KOHL, GRASSLEY: STOPPING "PAY-FOR-DELAY" DEALS ESSENTIAL TO LOWERING RX DRUG COSTS

Bipartisan effort to speed less expensive generic prescription drugs to market

WASHINGTON, D.C. - U.S. Senators Herb Kohl and Chuck Grassley have reintroduced legislation limiting pay-for-delay settlements used to keep lower-cost generic drugs off pharmacy shelves.  Under these pay-off agreements, brand name drug companies settle patent disputes by paying the generic drug manufacturer in exchange for a promise that it will keep its generic version of the drug off the market. Kohl and Grassley's "Preserve Access to Affordable Generics Act" will stop this anti-consumer practice by presuming these deals illegal, and giving the FTC the authority to stop them.

"Generic drugs save consumers and the federal government money, to the tune of billions of dollars a year. But in order to freeze out competition and delay entry of low cost generic drugs for consumers, brand-name drug companies pay-off generic manufactures to keep their products off the market.  It is past time to put an end to these backroom deals and pass this bipartisan legislation," Kohl said.

"These agreements between generic and brand name pharmaceutical manufacturers are only serving to line the pockets of the companies.  When people across the country are having a hard time making ends meet, this wheeling and dealing simply delays the entry of lower priced medicines into the marketplace, leaving consumers on the short end of the stick," Grassley said.

A compromise version of this legislation passed the Judiciary Committee in late 2009 and was included in the Financial Services and General Government Appropriations bill reported out of the Senate Appropriations Committee last year. Final passage of the bill stalled when the House and Senate failed to agree on an Omnibus Appropriations package last month.

The Federal Trade Commission has estimated that stopping these types of settlement agreements would save consumers at least $35 billion over the next ten years, and provide significant cost savings in the amount of $12 billion over ten years for the federal government, which pays approximately one-third of all prescription drug costs. A recent CBO report estimates that the federal government could save $2.68 billion over ten years, should this bill become law

Despite the FTC's opposition to pay-for-delay patent settlements, two 2005 appellate court decisions have permitted these payoffs.  In the two years after these two decisions, the FTC has found nearly half of all patent settlements involved payments from the brand name from the generic manufacturer in return for an agreement by the generic to keep its drug off the market.  According to a study by Pharmaceutical Care Management Association (PCMA), health plans and consumers could save $26.4 billion over the next five years by using the generic versions of 14 popular drugs that are scheduled to lose their patent protections before 2010.

Brand-name drug companies and generic manufacturers routinely enter into settlement agreements to end drug patent litigation, but until 2005, none of them included pay-for-delay provisions. From 2000 to 2004, companies assumed such agreements violated antitrust law.  But in 2005, following three courts of appeals decisions that prevented the FTC from taking action on behalf of consumers, pay-for-delay settlements became commonplace. In the four years following these court decisions 63 out of 194 patent settlements had provisions in which the brand name drug company made payments to the generic manufacturer in exchange for the generic manufacturer agreeing to delay entry of generic competition.  In 2009, there were a record 19 pay-for-delay settlement agreements that kept generics off the market.

Last Congress, Kohl served as chairman of the Senate Judiciary Subcommittee on Antitrust, Competition Policy, and Consumer Rights. Grassley is the incoming Ranking Member of the Judiciary Committee.

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...Legislation Bolsters Economy Without Adding To The Deficit

WASHINGTON (Thursday, Jan. 20, 2011) - A bipartisan group of Senators will introduce patent reform legislation when the Senate returns to session next week, Senate Judiciary Committee Members Patrick Leahy (D-Vt.), Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa) announced Thursday.  The Judiciary Committee has worked to advance patent reform legislation since 2006.  Leahy is the Chairman of the Senate Judiciary Committee, and has included the Patent Reform Act of 2011 on the Committee's first executive business meeting agenda.  Hatch is the Committee's senior Republican member and a former Chairman, and Grassley is the panel's incoming Ranking Republican.

The Patent Reform Act of 2011, which will be introduced on Jan. 25, mirrors key improvements to the long-pending legislation that were announced last March as part of an compromise reached by the bill's lead sponsors with then-Judiciary Committee Ranking Member Jeff Sessions (R-Ala.), Senator Jon Kyl (R-Ariz.), and others.  The legislation will make the first significant changes to the nation's patent system in nearly 60 years, creating jobs without adding to the nation's deficit.  The legislation remains based on the original version introduced in the 109th Congress by House Judiciary Committee Chairman Lamar Smith (R-Texas) and Congressman Howard Berman (D-Calif.).

"Patent reform is a commonsense, bipartisan effort to protect jobs and bolster the economy," said Leahy.  "The Patent Reform Act of 2011 is the product of years of careful consideration and compromise.  Promoting economic growth continues to be a top priority for both Democrats and Republicans, and patent reform is part of that effort.  This has always been a bipartisan, bicameral effort, and I look forward to working with Senator Hatch, Senator Grassley and others and with Chairman Smith in the House to enact meaningful reform this year.  This will be the first piece of legislation considered by the Judiciary Committee this year, and I hope the Senate will act promptly on this job-creating bill.  Action by Congress can no longer be delayed."

"Reforming our patent system is a critical priority whose time has more than come.  It is essential to growing our economy, creating jobs and promoting innovation in our nation," said Hatch.  "Working alongside Senate Judiciary Chairman Leahy, Ranking Member Grassley and House Judiciary Committee Chairman Lamar Smith, I know we can move this critical legislation forward."

"The United States is the most innovative country in the world," said Grassley.  "An efficient patent system is a necessary component to continuing and enhancing this job creating ingenuity and entrepreneurship. I look forward to working with Chairman Leahy and Senator Hatch to move this important legislation forward."

The Patent Reform Act makes changes to first-window post-grant review, inter partes review, willfulness, interlocutory appeals, Patent and Trademark Office funding, and supplemental examinations.  The legislation will also transition the nation's patent system to a first-inventor-to-file system and will provide certainty in damages calculations.  The legislation will also include important provisions to improve patent quality.

The compromise legislation on which the patent Reform Act of 2011 is based was supported by the Obama administration and by industries and stakeholders, including the National Association of Manufacturers, the United Steelworkers, the National Venture Capital Association, the American Association of Universities, and companies representing all sectors of the patent community who have been urging action on patent reform proposals for years.

This will be the fourth consecutive Congress in which comprehensive patent reform legislation has been introduced.  The Senate Judiciary Committee has held eight hearings in the last three Congresses examining the need for patent reform.  The Senate Judiciary Committee approved patent reform legislation in 2009.  That bill was cosponsored by 15 Senators.  In September, 25 Senators joined together to urge Senate Majority Leader Harry Reid (D-Nev.) to schedule floor time to consider the legislation.

The text of the Patent Reform Act of 2011 is available online.

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WASHINGTON - Senator Chuck Grassley today announced that Tyler John Husar of Muscatine has been selected to attend the United States Naval Academy in Annapolis, Maryland.  Husar is a student at Muscatine High School, and is the son of Cindy L. Husar.

"The U.S. service academies offer students an excellent education and an opportunity to serve their country at the highest level.  I'm proud that another young Iowan is meeting the challenge at one of these great institutions," Grassley said.  "The Naval Academy accepts only the best and brightest, and Tyler will represent Iowa well on campus."

Each year, Grassley nominates young Iowans for the U.S. Military Academy in West Point, NY, the U.S. Air Force Academy in Colorado Springs, CO, the U.S. Naval Academy in Annapolis, MD, and the U.S. Merchant Marine Academy in King's Point, NY.  Information on the application process is available on Grassley's website at http://grassley.senate.gov/info/academy_nominations.cfm.  Applications for the 2012 school year are due on October 1, 2011.

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January 12, 2011

Sen. Chuck Grassley of Iowa today responded to comments from two senators that a tariff on ethanol imports likely violates international trade rules, as Brazil argues in opposition to U.S. ethanol policy.  Grassley comment:

"This isn't a question for debate.  The highest authority on U.S. trade policy said more than two years ago that the U.S. ethanol tariff is clearly permitted under World Trade Organization rules.  Besides, the United States already provides generous duty-free access to ethanol from Brazil and other countries imported under the Caribbean Basin Initiative, but the CBI cap has never once been filled.  In fact, as of December 20, Brazil and other countries filled the cap for 2010 less than 1 percent."

A letter from then-United States Trade Representative Susan Schwab to Grassley concluding that the U.S. ethanol tariff is WTO-compliant is available here.  A letter from Grassley to Schwab is available here.

January 5, 2011                                                                       

Washington, D.C. - As the 112th Congress gavels in this afternoon, the bipartisan coalition fighting to end secret holds has introduced a resolution to eliminate the undemocratic practice and move the Senate closer to an up-or-down vote on their proposal.  U.S. Senators Ron Wyden (D-Ore.), Chuck Grassley (R-Iowa), Claire McCaskill (D-Mo.), and Susan Collins (R-Maine) introduced the Secret Holds Reform Resolution that forces all holds to be disclosed to the public after one day, eliminating the ability of one senator to hijack the legislative process without being held accountable.

"The first day of the new congress is the perfect time to begin making the Senate fairer and more accountable to the public," Wyden said. "For too long, secret holds have given one senator the power to grind the legislative process to a halt without any accountability. The bipartisan group of senators standing up against this practice is growing. The tide of reform is moving with us and the Senate must be able to take an up-or-down vote on the merits of secret holds to show who the allies of transparency are and who are the allies of obstruction."

"Holds protect the rights of individual senators, but with this power must come public accountability.  Lack of transparency in the public policy process exacerbates cynicism and distrust.  Senator Wyden and I have advanced reforms to make holds public for more than 10 years, only to have them undermined by both parties.  If a senator has a legitimate reason to object to proceeding to a bill or nominee, then he or she ought to have the guts to do so publicly.  It's time for each of us to stand up and be accountable to our constituents and our colleagues for any hold placed," Grassley said.

"The American people don't trust Washington, and secrecy is one of the reasons," McCaskill said. "If someone is opposed to legislation or a nominee, they should be willing to say it publically.  We're here to do the people's business and they deserve this basic level of transparency."

"We have a responsibility to assure the American people that the decisions we make are decisions of integrity, in which their interests are put first.  Placing a hold on a nominee is a legitimate use of Senate rules and can be used to provide additional time to seek answers to important questions and address concerns.  If Members of Congress are acting in the best interests of their constituents, then they should not hesitate to make public their reasons for placing a particular hold," said Collins.

Wyden and Grassley have spent more than a decade working to eliminate secret holds and have introduced bills and amendments and secured pledges from both caucuses to no longer honor the practice. However, an amendment to an appropriations bill in 1997 was removed in conference with the House of Representatives and though a 2006 Wyden-Grassley amendment requiring that secret holds be publically disclosed after three legislative days passed the Senate in 2006, it was altered as part of the 2007 "Honest Leadership and Open Government Act" to require disclosure after six days only after a nomination or piece of legislation is called up on the floor.  Senator McCaskill brought renewed momentum to the effort last year by drawing attention to the continued abuse of secret holds and authored a letter signed by 68 senators calling for the elimination of the practice.

The three joined forces last summer to introduce the Secret Holds Elimination Act that formed the basis of the current resolution. The resolution will require that all holds on legislation and nominees be submitted in writing and automatically printed in the Congressional Record after one legislative day, whether the bill or nomination has been brought up for floor consideration or not. The latter provision will eliminate the all-too-common practice of secret holds being used to indefinitely prevent bills from reaching the Senate floor.

Here is the text of Grassley's statement delivered on the Senate floor this afternoon.

Madam President, my colleagues as well as any of the public watching the debate today knows that there's a great partisan divide thus far.  Senator Wyden has already referred to the motion that he and I are putting before the Senate, and Senator Wyden being the Democrat and my being a Republican, and we're joined also by Senator McCaskill, the presiding officer right now, as well as Senator Collins in this effort, it is the only bipartisan issue before the Senate this particular day.  I emphasize that because I think the public ought to know that not everything in the Senate is partisan.

Senator Wyden and I have been chipping away at the informal backroom process known as "secret hold" in the Senate.  We've been working on this for well over ten years.  So it shouldn't surprise anyone that we're back again at the start of another Congress joined as I said by Senator McCaskill of Missouri who was very helpful in our pushing this issue to the forefront at the end of the last congress.  As I said, I'm also pleased that we have Senator Collins on board again.

There's been a lot of talk lately about the possibility of far reaching reforms to how the Senate does business that have been hastily conceived and could shift the traditional balance between the rights of the majority and rights of the minority parties. Now, in contrast, our resolution by Senator Wyden and this Senator is neither of those two things.  In other words, it does not shift any balance between the majority and the minority.

This resolution is a well-thought-out, bipartisan reform effort that has been the subject of two committee hearings and numerous careful revisions over several years.  In no way does it alter the balance of power between the minority and majority parties, nor does it change any rights of any individual senator.  This is simply about transparency, and with transparency I think you get a great deal of accountability.

I want to be very clear that I fully support the fundamental right of any individual Senator to withhold his consent when unanimous consent is requested.  In the old days, when senators conducted much of their daily business from their desk on the Senate floor and were on the Senate floor for most of the day, it was quite a simple matter for any Senator at that time to stand up and say, "I object" when necessary, if they really objected to a unanimous consent request.  And that was it. That stopped it.

Now since most senators spend most of their time off the Senate floor because of the obligations for committee hearings, the obligations for meeting with constituents, and a lot of other obligations that we have, we now tend to rely upon our Majority Leader, in the case of the Democrats, or the Minority Leader in the case of the Republicans, to protect our rights and privileges by asking those leaders or their substitutes to object on our behalf.

Just as any Senator has the right to stand up on the Senate floor and publicly say "I object," it is perfectly legitimate to ask another Senator to object on our behalf if he cannot make it to the floor when unanimous consent is requested.  By the same token, senators have no inherent right to have others object on their behalf while at the same time keeping their identity secret, thus shielding their legislative actions from the public, because that's not transparency, and that's obviously not being accountable.

So, what I object to is not the use of the word "holds" or the process of holding up something in the Senate, but I object to what is called secret holds.   So the adjective "secret" is what we're fighting here.  If a senate then has a legitimate reason to object to proceedings to a bill or nominee, then he or she ought to have the guts to do so publicly.  A Senator may object because he does not agree to the substance of a bill and, therefore, cannot in good conscience grant consent or because a Senator has not had adequate opportunity to review the matter at hand.  Regardless, we should have no fear of being held accountable by our constituents if we're acting in their interests, as we're elected to do.

I have practiced publicly announcing my holds for many, many years, and it hasn't hurt one bit.  In fact, some of the senators that are most conscientious about protecting their prerogatives to review legislation before granting consent to its consideration or passage are also quite public about it.  In short, there is no legitimate reason for any Senator to ever have to, if they place a hold to have that hold be secret.

So, how does our proposal achieve transparency and the resultant accountability?  In our proposed standing order for the Majority Leader or Minority Leader to recognize a hold, the Senator placing the hold must get a statement in the record within one session day and must give permission to their leader at the time they place the hold to object in their name, not in the name of the leader.  Since the leader will automatically have permission to name the Senator on whose behalf they're objecting, there will no longer be any expectation or pressure on the leader to keep the hold secret.  Further, if a Senator objects to a unanimous consent request and does not name another Senator as having the objection, then the objecting Senator will be listed as having the hold.  This will end entirely, once and for all, the situation where one Senator objects but is able to remain very, very coy about whether it is their own objection or some unnamed Senator.  All objections will have to be owned up to.

Again, our proposal protects the rights of individual senators to withhold their consent while ensuring transparency and public accountability.  And, you know, here in the Congress as well as almost any place in the federal government, except maybe national security issues, the public's business always ought to be public, and the people who are involved in the public's business ought to stand behind their actions.  As I have repeatedly said, the Senate's business ought to be done more in the public than it is, and most of it is public.  But, this secret hold puts a mystery about things going on in Washington that hurts the credibility of the institution.  This principle of accountability and transparency, this is a principle that I think the vast majority, if not all, senators can get behind.

I think the time has come for this simple, commonsense reform.

 

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WASHINGTON - Senator Chuck Grassley has asked the Attorney General and the Secretary of Health and Human Services to account for the way their departments allocate and utilize taxpayer monies aimed at health care fraud.  In his request, Grassley expressed concern about the stagnating number of criminal prosecutions for health care fraud, despite increased federal spending to fight fraud.

"The data raises all kinds of questions," Grassley said.  "Congress has been increasing appropriations for the anti-fraud program that's jointly run by Justice and HHS.  Administration leaders promote the value of a special fraud prevention and enforcement task force known as HEAT.  The health care law enacted this year dedicates even more federal dollars to these efforts.  Yet, despite the record number of defendants, actual criminal convictions for health care fraud violations are flat resulting in a falling conviction rate."

Grassley said that if the administration is focusing on civil prosecutions of health care fraud at the expense of criminal prosecutions, the risk may be that penalties simply become part of the cost of doing business for those engaged in fraud.

Grassley also said that HEAT criminal investigations grew from 30 in fiscal 2008 to 82 in fiscal 2009, yet the total nationwide number of criminal health care fraud convictions is down.  "This raises a question of whether the focus of the HEAT initiative is redirecting resources away from overall criminal enforcement of health care laws," Grassley said.

Grassley said of even greater concern is the plummeting conviction rate for criminal health care fraud cases.  Of the 803 criminal defendants charged in fiscal 2009, only 583 were convicted or plea bargained.  That represents a 72 percent conviction rate compared to past rates that topped 90 percent.

"Statistically speaking, the data shows that despite increased cases and defendants, fewer bad guys are going to jail for ripping off Medicare and Medicaid.  I want to know why the Justice Department is having a tougher time putting people behind bars when we're giving them millions more to do the job," Grassley said.

Grassley has long worked in Congress to strengthen efforts against health care fraud.  Legislation he co-authored in 1986 empowered citizen whistleblowers to file suit on behalf of the taxpayers against those who fraudulently claim federal funds, including Medicare, Medicaid, contract payments, disaster assistance, and other benefits, subsidies, grants and loans.  The amount recovered through the False Claims Act since the 1986 update was enacted is over $27 billion, which otherwise would be lost to fraud.  The whistleblower updates are a major force against health care fraud.

In the new year, Grassley will begin serving as Ranking Member of the Committee on Judiciary.  For the last ten years, Grassley has been either Ranking Member of Chairman of the Committee on Finance, which has jurisdiction over Medicare or Medicaid.  He will continue to serve as a senior member of the Finance Committee.

Click here to read Grassley's letter, including the data and analysis.

"I voted against the Treaty because it makes the United States give up more than Russia, it's silent on the major issue of tactical nuclear weapons, and the verification mechanism is weaker than START I, which I supported in 1992.  Amendments to make corrections were shot down in order to have the Treaty finalized by an arbitrary deadline and seemingly for a political victory.  Beyond that, the prospects of a nuclear war are far greater today with Iran and North Korea, so that's where U.S. national security concerns and work should be primarily focused."

In addition, the text of his extended statement follows here.

Floor Statement of U.S. Senator Chuck Grassley

Vote Against the New START Treaty

Wednesday, December 22, 2010

Mr. President.  Before I begin my remarks on the New START treaty, I'd like to point out to my colleagues that in 2002, I voted in favor of the Moscow Treaty.  I was also one of 93 Senators who voted in favor of START I in 1992.

I recognize the importance of maintaining a positive and cooperative relationship with Russia.  The proponents of the New START treaty argue that this treaty is necessary to continue the goodwill between our countries and the much-touted "reset" in our relations.  More importantly to me, however, are the merits of the treaty itself.  The Senate should not simply ratify this treaty to appease Russia or as a signal of cooperation with them.  The treaty should be considered based on its impact on our national security and the security of our allies.

A nuclear arms control treaty can be evaluated based on the level of parity it brings to the two parties.   In this regard, I believe this treaty falls short.  The fact is, while this treaty places new limits on warheads, as well as deployed and non-deployed delivery vehicles, Russia is already below the limit on delivery vehicles.  The treaty primarily imposes new limits on the U.S., while requiring modest, if any, reductions on the Russian side.  Also alarming is that this treaty is silent on the matter of tactical nuclear weapons.  It is believed that Russia has a ten-to-one advantage over the U.S. in terms of tactical nuclear weapons.

The Administration has argued that this treaty is necessary to provide strategic stability.  However, if we're reducing our strategic weapons without regard to Russia's overwhelming advantage on tactical nuclear weapons, I question whether this reduction isn't weakening strategic stability.  It should also be mentioned that some proponents of the New START treaty were critical of the 2002 Moscow Treaty for failing to reduce Russian tactical nuclear weapons.  I believe our leverage with the Russians to begin placing meaningful limits on tactical nuclear weapons existed with this treaty.  Now, I see no clear path to negotiating reductions in tactical nuclear weapons.

Like many of my colleagues, I have serious concerns about the inclusion of references to and limitations on U.S. plans for missile defense.  I don't believe there should be a connection between strategic nuclear weapons reductions and our plans for missile defense.   I'm equally troubled that Russia issued a unilateral statement at the treaty's signing stating that the treaty "may be effective and viable only in conditions where there is no qualitative or quantitative build-up in the missile defense system capabilities of the United States of America."

It's positive that the Resolution of Ratification makes a strong statement that the treaty does not limit the deployment of U.S. missile defense systems, other than those contained in Article Five.  It also says that the Russian statement on missile defense does not impose a legal obligation on the United States.  While I would have preferred that this treaty not contain any language on missile defense, I appreciate the work of the Foreign Relations Chairman and Ranking Member to include this language in the ratification resolution.  But the fact remains, this language is simply our opinion and is non-binding.

This treaty reverses the gains made in the Moscow Treaty which de-linked offensive and defensive capabilities.  Although a modified amendment on missile defense to the resolution of ratification was agreed to today, I'm disappointed that the Senate could not agree to the amendment offered by Senator McCain which would have stricken the language in the treaty's preamble that arguably gives Russia a say on our future missile defense plans.

Finally, Mr. President, I also share the serious concerns related to the issue of verification.  It has been the subject of much debate, and deservedly so.  I agree with the sentiment that as our deployed strategic nuclear weapons are reduced, it becomes more and more critical that the remaining weapons can be relied upon.  As the number of weapons is reduced, it becomes more important that we know that the Russians are abiding by the limits of the treaty.

After reviewing the classified material presented by Senator Bond, Ranking Member of the Senate Intelligence Committee, I have serious reservations about the new verification regime contained in the treaty.  Although Former Secretary of State James Baker supports ratification of the treaty, he stated that the verification mechanism in the New START treaty "does not appear as rigorous or extensive as the one that verified the numerous and diverse treaty obligations and prohibitions under START I."

I do regret that without a treaty in place that there is no verification regime, and no U.S. inspectors monitoring Russia's nuclear arms activities.  It's important to point out, however, that the Obama Administration had the ability to extend the verification regime for five years, as provided for in START I.  But the Obama Administration failed to act.   The Administration also insisted there would be a "bridging agreement" to continue verification until the entry into force of a successor agreement.  This agreement was never completed either.

I'm deeply disappointed that in these areas of concern, the Senate is simply being asked to be a "rubber stamp" rather than fulfill our constitutional obligation to provide our advice on these important matters.  Had the advice of the Senate on these important issues been incorporated into the treaty, I believe it would have gained overwhelming bipartisan support.  Without addressing these areas in a meaningful way, I am reluctantly unable to support it.

Finance Leaders Release GAO Report Indicating Better Guidelines for Budget Planning Are Needed

Washington, DC - Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) today called for new guidelines to be set for Medicare Quality Improvement Organizations (QIOs) so the Centers for Medicare and Medicaid Services (CMS) can ensure QIO funds are spent properly.  QIOs are organizations within each state contracted by Medicare to, among other things, determine the quality of services delivered to Medicare beneficiaries through quality-of-care reviews.  Baucus and Grassley called for improved budget planning today after releasing a Government Accountability Office (GAO) report which indicated that the methods QIOs use to determine and report the total costs of quality-of-care reviews currently vary among states.  The GAO found that clearer and more specific guidelines for the budget-writing process would better ensure that Medicare dollars are being well-used to improve quality of care for seniors.

"This report demonstrates the need for a sound budget development plan that guarantees that not one dollar of the Medicare Trust Fund goes to waste," said Baucus. "Reviewing the quality of care of health care providers plays a critical role in ensuring that seniors are treated fairly and have access to high quality care.  The money we spend to ensure quality health care should make people healthier and effective budget guidelines from Medicare will certainly contribute to making sure we meet that goal."

 

"There isn't a good system for the QIOs to keep track of what they find, meaning the value of their work cannot be determined," Grassley said. "It might be that CMS is overpaying for these services.  CMS has to do a better job of tracking this work so it can pay the appropriate amount and so taxpayers get what they're paying for, which is better quality of care for Medicare beneficiaries.  Improving its oversight of Medicare contractors is something CMS needs to accomplish, and it's one of my long-time priorities."

Currently, QIOs inform CMS of the total cost of quality-of-care reviews conducted and calculate labor costs therein, but do not follow a standard set of guidelines on how to calculate or provide that information.  As a result, QIOs' reporting systems vary among states, and CMS is unable to guarantee that its three-year QIO budget is appropriate. GAO recommended that CMS create clear instructions specifying how QIOs should detail the volume and costs of their quality-of-care reviews.  Such a standard would allow CMS to develop accurate budgets for quality-of-care reviews.

CMS enters into three-year contracts with QIOs in every state to perform various reviews to help guarantee Medicare dollars are spent wisely and health care providers in each state are maintaining a high standard of care.  Quality-of-care reviews, just one of the reviews QIOs perform, gauge certain measures like the standard of treatment patients receive and Medicare providers' adherence to their patients' medication schedules.  CMS creates a budget to cover the total cost of reviews at each QIO.  The current amount budgeted for all reviews, including quality-of-care reviews, for QIOs in every state is approximately $208 million for the three-year period between 2008 through 2011.

The full text of the GAO report is available at http://www.gao.gov/new.items/d11116r.pdf.

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Washington Needs to Get on Board and Tackle Deficit Spending by U.S. Senator Chuck Grassley

Taxpayers all across America can ring in the New Year with a sigh of relief. Thanks to a bipartisan agreement brokered between the White House and Republican congressional leaders, paychecks won't automatically see higher federal tax withholdings starting January 1.

For the last two years, the 111th Congress took a wait-and-see approach about taxes, causing considerable uncertainty for businesses that make investment and hiring decisions in part based on their tax burden. Many employers stockpiled cash instead of spending money on equipment upgrades or expanding their workforces. This uncertainty did not do the economic recovery any good.

Thankfully, the results of the mid-term elections delivered a crystal clear message in November. Washington went overboard. The federal spending spree and bailout binge added an even greater burden to taxpayers already on the hook for a $13.8 trillion national debt. Interest payments alone are eating up a growing percentage of the annual federal budget, including 414 billion tax dollars in fiscal year 2010.

A myth long used by big spenders inside the Beltway to justify raising taxes may at long last be on the chopping block. Raising taxes will not slay the deficit dragon. It does not cure the deficit problem; it serves as an invitation for big spenders to spend even more. Keeping the lid on tax hikes will force lawmakers to trim spending or keep borrowing. From my senior position in the U.S. Senate, I champion ways to keep the lid on spending. In 2010, I voted to reduce federal spending by $278 billion. America simply can't afford to keep borrowing more money.

Hopefully the bipartisan tax agreement signals a fresh start for the 112th Congress and the White House to tackle the national debt. As the report by the National Commission on Fiscal Responsibility and Reform concluded:  There's no easy way out. Shared sacrifice and tough choices must be made to get America's fiscal house in order.

Right now, the first order of business is to get the American economy back on the right track. A healthy economy will create new jobs and get more people back to work. More people bringing home a paycheck means fewer families will rely on social services paid for by the government.

The tax relief signed into law is a good step in the right direction.  Here's what it does:

  • extends the lower marginal tax rates on wages and income;
  • renews 51 tax incentives tailored to trigger economic growth and employment (including tax incentives for ethanol and biodiesel);
  • exempts family estates up to $5 million from a 35 percent federal death tax;
  • indexes alternative minimum tax for inflation;
  • extends refundable tax credits, including child tax credit and college tuition deduction created in the 2001 legislation I authored as Chairman of the Finance Committee;
  • spurs business investment by allowing a 100 percent tax deduction for equipment purchases in 2011; and,
  • boosts take-home pay by approving a two-percentage payroll tax holiday for workers in 2011, on wages up to 106,800. (Multiply your annual income by .02 to see how much more you can save, spend or invest in 2011 thanks to this tax break.)

Now Washington needs to get on the same page and tackle the looming fiscal crisis. Punting the ball down the field for another two years is a reckless, unacceptable choice. The voting public gets it. Washington needs to get on board.

Tuesday, December 21, 2010

WASHINGTON - Senator Chuck Grassley today said that he has nominated outstanding young Iowans to serve in the United States service academies.

"Nominating students to the service academies gives me the opportunity to see some of the highest caliber young men and women our state has to offer.  Every year I'm impressed with these young Iowans who are interested in serving their county," Grassley said. "I'm confident that these nominees will represent our state well, and I'm happy to nominate them."

Grassley nominates several young Iowans each year for a select few spots.  Each academy then selects students based on the number of vacancies for the 2011-2012 school year. Often, because of the high quality of nominations from Iowa, several students are selected to attend each academy.

Grassley said each of the Iowa students who applied for academy nominations were exceptional and he encouraged eligible students to consider submitting applications in the future.  "The academies are some of the best options in our country for a higher education," said Grassley.

Grassley will issue announcements when appointments to the academies are offered.


Here are Grassley's nominations.


U.S. Air Force Academy
Dylan Bechen, Woodbury Central High School, Moville

Daniel Deakins, West Harrison Community School, Mondamin

Daniel Eichman, Dulwich College (Beijing), Dubuque

Brett Heithusen, Williamsburg High School, Williamsburg

Isaac Kinrade, Maquoketa High School, Maquoketa

Felix Knutson, Hubbard

Peighton MacLeod, University High School, Cedar Falls

Jesse Phillips, North Mahaska High School, New Sharon

Alec Stenzel, Valley High School, Cumming

Mackenzie VanDenBerg, West High School, Waterloo

U.S. Military Academy
Shawn Burrows, Bondurant-Farrar High School, Bondurant

Charles Godwin, Exira High School, Exira

Levi Horsley, Carroll High School, Carroll

Travis Mallo, Mason City High School, Mason City

Jedidiah McCoy, Climbing Hill

Thomas McGuire, Gilbert High School, Ames

Kalie Plasier, Randolph Macon Academy (Front Royal, VA), Sioux Center

Sean Raes, Ballard High School, Slater

Caleb Titus, Danville High School, West Burlington

Wyatt VandeVoort, MOC-Floyd Valley High School, Orange City

 

U.S. Naval Academy
Erik Bergstrom, Johnston High School, Johnston                      

Andrew Chudzik, City High School, Iowa City

Morgan Clutter, Indianola High School, Indianola

James Cox, Jefferson High School, Cedar Rapids

Mary Dougherty, Bishop Heelan High School, Sioux City

Sarah Eikenberry, Roosevelt High School, Des Moines

Andrew Foster, West High School, Waterloo

Joseph Gallet, Iowa State University, Washington High School (Cedar Rapids), Atkins

Tyler Husar, Muscatine High School, Muscatine

Knute Klinker, South O'Brien High School, Primghar

Scott Pate, Clarke Community High School, Osceola

Alex Peschang, Waverly-Shell Rock High School, Waverly

Andrew Peterman, Bettendorf High School, Bettendorf

Andrew Pick, Dowling High School, Clive

Kristin Reichert, Indianola High School, Indianola

John Russell, St. Albert High School, Council Bluffs

Conner Sprague, Wayne Community High School, Derby

Jakob Stoner, Cedar Falls High School, Cedar Falls

Colton Van't Hof, Sioux Center Community, Sioux Center

Daniel Yehieli, Cedar Falls High School, Cedar Falls

 

U.S. Merchant Marine Academy
Tobias Gassman, Ames High School, Ames

Miranda Walz, Central High School - Elkader, Elkader

 

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