Grassley Concerned with Attempts to Further Weaken Visa Applicant Interview Rules
WASHINGTON – Senate Judiciary Committee Chairman Chuck Grassley is pressing the Obama administration to explain proposals that further weaken the law regarding interviews for foreign nationals applying for visas to enter the United States.
In a letter to Secretary of State John Kerry, Grassley wrote, “Given the heightened national security concerns around the world, I have questions regarding the Department’s intent to water down once again rules pertaining to interviews of visa applicants.”
The interview requirements were put in place following the attacks of September 11, 2001. The law helped ensure that, with very few exceptions, all persons between the ages of 14 and 79 applying for visas to the United States are interviewed in person by a consular officer.
Former Secretary of State Hillary Clinton took the first steps to undermine the law by abusing a narrow exemption allowed in the law to designate entire categories of visa applicants to be exempt from the visa interview requirement. Then-Secretary Clinton justified the expanded use of interview waivers by claiming they satisfied the requirement that the exemptions be “in the national interest of the United States.”
The text of Grassley’s letter is here. The letter can also be found on Grassley’s website.
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Patient satisfaction surveys, opioid abuse; Grassley, Feinstein, Ayotte seek progress report on federal review
Grassley, Feinstein, Ayotte Seek Progress Report on Federal Review of Any Link Between Medicare Patient Surveys, Opioid Abuse
WASHINGTON – Sen. Chuck Grassley of Iowa, Sen. Dianne Feinstein of California and Sen. Kelly Ayotte of New Hampshire today sought a progress report on a federal review exploring whether patient satisfaction surveys linked to higher Medicare payments encourage opioid pain reliever abuse, already a serious national epidemic. The senators also sought an explanation of why the federal government initially appeared to reject the need for such a review, then reversed itself and agreed to conduct one.
“We applaud HHS (Department of Health and Human Services) for undertaking this review, and request a report on its progress,” the senators wrote to Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services (CMS). “Specifically, we are interested in learning what, if any, actions CMS has taken to date to alter the … survey to reflect the findings of the review. In addition, we request an explanation as to why HHS decided to conduct the review after (CMS) Administrator (Marilyn) Tavenner’s response appeared to reject the need for it. Given the urgency of the opioid abuse epidemic and the need to find solutions to this crisis, we request that you respond no later than February 10, 2016.”
In October 2015, the Administration announced that HHS would undertake a review of how pain management is evaluated by patient satisfaction surveys used by hospitals, including a review of how the questions these surveys use to assess pain management may affect pain management practices and opioid prescribing.
This decision came after the then-CMS administrator downplayed the potential problem in response to a June 2014 letter from Grassley and Feinstein.
In their 2014 letter, Grassley and Feinstein said some practitioners have reported that they have prescribed opioids for the specific purpose of improving their patient satisfaction survey scores. The senators cited the examples of a South Carolina doctor who reportedly cited his low patient satisfaction scores as the reason why he prescribed Dilaudid, a powerful pain killer commonly used to treat cancer pain, to treat a patient’s toothache. One hospital with low satisfaction scores even went so far as to offer Vicodin “goody bags” to patients discharged from its emergency room in an effort to improve its scores.
In today’s letter, Grassley, Feinstein and Ayotte wrote, “The epidemic of abuse of prescription opioid pain relievers (OPRs) is worsening. New data from the Centers for Disease Control and Prevention (CDC) indicate that nearly 19,000 people died as a result of an OPR overdose in 2014, an increase of 16% from 2013. Additionally, over 10,000 people died from heroin overdoses in 2014, a 28% increase from 2013. In addressing this epidemic, all possible factors that have caused or contributed to it must be closely examined.”
Grassley is chairman of the Judiciary Committee and the Senate Caucus on International Narcotics Control. Feinstein is co-chairman of the Caucus on International Narcotics Control. Ayotte is leading multiple pieces of legislation to address the opioid abuse epidemic, which has hit New Hampshire especially hard.
The Grassley-Feinstein-Ayotte letter is available here.
The text of the Grassley-Feinstein June 2014 letter to CMS is available here.
CMS’ response is available here.
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