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tv   Key Capitol Hill Hearings  CSPAN  April 21, 2016 9:27am-10:01am EDT

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your. >> so those four things, how many times did you use it, could you get a probable cause warrant, do you have a nondisclosure with the fbi, and have you received the jones memo? >> we will get back to you on all four of those. >> appreciate it. thank you, mr. chairman. >> i thank the gentleman. i want to add one thing to that in terms of stingray technology, sinjar answering the gentleman back. i would like to ask if you've ever opportunity information, i.e., if you didn't get a board if you are following them their personal household, and like you to respond to that as well. the chair recognizes the gentleman from new mexico, ms. luan grisham. >> thank you very much, mr. chairman. and i'm going to kind of go off topic, and i apologize, kind of, except that i think that
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generally speaking as dr. conway is chief medical officer, and what -- while absolute appreciate your discussion about ways to improve quality. when we really do that those investments in fact save money in the health care system. i would want to talk about some issues that i'm sure you're aware, and if you are not, this is great, this is a great place to make you aware but i talked about it in nearly every context data came as a member of congress, that given the situation in our states, our governor determined that all, 100% of our behavioral health providers, were engaged in billing practices that goe roseo the level of a credible allegation of fraud. and so suspended payment to all. i disagreed with it, but be that as it may.
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yours issue for me given a three years later the companies that came in our largely now gone, that there is no behavioral health, let me repeat that, there is no vehicle health infrastructure, that there was no continuity of care, no transition plan requirement, no requirement by the federal government for their to be accurate, credible, what use that word on purpose, credible data from the state of new mexico which hhs and cms have both agreed are completely missing in this design. we have the worst public health outcomes in the country, including the second highest overdose deaths related by and large to a very fragile, very complex behavioral health population in the state of new mexico. it would seem to me that as a chief medical officer one rule is we know that hospital decisions, overdose, incarcerations, acute
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institutional care is not the right investment for both cost savings or quality in terms of treating these patients. and i would guess you probably are also very aware that when you have a highly complex patient, say someone with schizophrenia who has developed a relationship with the provider, who is now successfully on a medication management which is very hard for many of these patients to achieve, and then that is completely taken away. and if you can get in, you see a different psychiatrist or psychologist every single time you try to get access. wouldn't you agree that this would not be that kind of investment or sound practices that any state or any medicaid environment should be engaged in? >> congresswoman, thanks for
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your question. i am very aware of the issue and agree that appropriate mental health and behavioral health treatment is critical to medicaid beneficiaries. week, cms, have been working with the state as you said since 2013 on this issue recently in march responded in a letter summarizing some of that work. we are currently working to improve their behavioral health workforce. >> can you talk about the? i should also mention to the committee and for the record that all 15 have been cleared by the attorney general. it's taken us three years to get this administration to require the human services department to repay these providers the millions of dollars, but they are defunct. so what exact work force investment are occurring in our state because i'm aware of very little? >> we are directly working with the state, assuring that the
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state is currently following cms payment suspicion -- suspension to get guidance. >> how does that get at the new health system? >> on the medicaid side we are working directly with the state on axis of care issues, on assuring proper networks. we both from the program integrity side have put in place guidance at a working directly with the state on these issues moving forward. on the medicaid side -- >> given for three years has gone by, and i apologize for interrupting you, but this, as a physician, i was a cabinet secretary for health, this is untenable. can you provide something to this committee in writing that we talk about ways in which, god forbid, this ever occurs in any other state anywhere ever again, what cms ought to be doing to assure that you didn't spend
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that kind of acute care dollars? and, in fact, mr. chairman, people lost their lives in my state, continue to do so. so i would appreciate that response inviting to this committee if i may, mr. chairman. >> i agree with the principle of quality and save and exit the care being paramount, and we will provide a response. >> thank you. i yield back my time. >> the chair recognizes the gentleman from wisconsin for five minutes. >> we would do a follow-up on mr. jordan's questions. first of all can you explain what that stingray technology is a little bit for our listening audience? >> as i understand it, it is technology that allows law enforcement to capture cell phone information basically. >> you said you did know if you're getting a warrant. usage used at 37 times. do you think you should be getting a warrant?
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>> i'm not certain we didn't get a warrant. >> the question is do you think you should have? if it turns out you didn't are you going to say that was an oversight, we screwed up or are you going to say we don't need a warrant? >> i'm not certain to be honest with requirements are for use of this technology, whether it's required of a warrant or not. i will respond to that question in full when we have sent a response back. >> you a response back speed usage is used at 37 times -- >> i said i think we used about 37 times and i would get back to the committee on exactly how many times it's been used. >> it could be 36 or 38. why did you use it? >> we use it in the course of a tax investigation. >> like what sort of isis was there that you kind of had to know where people are? i would think that would be kind of a really major thing. can you give me like a hypothetical or even real fact
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situation that cause you to have to use this stop? >> -- this stuff. >> we use it in drug cases. we use in counterterrorism work that we do. i mean, we use it across a broad spectrum of activities that we have responsibility for. >> those would be things that would be outside the irs's purview, terrorism? >> it's things we have responsibility for but not exclusively, yes. >> accounting responsibility? >> i'm sorry? >> how jamie responsibility? >> i mean we do a lot of counterterrorism work around anti-money-laundering, drug cases that we are involved in that affect tax administration. so yeah, we have responsibilities of there. >> are all the times you use it things like terrorism related or
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drug-related? >> as i said earlier i would have to get back to committee on exactly how and when we used. >> we will go on to mr. dodaro. i want to ask you all of it about disability benefits, what you are doing on that sort of thing. i'd like to ask you what do you do about overpayment on disability benefits? getting them back to could you give us an overview of what you are doing? >> we have issued a report on that. we feel that the sauce is good administration could do a much better job not only in preventing overpayments but also their concert, they permanently waved repayment of about, over 2 billion i think, over a ten-year period of time. we think that they are not properly processing work requirements. when people start working the are supposed to report that the social security and then they
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are supposed to take action, but they were effectively processing of returned very quickly for the work requirements. because then they should take them off the disability rolls and cut off their payments. >> i want to ask a general question on disability. i'm sure just what every congressman other gets constant complaints of people on disability and nobody can figure out why they are disabled. what are you doing about that and what can you do about it? can you comment on your position on the problem? >> yes. we do, always have audits underway to look at the processes for the initial disability claims, what they're doing on continuing disability reviews. they are supposed to continue to evaluate these people. we have made lots of recommendations to improve the process over there. some of them have been implemented, some of them have not been implemented.
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some require legislative action. >> how often detect somebody? if i'm on disability for a bad back today, how often am i going to be checked to see if it's on the up and up? >> it depends. we've made recommendations that the target better criteria on that sort of thing. there's supposed to be reviews on the radio basis. i can provide for the record what the schedule is but there is a schedule. they are behind in meeting the schedule. they have backlog of cases. >> i'm out of time but i will talk to you later off the camera. >> i thank the gentleman. the chair recognizes himself for a series of questions but i want to thank all of you for your input today and the informative dialogue that we've had additionally i would be remiss if i didn't the thank our staff you. it certainly is just an unbelievable herculean job that our staff does on a regular basis to not only prepared the members of congress but to look
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in detail at the reports. mr. dodaro, that you provide. at some point you just acknowledged them. additionally, i would like to recognize the previous colleague, dr. coburn. obviously, this was part of his brain trust, and the fact that we have duplicative services. so long past and leaving the upper chamber, we continue to see the fruits of his vision. and so want to acknowledge that as well. esther dodaro, i want to come to you, and certainly thank you and your staff. angrily for the other witnesses just to let you know, if gao ain't happy, i'm not happy. and i just put a great bluntly, we are reading what they have. and i think in a bipartisan way we are willing to attack it. there may be some ideologically differing views on what we should attack first.
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but as much as i try to make gao be a political instrument, they will not do that. they keep it in a nonpartisan, in fact there are times when wanting to be outraged, and you get a calm cool gene today with their going well, we need to address this and address that. i can't, you know, i can't evoke emotion out of him. i would say that because it's a benefit, i really believe, to the three of you who are here today because you have been asked to testify because the implementation of those recommendations have really fallen short of where most of us believe that it should and i said in a kind way, but when you don't implement the majority, words like we are making progress, really are like nails on a chalkboard to me because what i wanted to do is see a matrix of which are going to get done, when you're going to get
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it done. so that's what a nasty. mr. dodaro, one of the things that has been shared with me is about shared services. we've had john come in a couple of times and talking about the benefits of potential using shared services. we've had ms. go bare, bath, come in and talk about some of the shared services that she's looking at. there some challenges in terms of who's fault, if they don't provide and who's ultimately responsible. but our you look at that? cumulative that further and perhaps maybe not across our entire federal government but in terms of some of duplicative services, how we could save some money where you want agency using services that perhaps we don't have to create individual departments.
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i will let you respond to that. >> yes. i mean, one classic, good example of where there's been a lot of benefit, years ago to get to be a proliferation of payroll systems across the federal government. a lot of consolidation has taken place there through shared services operations. even with the gao. we use shared service providers. i don't -- i think there's a lot of potential there. we've looked at it principally in the area of financial management services because that's common in terms of payroll processing and other things. so that's an area i'd like quite frankly for additional resources to do more in, but we haven't done a whole lot beyond the financial management area. >> if you would see if there's a couple areas we could address more, i'm making that official request today. perhaps look into i.t. area. there's some i.t. services that might be able to be shared. i see some of our experts are from that particular field.
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but if you look at and get that back. >> sure. >> to the committee. yes? [inaudible] >> mr. chaffetz come the irs sent a letter back to mr. chaffetz in november of last year, and at the bottom of page two, top o of page to at the end of the witnesses until july 2015 iran's had oneself side stimulate the one stingray which was acquired in 2011. in july 2015 he began the process temperature additional cell site stingley. unit of the irs has received a second stingray? >> on a certain whether we have it or not. again i'll get back to you on that. >> but the process was started according to the letter. you know that? >> that part i do know so -- >> you don't know if you got the second one are not speak i'm not certain. >> there's 112 recommendations that the gao making the irs to do with the tax gap or any of
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those recommendations for the irs to procure another stingray? >> no. i have not heard of stingray before this hearing. >> seagate 112 things, good ideas to do today with a $385 billion tax gap, and they've implemented less than 50%, 37% according to what you said, of the recommendations you gave them your and yet they are using stingray technology, a potentially purchasing a second unit to potentially infringe upon americans fourth amendment liberties. mr. dalrymple, that's why we raised the questions we get. why don't you start with a 112 recommendations mr. dodaro and descriptive, the good work they did on how to do with the facts we ate like and many were
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supposed to click in light of effect with that in 1900 dead and everything else, instead of buying stingray technology and potentially infringing upon the liberties of taxpaying americans? >> i thank the gentleman. reclaiming my time. dr. conway, i saw you shaking your head just when gene dodaro talked about the fact that we need to make sure that hospitals and private physicians in terms of the amount of money that we are actually paying them back. i saw you shaking your head that come at a don't put words in your mouth, but it is not linear or fair. is that correct? >> there is, in the president's budget as a recommendation around site neutral payment which would equalize payments for services across hospital outpatient physician setting. and as you know congress passed legislation starting in january.
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>> can we get to this committee within the next 120 days i plan on how cms plans to address that particular recommendation? >> we will work to get back to you with that information. >> all right. so in 120 days we will have some kind of response from you? >> we will attempt to meet that timeframe. >> okay. what timeframe would be reasonable, dr. conway? i see the person that is eyed for doing the work says you can make the 120 days. >> that is correct. >> my final question, go to recognize the ranking member for his closing remarks. mr. tillotson, let me share a concern that i have. we want to always give our fighting men and women the resources that they need. and yet what i heard today was a less than robust implementation of some of the gao reports as it
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relates to your particular area. i also heard you saying we are making progress and all the. what i don't want to do is see that 40% of what you would that really has no impact come substantial impact in terms of a bottom line to intimate it year after year and the 60% that would actually make very systemic changes continue to get rolled over. that's what i'm seeing. that's what i'm reading. is that we are making limited progress as it relates to that. and what happens is that makes t very difficult on someone who is trying to make those appropriation decisions on giving you the tools that you need, and yet we hear about gross inefficiency. so it is incumbent upon you to help prioritize the recommendations that gao is making on an annual basis and say we're going to ever do these companies these have the most
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significance. will you be able to report back to this committee within 120 days on the top recommendations for gao that have yet to be intimated, and how you're going to intimate those? >> mr. chairman, we will report back. >> within 120 days the? >> yes. >> without our recognize ranking up her for his closing remarks. >> mr. dodaro, i just want to go back to mr. jordan's questions. in talking about, i guess not only recommendations that may have been made with regard to irs, but to other agencies, but let's zoom in on the irs. how much, i mean, you take into consideration budget cuts, right? and the ability to get these things done in? >> yes. yes, we make sure that our recommendations are going to be cost effective recommendations.
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typically when we make a recommendation, the agency has flexibility in how to implement it. we don't tell them exactly how they need to implement the recommendations. so they have flexibility in order to do that, but we take that into account and we believe our recommendations if implemented will be cost effective. some of them require perhaps a little bit of it up front investment to implement the recommendations, but we believe the benefits will exceed the costs of implementing our recommendations. when i report to you and the rest of the members of congress that our recommendations in committed flash resulted in financial benefits over $70 billion, that's not the cause. so that's a net figure. so that's what we track. >> we can do about -- we can do a lot better, can't we? >> yes. >> is dod spending too much to account speak with they haven't been able to account to let me
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put it that way. they are the only major federal agency that is not been able to pass the test of an independent audit. they have just in the last year alone, they have scaled back the audit requirements. they don't prepare a full set of financial statements. only one year budget data and david abel, not been able to get an opinion on one year budget data. so i'm concerned, as mr. tillotson mentioned, i've been having peace with dod. in fact, we have another one this afternoon to focus on areas where they need to make improvement. they are not fixing the underlying problems satisfactorily, and what they promised is they were going to present a comprehensive direction action plan for making the changes necessary to be able to do it. but right now there is not proper accounting for the money that's being spent, and is not proper oversight over the assets that dod has, for property, plant and equipment issues that they have. they are in need of significant
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improvement. >> and, of course, everything you just said opens the door for all kinds of mischief, for lack of a more, a stronger word. >> what we said is control problems. >> all right. >> and unemotional fashion. >> thank you all very much. i appreciated. >> i thank the gentleman to. again, i want to thank each of you. let me tell you why this, not only does he is important, but it sets a benchmark every year for us to look at whether it's a high watermark or low watermark, we leave that up for debate for another day, but in doing that we need to set that standard for each one of you. what i would encourage each of you, i would hope that next year that it's not the same three agencies that are here that have yet to implement. let me to you the reason why, is
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because along with that, improper payments of which we will have a hearing in the coming weeks, those improper payments go right across the same groups. when we look at improper payments, whether it's medicaid and medicare for any of those, certainly it's hhs and cms having a role in that. there's a headline today, or within, in the last few hours am actually the irs admits that it encourages illegals to steal social security numbers for taxes. you can't control what's in the press, but here my point is this this, is that it's all about the earned income tax credit. and if there is something that is not allowing the irs to go after those improper payments, because this is not the first inning. i've been in four or five when we continue to have this problem. enough is enough.
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it's time we addressed that problem, and if there's something from a statute standpoint that doesn't allow you to share the social security numbers so that you can do the proper vetting that you need to do, let us know your we will work about that in a bipartisan way to address it. body hope that this is the last hearing where we are not addressing that particular problem. from a dod standpoint there's too many stories out there in terms of what we are spending, and the fact that you can pass an independent audit where you have the most responsible, hardest working people willing to put their lives on the line for the freedom of our country, and yet from an accounting standpoint we can't do it, it's time that we get our house in order to and so i encourage all of you to work with gao on implementing those. i thank you. if there is no other for the business before the committee, the committee stands adjourned.
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[inaudible conversations] [inaudible conversations] [inaudible conversations] >> american history tv on c-span3 this weekend.
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>> southerners felt compelled to explain why it was that this devastation had occurred and that, for example, 25% of southern white men between ages of 20-45 were dead. notches casualties, they were dead as a result of the civil war. >> then sunday morning at 10 on road to the white house.
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>> the union to send anyone outcome anyone but her to negotiate a contract or however cute at the forefront of the effort for a reason. her name evolves which is interesting because it was a meaning of the farmworkers movement, when you hear about them -- >> and at eight on the presidency. >> he just kind of tensed up and said those son of a is, those parts of mind, did any of them ever invite me to play golf at their fancy country clubs? did any of them invite me to their clubs? he just goes on and on. >> his lip was quivering. that's one of the few times and all those three and half plus years that i was so close to him
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that he, he was a very well contained, disciplined man. very disciplined. he did not out to keep this in but he erupted when he was talking to dawn. he was just saying, and he hated them for it. >> alexander butterfield at "washington post" reporter bob woodward reflect on the former president personnel policies from watergate to vietnam. for the pleased american history tv we can schedule go to >> thursday morning in washington, d.c. and the u.s. senate is about to gavel in to continue work on energy and water spending bill. it's the first of 12 appropriations bills for 20 something. the bill provides $37.5 billion in western states. at 11:45 a.m. senator senators e on a minute offered by north dakota republican john hoeven that would lock funding for and limiting the epa's clean water
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rules. more debate is likely and we are also expecting votes this afternoon. the senate does not expect to finish work on the bill this week. now to live coverage of the u.s. senate here on c-span2. . the president pro tempore: the senate will come to order. the chaplain, dr. barry black, -- today's opening prayer will be offered by the most honorable paul j. swain, bishop of the sioux falls catholic diocese in sioux falls, south dakota. the guest chaplain: almighty god, we thank you for the many blessings you have bestowed upon us and our country, especially thof


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