mr. chairman, do i have two minutes? >> 2:20. >> i'll be very brief. colleagues, i strongly support the murray amendment. this is what i meant when i said we were talking about fighting an inferno with a thimble full of water. just very briefly, according to research published in 2015, in the journal of the american medical association, 80% of people who were dependent on heroin or pain killers are not getting treatment. now, i don't want to tell families at home in oregon and across the country that they ought to wait around for the appropriations process. my staff did some research, apparently, it's been years since there's been a labor health and human services budget. so the question is, are we going to be able to tell families now that we are serious about securing the money when 80% of those who need treatment
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according to research done by one of the most reputable groups in the country, say they're waiting. and i don't think they ought to be waiting around for the appropriations process and the amendment to the amendment to the amendment that never really seems to get there when these families are in crisis. i urge colleagues to support the murray amendment. >> the gentle lady still has a minute left. she yields back. >> mr. chairman. >> gentleman from tennessee is recognized for five minutes. >> yes, thank you, mr. chairman. i thank the senator from washington, the senator from oregon for their amendments. i would not want the american people to get the wrong impression. we have bipartisan support here for the policy we're talking about today. 94-1 in the senate. 400-5 in the house. and we have bipartisan support for funding the opioid abuse. it's much more than a thimble full.
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it may not be a fire hose. but over the last two years, if you follow what the senate appropriations committee has recommended, we have increased funding for opioid abuse by a factor of seven times. seven times more money than two years ago. and if we do what the house appropriations committee announced today, it would be 14 times. so seven times more than two years ago. 14 times more than two years ago. that's an opportunity for bipartisan support. that's the way we always do it in the senate. we operate on two tracks. the senator from washington and i worked last year on fixing no child left behind. with members of the house of representatives. the president called it a christmas miracle. but it didn't spend one penny because it reformed programs. we passed a defense bill every year. it doesn't spend one penny. we do that in the appropriations process. we pass an energy bill, it doesn't spend one penny.
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the bills are good and so are the appropriations bills. so we are spending money on opioids and we're doing it in the right way. so we should go ahead and finish our work today on reforming the programs and then we should finish our work on funding, on funding opioids which, as i said, the appropriations committee in the senate wants to do at seven times the rate of two years ago and the house said today it wants to do at a rate of 14 times two years ago. that's a substantial improvement, and i think it would have bipartisan support. there's a second reason why i would oppose the amendment by my friend from washington state. that is its offsets come from the 21st century bill already passed by the house of representatives with 3343 votes. this is important legislation. it could be the most important legislation of the year. if we can finish it up this year in the senate and house.
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eventually, it may include precision medicine and cancer moonshot and the brain initiative and a whole variety of other initiatives that will get treatments and drugs and discoveries through the process and into the medicine cabinets faster. it's different than the opioid legislation, but it's related and the money to pay for it was 334 votes last year is the same money. we can't spend that money, that same money, twice. so let's recognize that we have bipartisan support for funding. that we are spending money. that there are not -- i cannot think of other provisions in the budget where we're spending seven times what we did two years ago or 14 times what we did two years ago, and we're still talking about additional funding in the senate in a bipartisan way, in the house in a bipartisan way, and surely, let's not take the money we use for 21st century cures which the
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house did so well with and try to spend the money twice. i'm opposed to the amendment. but i'm in favor of the policy and i'm in favor of funding. this is just not the way to do it. and we can get it done in the appr appr appropriate way soon. >> are there other members wishing to speak against it. if not, time has expired. the voting occurs. those in favor say aye. those opposed say no. opinion chair, the noes have it. recorded vote is asked for. on the senate side and the clerk will call the roll. >> mr. grassley? >> no. >> mr. grassley votes no. >> mr. alexander, mr. alexander votes no. mr. hatch. >> is there a proxy? >> no proxy. >> mr. hatch votes no. mr. sessions.
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>> no by proxy. >> mr. sessions votes no. >> mr. leahy. >> he votes aye. ms. murray. >> aye. >> ms. murray votes aye. >> mr. widen votes aye. >> are there members wishing to change their vote? if not, the clerk will call the tally. >> mr. chairman, on that vote, there were three ayes and four noes. >> the amendment is not agreed to. just the senate votes. next amendment offered by mr. leahy. as an amendment at the desk, clerk will read the title of the amendment. >> amendment to the conference report for 524 offered by mr. leahy. >> the amendment will be considered as read, and the staff will distribute the amendment to the senate side. and the gentleman from vermont is recognized for five minutes in support of his amendment.
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>> thank you, mr. chairman. i helped put together the amendment 16797. is that correct? >> is that correct, it is. >> thank you. i worked to help create the heroin task force program in the legislation. i hear from law enforcement people all over the country. they have to have additional funds to combat traffickers. this not only affects vermont, it affects states like tennessee, wisconsin, michigan. i mentioned those only because they got critical support from this last year. i was drafted the conference report remove task force funding. this would -- and puts it in a
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grant. it would really place the task force program at risk. it would allow it to be spent on nine other allowed issues. we really wanted this the way it was. senator grassley asked to add methamphetamine to it. i did it. i agree with him. the tennessee bureau of investigation, i just happened to mention to that state, wrote a letter on behalf of the state criminal investigative agency in support of it. the fact is, there is no easy way out of all this. but the fact is whether you're in a state with large cities or small areas, you need this help. this is set up so that if, like every state, you have also got small areas, rural areas
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everything else, you can get help. your big cities can, too, but you can get help in the smaller areas. it is something that has worked. that's the other advantage of it. all the police tell us, everybody else, they tell us it works. i think we should keep something that works. i yield back my time, mr. chairman. >> mr. chairman. >> gentleman from iowa. >> this amendment restores a separate stand-alone authorization for heroin and methamphetamine law task forces, as was provided in section 204 in the senate. the amendment authorizes these task forces at a funding level reflected in the current senate commerce justice state appropriations bill. the conference report currently provides resources for heroin investigations but only as an allowable use under section 201 grant program.
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the report does not authorize methamphetamine task forces at all. i know that these task forces are important for law enforcement in iowa and particularly the methamphetamine task force, given how strained resources are at the state level, i support having these task forces funded through a separate authorization. i urge my colleagues to support the amendment. does anybody else on the majority side want to speak? okay, i yield back my time. >> apparently, the wrong amendment was distributed on the house side. but the amendment is being debated on the senate. it will come back. we'll get you the right one. apologize. the wrong amendment on this side was distributed. yeah.
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i'm sorry about that. wish the gentleman had raised the question earlier. we would have had it in his claw earlier. all right, senate yields back the balance of the time. the vote occurs on the leahy-grassley amendment. those in favor say aye. those opposed say no. the ayes have it, the amendment is agreed to. amendment now comes for debate on the house side, as it was passed in the senate, and the gentleman from virginia, mr. goodlatte, will control the first five minutes. >> mr. chairman, thank you very much. i rise in opposition to this amendment. because the comprehensive opioid abuse reduction act is designed to be just that, a comprehensive grant program. a purpose area was specifically included to provide for grants for locating or investigating
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illicit activity related to the unlawful distribution ofopeioids, language that generally tracks the heroin task force language in section 204 of s-524. in contrast, this amendment would single out task forces resulting in a disjointed rather than comprehensive doj grant program for addressing the opioid epidemic. the leahy-grassley amendment wants to elimitinate these pet programs and has never been supported in a house appropriations bill. in fact, the justice department's fy 2017 budget submission proposed to eliminate these programs. indefensibly, the amendment gives these task forces preferential treatment over drug and veterans treatment court programs. prescription drug monitoring initiatives, residential substance abuse programs, and all of the other extremely important efforts supported by
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the comprehensive opioid abuse reduction act. moreover, this amendment gives these task forces an exclusive authorization for appropriations that is not even fully offset for the purposes of the comprehensive opioid abuse reduction act. it falls short by $15 million. the house went out of its way to offset the authorizations in the act. this amendment would negate that effort. it is an incontvertible fact that the funting level provided by the house for the comprehensive opioid reduction act is already significantly higher than the analogous authorization for appropriations included in s-24, and it is fully offset under the house's cut go protocol. the comprehensive opioid abuse prevention act goes above and beyond the authorize new funding for its diverse purpose areas. its authorization for appropriations was carefully developed as a result of a thorough consideration of both the senate provisions and the
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house amendment's language as well as a disciplined recognition of the need to focus resources on opioid addiction at this time. the leahy-grassley amendment also introduces unnecessary duplication into the comprehensive opioid abuse reduction act and attempts to shift some of the available funding from the anti-opioid efforts to methamphetamines. under the circumstances, this amendment is simply a poor fit for this bill. a vote to reject the leahy-grassley amendment is not a vote against grants for investigating illicit activities related to the unlawful distribution ofopeioids. it is simply a vote in favor of a comprehensive approach that supports law enforcement efforts to address opioid abuse. one purpose of which is to authorize grants for the purpose of investigating illicit activities related to the unlawful distribution ofopeioids. therefore, i urge my colleagues, the house conferees to reject
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this amendment. >> does the gentleman yield back? >> i reserve the balance of my time. >> gentleman reserves 1:28. other members wishing to speak in opposition to the amendment? i would note it's dr. mcdermott indicated, amendment oll-1967. so are there other members wishing to speak against the amendment? so the gentleman yields back. >> i yield back. >> and are there members on the house side willing to speak in support of the amendment? i see none. the vote occurs on the amendment adopted on the senate side, offered by mr. leahy and grassley. those in favor say aye. those opposed say no. the noes have it. amendment is not agreed to. and that's the way that it is. next amendment is gentle lady from washington state, ms.
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murray. amendment at the desk, i said it's hey-16852. and we'll have the staff -- the clerk will report the title of the amendment. >> amendment to the conference report for s-524. authored by ms. murray. >> the amendment will be considered as read, and the gentle lady is recognized for five minutes. >> thank you, mr. chairman. local v.a. medical centers have patient advocates that are responsible for hearing complaints from veterans seeking care and helping them get the care that they need. but the v.a. does a poor job overseeing patient advocate systemwide, tracking complaints from around the country, and intervening where needed to make sure veterans get the high quality care that they have earned. these failures led to tragedy in toma, wisconsin, when no one would listen, when jason raised
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concerns about how all of the medications he was being given at the v.a. medical center were making him feel and act. incredibly, the patient advocate at the facility where jason was treated reported to the chief of staff who was ultimately responsible for prescribing the deadly mix of medication that led to jason's death. to prevent that from happening again, this amendment would establish a central and independent office of patient advocacy to help patient advocates effectively meet their obligations to veterans. this office will give patient advocates national level support at the medical center will not resolve the problem they're working on and will insure patient advocates report to an independent office rather than the medical center. a dedicated office reporting to the undersecretary for health, will insure that the program
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remains accountable to the needs of veterans and their families and will prevent any undue pressure on advocates from the local medical facility leadership. this provision provision is wid supported by the veterans service organizations and was agreed to by both sides of the veterans affairs committee and is included in the veterans first act. i appreciate my colleagues including much of senator baldwin's vital legislation on opioid treatment in va. this provision is a key component and we should include it as well just as the veterans committee has. and i move its adoption. >> does the gentleman from tennessee want time? >> mr. chairman, i support senator murray's amendment. as she says, so does the chairman of the veterans affairs committee. >> are there other members -- mr. grassley? >> for reasons beyond just this
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amendment, i think we ought to support it, because going back to august 2, 2014, we passed legislation we thought would dramatically change the direction of the va. and it has accomplished very little. a new secretary's accomplished very little. we aren't doing enough for our veterans, and this is a step in the direction of congress weighing in to make the necessary changes so that the va gets the message. >> mr. chairman, senator murray, senator grassley, senator alexander, and i totally agree on this. it's easy to get a parade and talk about veterans. what we have to do is start doing some of the things we need to actually care for them. this does. it should be included and i thank the senator from washington state. >> other members on the senate side wishing to speak on the amendment? seeing none, the voter occurs on
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the amendment offered by the gentlelady from washington state. those in favor say aye. those opposed so no. the opinion of chair the ayes have it. the vote goes to the house side. the chair will recognize him is self-for five minutes this is a good amendment. we need to support it and i would urge my colleagues to vote in favor of it. other members wishing to speak on the amendment? seeing none, the vote occurs on agreeing to the murray amendment from the house side. those in favor will say aye. opposed, no. opinion shared, the ayes have it. the amendment is agreed to as part of the conference. further amendments to the bill? is the jackson-lee amendment ready quite yet? >> mr. chairman, we're ready. don't know if we have the copies. >> are the copies of the jackson-lee amendment revised? not quite. >> copies are coming to the desk. >> we'd like to go ahead --
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pardon me? why don't we go with the jackson-lee amendment as amended by -- i think she has a uc request first. is that right? to change it. >> i do, mr. chairman. members, thank you for your courtesy. >> just if the clerk will report the title of the amendment. >> amendment to the conference ront on s-524 offered by miss jackson lee of texas. >> to expedite things i'll just say the gentle lady has an amendment to that she offer evers eveoffers by unanimous consent. is there objection to the changes? no, we can't do it in the senate yet. this is still on the house side. it will come to you if it passes hoar. so with that the gentle lady's amendment, she's recognized for five minutes to offer her amendment. >> thank you, bl chairman. i have unanimous consent that
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the amendment be accepted as amended and -- >> the gentle lady has five minutes in support of her amendment. >> my apologies to you, we have been engaged in legislative compromise and i'm very delighted that that has happened. it is a sense of congress that decades of experience and research have demonstrated that the opioid abuse epidemic and other -- excuse me, i'm sorry. have demonstrated that a fiscally responsible approach to addressing the opioid abuse epidemic and other substance abuse epidemics requires treating such epidemics as a public health emergency emphasizing prevention, treatment, and recovery. let me thank my chairman and ranking member for working with me on this and ask my colleagues to support it. and that is, as i started out, i indicated that this is a significant moment in history. we want to move forward and to
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assure that as many of my colleagues have said, that we have resources. but we also want to use this as a model. many of you are -- need not to be reminded of the crack cocaine epidemic which resulted in now almost 2 million people who are incarcerated in the nation's prisons, both local, state and federal. at this point, simply says we have. found a model that deals with those who are addicted, who are not criminally involved, who are literally sick. and it is important to treat such epidemics, whether it is meth or other drugs, and public health emergencies, emphasizing prevention, treatment and recovery. no matter where each conferee ends up on the final conference report, it is safe to say the legislation we are considering holds the promise of saving and redeeming lives. tens of thousands. in many of our communities throughout america, we lost thousands of lives.
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families destroyed through the epidemic of crack cocaine and certainly meth is another one. we know that our health professionals were overwhelmed. our emergency centers were overwhelmed. in particular, those who are locked up, 80% of the defendants sentence for crack offenses were african-american. in spite of the fact that they were sick, addicted people with broken lives, i believe it is important as we look forward to this conference that we reflect what the american public health association has indicated, that the ending of criminalization of drugs and drug consumers prioritizing proven health treatment and harm reduction strategies, expanding and removing barriers to treatment and harm reduction services, including some innovative ways, is a way to address this sickness, this epidemic. and certainly we have experienced that in many of our inner city communities. i can't tell you the funerals
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that i've gone to simply because people were addicted to crack. and i'm sure there are many other stories. i'm a member of the opioid/heroin caucus. i want to applaud them and i want to applaud the conferees as well. the jackson-lee meamendment is groundbreaking legislation showing that congress listens to the american people, has courage to learn from the past, and is unafraid to embrace new innovative and promising methods of addressing the critical problem confronting our nation. clearly, i want to commend the chairman and the ranking members. i want to commend the senate counterparts, senator leahy, senator grassley. and i simply want to say, we buried too many people. we know what crack did. we know they're drug epidemics. we don't know what is next. my city just tried to do
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something about push users because of the drain on the public health system. we need to realize that we can deal with this in a way that is more the way that we've looked at before. so i ask my colleagues to support the jackson-lee amendment and i'm not sure -- did the gentle lady want me to yield? yield to the gentlelady so sorry, i didn't see you. thank you. >> thank you very much and thank you to miss jackson lee. i'm speaking on behalf of co-chair for the bipartisan congressional task force to combat the heroin epidemic. i just want to join your comments. i come from a rural state. this is a new phenomenon for us. but i commend your amendment. i urge a bipartisan support. we have now 85 members bipartisan in our task force because we recognize that this is a public health emergency. just very briefly, one county in my district, sullivan county. they were able to implement
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treatment during incarceration, have a year-long program after, and brought the recidivism rate from the 80th percentile to the 20th percentile. that is something that everybody, rs and ds, can embrace. we can save tax dollars and we can save people's lives so i commend your amendment and i urge a strong bipartisan vote. >> i yield back. ask to support the jackson lee amendment. >> gentle lady yields back. >> thank you, mr. chairman. i want to thank the gentle woman from texas for offering this sent to the congress amendment and i want to especially thank her for working with me and others on the committee to modify the language to make it bipartisan and acceptable to all. i commend her for doing just that. so i urge my colleagues -- >> if the gentleman would yield? i also want to thank the dwen e gentle lady from texas for sharing the amendment with us yesterday and for working with
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the gentleman from va to mirgin modify it. it is a very good amendment and i support it as well. yield back to the gentleman from virginia, who yields back. >> i yield back. >> all those in favor of the -- time has expired. so all those in favor of the jackson lee amendment say aye. aye. those opposed say no. in the opinion of the chair, the ais agre amendment is agreed to and goes to the senate. chair recognizes the gentleman from iowa. seeing none, the vote occurs on the amendment passed by the house conferees. those in favor say aye. those opposed say no. in the opinion of the chair, the ayes have it. the amendment is included. therefore, as part of the conference agreement. the next amendment is offered by the gentleman from tennessee, mr. cohen. has amendment at the desk. >> thank you, mr. chair. >> number 112.
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the clerk are report the title of the amendment. >> amendment to the conference report on s-524 offered by mr. cohen. >> the amendment will be considered as read. staff will distribute the amendment. the gentleman is recognized for five minutes in support of his amendment. >> mr. chairman, in my opening statement i talked about the messaging problem this congress and our governments in general have had with heroin and marijuana and other drugs. a young man who i dated his mother. we had a conversation one time at dinner about marijuana. and he smoked marijuana. he shouldn't have. he was young. but he did. and he said nobody my age believes marijuana's bad in any way for you because we smoked it and we've seen it does not have the same effects as people say it does. that young man died from a heroin overdose. he was from a very prominent family in memphis. east memphis.
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fortune 500 world. i talked to a family in new york, friends of mine, young man. young man's now a prominent actor and musician. and i asked him about marijuana several years ago. he said my friends all smoke it. they don't have a problem. therefore, they don't see a problem with other drugs like cocaine and crack and meth and heroin. we have mismanaged the messaging of this for years. so kids do drugs because they don't believe the government. they don't believe people when they tell them not to do heroin, not to do meth, not to do crack, not to do marijuana. marijuana doesn't belong in that class. this amendment would tell nih to study marijuana and see if it is an appropriate alternative to opioids. it may be. and study it they they should do. i have a further amendment 109 that asked that it be rescheduled to schedule ii to
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see can study it. all of the groups that are in favor of this have asked me to withdraw the amendments. i believe that the best i can do today is message. so with the permission of the committee, i move to withdraw the amendment and hope that we will in the future better address this issue and speak the truth to what the effects of heroin are and opioids compared to marijuana. >> gentleman withdraws his amendment. appreciate that. and the next amendment is offered by mr. widen. amendment tam-16328. the clerk will report the title of the amendment. >> amendment to the conference report for s-24 offered by mr. widen. >> and the amendment will be considered as read. the staff will distribute the amendment to the senate. the gentleman from oregon is
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recognized for five minutes in support of his amendment. >> thank you very much, mr. chairman. mr. chairman and colleagues, this is an amendment designed to make sure that when you have task forces and the conference report creates an inner agency pain management task force, you don't create a situation where the fox guards the hen house. there are non-federal members that will be serving as part of this task force. i think it is important that there be clear rules to make sure that there isn't bias in the work of the task force. there are going to be representatives, professional associations and paid advocacy groups which often receive substantial amounts of funding from pharmaceutical manufacturers. i have raised this issue before with the secretary of health & human services, the national academy of medicine, and it
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seems to me, if you're going to have non-federal participants, you ought to have clear guidelines to make sure the busy of the task force and any financial interest is fully disclosed. as of right now, the conference language has no safeguards to ensure that either occurs. and this is an approach that does not micromanage what the rules of the road ought to be. but it requires that there out to be rules. there ought to be rules to make sure that special interests don't hijack the work of the task force, and particularly in the opioid area, in effect, encourage overprescribing. so i hope my colleagues will support the amendment. it is a no-cost amendment obviously. it deals with conflicts of interest. and i urge colleagues to support this in a bipartisan way.
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i compare this to the kind of work that senator grassley and i have done over the years to watchdog for these kinds of abuses. i hope colleagues will support it and i yield back. >> gentleman might want to yield to the gentleman from iowa, mr. grassley. >> i'd be happy to yield to my colleague from iowa. >> with moo i reputation for transparency ain public policy, i'm going to support this recommendation -- or support this amendment and recommend that my colleagues do as well. i yield. >> mr. chairman. i'm in favor of transparency in public policy but i think the conference report already provides that. it requires that the task force provide the public with at least 90 days to comment on any recommendations made by the task force. so if we have an urgent situati here, and we're trying to find the best practices for pain
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management to recommend to doctors and to hospitals and to others dealing with the abuse of pain medication. i'm afraid that having the secretary develop guidelines and procedures in the federal government, that takes a long time and it would discourage, i'm afraid, many of the best minds, the people who know the most about what we're talking about, from volunteering their ideas and suggestions. so i like transparency. i like openness. and i like the provision in the conference report that requires the task force to provide the public at least 90 days to comment. i also like the idea of having people who know the most about the subject available to tell us what the best practices are. so i'm going to vote no. >> mr. chairman? i don't think i used all my time. >> you didn't. but you yielded back.
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but -- >> one additional minute? >> gentleman is recognized. >> thank you. the concern that i have is with respect to this task force. there are no standards in the bill with respect to conflicts. we've had this problem before, colleagues. i don't know why we'd want to open this up again. particularly at a time when there's been concern that through these task forces there's been encouragement for overprescribing of opioids. so i thank my colleague for the extra time and i very much appreciate senator grassley's support. . >> i think that we need a roll call on this. roll call has been requested on this amendment. >> mr. grassley. >> aye. >> mr. grassley votes aye. mr. alexander. >> no. >> mr. alexander votes no. mr. hatch. >> is there a proxy?
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mr. hatch votes no. mr. sessions. >> no by proxy. >> mr. sessions votes no. >> mr. leahy. >> aye by proxy. >> mr. leahy votes aye. miss murray. >> aye. >> in is murray votes aye. mr. wyden. >> aye. >> mr. wydenim votes aye. >> votes aye. >> votes aye. >> mr. chairman on that vote there were four ayes and three nays. >> four ayes, three nays. the amendment is agreed to on the senate side which then sends it to the house side. does the house have the language of the bill? i think we do have it. we do have it. i will claim the time on the majority side and would just note that this amendment to the pain management task force was never raised as part of either chambers deliberations that we're aware of during committee or floor consideration.
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particularly given some of the vague terminology used, it could have unintended consequences that have not been carefully considered such as making qualified participants less willing to participate in the task force, including some of the foremost experts in pain management. it could also cast unwarranted doubt on the integrity or validity of the recommendations raised by participants, including patients and veterans. so i would respectfully urge my colleagues on the house side to vote no on the amendment, and ask if anyone in the majority would like to speak. seeing none, i yield back. would recognize mr. mr. palone for five minutes on the majority side. >> i would disagree and urge that my colleagues support the wyden amendment. it seems clear to me that it is moving in the direction of
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ensuring greater transparency, and i think it is important to address the potential conflict of interest. so i would urge my colleagues to vote in favor of the amendment. and i would ask mr. chairman that we have a roll call. >>. >> gentleman yields back. as for roll call vote would note to the clerk that on the house side, the general conferees, energy and commerce and judiciary are appropriate to vote on this amendment as passed by the senate. the clerk will call the roll. >> mr. pitts. mr. pitts votes no. mr. lance. >> mr. lance votes no by proxy. >> mr. lance votes no. mr. guthrie. >> mr. guthrie votes no by proxy. >> mr. guthrie votes no. mr. kinsinger votes no. mr. buchon votes no. mr. is brooks.
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>> mrs. brooks votes no by proxy. >> mrs. brooks votes no. mr. goodlatte. >> no. >> mr. sensen ben nbrennersens. >> votes no by proxy. mr. smith. >> mr. smith votes no by proxy. >> mr. smith votes no. mr. moreno. >> mr. moreno votes no by proxy. >> mr. collins. >> mr. collins votes no by proxy. >> mr. collins votes no. mr. traut. >> no by proxy. >> mr. trot votes no. >> mr. bishop. >> mr. bishop votes no by proxy. >> in mccarthy. >> no by proxy. >> mr. palone. >> aye. >> mr. palone votes aye. mr. luhan. >> aye by proxy. >> mr. sarbanes. aye. mr. green. >> aye. >> mr. green votes aye.
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>> mr. conyers. >> aye by proxy. >> mr. conyers votes aye. miss jackson lee. miss jackson lee votes aye. miss chu. aye. mr. cohen. mr. cohen votes aye. miss este. aye. miss custer. miss custer votes aye. mr. courtney. mr. courtney votes aye. chairman upton. >> votes no. >> chairman upton votes no. >> members wishing to change their vote? seeing none, the clerk will report the tally. >> mr. chairman, on that vote, there are 11 ayes and 15 nays. >> 11 ayes and 15 nays. the amendment is not agreed to. chair would recognize gentleman from tennessee, mr. cohen, to offer amendment number 109.
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and the clshg wierk will report title of the amendment. >> mr. chair, as in the last amendment, i think this may go beyond our call on rescheduling marijuana and i don't want to put people to that issue, nor do i want them to vote no on process rather than substance. i hope that in the future we will get this straight and we will at least have study on marijuana which we should. i would ask unanimous content to withdraw amendment at this time. >> unanimous request is granted. the amendment is withdrawn. the chair would now recognize ms. murray for an amendment and the clerk will report the title of the amendment on the murray 2, i believe is the amendment. >> amendment to the conference report for s-524 order by miss murray. >> and the amendment will be considered as read. staff will distribute the amendment and the gentle lady is recognized for five minutes in support of her amendment. >> thank you, mr. chairman.
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i'm be short. this is a very simple amendment that adds language saying it is the sense of congress that reductions due to the limitation on bonuses at the va should not disproportionately affect lower wage employees. it also says va should prioritize awarding bonuses to incentivize high-performing employees in those positions where the va struggles to retain good people. the va certainly needs important reforms in many areas, but i hope we can agree that the rank and file employees should not be targeted first over top executives. both the majority and the minority on the veterans affairs committee worked on this language for the veterans first act, and i hope we can support it for this language. >> mr. chairman? i support this amendment and urge my colleagues to support it as well. >> those in favor say aye.
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those opposed say no. the ayes seem to have it. the ayes do have it and the amendment is adopted on the senate side. >> amendment is adopted on the senate side. now comes to the house side. let me say i think this is a very good amendment. i look forward to voting for it. i would urge my colleagues to support it and yield back. with that, the vote occurs on the amendment offered in the house, by the adopted amendment by miss murray. those in favor say aye. those opposes say no. in the opinion of the chair the ayes have it. the amendment is agreed to and made part of the conference. chair will now recognize mr. wyden. sorry. gle- gle-16301 i believe in the
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number? >> mr. chairman, i am not offering that amendment. >> all right. >> but if you want to ask me to offer the med kaicaid windfall amendment, i would be glad to. >> that's fine. go ahead. you want to do the -- >> medicaid windfall. >> ern-16169. >> yes, that's it, mr. chairman. >> the clerk will report the title of the amendment. >> amendment to the conference report for s-524 offered by mr. wyden. >> and the amendment will be considered as read. staff will distribute the amendment and the gentleman is recognized for five minutes. >> i think there is a little confusion here. this is the amendment that i've authored on the medicaid windfall. not the amendment on -- >> that's right. >> you got it? >> yes. >> great. colleagues, in the medicaid program, the drug companies pay a rebate to the state and the
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federal government to offer their drugs to the 70 million americans on medicaid. currently, drug companies making opioids pay the full rebate. there is a provision in this bill, however, that would allow the companies to get special treatment, special treatment and a reduced rebate if they sell opioids that are considered so-called abuse deterrents. now the truth is, this is a w d windfall to the companies because they are already making their drugs in that manner, and they have been doing so for many years. so what this amendment does is it strikes the windfall to the manufacturers who, at least in some cases with overprescribing, have contributed to the problem, and instead funds care for
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low-income pregnant women on medicaid who very much need addiction treatment. these women who need assistance ought to have every opportunity to get back on track, and that's what this amendment would do. >> the gentleman yield back? >> i do. >> mr. chairman, only -- i want to wait and hear the response. i'm going to retain my time. >> chair would recognize the gentleman from tennessee on the wyden amendment. >> unless senator grassley wants to go. >> i would take my time off of wyden's because i'm going to vote for this amendment. i think it is something that needs to be done, and this clarifies it. and so i urge my colleagues to vote aye. >> mr. chairman.
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tennessee. >> mr. chairman, senator hatch as chairman of the finance committee has asked me to speak on this amendment which poses to strike bipartisan language included by the house of representatives to encourage the manufacturer of drug formulat n formulations that are more difficult to abuse, that are resistant to crushing up for injecting or snorting by drug addicts. it is a policy supported by the food and drug administration and included in the president's budget request. so what the policy seeks to do is to provide an important incentive to develop abuse deterrent formulations for drugs such as opioids. that seems to me to be a good incentive, a good practice, one that's consistent with our goal here. on top of that, this amendment would replace that policy with another policy that's a very large issue and hasn't been
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fully vetted. we are having large discussion in the senate about whether and to what extent to allow medicaid to pay for patients who go into institutions for mental health. to do that for all patients who might go is a very expensive proposition, and is something that we'll need to discuss on the senate floor and find a way to pay for it and be consistent and fair to all patients. so because it gets rid of a valuable incentive that could discourage opioid abuse, and because it gets into an area that hasn't been fully vetted and there is a larger discussion on the senate floor, i'm going to join senator hatch in voting no. >> mr. chairman? >> gentleman still has two minutes left. >> thank you. colleagues, this is a pretty obvious choice. we are going to choose
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low-income pregnant women. you do that by voting for my amendment. or you go with the companies who are getting a windfall here. it would be one thing, colleagues -- because senator alexander, as is often the case, raises an important issue. if we were talking about research, if we were talking about something that hadn't been done, i can see why there might be an argument for what's in the conference report. but the reality is the companies have been making the drug in the manner i've described for years and years and years. there's no need to give them this windfall. so this is a clear choice. i'm very appreciative, senator grassley, my colleague on the finance committee. once again, supporting an effort that in effect, promotes the public interest and i hope colleagues will support this. >> gentleman yields back. >> ask for roll call vote. >> roll call is requested.
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>> mr. grassley. >> aye. >> mr. grassley votes aye. mr. alexander. >> no. >> mr. alexander votes no. mr. hatch. >> no by proxy. >> mr. hatch votes no. mr. sessions. >> no by proxy. >> mr. sessions votes no. mr. leahy. >> aye by proxy. >> mr. leahy votes aye. miss murray. miss murray votes aye. mr. wyden. >> aye. >> mr. wyden votes aye. >> clerk will report the tally. >> on that vote there were four ayes and three nays. >> four ayes, three nos. the amendment is agreed to and now comes to the house conferees. for the majority, recognized for five minutes. >> thank you, mr. chairman. i appreciate this. i oppose this amendment because it strikes a bipartisan policy which was included in the house
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passed bill and which the administration supports. this amendment strikes and important policy that represents a key step forward in combating opioid abuse. this policy fixes an unintended consequence with the medicaid drug rebate program that effectively discourages drug manufacturers from producing opioids that are harder to abuse. specifically this policy would exempt abuse deterrent formulations of drugs from the defeninition of line extension r purposes of calculating medicaid rebates. this policy is bipartisan and has strong support from this administration. supporting this amendment would remove a key policy to help combat opioid abuse and i oppose the amendment. i yield back the balance of my time, mr. chairman. >> gentleman yields back.
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>> i would urge support for the wyden amendment. in my opinion, every effort should be made to encourage and facilitate pregnant and postpartum women to seek substance abuse treatment, both for themselves and for their babies. this amendment ensures support for this vulnerable population when seeking treatment, will support continuity of care, and will maintain the continuity of care. so i support this amendment. it is, as mr. wyden said, fully offset and i would ask for a roll call, mr. chairman. i would yield to my colleague -- >> inquiry. what section is being struck by this amendment? >> i don't have the amendment. 705. that's what i'm told. >> further speakers on the n minority side? seeing none, roll call is requested.
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>> no. i just want a brief moment. i want to support the wyden amendment because over my legislative efforts i've been working with pregnant women. i can't emphasize enough as a woman the importance of this initiative dealing with women when they're most vulnerable and they're working, i hope, to recover and to restore a better health for that unborn baby. i support the amendment. i yield back. >> i thank the gentle woman. >> gentleman yields back. a recorded vote has been asked for. so would now instruct the clerk that the general conferees, energy and commerce, and judiciary members are included on the vote. and the clerk will call the roll. >> mr. pitts. >> no by proxy. mr. lance. >> no. >> mr. lance votes no. mr. guthrie. >> no.
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>> mr. kinsinger. >> no. >> mr. bushon. no. mrs. brooks. >> no by proxy. >> mr. goodlatte. no. mr. sensenbrenner. >> no by proxy. >> mr. sensenbrenner votes no. mr. smith. >> no by proxy. >> mr. smith votes no. >> mr. moreno. >> moreno no by proxy. >> mr. collins. >> no by proxy. >> mr. collins votes no. mr. trott. >> no. >> mr. bishop. >> no by proxy. >> mr. bishop votes no. mr. muccarthy. >> no by proxy. >> mr. palone. >> yes. >> mr. luhan. >> yes by proxy. >> mr. sarbanes. mr. sarbanes votes aye. mr. green. mr. green votes aye. mr. conyers. >> yes by proxy. >> mr. conyers votes aye. miss jackson lee. >> aye.
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>> polimiss jackson lee votes a. miss chu. miss chu votes aye. >> mr. cohen. >> yes by proxy. >> miss es tchteste. miss este votes aye. miss custer. aye. mr. courtney votes aye. chairman upton. >> votes no. >> chairman upton votes no. >> members wishing to change their vote? seeing none, clerk will report the tally. >> mr. chairman on that vote, there are 11 ayes and 15 nos. >> 11 ayes, 15 nos. the amendment is not agreed to. mr. scott has an amendment at the desk to be offered with mr. palone, as i understand it. the clerk will -- number 056? clerk will report the title of the amendment. >> amendment to conference
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report on s-524 offered by mr. scott. >> and the amendment will be considered as read. the staff will distribute the amendment and the gentleman from virginia is recognized for five minutes. >> thank you, mr. chairman. mr. chairman, this simply adds educational and recovery programs for offenders in prisons, jails and juvenile facilities to the title 6 block grant program that would be allowed to be used in states. this would allow pilot programs to enable us to figure out what works in these programs. as it's already been said, this is the opioid bill and it is hard to -- it would be hard to explain a comprehensive bill that does not deal with persons already in prison. we're not going to solve any problems by putting people in jail and having them come out and addicted as they went in. this provision was part of the senate passed bill that passed with virtual unanimous support
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and was introduced in the house with over 100 co-sponsors, 40 of which were republicans. so it has strong bipartisan support. so i would hope, mr. chairman, that we would adopt the amendment. >> the gentleman yield? >> i yield. >> i'd like to -- i'm pleased to join mr. scott in offering this amendment. the purpose of section 601 is to provide funding to states for the implementation of a comprehensive response to this crisis, including by expanding education and prevention efforts, improving state prescription drug monitoring programs, and expanding access to treatment. this amendment would ensure that states include a focus on helping offenders recover from opioid use disorder as part of efforts to expand access to treatment services in the state. such a focus will help ensure that offenders get the treatment and support services they need in order to recover from their substance use disorder as well as to lead healthy and productive lives upon their release from incarceration. so i think this is an important amendment. i urge my colleagues to support
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this amendment and yield back to mr. scott. >> thank you to mr. scott and thank you, mr. palone. i want to join in this amendment and i appreciate you bringing it forward. we have such a catch-22 that we're just locking people up and not giving them any treatment. then we act shocked when they come out and end up back in this vicious cycle of committing crimes in order to pay for their drug habit. and so i've seen, i've been, i've visited treatment facilities in house within our incarceration facilities that are effective, that they can make a difference, they can turn people's lives around. for my colleagues on both sides of the aisle, i just want to say, it is a very cost-effective choice for the taxpayer because we can drop those recidivism rates from, as i said, the 80th
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percentile down to the 20th pert ti percentile, put people back to work, they're in their communities, they're raising their families and they've overcome this disease that we know as substance use disorder. thank you. i yield back and appreciate your time. >> you can reserve it. i'll give you an extra minute. let me take five minutes against the amendment. the amendment would direct the grants awarded under 60s 601 administered by the secretary of hhs to go towards incarcerated individuals. currently, as why know, the justice department is responsible for providing treatment for offenders in prisons, jails and juvenile facilities. though i support the goal of what the gentleman is trying to do, there is a clear delineation between who's responsible for care in different settings when someone's incarcerated or not. the amendment would make it less clear i think on the state level who's held accountable and responsible for providing
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treatment so i would urge my colleagues to oppose the amendment and yield back my time. does the gentleman still wish his minute? >> yes. thank you, mr. chairman. reclaiming my time. i would just say that it doesn't direct the states to do anything. just makes it an allowable use. there's not a lot of money on this line item so it would be more like pilot projects so we can find what works and what doesn't work. so i appreciate the support of the purpose of the amendment and i hope the amendment will be adopted. >> you know, in the future i'd like to work with the gentleman, maybe we can get language that we can accept on our side but i appreciate the amendment. with that, time is expired. those in favor of the amendment will say aye. those opposed say no. no! in the opinion of the chair -- my mike was on -- the nos have
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it. the amendment is not agreed to. >> mr. chairman? i have a unanimous consent for introduction into the record. am i recognized? >> yes. >> thank you, mr. chairman. i'd like to add into the record a statement from the american public health association for science for action and for health. ask unanimous consent to place this into the record. >> without objection, it is included. it is my understanding there are no further amendments to be offered. is that correct? any member wish to offer an amendment that was put in by last night? so seeing none, we've now concluded debate on the amendments filed for today's meeting of the house and senate conferees on s-524. the cara act of 2016. we'll amend the text of the report to reflect the amendments adopted today. i want to thank members and their staff for the hard work today and over this congress on this very, very important issue. at some point following the meeting, we'll announce a
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unitary time and place for member to review the final conference report text, and to then sign that conference report. without objection, staff is authorized to make technical and conforming changes to the legislation approved by the committee today. so ordered. without objection, the committee stands adjourned.
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the conference report on the opioid and addiction treatment bill goes to the house and senate for votes. watch this on our website, c-span.org. well, after today's meeting with the house republican conference, house speaker paul ryan had some comments about the fbi's investigation into hillary clinton's private e-mails. >> speaker ryan, are you confident in the outcome of the investigation? >> i'll let everybody be the judge of that. i'd say a couple of things. number one, i think director comey's press conference tomorrow raises more questions than provides answers. that's point number one.
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point number two, there are a lot of questions that have to be answered. so we're going to be asking those questions. i know the judiciary committee sent a letter i think last night with a number of questions. ogr, that committee is going to invite the fbi director to come up and testify. he did say that short of prosecution, some kind of administrative action might be in order. look, i was on the ticket in 2012. after the convention you get the full deep classified information as part of transition, as part of being a nominee. i think the dni, clapper, should deny hillary clinton access to classified information during this campaign given how she so recklessly handled classified information. that's point one. point two, director comey's presentation shredded the claims that secretary clinton made throughout the year with respect to this issue.
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he laid out a case how the things she had been saying she had or had not done were false. so we have seen nothing but stonewau stonewalling and dishonesty from secretary clinton on this issue. that means there are a lot more questions to be answered. earlier today, president obama announced that he'll be keeping 8,400 combat troops in afghanistan until the end of his presidency. here's some of what he had to say. >> general nicholson conducted a review of the security situation in afghanistan and our military posture. it was good to get a fresh set of eyes. and based on the recommendation of general nicholson, as well as secretary carter and chairman dunford, and following extensive consultations with my national security team, as well as congress and the afghan government, and our international partners, i am announcing an additional adjustment to our posture.
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instead of going down to 5,500 troops by the end of this year, the united states will maintain approximately 8,400 troops in afghanistan into next year through the end of nye administrati my administration. the narrow missions of the forces will not change. they remain focused on supporting afghan forces and going after terrorists. but maintaining our forces at this specific level based on our assessment of the security conditions and the strength of afghan forces, will allow us to continue to provide tailored support to help afghan forces continue to improve. in coalition based in gentleman lol b kandahar. the decision i'm making today can help our allies and partners align their own commitments.
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as you know, tomorrow i depart for the nato summit in warsaw where i'll meet with our coalition partners and afghan president ghani and chief executive abdullah. many of our allies and partners have already stepped forward with commitments of troops and funding so that we can keep strength being afghan forces through the end of this decade. the nato summit will be and opportunity for more allies and partners to affirm their contributions. i'm confident they will. because all of us have a vital interest in the security and stability of afghanistan. my decision today also sends a message to the taliban and all of those who have opposed afghanistan's progress. you have now been waging war against the afghan people for many years. you've been unable to prevail. afghan security forces continue to grow stronger, and the commitment of the international community, including the united states, to afghanistan and its people will endure.
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i will say it again. only way to end this conflict and to achieve a full drawndown of foreign forces from afghanistan is through a lasting political settlement between the afghan government and the taliban. that's the only way. that is why the united states will continue to strongly support an afghan-led reconciliation process and why we call on all countries in the region to end safe havens for militants and terrorists. following the president's statement, house armed services committee chair mac thornberry issued a statement which read, in part, the white house must submit a supplemental funding request to accommodate troop levels in afghanistan immediately. his senate counterpart, senator john mccain, said i welcome president obama's decision to reverse his previous plan to drawdown u.s. forces in
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afghanistan. coming up this afternoon live at 3:00 p.m. eastern time, the house rules committee will be taking up the defense programs and policy bill. that's live here on c-span3. and tonight, donald trump and newt gingrich campaign together in ohio. c-span2 will have live coverage of the rally from cincinnati is. that gets under way at 7:00 p.m. eastern. the former house speaker has been mentioned as a possible vice presidential pick. dr. patrick conway, chief medical officer of the centers for medicare and medicaid services, testifies now on proposed changes to medicare payments. dr. conway who also heads the innovation center for cms outlined the center's five-year pilot program changing our hospitals and doctors are reimbursed for outpatient drugs. he testified last week before the senate finance committee.
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>> i'd like to welcome everyone to this morning's hearing that will allow the committee to examine the obama administration's proposed medicare part b demonstration. i would particularly like to thank dr. patrick conway from the center for medicare and medicaid services for testifying. today's topic is very important. the proposed cms demonstration project would radically alter the ways in which medicare pays for drugs and biologics, treatments physicians prescribe and administer to patients in outpatient settings covered under part b. typically these are drugs and treatments that are tested in a physician's office or hospital. they're used to treat vulnerable beneficiaries with serious medical conditions such as cancer, macular degeneration, rheumatoid arthritis, neurological disorders, primary immuno deficiency diseases and a number of rare illnesses. from the day cms made their
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proposed demonstration public this past march, i've made my opinion very clear. i believe this experiment is ill-conceived and likely to harm beneficiaries. it is an overreach on the part of cms that, in my opinion, goes beyond the agency's statutory authority, extends nationwide, and requires all medicare part b providers to participate. as we all know, the experiment would change the part b statement system in two phases, both of which are very troubling. and that's putting it kindly. given these inherent concerns i'd like to hear an explanation from cms as to why they believe their new payment changes will not harm medicare beneficiaries. so far, what they've given us lacks any explanation or justification, and that's not all that's missing from the elements of the demonstration that have been made public. indeed, this proposal's troubling. and again, i'm being kind with
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that description. not only for what is in it but what has been left out. for example, with its proposal, cms has not indicated the conditions in which a physician has the option to prescribe a high or low-cost drug that have the same patient benefit. in addition, cms has not provided an analysis of how many physicians, including those in small and rural practices, would lose money purchasing needed drugs. there is no cost analysis to how physicians would refer to the more costly outpatient setting. cms has not indicated how it will assess the impact on beneficiary access and quality both during the course of the demonstration and the formal evaluation of it. not surprisingly, the proposed experiment has been widely condemned by experts and
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stakeholders. almost immediately after its proposed demonstration was released we received a letter from over 300 stakeholder organizations asking for our help in getting cms to withdraw the proposal. now these organizations included the arthritis foundation, the caregiver action network, the immune deficiency foundation, the lung cancer alliance, and the national alliance for mental illness. the organizations that have reached out with concerns about how this proposal represents patients who suffer from the diseases treated by these drugs, including cancer, arthritis, mental illness and hiv, they represent the physicians who treat the patients with these devastating conditions, including enkol gistinclude ing oncologists, optimal gist blb many utahns feel the proposed demonstration would deprive them of the drugs that best treat their conditions and require them to have to travel great
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distances and incur significant additional expenses to receive the needed care. obviously utah's not alone here. patients and providers from virtually every state have prompted all of the republican members of the finance committee to send a letter urging the withdrawal of the proposal. that's right, 14 senators from the only senate committee with oversight jurisdiction sent a detailed and thoughtful letter to cms about their proposal. and how did the agency respond? we received what essentially amounts to a form letter thanking the committee members for sharing their views and noting cms will consider all public comments. it could not have been more dismissive. the seriousness cms described from congress and, sadly, this is not an isolated incident. for seven years now the entire obama administration has
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patronized, stonewalled or flat-out ignored efforts on the part of republicans. there are countless examples. sometimes the agency showed disregard for the law like when they refused to provide any meaningful response to numerous inquiries about illegal reinsurance payments issued and other times they discount our rule entirely like when they denied staff access to last week's medicare and the trustees report. until the press conference putting the administration's own misleading spin on the reports are well under way. i have on numerous occasions in writing during these hearings like this and elsewhere expressed my hope that the administration as a whole would be more transparent.
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i've asked countless nominee to commit to being responsive to senators' inquiries. this it level of disregard has continued unabated. given the short time left with this administration, i won't renew these calls for more cooperation and responsiveness today. given that we have a high-ranking administration official before us today, i hope that we can finally get straight answers raised by cms' part "b" proposal. i note that our witness stated in early may interview on the proposed demonstration that cms will interact with congress and take feedback and make adjustments as necessary, unquote. and i do hope that our conversation today will be more
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consistent with that sentiment than a dismissive response letter shortly after the statement was made. the senators on this committee, and more importantly the constituents we represent deserve at least that much. now with that i'll turn to senator wyden for his opening remarks. >> thank you very much, senator. in my view, what underlies this debate is we are entering an era where there are going to be miracle treatments and there are going to be cures. there are drugs on the market and close on the horizon that were science fiction not very long ago. the foremost question is whether or not the american people are going to be able to afford these medicines. with business as usual, too many of these treatments are going to clobber too many family budgets and threaten health programs
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across the country. and that was one of the big takeaways, colleagues, from the 18 months' investigation senator grassley and i conducted on a bipartisan basis into the rollout of one blockbuster drug. it was a drug that treats hepatitis "c" and had a list price of $1,000 a pill. and i think this is going to be the pattern, colleagues, for years and years to come absent reform. lots of cures and a big, big question mark when it comes to access and affordability. now the hepatitis "c" drugs that senator grassley and i did our bipartisan inquiry into are not the primary focus of today's hearing.
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today the committee is going to examine a demonstration project set to begin in medicare part "b" which, of course, is the medicare program that covers outpatient care. part "b" pays for a small share of the drugs many seniors are prescribed and the demonstration would affect the way those drugs are paid for. the demonstration has brought to the forefront additional major questions about how the country is going to afford to address the trend of escalating pharmaceutical prices. the fact is too many seniors are getting pounded today by prescription drug bills. there's an enormous amount of work that has to be done to guarantee seniors have affordable access to the medications they need. in medicare part "b," seniors are often hit especially heart because their share of drug costs is a co-insurance instead of a co-pay.
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that means rather than a flat, manageable fee, some older people face a huge burden stuck paying a percentage of a drug's total cost. i look at that burden the same way i look at the rising out of pocket cost for older people in medicare part "d." for part "d" i propose legislation that would establish an out of pocket cap to help protect older people and in my view this committee ought to take a close look at ways it to make sure seniors don't get pounded under part "b" as well. all of the democrats and i sent a letter in april. the acting of the administrative care centers for medicaid.
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the acting administrate for medicaid services outlining the key concerns we had about the impact the project is going to have on patients. at their core our concerns are about making sure that older people who are especially vulnerable have access to lifesaving medications, protecting access is especially important in rural america where seniors today so often face fewer choices and lower quality of care. it is extremely important as well that the project not result in patients being told they have to get treatment at the hospital where treatment is often more costly and less convenient. finally our letter said this demonstrate project has to be in sync with the effort medicare is making to move towards treatment based on value rather than volume. when you focus on the value and efficiency of care, there's the potential to raise quality of care for older people while saving money at the same time. i hope the committee will
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examine these issues carefully as it looks at the medicare part "b" demonstration. i want to thank dr. conway for joining the committee. we look forward to his testimony and members having the chance to ask questions. thank you. >> thank you, senator. i'd like to take a few minutes to introduce today's witness. dr. patrick conway is here on behalf of the centers for medicare and medicaid services. dr. conway holds a number of high-ranking titles at cms. in those positions he has responsibility for overseeing health programs, providing services to over 100 million people. two of his roles in serving as the agency's chief medical officer make him well suited to testify on the agency's part b drug demonstration. prior to coming to cms he was the director of hospital medicine and associate professor at cincinnati children's hospital.
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dr. conway earned his degree from baylor college of medicine and completed his residency at harvard's children's medical hospital, boston. i want to thank you for taking the time to appear here today and we'll be glad to take your statement at this time. >> thank you, sir. chairman hatch and members of the committee, thank you for the invitation to discuss medicare and medicaid initiatives, improving how medicare pays for part "b" drugs, to support physicians in delivering higher quality care to beneficiaries in the medicare program. we very much value the input and feedback we receive from congress and members of this committee and we are carefully reviewing the comments from you and the public. drug spending has increased over time. the cost and value of drugs. the aim of improving patient
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care and the value of drug spending. this alliance with the statutory goal to test service delivery models, preserving and enhancing the quality of care. the proposal is part of the administration's broader strategy to encourage better care, smarter spending and healthier people by paying for what works and finding new ways to coordinate and integrate care to improve quality. cms values public input and comments and looks forward to working with stakeholders in an ongoing manner to maximize the value and learning from the proposed model. we have received feedback from a wide range of stakeholders on several issues including the size of the model, patient access and small practices in rural areas and the importance of patient input. we are reviewing all comments closely to determine whether
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