Spencer Abraham

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, I yield myself such time as I may use to briefly comment on the amendment before us, and then I will yield further time to other Members on our side.

Mr. ABRAHAM. I will.

Mr. ABRAHAM. I committed time at this point to other Members. Maybe they would be able to yield at this point, but I have to, at this point, yield my time to the Senator from New Hampshire. Might I make an inquiry as to how much time we have left?

Mr. ABRAHAM. At this time I yield myself such time as I may need, and I will be very brief. Then I will yield to other Members--the Senator from New Hampshire, who has been in the chair. We have obviously been hearing a number of claims, accusations, and allegations both about the motives of the Republicans as well as the substance of the legislation before us. I know that other speakers will get into more detail in responding, but I will just point out a few things. The comments with respect to the condition of the part A trust fund are not just whimsical comments, they are inaccurate comments, and they are very important comments to America's seniors. They should know today that starting in 1996, for the first year the part A trust fund will begin to run a deficit. We are no longer talking about problems that are somewhere out in the future that we cannot visualize. We are talking about concrete problems that are going to be before us in the very immediate sense soon. Just last year we heard from the entitlement commission, a bipartisan group of Members of Congress who reported to us that at the rate of growth in entitlement spending in this country in just 15 to 20 years, entitlement spending and interest on the Federal debt alone would exceed all Federal tax collections combined. These are not problems that can be fixed by the old process of finding a few extra dollars and throwing them into the Medicare trust fund. These are problems that can only be fixed through substantive changes of the sort which we are offering here. The Medicare Program is like a ship that is badly damaged. It is leaking water. There are two ways you can deal with the problem. You can pour more water over the side and try to bail your way out, but that will not solve the problem in a long-term sense. The alternative is to repair the damage. That is what we are trying to do because we do not want to just guarantee that Medicare will be safe for an additional 1 year or 2 years. We want to change the program to make it stronger, to protect it, to preserve it well into the future. We want to give seniors the right to choose a program that is best for them, and we want to make sure that we do that in a way that is not just cover us for the next election but, rather, in a way that truly protects seniors in the long-term sense. And so at this time, I will yield the floor and grant whatever time he may need to the Senator from New Hampshire.

Mr. ABRAHAM. At this time, I yield 7 minutes to the Senator from Minnesota.

Mr. ABRAHAM. Mr. President, I yield myself as much time as I may need just to make a couple of comments on the second-degree amendment to the first-degree amendment, and then I will yield the balance of time on that point. The Senator from Iowa commented that the first-degree amendment was a good amendment, but not nearly adequate to deal with the issues of fraud and abuse in the Medicare system. I do not disagree with that point. It was not intended to be the comprehensive solution to fraud and abuse problems with Medicare. Indeed, we do not need that in my amendment because the reconciliation bill includes a whole variety of projects and sections which try to address these problems. First, the Senate Republican proposal directs the Secretary of HHS, through the inspector general, and the Attorney General to establish a joint program to coordinate Federal, State, and local law enforcement efforts to combat health care fraud and abuse. Second, our bill creates a new health care antifraud and abuse account to cover the cost of this coordinated health care antifraud and abuse program between the inspector general at HHS, the FBI, State fraud control units, and Department of Justice prosecutors. All moneys collected in the form of penalties, fines, forfeitures, and damages from health care fraud cases will be turned back over to the Medicare hospital insurance trust fund. Third, the bill establishes new health care antifraud and abuse guidelines relating to safe harbors, interpretative rulings, and special fraud alerts. For instance, under this provision, any person may request the HHS inspector general investigate and issue a special fraud alert informing the public about suspected fraudulent activities against Medicare or Medicaid. Fourth, the bill strengthens current sanctions by requiring the Secretary of HHS to exclude from receiving Medicare or Medicaid payment individuals and entities against whom there have been convictions for fraudulent activities. Fifth, we create intermediate sanctions for the Secretary of HHS to use against Medicare HMO's which fail to live up to contractual responsibilities. Civil monetary penalties range from $10,000 to $100,000. Sixth, our bill establishes a national health care fraud and abuse data collection program and requires the information collected be made available to Federal and State government agencies and health care plans. Seventh, this proposal increases the amount of civil monetary penalties for current law, adds new offenses to those subject to civil monetary penalties, and requires that all civil monetary penalties be used to reimburse the Medicare or Medicaid program and any remaining dollars be returned to the health care fraud account. Eighth, for the first time, a health care fraud section is added to the criminal code. Ninth, this measure extends the authority of State health care fraud control units by allowing the Units to investigate other Federal fraud abuses and allowing investigation and prosecution in the case of patient abuse in non-Medicaid board and care facilities. Finally, Mr. President, the 10th reason the Senate Republican bill is tough on fraud and abuse is that it will clarify existing provisions of the criminal antikickback law in the areas of discounting and managed care related to Medicare choice plans. Direct the Secretary of HHS to study the benefits of volume and combination discounts to the Medicare Program and develop regulations based on the findings of such a study. And I just conclude my statement by saying we have worked hard already in this legislation to address the areas of fraud and abuse in Medicare to try to save the taxpayers' dollars. I would just add this point. As I inspected the things that we had already done, it struck me the one missing ingredient, important missing ingredient was to provide an incentive whereby the Medicare beneficiaries themselves could help us to solve these problems in the years ahead and to provide an incentive for the Medicare beneficiaries to help us solve these problems in the twin approaches which we have outlined in our amendment. That said, at this point----

Mr. ABRAHAM. Mr. President, at this time I would like to yield 10 minutes of our remaining time to the Senator from Maine, but before I do I just want to recognize and commend the efforts of the Senator from Maine. It was Senator Cohen who last year served as the ranking minority member of the Senate Special Committee on Aging, and it was his staff that produced the document which I have read from several times tonight pertaining to investigations of the kinds of Medicare fraud and abuse which the amendment I have brought this evening tries to address. It was his fraud and abuse legislation, in fact, introduced earlier this year, which served as the basis for the antifraud and abuse provisions contained in the legislation before us. His earlier legislation had bipartisan support. Provisions in the pending legislation are tough. They are comprehensive and they are unprecedented in their effectiveness. I believe that this is the first time health care fraud and abuse provisions have been scored by the Congressional Budget Office as generating savings. In fact, according to CBO, these provisions yield over $4 billion in savings. So, I want to commend the Senator from Maine for these efforts. They are productive ones. And I applaud what he has done. And at this time I turn the floor over to him.

Mr. ABRAHAM. Mr. President, I have sent an amendment to the desk which has been read. Mr. President, the savings necessary to rescue the Medicare program from bankruptcy will not be found solely through eliminating waste, fraud and abuse. Nevertheless, I believe it is incumbent upon us to diligently pursue and root out every vestige of inefficiency in the system. Therefore, I am offering this amendment which I think will produce additional vigilance in the ballots against Medicare waste and fraud. This amendment calls on the Secretary of Health and Human Services to establish programs that enlist Medicare beneficiaries in our efforts to eliminate waste, fraud and abuse in the Medicare system. These beneficiary incentive programs, as they would be called, would come in two forms: One program would reward individuals who report fraudulent activities; the other program would reward individual beneficiaries for suggestions they make which result in greater efficiency and overall savings to the program. The Secretary of Health and Human Services would be responsible for setting up each program and for providing financial remuneration to those individuals reporting instances of tangible fraud and waste. The Senate Finance Committee's reconciliation package currently does not contain a beneficiary incentive program or provision. The amendment I offer would include in the Senate reconciliation bill language which is similar to that currently in the House proposal. It is difficult to explain to Medicare beneficiaries why dramatic changes in the program are necessary to keep it from going bankrupt when many of these same individuals have firsthand experience with waste and fraud in the system. Indeed, Mr. President, in my own State we recently had an incident where a Congressman had a constituent come to him with an overcharging of something in the vicinity of $400,000 that was made in error. Nevertheless, it has been paid. Those kind of circumstances make at least my constituents who are part of the Medicare Program frustrated, angry, and especially concerned when they hear about changes we are making in the program. They do not want to see us just address the growth issues or just the solvency issues. They also want us to address the problems they see every day with fraud, waste, and abuse in the program. That, in my judgment, has to be addressed in our bill. That is why I offered this amendment. If our efforts at Medicare reform are to succeed we must demonstrate our seriousness about ending these abuses. I believe enlisting the aid of Medicare beneficiaries, showing our resolve to combat the problem can prove to be a valuable asset in exposing and eliminating waste and fraud from the system. Just to clarify, Mr. President, my amendment authorizes the Secretary of HHS to within 3 months establish two separate programs, one which would basically be called a beneficiary incentive program designed to allow seniors to report fraud, waste and so on, and if the fraud is significant, allow the Secretary to provide a financial reward to the individual who reports it. The second program, also designed to allow Medicare beneficiaries to benefit from ideas and suggestions in improving the program, would provide Medicare beneficiaries awards for providing us with recommendations specifically to the Secretary of HHS for improvements to the Medicare Program by way of promoting greater efficiency. Once again, if the savings are significant, the Secretary of HHS may provide a financial award to the individual whose recommendation was submitted. Mr. President, we are addressing the growth of Medicare and its expense in many different ways in this legislation. I think a key component in the long-term control of those costs has to be ferreting out this abuse and waste. I believe this amendment, as part of a package of similar reform, can make a significant impact in reducing those kind of costs that stem from either inefficiencies in the program or fraud or mismanagement in the program. I am pleased to offer this amendment tonight and I urge my colleagues to support the amendment.

Mr. ABRAHAM. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. ABRAHAM. Mr. President, I inquire as to how much time is left at this point?

Mr. ABRAHAM. Mr. President, I yield 5 minutes to the Senator from Delaware.

Mr. ABRAHAM. At this point, I would like to yield 12 of our remaining minutes to the Senator from New Hampshire, to be followed by 10 minutes to the Senator from Idaho.

Mr. ABRAHAM. Sure.

Mr. ABRAHAM

Mr. ABRAHAM. I would yield myself 1 additional minute. In addition, we have an adoption credit, marriage penalty relief, student loan interest deduction, individual retirement accounts, and countless other provisions in the bill that are aimed at people in the income categories I have already referenced, primarily people making under $75,000 a year and to a large extent, approximately 85 percent of this tax cut to people making less than $100,000 a year. It is a middle-class tax cut. That is why yesterday, in describing the reconciliation bill, the Washington Post in referencing the tax sections described it as family friendly. It is family friendly to middle-class families, to people who have felt the squeeze for so many years. That is why it is part of this legislation and why we are supporting it. Mr. President, at this time I yield the remainder of our side's time to the Senator from Delaware, the chairman of the Finance Committee.

Mr. ABRAHAM. Could I inquire as to how much time is remaining?

Mr. ABRAHAM. I yield the Senator from Iowa 10 minutes.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, today I am introducing a bill to terminate U.S. agricultural price support and production adjustment programs for sugar contingent upon a GATT agreement which would eliminate export subsidies and price supports in other countries of the world. While I firmly believe that the free market should be allowed to work, it does not make sense to put our producers at a competitive disadvantage in the world subsidized market. I can't speak for the rest of the country, but Michigan sugar beet producers are some of the most efficient producers in the world, yet without a U.S. sugar program they would most likely find it impossible to compete against less efficient foreign producers who are more highly subsidized. Other countries subsidize their sugar at a level so high that they are able to dump the excess sugar on the world market at a price well below the world's cost of production. Unilateral elimination of our sugar program would put the best producers of sugar in the world at a competitive disadvantage to less efficient producers. This simply does not make sense. We cannot give up the hope that the world will have a free sugar market. Through the GATT, we have begun and will continue to work diligently toward that goal. I am hopeful that my legislation will prompt other Members of the House and Senate to contact the Administration in favor of further GATT talks that would move us closer to a free world market for agriculture. Until this occurs, however, we must carefully examine the consequences of the steps we take to reform or eliminate our support programs so that we do not put our producers in a position of weakness compared to other countries. Furthermore, we cannot simply assume other countries would follow our lead if we were to eliminate our sugar program. In fact, the result may be quite the opposite. Without a trade agreement, other countries would have greater access to the U.S. market, helping to perpetuate these foreign subsidies rather than encourage their elimination. Mr. President, I assure you that during my tenure as a Member of this body I will fight diligently on the side of free trade. Understanding the importance of global free trade in a growing world market, I will continue to work to eliminate export subsidies and other price supports worldwide so that we may eventually achieve true free trade.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, today I am introducing a bill to terminate U.S. agricultural price support and production adjustment programs for sugar contingent upon a GATT agreement which would eliminate export subsidies and price supports in other countries of the world. While I firmly believe that the free market should be allowed to work, it does not make sense to put our producers at a competitive disadvantage in the world subsidized market. I can't speak for the rest of the country, but Michigan sugar beet producers are some of the most efficient producers in the world, yet without a U.S. sugar program they would most likely find it impossible to compete against less efficient foreign producers who are more highly subsidized. Other countries subsidize their sugar at a level so high that they are able to dump the excess sugar on the world market at a price well below the world's cost of production. Unilateral elimination of our sugar program would put the best producers of sugar in the world at a competitive disadvantage to less efficient producers. This simply does not make sense. We cannot give up the hope that the world will have a free sugar market. Through the GATT, we have begun and will continue to work diligently toward that goal. I am hopeful that my legislation will prompt other Members of the House and Senate to contact the Administration in favor of further GATT talks that would move us closer to a free world market for agriculture. Until this occurs, however, we must carefully examine the consequences of the steps we take to reform or eliminate our support programs so that we do not put our producers in a position of weakness compared to other countries. Furthermore, we cannot simply assume other countries would follow our lead if we were to eliminate our sugar program. In fact, the result may be quite the opposite. Without a trade agreement, other countries would have greater access to the U.S. market, helping to perpetuate these foreign subsidies rather than encourage their elimination. Mr. President, I assure you that during my tenure as a Member of this body I will fight diligently on the side of free trade. Understanding the importance of global free trade in a growing world market, I will continue to work to eliminate export subsidies and other price supports worldwide so that we may eventually achieve true free trade.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, I am delighted to support S. 1328. I just want to address one aspect of this legislation: why the bill does not extend the temporary district judgeship in western Michigan. That judgeship is not being extended because the judges of the western district contacted the offices of members of the Judiciary Committee, including mine, and requested that it not be extended. I will admit that I was surprised to receive this request. It is, I believe, the only request I have received on behalf of any government entity to give it fewer resources. Indeed, I was so surprised I thought I should see if there was some hidden agenda behind it. Remarkably enough, however, there proved to be none. Rather, the judges in the western district were simply saying the following: ``We believe the government should be run for the benefit of the governed. We are volunteering to work longer hours and take fewer vacations with no gain to ourselves in order to live up to that obligation. We also appreciate the efforts of our senior judges, who in many cases are continuing to carry very full dockets despite being under no obligation to do so.'' ``For these reasons, we do not need this judgeship. Not filling it will thereby save the taxpayers millions of dollars. To be sure, given the size of the deficit, that will not make that much of a dent. But we believe it is our responsibility to do our part in reducing the size of the government, and the burden it places on taxpaying American citizens.'' While there is much talk of shared sacrifice, there are not very many offers to take on a greater share of it. I simply want to express my thanks, and the thanks of my fellow Michiganders, to the western district judges, for making this unusual request, to which my colleagues and I are glad to accede.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, I rise today to congratulate Dr. Sam Williams, Chairman and Chief Executive Officer of Williams International, on his winning the 1995 Medal of Technology. This medal is given by the U.S. Department of Commerce in recognition of Dr. Williams' unequaled achievements as a gifted inventor, tenacious entrepreneur, risk-taker and engineering genius in making the United States of America No. 1 in small gas turbine engine technology and competitiveness, and for his leadership and vision in revitalizing the U.S. general aviation business, jet and trainer jet aircraft industry. I can think of no one who deserves this recognition more than Dr. Williams. He pioneered the design and development of small gas turbine engines at a time when most companies were preoccupied with developing larger engines. He blazed a new trail by developing engines for small, lower cost aircraft, missiles, and unmanned vehicles such as the Tacit Rainbow and TSSAM. And Dr. Williams did not stop there. He led the design and development of the FJ44 turbofan engine; an engine that makes possible a new class of lightweight business jet aircraft and new low-cost military and civil trainers. Dr. Williams has contributed greatly to America's technological advancements, to our defense and to our provision of good jobs to our citizens. He has brought numerous high paying, long lasting jobs to the Detroit metropolitan area and his continued success promises continued advancement for America's technology and her workers.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, on September 20, the Senate passed the Agriculture appropriations bill. I would like to take this time to explain some of the votes I cast during debate on this bill. I voted for several amendments related to reducing the scope of the Market Promotion Program including an amendment which would reduce funding for the MPP's and limit potential users to small U.S. businesses. While many businesses have benefited from this program, in these times of extreme budgetary austerity, we must prioritize Federal Government spending. These are tough choices, but if we don't make them now, the results will be devastating for future generations. One of our goals in this Congress has been to free citizens from unnecessary burdens and excessive taxation of bureaucracy. In doing so, some Government programs which support businesses also must be reduced. It is my hope, however, that in the long run, we will allow individuals and businesses to keep more of the money they are now paying in taxes so that they are able to create programs like the Market Promotion Program without Government involvement. I also voted against an amendment which would have eliminated from the bill a provision to provide assistance to cotton farmers whose crops were devastated by tobacco bud worms, beet army worms, and other pests. This amendment was accepted without my support. Many farmers were told that the newly created Catastrophic Crop Disaster Insurance Program would provide the same level of protection as previous Federal disaster programs. These farmers, therefore, relied on the new program for help in disasters such as this. Unfortunately, the level of protection is not the same as previous disaster programs. The provision to assist cotton farmers was included in the bill because the Catastrophic Crop Disaster Insurance Program is not sufficient to help these farmers. Mr. President, recognizing the extreme losses these farmers are experiencing through no fault of their own and over which they had absolutely no control, I feel it is appropriate that the Federal Government, assuming that the Secretary of Agriculture deems the losses disastrous, step in to provide these low interest loans to cotton growers who have been economically devastated by this disaster.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, I rise in support of the Regulatory Review Act of 1995, which I introduce today on behalf of myself and Senators Heflin, Lott, Nickles, Hutchison, Craig, and Kyl. It is only common sense that the utility of a rule may change as circumstances change. Under current law, however, a rule enjoys eternal life unless the agency that promulgated it takes affirmative steps to terminate it. And in fact agencies rarely choose to burden themselves with the task of reexamining the rules they have promulgated. As a result, our rulebooks are littered with rules that are obsolete, inconsistent with other rules, or just plain unnecessary. The weight of this heap of outdated rules rests most heavily on the small businesses of this country. Unlike larger firms, small businesses cannot spread the costs of regulation over a large quantity of output. Nor can they pass their regulatory headaches on to an accounting department, legal counsel, or human resources division. Instead, in case after case the entrepreneur himself must spend innumerable hours attempting to comply with the mandates of Federal regulators. It comes as no surprise, then, that problems relating to regulation and Government paperwork were the fastest growing areas of concern in a recent survey conducted by the National Federation of Independent Businesses. The Regulatory Review Act would solve the problems caused by unnecessary rules. Under the act, the Administrator of the Office of Information and Regulatory Affairs in the Office of Management and Budget would coordinate and supervise agency reviews of covered rules, which largely would be rules that impose annual costs of $100 million or more. Covered rules not reviewed by the end of their review period would terminate. The duration of review periods under the act would be up to 7 years, plus a possible extension of 6 months. Finally, the act itself would sunset after 10 years. There are several reasons why OIRA should be given supervisory authority over the regulatory review process. Obviously, the review process will involve determinations as to whether the rules of one agency conflict with or duplicate those of another agency. Those determinations will require a global, interagency perspective that comes much more naturally to OIRA than to the individual agencies themselves. Additionally, vesting this authority in OIRA, rather than scattering it among the various agencies, will provide a timely reaffirmation of what Alexander Hamilton called the unity of the executive in Federalist No. 70. It is also worth noting that the act avoids two areas of contention that arose during debate on S. 343, the regulatory reform bill. First, the act contains no decisional criteria; instead, rules would be reviewed according to whatever criteria already exist under current law. Second, the act would not affect the availability of, or standards for, judicial review of final agency action. Thus, at bottom, the act stands for the commonsense principle that agencies should be required to review their rules periodically. Mr. President, I urge the Senate to address this issue without delay. The small businesses represented by the National Federation of Independent Businesses, which strongly supports the Regulatory Review Act, demand no less.

Mr. ABRAHAM

Mr. ABRAHAM. Mr. President, I rise in support of the Regulatory Review Act of 1995, which I introduce today on behalf of myself and Senators Heflin, Lott, Nickles, Hutchison, Craig, and Kyl. It is only common sense that the utility of a rule may change as circumstances change. Under current law, however, a rule enjoys eternal life unless the agency that promulgated it takes affirmative steps to terminate it. And in fact agencies rarely choose to burden themselves with the task of reexamining the rules they have promulgated. As a result, our rulebooks are littered with rules that are obsolete, inconsistent with other rules, or just plain unnecessary. The weight of this heap of outdated rules rests most heavily on the small businesses of this country. Unlike larger firms, small businesses cannot spread the costs of regulation over a large quantity of output. Nor can they pass their regulatory headaches on to an accounting department, legal counsel, or human resources division. Instead, in case after case the entrepreneur himself must spend innumerable hours attempting to comply with the mandates of Federal regulators. It comes as no surprise, then, that problems relating to regulation and Government paperwork were the fastest growing areas of concern in a recent survey conducted by the National Federation of Independent Businesses. The Regulatory Review Act would solve the problems caused by unnecessary rules. Under the act, the Administrator of the Office of Information and Regulatory Affairs in the Office of Management and Budget would coordinate and supervise agency reviews of covered rules, which largely would be rules that impose annual costs of $100 million or more. Covered rules not reviewed by the end of their review period would terminate. The duration of review periods under the act would be up to 7 years, plus a possible extension of 6 months. Finally, the act itself would sunset after 10 years. There are several reasons why OIRA should be given supervisory authority over the regulatory review process. Obviously, the review process will involve determinations as to whether the rules of one agency conflict with or duplicate those of another agency. Those determinations will require a global, interagency perspective that comes much more naturally to OIRA than to the individual agencies themselves. Additionally, vesting this authority in OIRA, rather than scattering it among the various agencies, will provide a timely reaffirmation of what Alexander Hamilton called the unity of the executive in Federalist No. 70. It is also worth noting that the act avoids two areas of contention that arose during debate on S. 343, the regulatory reform bill. First, the act contains no decisional criteria; instead, rules would be reviewed according to whatever criteria already exist under current law. Second, the act would not affect the availability of, or standards for, judicial review of final agency action. Thus, at bottom, the act stands for the commonsense principle that agencies should be required to review their rules periodically. Mr. President, I urge the Senate to address this issue without delay. The small businesses represented by the National Federation of Independent Businesses, which strongly supports the Regulatory Review Act, demand no less.

Mr. ABRAHAM

Mr. ABRAHAM. I appreciate the Senator's assistance. [[Page S 15306]]

Mr. ABRAHAM. Mr. President, I would like to touch on a related subject. During consideration of H.R. 2099, the VA, HUD, and independent agencies appropriations bill for fiscal year 1996, I provided to the distinguished subcommittee chairman, Senator Bond, a brief summary of the value of CIESIN's work for NASA. CIESIN is one of NASA's nine Distributed Active Archive Centers [DAAC's] supporting the Earth Observing System Data and Information System. CIESIN is the only one that provides integrated socioeconomic data access for the study of the affect society has upon the environment. This is a unique capability and one that NASA officials consider vital to EOS. As the distinguished manager of the bill may know, the Senate's version of H.R. 2099 advises NASA to integrate CIESIN into the EOS plan for 1996. Obviously, CIESIN's SEDAC activity is hardly irrelevant to NASA's mission and should not be eliminated, as proposed in the committee's report. And, CIESIN's valuable skills and expertise may be of use to NASA in non-SEDAC ares or to other Federal agencies. The House's NASA authorization bill explicitly provides that CIESIN will not be precluded from receiving contracts awarded following a full and open competition and that the rights of any parties under existing contracts shall not be affected. This language would allow CIESIN to compete for NASA or any other Federal agency grants or contracts. Would the chairman be able to support this non-controversial language?