Monday, December 06, 2010

Sen. Chuck Grassley of Iowa, ranking member of the Finance Committee, today joined the committee chairman in releasing a committee report detailing ties between a Maryland doctor who is accused of implanting hundreds of potentially unnecessary cardiac stents and his ties to the drug company that manufactured the stents.  The doctor is said to have accepted payment for at least two social events at his home paid for by the device maker, including a pig roast, and became a paid contractor with the company, Abbott Labs, to promote its stents in China and Japan.  Grassley is the co-author of the provisions enacted through the new health care law that will require drug companies and medical device makers to disclose their payments to doctors.  The payments will be publicly available on Sept. 30, 2013.  Grassley made the following comment on today's report and future payment disclosure.

"It's standard operating procedure for drug and device makers to give doctors honoraria or pay for dinner parties or travel to promote certain products.  That's all legal, but it's been disclosed to the public only in limited cases, either voluntarily by the drug companies or as part of lawsuits.  For the most part, people scheduled for surgery don't know if there's a financial relationship between the doctor implanting a device and the maker of that device.  Starting in 2013, that will change.  The public will have access to the financial information.  There will be transparency.  I hope that bringing this information out of the shadows will help rein in the most questionable cases.  It's common sense that doctors should choose medical devices because the devices will help their patients, not because the device makers paid the doctors to give a speech about their product.  Also, Medicare and Medicaid can't spare a penny for procedures that aren't medically necessary.  Limiting abuse in this area will help program finances.

The Finance Committee report released today is available here.

An article in the Baltimore Sun, which broke the Maryland stent story, on today's report is available here.

A series of articles about Grassley's work on payment sunshine is available here.

Floor Statement of U.S. Senator Chuck Grassley

Ranking Member of the Committee on Finance

Still Another Chapter of Revisionist Fiscal History: Lame Duck Tax Relief Debate

Thursday, December 2, 2010

Since yesterday, we've witnessed in this chamber the resumption of a set of tired and worn talking points that the other side drags out whenever they are forced to finally get around to discussing tax policy.

By once again beating the same dead horse, the other side has attempted to go back in time, again, and talk about fiscal history. Earlier this week there has been a lot of revision or perhaps editing of recent budget history.  I expect more of it from some on the other side.

The revisionist history basically boils down to two conclusions:  1. That all of the "good" fiscal history of the 1990's was derived from a partisan tax increase bill of 1993; and 2. That all of the "bad" fiscal history of this decade to-date is attributable to the bipartisan tax relief plans

Not surprisingly, nearly all of the revisionists who spoke generally oppose tax relief and support tax increases.  The same crew generally support spending increases and oppose spending cuts.

For this debate, it is important to be aware of some key facts.  The stimulus bill passed by the Senate, with interest included, increased the deficit by over $1 trillion.  The stimulus bill was a heavy stew of spending increases and refundable tax credits, seasoned with small pieces of tax relief.  The bill passed by the Senate had new temporary spending, that, if made permanent, will burden future budget deficits by over $2.5 trillion.  That's not Senate Republicans speaking.  It's the official Congressional scorekeeper, the Congressional Budget Office (CBO).  In fact, the deficit effects of the stimulus bill, passed within a short time after Democrats assumed full control of the Federal Government, roughly exceeded the deficit impact of the 8 years of bipartisan tax relief.

All of this occurred in an environment where the automatic economic stabilizers thankfully kicked in to help the most unfortunate in America with unemployment insurance, food stamps and other benefits.

That anti-recessionary spending, together with lower tax receipts, and the TARP activities, set a fiscal table of a deficit of $1.4 trillion that was the highest deficit, as a percentage of the economy, in Post World War II history.

From the perspective of those on our side, this debate seems to be a strategy to divert, through a twisted blame game, from the facts before us.  How is the history revisionist?  Let's take each conclusion one-by-one.

The first conclusion is that all of the "good" fiscal history was derived from the 1993 tax increase.  To test that assertion, all you have to do is take a look at data from the Clinton Administration.

The much-ballyhooed 1993 partisan tax increase accounts for 13 percent of the deficit reduction in the 1990's.  Thirteen percent.  That thirteen percent figure was calculated by the Clinton Administration's Office of Management and Budget (OMB).

The biggest source of deficit reduction, 35%, came from a reduction in defense spending.  Of course, that fiscal benefit originated from President Reagan's stare-down of the communist regime in Russia.

The same folks on that side who opposed President Reagan's defense build-up take credit for the fiscal benefit of the "peace dividend."

The next biggest source of deficit reduction, 32%, came from other revenue.

Basically, this was the fiscal benefit from pro-growth policies, like the bipartisan capital gains tax cut in 1997, and the free-trade agreements President Clinton, with Republican votes, established.

The savings from the policies I've pointed out translated to interest savings.  Interest savings account for 15% of the deficit reduction.

Now, for all the chest-thumping about the 1990s, the chest thumpers, who push for big social spending, didn't bring much to the deficit reduction table in the 1990's.  Their contribution was 5%.

What's more the fiscal revisionist historians in this body tend to forget who the players were.  They are correct that there was a Democratic President in the White House.  But they conveniently forget that Republicans controlled the Congress for the period where the deficit came down and turned to surplus. They tend to forget they fought the principle of a balanced budget that was the centerpiece of Republican fiscal policy.

Remember the government shutdown of late 1995?  Remember what that was about?  It was about a plan to balance the budget.  We are constantly reminded of the political price paid by the other side for the record tax increase they put in the law in 1993.  Republicans paid a political price for forcing the balanced budget issue in 1996.  But, in 1997, President Clinton agreed.  Recall as well all through the 1990's what the year-end battles were about.

On one side, Congressional Democrats and the Clinton Administration pushed for more spending.  On the other side, Congressional Republicans were pushing for tax relief.

In the end, both sides compromised.  That's the real fiscal history of the 1990's.

Let's turn to the other conclusion of the revisionist fiscal historians.  That conclusion is that, in this decade, all fiscal problems are attributable to the widespread tax relief enacted in 2001, 2003, 2004, and 2006.

In 2001, President Bush came into office.  He inherited an economy that was careening downhill.  Investment started to go flat in 2000.  The tech-fueled stock market bubble was bursting.  After that came the economic shocks of the 9-11 terrorist attacks.

Add in the corporate scandals to that economic environment.

And it's true, as fiscal year 2001 came to close, the projected surplus turned to a deficit.  But it is wrong to attribute the entire deficit occurring during this period to the bipartisan tax relief.  According to CBO, the bipartisan tax relief is responsible for only 25% of the deficit change, while 44% is attributable to higher spending, and 31% is attributable to economic and technical changes. In just the right time, the 2001 tax relief plan started to kick in.   As the tax relief hits its full force in 2003, the deficits grew smaller.  This pattern continued up through 2007.

If my comments were meant to be partisan shots, I could say this favorable fiscal path from 2003 to 2007 was the only period, aside from 6 months in 2001, where Republicans controlled the White House and the Congress.   But, unlike the fiscal history revisionists, I'm not trying to make any partisan points, I'm just trying to get to the fiscal facts.

There is also data that compares the tax receipts for four years after the much-ballyhooed 1993 tax increase and the four year period after the 2003 tax cuts.  I have a chart that tracks those trends.

In 1993, the Clinton tax increase brought in more revenue as compared to the 2003 tax cut.  That trend reversed as both policies moved along.

Over the first few years, the extra revenue went up over time relative to the flat line of the 1993 tax increase.

So, let's get the fiscal history right.

The pro-growth tax and trade policies of the 1990's along with the "peace dividend" had a lot more to do with the deficit reduction in the 1990's than the 1993 tax increase.  In this decade, deficits went down after the tax relief plans were put in full effect.

No economist I'm aware of would link the bursting of the housing bubble with the bipartisan tax relief plans of 2001 and 2003.

Likewise, I know of no economic research that concludes that the bipartisan tax relief of 2001 and 2003 caused the financial meltdown of the September and October 2008.

As I said, from the period of 2003 through 2007, after the bipartisan tax relief program was in full effect, the general pattern was this:  revenues went up and deficits went down.

One major point that needs to be said right here is to state where the government gets the money it spends.  Basically I'm asking "Where do taxes come from?"

I would have thought this would have been perfectly obvious to most people, but I may have been wrong.  Taxes come from taxpayers!  I say this because we have heard tax relief for certain individuals referred to as a bonus.  A search of The Congressional Record for the Senate on December 1, 2010, shows that the word "bonus" was said nearly 50 times.

The implication being that by extending tax relief for all Americans we are giving some people a bonus that other people are paying for.  Let me try to simplify this for my colleagues that are having trouble understanding.  There is no proposal to cut taxes for anyone before this body.  The question is are we going to allow taxes to go up, or are we going to prevent a tax increase?  If we prevent taxes for everyone from going up, we are letting taxpayers keep more of their own money that they have earned and worked hard for.  No one is proposing a bonus or a gift for anyone.  The question is, do we want taxpayers to have more or less of their own money.

My colleagues on the other side have been especially incensed by what they consistently refer to as "tax cuts for the rich" and seem to believe that tax relief for everyone is responsible for our disastrous budget situation.  However, I think nearly everyone serving in the chamber, and certainly the President and House and Senate leadership, supports extending around 80% of tax relief.  If those on the other side are serious in their pleas that taxes must be increased in the name of fiscal responsibility, how can they claim 80% of tax relief is absolutely necessary and that 20% of tax relief is absolutely wrong?

This chart, drawn from Congressional Budget Office (CBO) data, should get more insight into the two groups the other side is talking about.  The orange line measures the effective tax rate paid by the top 5% of taxpayers.  By the way, this is where the Small business owner tax hit occurs.  This group roughly represents those taxpaying families with incomes over $250,000.  Under the Democratic Leadership's preferred tax policy, this line will go back up to where it was in 2000.  Republicans would prefer to prevent this tax increase, and we have shown that it falls primarily on the backs of small businesses.  The main point this chart shows though is that the tax relief undertaken during the last administration benefited all taxpayers, and characterizing it as "tax-cuts-for-the rich" is simply not accurate.

Of course I want to put our country on a path to fiscal responsibility, but I do not believe that higher taxes will lead us to that path.  Rather we need to carefully examine how we spend the money we already collect.  This debate is about one fundamental question. Who does the money you, the taxpayer, have worked hard for belong to?  Does it belong to the citizen that earned it, or does it belong to the government?  Is whatever the taxpayer is left with an allowance, with the balance to be spent by a government that knows best?  I think most people would answer my last two questions with a strong "No."

As we continue to discuss pressing tax matters in Congress, we need to keep these fundamental and simple truths in mind.  We need to stop taxes from increasing for all Americans.

Charts used:

Spending Largest Source of Deficit Change Since 2001

Changes in Federal Revenue as a Percentage of GDP

Inherited Deficits 2009 - 2019

Deficits 2001 - 2019

Source of Deficit Reduction 1990 - 2000

Tax Relief vs. Stimulus

Total Effective Federal Tax Rates 1979 - 2007

Pigford II Funding Agreement Clears House

WASHINGTON -- Senator Chuck Grassley praised the quick action of the House of Representatives after it passed legislation to fund the Pigford II settlement.  The Claims Resolution Act of 2010 resolves claims against the government related to the Cobell class action lawsuit, the Pigford class action lawsuit, as well as tribal water rights claims for the White Mountain Apache, Crow, Taos Pueblo, and Aamodt Tribes.  The legislation is fully paid for, and contains additional safeguards to better fight fraud in the program.  The bill cleared the Senate on November 19.

"When I first started working on this issue, I had hoped to resolve these civil rights issues through the administrative process.  I knew that if we had to pass legislation, it would take years," Grassley said.  "As we've seen, the legislative process did take years, but these farmers who were wronged by our own federal government agency will now, once President Obama signs the bill, finally be able to plead their case in front of a neutral party and be judged on the merits."

Grassley led the effort to ensure fair treatment for African American farmers who were denied the opportunity have their case heard for the Pigford v. Glickman settlement, which ended a discrimination lawsuit between African American farmers and the U.S. Department of Agriculture.

Approximately 75,000 black farmers filed their claims of discrimination through the Pigford consent decree process past the deadline for their claims to be evaluated on the merits.  As a result, thousands of victims of discrimination continue to be denied an opportunity even to have their claims heard.

Grassley worked to put in place a process where these African American farmers can have the opportunity to plead their case based on the merits.  He introduced legislation in 2007 and pressed for it to be included in the 2008 farm bill.

The Pigford II settlement includes several substantial changes from Pigford I in order to better fight fraud.  Changes have been made to the settlement agreement that will enhance the Department's ability to fight fraud including requiring adjudicators to be a truly neutral party; allowing that neutral adjudicator to ask the claimant for additional documentation if he or she suspects any fraud; requiring the claimants' attorneys to certify that there is evidentiary support for the claims; and requiring the Office of Inspector General and the Government Accountability Office to evaluate the Department's internal controls and audit the process in adjudicating the claims.

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WASHINGTON -- Sen. Chuck Grassley and Sen. Herb Kohl are asking the federal government to move forward in implementing new physician payment sunshine provisions.  The senators said some drug and medical device makers are preparing to meet the new requirements but in the absence of clear guidance from the federal government, are preparing payment data in non-uniform ways, causing the material to be difficult for the public to use.

Kohl is chairman of the Senate Special Committee on Aging and Grassley is ranking member of the Senate Committee on Finance.  They sponsored the Physician Payment Sunshine Act, which became law as part of the health care overhaul enacted this year.  The new provisions require drug and medical device manufacturers to disclose to the Department of Health and Human Services anything of value given to physicians, such as payments, gifts, honoraria or travel above certain minimum thresholds.  The goal is to inform consumers in case they want to consider the role such payments or gifts play in the provision of medical care.  The senators said the information will be collected in 2012 but some companies are preparing now, and greater guidance from the agency would help the utility of the information for the public.

The text of the senators' letter is available here.

Friday, November 05, 2010

Sen. Chuck Grassley, ranking member of the Finance Committee, with jurisdiction over key federal health care programs, made the following comment on a news report that health care costs will go up for AARP employees.

"AARP supported a partisan health care overhaul that cut Medicare by almost $500 billion. That will result in less choice, fewer benefits and decreased access to care for millions of its members. But now we hear that AARP's members aren't the only ones who will bear the brunt of the new health care law. Like companies across the country, AARP is shifting more costs onto employees in reaction to the health care overhaul. Despite their employer's support, AARP employees are learning that the health care law is not going to address the top priority of making health care coverage less expensive.  Supporters of the law tend to have tunnel vision and focus on how it will affect narrow groups of people, rather than recognizing that most people will just end up paying more.  But the big picture is clear.  Employers and employees nationwide will pay more for health care because of the new law."

A news article from the Associated Press follows.

Citing health overhaul, AARP hikes employee costs

By RICARDO ALONSO-ZALDIVAR, Associated Press Ricardo Alonso-zaldivar, Associated Press 2 hrs 52 mins ago

WASHINGTON - AARP's endorsement helped secure passage of President Barack Obama's health care overhaul. Now the seniors' lobby is telling its employees their insurance costs will rise partly as a result of the law.

In an e-mail to employees, AARP says health care premiums will increase by 8 percent to 13 percent next year because of rapidly rising medical costs.

And AARP adds that it's changing copayments and deductibles to avoid a 40 percent tax on high-cost health plans that takes effect in 2018 under the law. Aerospace giant Boeing also has cited the tax in asking its workers to pay more. Shifting costs to employees lowers the value of a health care plan and acts like an escape hatch from the tax.

"Most plan co-pays and deductibles have been modified," Jennifer Hodges, AARP's director of compensation and benefits, wrote employees in an Oct. 25 e-mail. "Plan value changes were necessary not only from a cost management standpoint but also to ensure that AARP's plans fall below the threshold for high-cost group plans under health care reform."

AARP officials said medical inflation is the main reason employee costs will be going up. The health care law is "a small part," said David Certner, legislative affairs director.

Although the tax on so-called "Cadillac" health care plans doesn't take effect for years, employers are already beginning to assess their potential exposure because it is hefty: at 40 percent of the value above $10,200 for individual coverage and $27,500 for a family plan. The tax is intended as a savings measure, to prod employers and workers into more cost-efficient plans.

Certner said AARP's plans are currently under the threshold for the tax. "We intend to stay below those thresholds," he said. "It's not in anybody's interest to move above those thresholds, not the employees' nor the employer's."

AARP officials say the organization's public policy recommendations are made independently of other considerations, including its range of business ventures, from travel, to insurance, to publishing.

The 40 million-strong AARP represents people 50 and older, including retirees on Medicare and Social Security. Its endorsement of health care overhaul came at a critical time last year, days before a close vote on the House floor.

"The impact on AARP employees is not a factor at all in our policy making, which is directed at the impact on our membership and on all older Americans," said Certner.

About 4,500 people are covered by AARP's plans, including employees, dependents and retirees.

"We supported the (health care) package because it contained incredibly important protections for our younger members, who often have problems getting access to care," said spokesman Jim Dau. "And because it helps our older members in Medicare with important new benefits."

Starting in 2014, the overhaul law prohibits insurance companies from turning down people with medical problems, and limits what they can charge older customers. It gradually closes the coverage gap in the Medicare prescription benefit, and improves coverage for preventive care.

The Obama administration says changes required by the law so far have only had a minimal, single-digit impact on premiums. Many benefits experts agree with that assessment but point out that the increases come on top of untamed health care inflation.

AARP warned its employees that more cost-shifting could be in store. "AARP intends to make similar changes, as necessary, in the future to avoid the (health plan) tax," said Hodges' e-mail.

Current forecasts are that the overhaul will only have a small impact on job-based coverage, slightly reducing the number of people who would otherwise be covered by employer plans. Those workers would have access to taxpayer-subsidized coverage through new insurance markets.

 

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Wednesday, November 03, 2010

Sen. Chuck Grassley made the following comment on the terms of GM's initial public offering of stock that were made public today.  Grassley is concerned about whether the taxpayers will be repaid for rescuing the automaker.

"The inspector general confirmed for me weeks ago that the GM initial public offering would need to clear a high bar to repay taxpayers.  The inspector general said GM stock would need to sell for an average of $133.78 a share to fully recoup the tax dollars spent to rescue the automaker.   The highest share price the former GM ever reached was $94.63 in 2000.  Today's filing says at least 365 million shares will be offered at a projected $26 to $29 each.  Short of a miracle, the initial public offering won't repay the taxpayers.  The onus is on the Treasury Department to come up with a plan to make sure taxpayers get their money in full."

A press release describing what Grassley learned from the inspector general follows.

For Immediate Release

Wednesday, September 22, 2010

Grassley Finds Out What's Needed to Make Taxpayers Whole in GM Bailout

WASHINGTON - Continuing to look out for taxpayers in the bailout of General Motors, Senator Chuck Grassley has secured an official determination that the U.S. government needs to sell all its stock in GM at an average price of $133.78 a share to fully recoup the tax dollars spent to rescue the automaker.

The highest share price the former GM ever reached was $94.63 in 2000.

The latest assessment comes from Neil Barofsky, the Special Inspector General for TARP, in response to a request from Grassley last month.  Grassley worked to establish and empower this inspector general in order to hold the government accountable for the use of bailout dollars.

"I didn't support the government bailout of the automakers, and I'll continue to work to see taxpayers repaid and to hold the Treasury Department accountable for the sale of the taxpayers' share of GM," Grassley said.

Earlier this year, the Iowa senator exposed the misleading claim by the Treasury Department and GM that the car company had "paid back" its $6.7 billion taxpayer-funded loan "in full, with interest, ahead of schedule.  In fact, the loan had been repaid by another taxpayer account.  Because most of the government's emergency loan to GM was converted to shares of stock during bankruptcy, that money can only be recovered if the government can sell its shares of GM at significantly higher prices than it is currently estimated to be worth.

Click to read Grassley's letter Barofsky and Barofsky's reply to Grassley.

Grassley Presses the Administration to Fix Lax Oversight of Tax Dollars at Public Housing Agencies

WASHINGTON - Sen. Chuck Grassley of Iowa is pressing the federal government to fix its lax oversight over the billions of taxpayer dollars given to public housing agencies.  Grassley's review and media reports have exposed millions of dollars being paid to local agencies that the Department of Housing and Urban Development (HUD) has classified as "high risk," salaries for some housing agency directors that exceed the governor's salary in their state, and sexual predators residing in public housing.

"This tax money is supposed to provide housing that's safe, decent and sanitary," Grassley said.  "So far, the federal government has failed to protect its tenants and the American taxpayer.  The Department of Housing and Urban Development appears to have lost sight of its mission and ultimately the tenants and the communities suffer the consequences.  It's an understatement that too many public housing authorities operate poorly.  It's up to the Administration to require improvements and hold the authorities accountable to taxpayers and residents."

Over the past year, Grassley has conducted oversight of federal stimulus spending, including that given to public housing authorities.  HUD has received approximately $14 billion in total stimulus funding, including approximately $4 billion to the public housing authorities.  HUD has obligated more than $94 million in stimulus funding to housing authorities that HUD classified as "high risk."

This week, Grassley wrote to HUD, expressing concern about high salaries and allowances being paid to some executive directors of public housing authorities and sexual predators residing in public housing.

The text of his letters is available here and here.

Grassley Releases Report on Lack of Inspector General Oversight

at the International Trade Commission

WASHINGTON - Sen. Chuck Grassley of Iowa today released a new Government Accountability Office (GAO) report on the lack of Inspector General (IG) oversight at the International Trade Commission (ITC).  Although, the Inspector General Act requires that agencies appoint an IG to detect waste, fraud, and abuse, the ITC failed to fill the position for more than four years.  Instead, the GAO report found, ITC relied on "acting" and "temporary" appointments for most of the period between November 2005 and December 2009.  For 17 months during that time, ITC operated with neither an acting nor a temporary IG, according to the GAO report.

"Agencies need to understand that Inspector General oversight is not optional," Grassley said.  "The law requires that they have an IG on the job and that the IG be given the resources and access to information necessary to do the job.  The ITC needs to finish implementing the GAO's recommendations for corrective action as soon as possible to ensure that there is adequate oversight of the agency from now on."

GAO also found that the ITC failed to support the temporary and acting IGs with policies and procedures to ensure access to agency records.  The ITC failed to provide notice and coordination with the temporary IG on a criminal referral to the Justice Department.  And, the ITC kept the IG's budget flat while its own budget increased by 23 percent.

Grassley is ranking member of the Committee on Finance, with jurisdiction over international trade, and a long-time advocate for inspectors general.

The GAO report on the ITC is available here.

BAUCUS, GRASSLEY, STARK RELEASE GAO REPORT  SHOWING NEED FOR TRANSPARENCY IN NURSING HOME OWNERSHIP
Report Highlights Need for Better Accountability and Transparency
in Private Investment Firm Ownership of Nursing Homes

Washington, DC - Senate Finance Committee Chairman Max Baucus (D-Mont.), Ranking Member Chuck Grassley (R-Iowa), and House Ways and Means Subcommittee on Health Chairman Pete Stark (D-CA) released a new Government Accountability Office (GAO) report today on the need for greater transparency regarding companies' ownership of nursing homes.  Baucus, Grassley and Stark requested the report, titled "Complexity of Private Investment Purchases Demonstrates Need for CMS to Improve the Usability and Completeness of Ownership Data."  The report highlights the increasing rate at which private investment firms are purchasing nursing homes and the lack of transparency in nursing home ownership arrangements that often results.  The lack of clear ownership information makes it difficult for consumers and regulators to know who owns the nursing home and who bears responsibility for decision-making affecting quality of care and to hold those responsible parties accountable.  Baucus, Grassley and Stark have long worked to improve the accountability of nursing home owners across the country in an effort to protect Medicare and Medicaid beneficiaries and taxpayer dollars.  The lawmakers have requested a subsequent GAO report that will evaluate the relationship between these corporate structures and the quality of care provided to nursing home residents.

"Nursing home residents and their families deserve to know the full story about who is ultimately responsible for their care," said Baucus.  "Federal health care officials need full and detailed information so they can properly oversee these nursing homes and hold the correct parties accountable for keeping patients safe and well-cared for.  The new health reform law, the Affordable Care Act, works to address some of the problems highlighted in today's report by significantly increasing transparency and shedding light on the ownership and safety of nursing homes.  We will continue to keep a close eye on the implementation of these transparency measures to ensure we have a clear picture of who is accountable for the quality of care in nursing homes."

"I've been fighting for greater transparency and accountability for nursing home residents and their families for more than decade," Grassley said.  "This report provides further evidence of what we already knew - that the federal government needs to do a better job giving nursing home residents -- including Medicare beneficiaries - complete, accurate and timely information so they can make the right choices when choosing a nursing home.  I'll continue my vigorous oversight to hold the system accountable.  We owe that to nursing home residents."

"This GAO report found that a handful of private equity firms have been buying up nursing homes over the past decade - leaving seniors and their loved ones in the dark about who is making the decisions about their care," said Stark.  "New disclosure requirements in the health reform law will shed light on who owns nursing homes, who is making care decisions, and how these facilities are being run.  I intend to monitor CMS's progress in implementing the law, and look forward to a future report on the relationship between ownership and quality of care."

The GAO report details how private investment firms acquired 1,876 nursing homes from 1998 to 2008, with ten large firms accounting for 89 percent of the purchases. According to the report, then-current law did not require sufficient disclosure of information on multi-home chains and led to a lack of accountability across the industry.  The three lawmakers noted that provisions enacted into law in the Patient Protection and Affordable Care Act provide CMS an opportunity to address these shortcomings and may be the solution to problems identified in the GAO report.  Specifically, the Affordable Care Act requires nursing homes to provide information to state and federal health officials about the facility's ownership, governing body and organizational structure.  The new law also increases transparency of information related to nursing home staffing, certifications, complaints, criminal violations and expenditures, including wages and benefits for staff.  This increased transparency will help improve patient care by making clear who is ultimately responsible for keeping patients safe and well cared for.    The three lawmakers will be monitoring CMS's efforts to improve transparency as required by the Patient Protection and Affordable Care Act and as recommended in the GAO report.  Today's GAO report is available here.

 

 

# # #

 

Sen. Chuck Grassley, ranking member of the Committee on Finance, today made the following comment on a report released from the Government Accountability Office, "Tax Debt Collection: IRS Could Improve Future Studies by Establishing Appropriate Guidance."  The report is available here.  Grassley has written to the IRS regarding private contractors for debt collection. The March 5, 2009, IRS response to Grassley is available here.  The May 6, 2009, IRS response to Grassley is available here.

"According to this report, the IRS used a flawed study to justify ending its contracts with private agencies to collect owed taxes that the IRS wasn't collecting on its own.  The IRS knew the study was flawed because the GAO told the IRS how to do the study.  But the IRS didn't implement the GAO's recommendations to fix the study, even though it agreed with them.  The IRS used the results from the defective cost-effectiveness study to defend its decision to terminate the use of private collection agencies, even though that wasn't the primary purpose of the study.

"Union advocates, including members of Congress, Obama administration officials and the taxpayer advocate, tried to tell the public that IRS employees could collect the tax debts cheaper and better than private employees.  Yet, the IRS' own information shows that the fledgling pilot program was returning money to the Treasury and that private employees' quality ratings were consistently higher than that of IRS employees.  Union supporters' successful disinformation campaign ultimately hurts other taxpayers, as private agencies were collecting dollars that the IRS wasn't and isn't going to collect anyway."

"The IRS used a poor study to secure a task it said it could perform but hasn't.   As of the most recent fiscal year, unpaid tax debts equal $328.1 billion. Only $120.4 billion of that amount is deemed potentially collectible and IRS is not actively pursuing $27.4 billion that it says is collectible. These are significant increases from when GAO first started tracking these numbers.  So, not only has the IRS made no progress in reducing unpaid tax debt, but also we're worse off every year."

"Private collection agencies were supposed to help the IRS collect debts that it couldn't or wouldn't collect on its own. And, despite the IRS' announcement last year that it would be dedicating IRS resources to working cases that the private agencies would have worked, GAO tells us today that that isn't the case. At the same time, the number of hours IRS employees dedicate to union activity at the office, on the taxpayer's dime, is significant.  Those IRS employees should spend more time doing the government's work and less time protecting their jobs."

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