guest: the argument in favor of high levels of low-skilled immigration is pretty weak and anytime. and a time when we have over 9% unemployment, there is no justification for it. we have seen instance after instance were illegal immigrants have been removed from jobs whether because of a raid. they have done these audits of people's personal files. a restaurant chain had its personnel files audited. they had to let go a lot of people. the next day, there is all line of legal immigrants and american citizens applying for those jobs. there is no excuse for not acting aggressively to remove illegal workers from the work force when we are in this kind of economy.

guest: why is the onus on the government? under the law, they have to except the phony documents that the legal documents present. if they say, do you have something else? this green card looks kind of fishy. they can be fined by the justice department. there are corporate employers knowingly hiring illegal employees. we need legislation to have all employers when they hire somebody verify that social security number and name and date of birth through a system called e-verify. host: jeffrey is a republican in washington. caller: that was a good comment.

i think there is a tier system in america. i was born in california and have been on the bottom of the my entire life. i watched employers hire people. they were not worried about documentation. they were worried about making a larger profit. that's what we do with children of our middleclass. we send them to walmart. those jobs were taken during the good times. those are not the jobs that will bring you wealth and stability and a college education. those jobs were being taken by people that did want them. the children of our country don't want those jobs. they want the better jobs and

the better future. we would rather have that job than none. but they were taken. guest: there is frustration with the unemployment crisis. that is very real and we cannot dismiss that. people are unemployed and that is hurting peoples' household. the day laborer and the street corner -- it was wall street that brought us into this crisis. immigrants are being used as scapegoats and fingers are pointed at immigrants for causing this recession, which is not the case. in terms of improving wages and labor standards, giving people amnesty and work authorization is the way to elevate and create a level playing field. we have unscrupulous employers

that are willing to pay less than the minimum wage to drive down wages in this country. host: betony read you a tweet here. -- let me read you a tweet. guest: not really. there are some people in a gray area. the great areas are created by immigration lawyers. there was a blog on someone from the previous amnesty in 1986 who lied on this amnesty application. the whole thing was a tissue of lies. a lawsuit in supposedly this gray area and has constantly been put off and filed another lawsuit. he has been in limbo.

almost all the immigrants that are in a gray area created that limbo as a way -- they are holding on with their fingernails to stay in the united states and to prevent the law from being enforced. guest: my mother received her citizenship. it has been 20 years since we last had an amnesty. we have millions of people in this country that have not seen an amnesty. there is not a pathway to citizenship in this country as we have that right now. is about time we modernize our loss. -- it is about time we modernized our laws. this is nothing new for reuniting families. host: we have an e-mail.

guest: that is right. we are not all mexicans. 50% are from mexico and the other 50% are from different parts of the world. this announcement by the administration is not amnesty. people's cases are being closed but they are not being dismissed. they are not going to drop the deportation numbers. there are still at an all-time high. i mentioned operation wetback. we deported 800,000 people. today, we of deported over 1 million people. we're seeing a historic levels of deportation right now. that is creating a serious

crisis for the hardship that these communities are facing and public safety. 60% are from mexico. they have to adopt a mexican accent to not be discriminated against by mexicans. the immigration problem is fundamentally a problem of mexico. the basic point does not matter where any of the illegal immigrants are from. the reason we have this problem is because we are on willing to enforce the law. we do not have amnesties for the heck of it. the 1986 amnesty was to be the one analyst example of a it. e will tie up the loose anends

by giving amnesty. we're going to enforce the law. the illegal immigrants of the amnesty up front. the promises of enforcement were abandoned. fool me once, shame on you. fool me twice, shame on me. host: here is an e-mail from don. guest: there are employers out there that loved the cheap labor. they want to export -- exploit workers. the threat of deportation is used to drive down wages. there used to be used in jobs --

there used to be union jobs. people have second-class citizenship in the united states. give them papers. give people and the state. host: michael in santa barbara. caller: good morning. i am concerned about the immigration problem. most americans feel the illegals come into this country. what they really want to do is just send their money back home. americans are left out in the cold trying to figure out how they are going to survive. what my question is, since the

government has failed the people, do we have a right to form a militia to get the illegals out of this country? host: mark krikorian? guest: we can for slaughter normal methods. we do not need machine guns, land mines, or citizen militias. we need normal law enforcement. even though there are legal changes that, i think, are necessary, even the existing law provides adequate tools. host: is their common ground between the two of you? guest: i think we agree that the system is broken. guest: as much as i think the implementation of the dream act is a lawless extra- constitutional measure, there is an idea in the dream act that

kids who grow up here known no other language and they are psychologically americans. i think there is a case to be made for those kids under certain circumstances with other enforcement guarantees. the problem is that discussion has never taken place. supporters of the dream act of attempted to use it as a poster child in the vehicle for amnesty saying here a little johnny brought here of three months old, valedictorian, wants to go west point and lives to kill terrorists. therefore, all 11 million illegal aliens need citizenship. if we start looking out it -- if we stopped looking at it as a gimmick and a look at those who have been brought here and the young age -- host: soaring number less than

300,000? guest: that is the number in proceedings. some of them will get the amnesty and some will not. there are some not that could benefit. guest: this is not amnesty. their cases are being administratively closed-end it does not mean that they now have amnesty for political equality. amnesty is not happening anytime soon. i think everyone knows that. there is no appetite for it in congress. the president can and the so- called secure communities program and he can stop the collusion between local police and immigration and customs enforcement. matter where people stand on the issue of immigration, which we know, can be very controversial, very emotional, at the end the day police are here to protect and serve our communities.

if several immigration violations are getting in the way about, it does not make sense to make them do the government's job. host: you mentioned your mother got amnesty under the 1986 law? where was she from? guest: mexico. she crossed the border as a domestic worker. she put all of my sisters through college and we went to some of the best colleges in the world. now we are here today. host: do you have your citizenship? guest: i was born in los angeles, so i have my citizenship. we would drive around los angeles and if she ran a red light or had a traffic offense and i think about losing my mother because of that, it really strikes from and it really makes it real how on just these immigration laws are and how they just do not make sense. host: republican from knoxville, tenn.

caller: this issue is about politics. democrats cannot alexian's without illegal immigrants. we had tight restrictions in 1956 and they lost. when we passed the law,, and some people have said this, it keeps right people and the country, which i think is an exaggeration. the lady on the left does not care about immigrants. she is a political hack. all three of those governors are democrats. democrats love immigration because it gets them votes. politics is about winning. that is all it is about to. they do not care, okay? unemployed people vote 20 to one democratic. roosevelt won three elections

with high lanham hyman. they love unemployment. the problem in this country is on the left side of the street and it is the liberal democrats. guest: voters are definitely turning into the debate and many of the more frustrated, including myself, about the president's broken promises. the president has supported more people than any other in u.s. history. for latinos, this is a slap in the face for a president who would like to see himself as a champion of immigration reform. and fidelity no vote is angry about this and we hope -- and the latino vote is angry about this. host: a recent piece from "the washington post."

coppermark krikorian -- mark krikorian? caller: -- guest: hispanics vote two to one democratic regardless. this is the way it has always been with a few notable exceptions. the caller had a point though. it is not that illegal immigrants boat a lot. we need to make sure the people voting are eligible to vote, but even nationalized citizens do not vote in huge numbers. the benefit of emigration to those promoting a bigger government, higher taxes, a bigger state, is that it makes things, economic and social

conditions, worse than then enabled los promoting bigger government to say that they need their solutions. 33% of all people who lack health insurance are immigrants or children of immigrants. that makes the argument over government involvement in health insurance making it the more salient. immigration increases the gap between the rich and the poor. it increases the number of the poor. it increases the clientele for government programs, the welfare state, generally speaking. that is the benefit. immigration makes social problems worse enabling those who want a bigger government, to say, "look at how bad these problems are. we have the solutions." host: next is an independent in arlington, va. caller: there is the green card

lottery. there is the j-1 visa and h-1 visa. you are either here legally or you are not. i commend president for getting rid of 1 million. that is remarkable. that is the reason health care costs are up, you know? you are sitting there. i am a social conservative and i am a religious conservative, as well. i do have sympathy, but i do not think this about illegal immigrants. you break the law. you go back to your country. host: reborn in the united states? caller: yes. my dad was in the service so i grew up in england. there are some laypeople who were trying to get to the u.s. illegally and that is the way to do it.

employers as well, both republicans and democrats, they are all using us as pawns. they like using illegal immigrants as slave labor. host: ms. uribe? guest: there is no way we are going to deport the 12 million people and documented in the united states. what would be disastrous for the economy, immoral, and it is not happening. well, what every going to do with the people that are already here? if we do not deport them all, one of going to do? the idea that everyone who crosses the border as a criminal and somehow that eclipses every other contribution they have made to this society is, i think of very dangerous. it is then easy to take the right away from people who are dehumanized. my mother crossed the border. she was undocumented.

but that did not make her into a criminal. maybe that was an illegal act, but when someone runs a red light, all of a sudden your child is not an illegal. guest: the important point is that we are not going to deport all of the illegal immigrants. we are not going to round up 11 million people and drive them to the desert on tuesday like a scene out of "the 10 commandments" movie. that is not the alternative to amnesty. the alternative is gradually reducing the illegal population through attrition and enforcement. the reason we do not have 12 million immigrants is partly because of the economy and better enforcement. we had a peak of 12.5 illegal immigrants in 2007 before the recession. it started declining and it is now down to something less than

11 million. part of that is because of deportation. part of that is because of better enforcement, making a harder to get in, and part of it is because a lot of them took the hint. it may be the party is over and they should leave. we have seen this in arizona and georgia. people are packing up and saying, "apparently they do not want me, so i will go home." that is the key. host: sarahi uribe and mark krikorian. we have a few minutes left here with both of you. we will try to take a few more phone calls. a republican from baltimore. go ahead. caller: appreciating that the system is broke, instead of record rewording that behavior, which is what amnesty is, why not invest money and time in giving these people a one or two

year temporary station and place them at the back of the line? host: ms. uribe? guest: we are more rewarding people. they said they were and clogging the immigration courts and making room for people they believed were a higher priority and that the deportation of 400,000 per year would not drop. it is inaccurate to say that people are being rewarded. i want to go back to the point about arizona and attrition through enforcement. one of the first lines of s.b. 1070, the bell stopped by the department justice, said it was a bill about attrition through enforcement. if we want to create an arizona- ification, we are in trouble. it collapsed because of some of their very hateful legislation,

and it has shown to be one of the worst in this country's and it gained international attention at the time. even hillary clinton said that it became an international incident and countries were rightly criticizing the u.s. for a policy that would create an apartheid. host: democrat in indiana. last caller. caller: i wanted to speak to the lady. only her. i wanted to ask if -- there are rules in the bible that do talk about being your brother's keeper, caring, and emphasize the.

that is what jesus came to earth for. -- caring and empathy. we need to represent jesus if we [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011] >> wednesday, and discussion on the prescription drug program and thursday, the fiscal challenges. live at 9:15 a.m. on eastern and rearing on c-span2. in the get medicare issues this week on "washington journal." >> dr. martin luther king was not a president of the united states. at no time in his life did he

hold public office. he is not a hero of foreign wars. he never had much money. while he lived, he was reviled at least as much as he was celebrated. by his own account, he was a man frequently wracked with doubt, a man not without flaws, a man not on like moses before him had questioned himself why he had been chosen for so arduous task, of leading his people to freedom, of feeling the festering wound of a nation's original sin. >> watched the groundbreaking of the dr. martin luther king, jr., memorial. five years later, sunday, the memorial will be dedicated live on c-span. during the week, coverage of other events surrounding the

dedication on the c-span networks. a recent report on medicare revealed $48 billion in improper payments for fiscal year 2010. the deputy chief operating officer testified before a house oversight and government reform subcommittee on efforts to curb improper payments, broadcom and waste. other witnesses included the hhs inspector general. this is just over 90 minutes. >> this hearing of the subcommittee on government organization and efficiency will come to order. first, i appreciate everyone's patience and understanding. i apologize for the slightly late start as we were wrapping up a committee meeting in the capital.

this figure represents 38% of all identified improper payments made by the federal government in fiscal year 2010 and is likely only a partial accounting of the total account of the improper payments. medicare is considered a high risk program by the gao. it is known to be susceptible to fraud, waste, and abuse. the medicare fee-for-service program reported more improper payments than any other program. lot of these are due to improper financial management. the process almost 5 million

claims every day remain -- relying on automated processes. this leads to improper payments resulting to clients without sufficient documentation come insufficient or fraudulent documentation, incorrectly coating claims, or service is not deemed reasonable or necessary. cms has been making efforts to decrease the amount of improper payments within medicare. in 2009, they filed recommendations to the office of inspector general to calculate payment error rate. using this methodology, they identified more improper payments in 2009 and 2010. they are looking to calculate improper payments made to medicare part d. cms had not previously calculated improper payments for part d .

this soap for the first fiscal year in 2011. they want to perform more audits including on-site audits. cms announces they will evaluate things put in place by insurance companies in part d. more must be done to strengthen the internal controls, especially within contract management. they began using recovery audit contractors to identify and recover improper payments. the recovery audit contractors have identified numerous smaller abilities in the cms programs. unfortunately, it has only taken steps to address 40% of these significant vulnerabilities. gao has found deficiencies in the contract management internal controls. gao issued nine recommendations

to improve internal controls in 2009. one year later, on they had only taken steps to address two of the recommendations. improper payments cost taxpayers billions of dollars. this is a part of a continued effort to prevent improper payments and other instances of waste, fraud, and abuse in government. i welcome the opportunity to hear from our witnesses today on cms's progress on improper payments and i would conclude with just to focus that given the ongoing debate with deficit reduction, the ongoing debate over the debt limit and the broad picture of spending in washington in how we need to do better with the american people's money. when we are the king and debt reduction plans and talk about reducing spending and $10, $20, $30 billion and then we look and see what we know of, at least

$125 billion each and every year that is improperly paid by the government, almost 40% of which is identified with in medicare, we have a lot of work to do. we're grateful for the witnesses being here today who will help us in this partnership approach to getting this work done in going forward in positive light. with that, appeal to the ranking member of new york, the former chairman of the full committee. >> we should be clear about one thing. improper payments by medicare or any other agencies may be over payments for underpayments. they may be fraudulent payments, ballad payments, lacking proper

documentation -- valid payments lacking proper documentation. looming's context of a breach of the federal debt ceiling, it may be tempting to view the medicare improper payments as an easily identifiable budget safety. that is not the case. solving the problem of improper payments does not necessarily translate to a government savings or a lower federal deficit. still come eliminating improper payments is the right thing to do and we should. i think we can all agree on that. i thank the chairman for holding this meeting and i thank our witnesses for cheering their expertise with us today. according to the gao, a government-wide improper

payments total approximately $125 billion in 2010. medicare alone accounted for $48 billion, as my colleague indicated. that is 40% of the improper payments of the entire government. i find these figures deeply troubling which is why we look forward to hearing from our witnesses today. president obama has taken many positive steps toward reducing improper payments since the beginning of his administration. in 2009, the president signed an executive order, 13250 which sought to increase accountability regarding improper payment. in 2010, the president issued two memorandum that instructed omb and agencies to make it a priority not only to find

improper payments but to recapture the money that was paid. the administration announced last year that the center for medicaid and medicare services would cut the fee-for-service plan and improper payment rates in half by 2012. i would certainly like to hear nore about the cms progress i this matter. this is one of the watchdog agency's to recommend improvements in proper payments. the gao is the other watchdog. between these two and independent innovations, i am looking forward to hearing about how and when we can eliminate improper payments. i am encouraged that the progress the administration has made in the last two years in reducing improper payments.

whatever it is that this committee needs to do to assist in terms of the reduction, we stand ready to do just that. thank you very much for being here and i look forward to your testimony. thank you. i yield back. >> the members will have seven days to submit opening statements and extraneous materials for the record. unless any other member wants to make a brief opening statement, we will move on to the witnesses. we are honored to have four distinguished public servants with us today. daniel levinson, the inspector general of hhs, and serves on the council of integrity and efficiency on inspection and evaluation. mishal snyder coming the deputy chief operating officer for cms

where she leads the improvement initiatives for promoting excellence in operations. from the gao, the director of financial management where her responsibilities include financial management systems, improper payments, contract cost analysis, and health-care management issues. we also have kathleen king, who will also be making an opening statement, but is available for statements. she is the director of health care for the gao and is responsible for leading studies of the health-care system and specializes in health-care management and prescription drug coverage. pursuant to the rules of the committee, all witnesses are sworn in before every hearing. if i could ask all to stand and raise your right hand. do you solemnly swear or affirm the testimony you are about to give to this committee will be

the truth, the whole truth, and nothing but the truth? that the record reflect that the witnesses all answered in the affirmative. we will set the clock for five minutes. we do have your written testimony to be made part of the record. you can stay as close to the five minutes, then we look forward to getting into questions. general levenson, if you would like to begin, please. >> good morning, chairman, ranking member, chairman i sat, and other members of the subcommittee. thank you for the opportunity to testify. in 2010, cms reported medicare errors totaling nearly $48 million. by written statement discusses the allied to work discussing the targeted reviews about medicare improper payment.

my testimony this morning summarizes the elijah recommendations in this area. -- the oig recommendations. they've fallen to the following four categories. increased pre-payment and post- payment review of the claims. strengthen requirements to address vulnerabilities can increase oversight and validation of supporting documentation, and educate and issue more guidance to providers. has consistently recommended pre-payment and post-payment review of claims. the analysis for diabetes supplies found improper payments. pre-payment editing cannot reduce improper claims for these supplies. in certain areas, cms should strengthen requirements to address integrity vulnerability.

we recommended that cms establish a payment cap on chiropractic claims to prevent improper payments for maintenance therapy. we've recommend an increase in review of supporting documentation. for example, we found that medicare spent $95 million on claims for power wheelchairs' that were either medically unnecessary or lacked sufficient documentation to determine medical necessity. one of the recommendations is that cms review records from sources in addition to the wheelchair suppliers, such as the prescribing physician. provider education is also critical to ensuring compliance in protecting beneficiaries. 82% of hospice claims and nursing facilities did not meet at least one medicare coverage requirement. requirements are in place to protect beneficiaries health

care and well-being. medicare paid $1.80 billion for these claims. we recommend they provide hospices with rules for certifying a terminal illness and check with providers that must be included in their plan of care. for our parts in the provider education, we conducted free training seminars in six cities to ridge care providers on fraud risk and share compliance best practices. we also published a road map for physicians to provide guidance on compliance with fraud and abuse laws. i have copies of this available this morning for each and every member. oig investigations resulted in

$3.80 billion in court ordered fines, penalties, restitutions, and settlements in 2010. to prevent improper payments from compromising the medicare trust fund, we refer them to implement payment suspensions, helping to turn off the spigot for fraudulent claims. improper payments cost billions of dollars to taxpayers every year. the executive order on reducing improper payments states the federal government must make every effort to make sure the right recipient receives the right payment for the right reason that the right time. oig is committed to this goal and i would be happy to answer any questions. >> thank you. miss snyder? >> good morning. thank you for being with us today.

thank you for this opportunity to discuss the cms efforts to reduce improper payments and in medicare. we are committed to reducing the amount of improper payments and in sure that our programs pay the right amount for the right service to the right person in a timely manner. like other large and complex programs, it is susceptible to improper payments. cms calculates an improper payment rate annually. while these payments represent a fraction of total program spending come at any level of improper payment is unacceptable and cms is aggressively working to reduce errors. there is confusion about what improper payments are and are not. they are errors that result from one of the following situations. the provider failed to submit documentation or insufficient documentation. the provider incorrectly codes the service or the documentation

submitted sure the services provided were not reasonable or necessary. improper payments to not always represent an unnecessary loss of medicare funding, rather an indication of an error . improper payments are usually not fraudulent. cms is committed to reducing improper payments and we have implemented programs. the traditional medicare fee- for-service program represents the majority of medicare spending. it is administered through contract with private companies that process as 5 million claims every day, a 1.2 billion claims in its fiscal year. siemens uses the conference of error rate testing to estimate. between fiscal year 2009 and 2010, cms was able to reduce the improper payment rate by 1.9%

down to 10.5%. it provides valuable information to systems developed to reduce improper payments in the future. we believe the best way to address the documentation problems is through provider education and outreach efforts, more review of records to ensure services billed meet payment rules, and enhanced systems and analytic tools. some of our research provider education includes the issuance of quarterly compliance reports and conducting routine forms to discuss medicare policies and documentation requirements. we recently implemented the national recovery audit program. it allows recovery auditors on a contingency basis to identify it over and underpayments in claims. the permanent fee-for-service audit program has attracted a total of $685 million during 12

months. the program also provides valuable information about areas for increased affirmation and where prepayment medical review is most productive. this assists in automated elements were these are medical and likely. in medicare part c and d, they require different approaches to address improper payments. there is a monthly payment for each enrolled beneficiary. these per person payment are risk adjusted on the beneficiaries of health status. the rate was 14.1%, a reduction of 1.3% from the 2009 rate. most of the part c errors were relating to the fact that the records submitted did not include enough data to support

the risk adjusted payment. we are working very closely to implementing number of audit strategies and in medicare part c and d. we're happy to report that in november this year, we will be reporting a part d rate. we believe the information, as we go through establishing, will help us to figure out what we have learned through that measurement process. we have a number of strategies in place that i'd be happy to talk about as we proceed through this hearing. i would also like to assure you that we are examining techniques used by the private sector, insurance companies come and others to combat improper payments. we are eager to learn from successful private sector ways and we have a form partnerships to make sure we have the best information we have to make a difference in the medicare program and help them learn from

our experiences in what is a very large payment program. while cms has had progress in reducing waste and errors, we understand more work remains. i'm confident that the ongoing corrective action that cms is undertaking plus the help of our partners in the office of inspector general, as well as other parts of the department, will help us in understand this undertaking when we saw continued reductions. i look forward to working with the said committee to make sure we can answer any questions you may have. thank you. >> thank you. ms. daly. i want to -- >> i want to thank you for the opportunity to be here today to discuss improper payments in the medicare. in 2010, medicare covered 47 million elderly and disabled beneficiaries and had an outlay

of about $516 billion, one of the largest federal programs. it consists of four parts, a and b, fee-for-service, part c which is advantage, and part d, prescription coverage. it is any payments that should not have been made, an incredible amount, overpayments, or underpayment. for 2010, hhs reported an estimate of almost $48 billion of improper payments. this was attributable just to medicare fee-for-service and medicare advantage. from a government-my perspective, the medicare program represents 38% of the $125 billion in estimated improper payments reported by the 70 programs. hhs estimated improper payments

is incomplete because it has yet to report a comprehensive improper payment rate for the prescription drug program. as ms. snyder indicated, hhs is going to release a comprehensive report in the fiscal year 2011. it is important to recognize that the $48 billion reported in fiscal year 2010 is not an estimate of fraud in medicare. reported improper payment estimates include many types of overpayments come under payments come and payments not adequately documented. -- include many types of overpayments, underpayments, and payments not adequately documented. there may be brought that exists that is not encompassed in the reported improper payment estimate. in 2010, cms treated the center

for program integrity to serve as a focal point for all national medicare program integrity issues. the cpi address is program integrity issues and vulnerabilities that lead to improper payment. they collaborate with other cms components to implement a comprehensive strategic plan, objective, and measures to carry on the mission goal. cms has begun a number of initiatives related to five strategies identified in our previous reporting. these are key to reducing medicare improper payments. cms still faces significant challenges in designing and implementing internal controls to prevent or recoup improper payments. effective their implementation of the recommendations, some provisions recently enacted, and recent guidance related to these key strategies could help mediate fraud, waste, abuse, and improper payments in the

program. the five key strategies are strengthening provider and lowman standards and procedures, improving prepayment review of claims, focusing post-payment claims on the most vulnerable areas, improving the oversight of contractors, and developing a robust process for addressing identified vulnerabilities. for example. having a mechanism in place to resolve all vulnerabilities that lead to improper payment is key to effective management. towercam shown that cms has not yet established an adequate process during the recovery on the or in planning for the subsequent recovery audit national program to ensure that the vulnerabilities that had been identified were properly resolved. in conclusion, with the amount estimated in improper payment and the unknown amount of potential waste, fraud, and abuse, it is critical for cms

direct quickly to reduce them. as the implement other issues that have been brought up for medicare, cms has an opportunity to use these new tools to further address waste, fraud, abuse, and improper payments. members of the committee, this completes my prepared statement and i will be glad to answer any questions you may have. >> thank you, ms. daly. thank you to the witnesses for testimony. we will now move to questions and i yield myself five minutes for that purpose. i want to first and knowledge --acknowledge that you and your colleagues are being dutiful in try to identify preventing improper payments and are being good stewards of the taxpayer money. one reflection in your written

testimony is that, "while this represents a fraction of total spending, and the amount is unacceptable and cms is aggressively working to reduce these errors." hybrid that is that it is only a fraction and that any amount is wrong. $40 billion is about 10% or so of the total payments, but that is a huge amount of money. it is not just any amount, but a huge amount. i do not want to minimize the effort to prevent it, but when i share back home that the total number for the entire government that we know of the estimated at $125 billion every year, my constituents think i misspoke. then when we talk about an

individual program, medicare, that is 38% of that, it is staggering. one issue in your testimony, and i appreciate that you referenced either here today or in your written testimony that when we hear of improper payments we think of the worst. we do appreciate that is not the case and a lot of this is just insufficient documentation or the wrong documentation. is there an estimate of the $48 billion that is fraught-related? -- fraud related in gauche billing? is there an estimate to about%? >> my mother is a medicare beneficiary and i heard what you said. it is a big number. >> my mother asks me questions when she gets her statement.

>> exactly. sometimes it makes you not want to go home for thanksgiving. in relation to your question about the fraud rate, one of the toughest problems we have at cms is defined methodology is something that allows us in a way to estimate what amount is broad. we have gone to the private sector. we asked them how they estimated fraud. we have looked at literature, when people make comments, we look behind something to see how they measure because we want to do so. there is not a methodology. the center for program integrity has started a new program and were just awarded a contract. we are going to try and estimate levels abroad. we will start with two areas that we believe ought are prone to fraud, and we know that it is

because of the work done by the investigations from the office of inspector general and geode. these are medical equipment and in home health. we know there are huge issues there. we hope we will be willing to actually say here is the methodology that will work so that you can apply this to different types of service categories and estimate actual fraud rate. we hope to have that done over the next six-eight months. we have invited the private sector in to help develop this methodology and we hope we will be successful because we think this is something that will not only work for cms but the private sector as well. if it works, we will share it. >> i appreciate the challenge of having that methodology to estimate. do you know what the fraud at numbers work for 2010? and now you found was fraudulent

going back? >> we have a number of the collections. we have cases that went to the department of justice, investigations where we have actually collected dollars back. it amounts to many hundreds of millions of dollars that come from those particular cases. those are specific cases. >> so rather than trying to estimate going forward, what is the track record that you know is fraudulent in the last three years? how much money do we know was fraudulent because we caught the perpetrators? >> i will submit that number for the record. it is in the hundreds of millions of dollars probably over the three-year period. there are tasks for risks that we have been involved in and

there are particular dollars -- there are task forces that we have been involved in. it is definitely hundreds of millions of dollars. i do not want to give you a wrong number, but it is significant. >> if it is hundreds of millions, we know that is a portion of what the actual fraud is. that is what we have been able to identify, so again we are talking real money here that we need to go after in addition to what i call administrative problems, documentation, other types of improper payment. i yield to the gentleman from new york, the ranking member, for five minutes. >> thank you very much, mr. chairman. if we spent the night, do you think it would cut down on the amount of waste, fraud, and dubious, if we skipped the

background check initially? >> providers to have paid into the medicare program? that is a suggestion that has come to us, usually the general accounting office has cited is a possibility as has the office of the inspector general. what we have found is one of the best ways to prevent waste and fraud is to keep bad actors out from the very beginning. part of keeping bad actors out from the beginning is making sure that we do appropriate provider certification certificd screening. part of that is taking a look at an application and making sure that you have a license. have you lost your license? are you, indeed, a real operation? going through a number of screening criteria and doing it up front, not giving a person in medicare provider #is one way to proceed.

we hope to have that mostly done, or at least a large part under way. we never had the opportunity to do backgrounds tracks, fingerprinting, to take them through the scope. in to take a look at all kinds of public information. yes, it is an excellent technique and we are employing that.

>> keeping bad actors out is one of the best ways to prevent fraud. it gives considerable authority to strengthen the enrollment process, and the have separated providers into different categories with medical equipment being in the highest category. they have strengthened ability to let them get in. >> let me ask in the context we're talking about, what does correction really mean? >> i think the executive order states exactly what the goal is for every dollar spent.

and that is to get it right. if there is missing information, if the record is not complete, there is simply no assurance that the dollar spent is appropriately spent. in that sense, it is an error. is it necessarily fraud? no. i would underscore that the most successful and sophisticated fraud reveal no improper payments at all because the paper record is so well done. while the improper payment amount is likely to include cases of fraud, it would be counterintuitive to think that they don't. it doesn't really capture a fraud figure. >> i think it is very similar to what he is saying, you have to look at the claim that his file.

we have several million of them today, just going through the system. when you look behind the face of that record, you find the justification of that expenditure. you give folks every of virginity to see that the record is correct. to us, it means that the service record. it occurred in the right setting and we paid to the right amount for its. if that is not the case, it is an improper payment and it needs to be corrected. the only correct way you make sure your providing this service in the right place, you are in partner with the medicare program. >> i would echo some of the sentiment that mr. levenson and ms. snider had just spoken. having the right documentation there to pay the bill, making sure the patient is due for the

services are all very important, and all of that needs to be done correctly at each step of the process. getting it done right the first time saves a lot of time and effort. if it is not done correctly the first time, it is considered to be payable and we have to spend a lot of time and effort to make corrections. >> and to add on to that, if we talk about corrective action, what we are thinking about, if a vulnerability has been identified, you know that people are doing things that they should not, you put a process in place to try to prevent that in the future by strengthening your enrollment standards for doing it -- or doing it on post-pay. >> my time has expired, but let me ask you this question. if a group comes to you and says

this is the problem, can you make that adjustment? i was looking at the terms, and i notice there are some issues. they have been raised over and over again. which, to me, seems like a legitimate concern, but nobody sort of responded to it. do you respond when a group says that this is the problem? and you make an adjustment? >> let me take a stab at that one first because it is a particularly interesting one to me. the first place that we go is to look at the statutory requirement of the benefit category. how has it been defined? for power wheelchair's, it was a homebound benefit that says you have got to be able to use that power will chair inside of

your home. you have to be unable to walk three or four steps inside the confines of your apartment, house, what ever it may be. if you take a look at that and the folks come to you and say, this power wheelchair enhances the quality of my life because it lets me go to the mall or church or however it might allow you to get outside, that certainly is a valuable thing into the quality of that individual's live. if you look at the statute requirement and the legal requirements, high-definition, you don't meet the requirement for that wheelchair to be provided to you. that is a particularly tough one. somebody's daughter, he said that my mom really could use this. but the ability to do something about that is limited by the

statute. the second place that you go, is there a regulatory policy are around this? it makes sense to make change, and you take a third look at it and say that it is a matter of policy that we have interpreted to put something in place. how much room do you have to work with that provider or service to change it? it is a pretty rigorous process. we look to see what makes the best sense for the beneficiary. but what makes the best sense in terms of the regulations in place are sort of beyond that particular benefit category. we have a very high error rate there because of the reason i described. it does not satisfy the definition of the benefits. we are looking at ways that we

can put some controls in place on the very front end of its so that we are not paying and chasing for power will shares and devices that are out there that don't meet the requirements of the benefits. >> former chairman? the gentleman from oklahoma, five minutes. >> my mom is also one of the medicare recipients. she will never have the opportunity to meet and say thank you, what you do as a great service to a lot of people. let me mention a couple of things that come back. i go home on thanksgiving and that is what we're going to be talking about.

things that she perceives to be fraud and all of those things. i also hear from doctors and hospitals that are very frustrated with recovery audit contractors. there is a perception in their mind that they walked to the door and are guilty. they will stay there until they prove they are guilty, no matter how long it takes. they are paid by the paperwork so they are going to find some nurse that was in a hurry in and did not put the day on the form and they are going to get fined for it. they fight for years through a process where this code was active and now suddenly it is not. sometimes thousands or millions of dollars in fines. i am talking good hospitals. how do we fix this? they hate the federal government. those contractors, they know

they are their enemy and they will stay until they have made money off of them. the hospital says, and i am the good guy, how come i am getting hammered? >> we did and a valuation of the demonstration of the recovery of the program, and i think we did identify some missteps in terms of the initial actions that were taken. it is our understanding that they have instituted a process, a committee that has to prove the issues that they are going to undertake. >> that has not trickled down yet. i have been in communication with another hospital that is fighting for the same thing. it is a bounty hunter that is determined to find something wrong. they are not happy at all because they are adding additional staff and compliance

areas for things that are not fraud, and missed out on something in my understanding is that these contractors are paid, even if they determined that it wasn't true, that it was correct. >> is not the case in a national program. if something is overturned on appeal, they do not get paid. >> how do we develop this relationship? >> the good news is, that is not news to us. in the demonstration that went on for three years, we learned a lot of things. some of the things that she has referenced, having a committee that asks if this is legitimate.

making clear to the right contractor is that if this is overturned on appeal or whatever, you will pay us the money back. it is not that you're not going to get looked at. we hired someone to watch the validation contract. they do spot checks of the work. were you inappropriately aggressive, did you really use these standards of accounting practices? this is a continuing education and outreach. one of the topics that is always on the air, we get hundreds of providers the call and and we talk about the issues. we have encouraged folks, if you think in your area they are being over aggressive or having continuing problems, let us know.

the hospital that you just mentioned, i will be happy to reach out to them and and look to see if it is just a matter of hard feelings because they don't like the program. whether or not those corrective actions and redoubling of our effort to make sure that folks understand the intention of this is not forgotten. the intention is making sure that we are looking every it appropriately. >> that was part of the hearing of an improper medicare payments. you can see all of it on our web site. c-span.org. >> and dr. martin luther king was not a president of the united states. at no time did he hold public office. he is not a hero of foreign wars. he never had much money. while he lived, he was reviled

at least as much as he was celebrated. by his own account, he was a man frequently wracked with a doubt. a man not without flaws and, why he was chosen for so arduous task. leading people to freedom. the festering wounds of the nation's original sen. >> watch this groundbreaking of the martin luther king jr. memorial. and now, five years later, the memorial will be dedicated in washington, d.c.. and we will have coverage surrounding the dedication on the c-span that works.

>> notice the color of the bourbon. the amber color is all coming from the inside of the barrel. this is where bourbon gets all of its color and a lot of its flavor. over 200 chemical flavor is from the barrel. gosh we highlight frankfurt kentucky on both tv and american history tv. but for the history of literary

life of the kentucky state capital. violence, corruption, and urban renewal. and an author on the life of john porter. and on c-span 3, a trip to a distillery in operation for prohibition, for medicinal purposes, of course. and the old state capital. american history tv this weekend. >> nato said it would continue libya operations and will bomb forces if they keep fighting. those comments came during a press briefing in brussels. it is 50 minutes.

>> good afternoon, welcome back, and welcome to those following the press conference through the internet. see, byed, as you can the military spokesperson who will give us an update on the

events in libya. it has been a remarkable week. we have seen forces lose their grip over towns and cities that they had been threatening for so long. we have seen people rejoicing as the regime crumbles. they lived under the threat of violence for decades. they can hope for a new beginning. the partners have conducted a highly effective campaign under the mandates of the united nations security council. we have the war machine build up over more than 40 years. today, we will pass the milestone. we have damaged or destroyed over 5000 legitimate military targets including a hundred

tanks and artillery. we have done so with unprecedented precision and as much care as possible to minimize the risk of civilians. for the regime, this is the final chapter. the end is near, and events are moving fast. what is clear is that gaddafi is history, and the sooner he realizes it, the better. the remnants of the regime are desperate. they hope to fight back here and there. but they are fighting a losing battle. the launch of another missile is proved that we cannot drop our guard. the use of indiscriminate weapons against the city shows beyond a doubt why it remains necessary.

we cannot drop our guards. nato is committed to the united nations security council commitment and our mandate to protect civilians. we will keep on implementing its for as long as necessary. this afternoon, ambassadors will meet at nato headquarters to take stock of the operation in libya. they will discuss the way forward and i suspect they will look at options for a possible nato role once the conflict is over. any future nato engagement will be governed by three principles. firstly, the leading role in supporting the people rests with the united nations and the contact group. nato will be in a supporting

role. nato will have no troops on the ground, and any possible future role in libya in addition to the current one will have to be upon request. right from the start, the international community has come together to confront the libyan crisis. nato has taken a vital roles in protecting the people of libya. they will bring this crisis to the conclusion that the people of libya want and deserve. >> welcome to those of us -- joining us from brussels and naples as well. the last few days, we have

noticed significant changes, advances. and in the city, and locations previously known. there is no doubt that the forces are severely eroded, capturing key decision makers and being expelled from military positions. and losing the ability in a growing number of cities and villages. ,

and i would like to stress that the government, our military mission has not changed. our mission remains to protect the civilian population against the threat of attack. as well as the no-fly zone. let there be no doubt that will monitor as we have. if we see threatening moves, we will act in accordance with our un mandate. this has been and continues to be a 24-7 operation. as such, the un mandate remains vigilant and determined to protect the people of libya.

we will keep up the pressure until there are no more attacks against civilians. the number of areas still contested, we have to remain vigilant. specifically, there are clashes. and attention is far from being over. it is very dynamic and complex. even today. outside tripoli, fighting and actions still occur. and also where civilians are

uprising and being repressed by indiscriminate shelling. a surface-to-surface missile was fired and landed in the vicinity, apparently without any casualties. nato has also destroyed rockets firing from a western position towards the recently freed in city. for some, our mission is not over yet. what is left of the military is no sign that they will stop in the occupation. they are aggressively fighting to keep control over the access , and to preserve freedom of movement.

we urge them to stop, return to their bases, and returning access to all people. until that is the case, we will carry on with our mission. thank you. we will take a few questions. can you give us an idea what the strategy is at the moment, whether you are bombing directly, where gaddafi is supposed to be now? if you allow a second one, how many soldiers do you still expect their in libya to work

for gaddafi? >> first our mission remains. we continue to protect the civilian population, to be vigilant and to enforce the no- fly zone. we're doing is 24/7. regarding the institution, i cannot comment on current operations, of course. but we remain vigilant and we will seek out and strike targets. this is what we have done since the beginning and what we will continue to do with a determination. with respect to the number of soldiers, this is not something

that we can estimate with precision. is the number of soldiers you have that counts because many of them can be demobilized. what is important is the ability to fight. since the beginning of the campaign, we have severely eroded the military regime capability to appoint or their combat capabilities are severely affected. the controls many taxis within the country. and they have leaders that have either defected or have been captured. despite the no is, it is going

down. it is a matter of when. >> i have understood that you are protecting civilians, but i like to know how you're doing it now enter a plea, where there are many people around this bunker where gaddafi is supposed to be. why are you doing that? >> the operations as we are conducting them now, there are still weapons out there and still targets. if there are any signs that they can threaten the civilian

population, yesterday, for example, we took out m21's in the direction from the west of the city. these weapons were firing. we engage them. in the urban city, it is far more complex. have precision to take targets if there is a threat against a civilian operation. in the past, we have taken facilities, buildings, pieces of artillery, radar sites. and we will do so if there is [unintelligible] >> james? >> two questions.

unless tripoli falls quickly, the rebels will meet air support. as nato categorically ruled out that option? providing it to them, that is. and the un is debating the renewal of the mandate. she sees the need for combat craft after mid september? , it is very complex. we talked about urban fighting. doing is more to look at -- i can't go into the

details, but essentially, we are looking at what is going on on the ground. and what is identifying a trip for a civilian population. it might be if there are movements, these are examples. no, we don't provide support. >> on your second question, this mission isn't over. nato remains vigilant. they have extended the mandate at the end of june for another 90 days.

so the operation is still ongoing. clearly, the situation remains fluid on the ground. and in the adaptation will be done following the advice from the military authorities and decisions will have to be taken by the north atlantic council. at the moment, we continue to assess, consult, and discuss within authorities and, of course, with all of the other relevant international actors.

presumably, it did not come as a complete surprise to you. and referring back to the initial question, there is clearly a lot of outgoing fire at the moment for the bunker and compound in tripoli because it is under attack by rebel forces. does that mean it constitutes a legitimate target? >> will have quite a good understanding of the large- scale, if you wish. of course, we are not coordinating what we do in technical fashion with any of the mayors. there are technical operations

with the forces. the second question, you're referring to what is going on -- can you repeat that, please? >> there are a lot of reports of fire coming out where he may or may not be. probably the primary reason coming out of the compound is that rebel forces are attacking it. does that make it illegitimate target for nato action? >> we have no signs that the forces will behave in a way that is inconsistent with a un resolution. we are maintaining vigilance there.

i will not speculate on any future operation. i can tell you that we have received assurances from the national council that they will want to respect the letter and the law. and what we are seeing on the ground, potentially reflects that. if i remind you, some of the eccentricities that occurred in the last weeks and months, the missiles being launched toward an urban area, this is the forest here, conducting very --

>> lee can go to naples for the next three questions, if there are any? [unintelligible] the that the situation has changed, how long the will you into nato -- can it be enough? >> i think we have to look at this from a global perspective. probably, there is nobody, and if anybody thinks so, nobody can predict exactly when the forces will drop their weapons.

with a fulfillment of conflict. nobody can say exactly when. however, over the last few months, the regime -- we could see the difference it makes from a day to day fashion. over time, what we're seeing, it is not a major offensive. what we see is doctors, teachers, farmers. citizens that realize it is not fully controlled anymore.

it is quite encouraging and also quite difficult to predict. about military formations of dancing. we talked about citizens that can take their destiny in their hands. i think there is no doubt it is coming. exactly when, we will see. >> is it true, nato already allows ground troops to fight

close to the rebels in libya? >> if you know, let me know. we don't know. i am not sure that this really does matter. the resolution of this situation will be political. it will likely not be part of the solution. from that perspective, we don't know. i don't fake it really matters. but we realize the value. in terms of adding ground troops to libya, if you refer to nato

ground troops, our mandate is very strict. enforcing the no-fly zone. >> here is a quick hypothetical. let's say that the surveillance -- under the mandate, does he get targeted at that point? in the discussions being held today, you know, is there any timetable for the decision or anything that will be announced by the nato member states regarding the next steps if the rebels consolidate their gains?

>> we do not target individuals. he leaves the country and to let the political process help find a solution. he is not the target. of course, part two of the answer, he is located in a facility that controls the tax. i will not comment on the other part. >> the second question, we will keep you moving forward. decisions today and in the future through of this crisis.

>> the rebels claim that they controlled 95%. i don't know if you can confirm this, but we will be talking about tanks, presumably from the regime leaving the presidential palace. what can you identify as the main people remaining in tripoli? business, and i remind you to account assets. what i can tell you is that globally, it is not under control anymore.

i would not risk going to percentages because there is still fighting. it brings me to your second question. the situation is very serious and very dangerous. especially in the light -- in an urban area, snipers shelling, they cannot change the course of history or the course of this campaign. but it can explain why we are keeping up with that mandate. >> we talked about the

principles imagining a post. you talk about nato plane and supportive role. what would that role involved? -- involve. ? >> there is clearly a leading role in the time that has already started and in the united nations and the contact group, we welcome the fact that both have announced meetings of the matter of urgency. we continue to hold staff meetings and be involved actively. nato, as i said, will have a supporting role, if required, on

request. nato will consider how can play a role in helping stabilize libya further. the details remain to be discussed. within nato itself, there are contributing partners and to the international organizations in the league with the libyan people. they are in the lead themselves with transition. >> first, a question for naples. colonel, a follow up on the 95% question. putting percentages aside, can you tell us how accurately assistance from the transitional council has been, particularly given the recent incident where

he was not captured? are you relying on the assessment that you find credible? and if i can ask, a little bit more on what will happen this afternoon, you mentioned in your opening remarks that there were not review options. has the military committee actually been tasked to look at specific options? i believe the secretary general said that they are waiting for guidance from the un. to either plan for or present options for stabilization. can you address that? >> you may not find my answer fully satisfactory. nato is not in the business of overseeing capabilities of belligerence and conflict.

in which we are only a party with a limited role to enforce the embargo, the no-fly zone. of course, we have an overall appreciation of the situation, and it is quite clear. we can even watch it on tv. the regime has lost its control over key strategic areas in the country. i will not venture into a guessing percentages or commenting on other people's estimates. in the dead of night and does not indicate somebody who is in control of the country or capital or anything at all, really.

it shows the remnants of the regime are on the run. and it is up to the libyan people to decide the fate of the three that have been indicted by international criminal court. and as we have seen very recently, those that are on the run from international justice may be on the run for some time. in terms of what will be decided this afternoon, as i said, he can't expect me to prejudge the discussions of the ambassadors. rest assured, will let you know as soon as the decisions are taken. and nato will continue to make improvement planning as we have done from the beginning of this crisis.

and i think we have all seen that prudent planning has been paying off with a very effective campaign. >> are they preparing something in preparation for the meeting? >> they are always asked to provide their assessment of for the decisions of the north atlantic council. >> i was going to ask the same question about the military. >> i have a broad question. can you assess to what extent nato coordinated with the rebels in terms of picking targets or any kind of coordination, and if

there was any, how did it change over the last nine months? >> we do not coordinate with the opposition. we do our missions, basically to do the no-fly zone and the embargo. of course, we obtain information from our allied nations present on the ground to know what is going on, to know where and when we can better finished our mandate. but we're not in contact with the forces. will have quite a few

questions still here in brussels. thus we have one. >> could you just clarify the last thing you said, you obtain information halide nations? there have been reports that british and french special forces have been army and training the rebels through different parts of the conflict. is that outside of the nato umbrella? or can you elaborate a bit more on what you meant by allied nations with a presence on the ground? i can't comment on the other nation's activities. we do have eyes and ears in the country, which is basically that

intelligence has emerged within the intelligence we can get for these operations. we don't have anymore questions from naples? >> i know you are saying the situation is still very fluid. talking about the next steps, there is this waiting atmosphere that the un will take over whatever will be necessary. my first question is, wouldn't it be the duty of the europeans and nato to take over the responsibility here?

and what do you expect from regional players? what should they take now? >> we have seen the united nations together with other international organizations in the lead, on the political front trying to bring this crisis to a solution. nato is implementing a mandate from the united nations security council, and we will continue to do that until all attacks and threats of attacks against civilians have sought, until all of the forces have withdrawn to the base, and until there is full and free humanitarian access. if nato and our partners have decided in berlin, these are the clear military goals.

but we have also made clear that in the post-gaddafi period, nato will take a supporting role if required. it is for the united nations and the contact group to take the lead in conducting any civilization operation. in taking decisions as to how to support the people of libya to build a stable and secure future. nato is willing to help in a supporting role. if requested, and if needed. we have made clear, also, that there will be no nato troops on the ground in the future. as we have seen in the past, who i trust and we have already seen that all of the

international actors have stepped up to the plate and play their full role in bringing this crisis to a solution that responds to the legitimate aspirations of the people. we had a question over there. >> [speaking french] >> [speaking french]

>> [speaking french] >> thank you, terry schultz with national public radio. the defense minister has called upon it to step up bombing of the complex. he said it would be symbolically

important to show that there is no sanctuary. given your saying that it is not important where he is, do you disagree that it would be important to destroy that complex? and given that the tnc has been here, recognize as partners of the rebels, why is there no coordination? >> with respect to the complex, we have strikes at the complex. and regarding future operations, we will continue to, without remissions, we will do strikes. conduct strikes whenever necessary to protect the opposition in libya. it has to be very clear that we will strike at every trip that

could be present in libya against the civilian population. >> you are saying that if it is not tactically important, you don't find it necessary to intensify the bombing? >> i will never speculate about current or future operations. if the location is of no importance, we would not have struck in the past. we were talking about the symbolism, we're talking about gaddafi himself. stay tuned. >> the national foundational council, clearly we are -- we

consult with them. we are in touch with them. the mandate of this mission remains the same. the mandate is clear. that is the protection of civilians and civilian populated areas. >> you said it had to be a request. can you specify if libyan request or international?

>> can you please introduce yourself? i will not predestined judge in the discussion. -- pre-juddge the discussion. >> [speaking french]

>> [speaking french]

>> i have another question. no troops on the grounds in the future. post-conflict that can only be true for nato. the other would be sector reform. that is something i assume would be led by the other major organizations. reform embodied in the zero kinds of personnel. when you say no ground troops are you including or excluding them? >> that is another excellent

question. at the moment, i will not go into any more details. i said the secretary general of mentioned the possibility of the defense secretary reform. one of the areas in which nato that could pay a possible role in libya or in other countries in the region. at the moment, we will continue with that. >> they say no boots on the

ground. >> thank you. >> boots on the ground? >> [speaking french]

>> i wonder how important is it that the other people come out of this alive and what exactly do you do? >> thank you. >> he has given their some already. it is up to the libyan people to decide their fate of those who have been indicted against humanity and other serious crimes. there was that transition in

libya. there are states that are democratic. it is based on reconciliation. the rule of law is important. in the last few days, it is given by the leadership of the national transitional council. i think they made it very clear. it is very clear. we have one last question.

>> when you say boots on the ground, there is another formula. they remember its. >> i thought i said no nato forces on the grounds. national decisions are national decisions. i will not be judged by any national decisions that have not even been made. it is a matter of bowl -- matter of policy that we have not discussed it. thank you very much. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2011]

>> this is all coming from the inside. this is where bourbon gets all of its color and a lot of its flavor. they discovered it just from the barrel. >> this week, we highlight frankfort, ky on american history television.

it is on the crawfish bottom. and on american history tv, at a visit to the buffalo distilleries. it was one of the only two distilleries during prohibition, for medicinal purposes. this weekend on c-span2 and c- span3. >> for nonfiction books and american history, it is the c- span networks. it is all available to you on television, radio, online, and social media websites. weston share all of our programs any time with the c-span video libraries. we are bringing our resources to

local communities and showing events from around the country. it is washington, your way. it was created by cable and provided by a public service. >> now remarks from adam. he is running for a u.s. senate seat next year against bill nelson. this is 25 minutes. >> i do have to tell you that this has a very special place in my heart. this is where i propose to my wife who is here with us today. i want to thank everyone who is here today and has taken the time outer their schedule and ordered to be a part of this event. this state has become a central pillar of the conservative

movement. i am always ask how it is possible that i turned out to be a conservative let alone a republican. i can tell you if it is certainly -- i can tell you it certainly was not my upbringing. my parents were liberal jewish democrats you were schoolteachers from brooklyn, new york. when i was born, and they had $31 to their name and a sacrifice of that we can move to florida. i got the passion from my mom. i got the love of baseball from my dad. i thought the politics from someone as big.

when i turned 18, i registered as a republican. i am sure you can imagine that conversation. after the malaise of the carter years, he led this to the shining city on the hill. he had a profound influence on my life. i was inspired by his can-do spirit. his moral clarity and is common sense. for all of that, ronald reagan was the original tea party in

surgeons. when he disagreed with the republican party, he did not abandon its. he changed permanently and for the better. his example inspires me to this day. america's decline. he refers to it. he did not campaign on making campaigning less painful. he stopped it. he did not just slow down the soviets, he defeated them. [applause] ronald reagan came on the scene and swept away the conventional wisdom of the day.

we win,the they lose. it sounds so simple. they say the world is too complex for simple answers. they are wrong. that is even more true today. the experts and the establishment are telling us that we have to get more of our freedoms, our money, and our decisions to people in washington, d.c. we hear this talk about changing the debate in washington and have the policies that we know our rights are not realistic. our job is not just to slow down a obamacare or manage the national debt. our job is to provide a clear alternative to the policies in washington and offer real

solutions to turn america a round. the nature of the challenges we face simply demand that we put principle furs and our -- first and our country's fate ahead of politics. i signed on because it was the only proposal that actually attacked the real problems. it was the only proposal that may have given us a fighting chance to stop the angeles borrowing and spending, to stop the mountains of foreign debts and to start us down the path of reuniting america's economy. even the experts in washington declared impossible. it turned washington on its

head. it is exactly what we need to be doing. the debt deal is a perfect example of what is wrong in washington today. too much gamesmanship and not enough leadership. i have heard all of the arguments. some good friends defend it. that is their call. it does not change the fact that it is a bad deal. the downgrade and common sense proved it. the whole process was a dysfunctional mess. only in washington could they make this up. they tossed it aside. for what that's a deal that at $10 trillion more to our national debt?

they opened the door for higher taxes and and our national security pickete. if it does improve, we need more principle conservatism washington. it is about growing. it is about growing the jobs and opportunities. we need leaders that will stick out. we need to be aggressive on sweeping tax reform. we should push to eliminate loopholes, subsidies, and special interests car about spirit -- special interest carveouts. democrats see tax reform as an

excuse to raise taxes, punished creatures and re-should paroom redistributioe this. this is not mean reforming taxes. it means reversing job killing regulation. president obama wants 4200 new regulation. they want things done everything from farms to construction sites. let breed any new regulation that would have an impact. we should be pursuing more a domestic energy exploration. while we're at it, let's shake up the agency's.

let's begin with the national labor relations board. we must stop them from advancing big labor agenda through the back door. what they are doing to companies like boeing is economic extortion. it is anti-american. lastly, if we are going to solve our nation's debt crisis and the job crisis, we must repeal obamacare. this will make our system worse not better. what's it is implemented, it to

be impossible to get rid of. the fall of great society's began when freed them gives weight to this. if we act boldly, we can reverse the course that washington politicians have placed us on. it is not too late. america's decline is not inevitable. it is not in the power of the state. we will usher in a new era of economic prosperity and security. we will take back the united states senates and the vital reforms necessary to turn america around.

it is not easy. it takes a lot of money,, and prayer. it works. that is how i ended up here. in 2002 when i decided to run for the florida house, a lot of people said i did not have a chance. they said i was too young and too conservative. they told me to wait my turn. i knocked on over 10,000 doors ticket. a primary cricke people said it would not last. they said i could never get reelected from the nra >

they attacked me for standing up against the union. my local newspapers beat for being too ideological and rigid. despite it, i've won reelection three times. the eight years that i served as a part-time legislature was a tremendous honor. we were proud foot soldiers in the conservative revolution. we cut taxes. a reformed education. we balance every budget. -- we balanced every budget. i was picked to serve as the majority leader. i was picked by marco rubio. he once described me as the most partisan republican in tallahassee.

the day he was sworn into office, he began governor as a barack obama liberal. people have short memories of politics. before the great american awaking, of the establishment was telling conservatives that the way to beat the democrats was to be more like them. i stood by his side while they parliament stood by. he was on the cover of every

magazine. it is the future of the republican party. we stood up to them. we ignore the polls and the establishment and those who declared that conservatism was dead. we proved them wrong. we can do it again today. fight, noot stand iand one else will. we began this revolution in 2010. we must work even harder now. we mess and more people to washington he will do what is -- we must send more people to washington to do what is right.

we need conservatives who will stand up to the democrats and republicans that act like them. [applause] this is even more important now than ever. after the message we sent last year, every politician is trying to reinvent themselves as a conservative. it is getting so silly right now in florida. charlie crist, and the same guy to two years ago described himself as a republican and was marco rubio, is now trying to run as a true blue republican. now is not the time for reinvention.

now is the time for reenforce mechanics -- for reinvention of republicans. i would be proud and honored to be one of the leaders that you sent to washington next year. please, join our movement. connect with us on facebook and twitter. this is a battle for the heart and soul of our country. we must rise to the generational challenge like those before us rose to theirs. when we but balook back, i wants all to say that we answered the call. together we will save the united states of america. thank you. god bless the united states.

[applause] >> we put him on the spot here. they have to take questions. they can stop the whole market rubio person. he gives a speech himself. right here in the second row. >> [inaudible] >> let me share with you that i was one of the first in the

country of the candidates to embrace the paul ryan plan to save medicare. i recognize many of the challenges we have and the decisions we have to make in order to preserve social security. and florida, we have 3.3 million floridians who are currently on medicare. the medicare trustees have said that medicare is going bankrupt in the next 10 years. if we did not make the tough decisions now and transformed the system from one that currently does not work with baby boomers coming on the rolls, if we do not make these tough decisions now for future generations, these programs are blind to collapse of current beneficiaries. they are going to burn with crushing taxes, lower standard of living, and an infringement on their personal freedom. you are running for the united states senate and the state of

florida. the senior population is so high. florida seniors have the most to lose if we do not have this conversation. we need to go out and our people with the facts. republicans are often too passive. we need to be aggressive and have the statistics and numbers. we need to go out and persuade the american people to preserve our greatness p. i believe that the reforms start with the ryan plan. it is a great first step. i fully embrace it in terms of providing individual with the

payment so that they can go out and purchase their own health insurance. we trust them. we need to be more specific about raising the retirement age. we need to be more specific about how we calculate benefits. we need to be more specific about giving people the opportunity to be able to opt out. that will preserve the social safety net. we have not gotten there yet. thank you for your optimism. >> [inaudible] it is not that we are losing the

war on drugs. we have already lost it. >> we were just there for the political barbeque. while i recognize that so much of the time in florida and elsewhere is job-related i am watching what is going on among our southern border. we have a full-fledged war taking place along armed mexican border. what we're seeing with the drug cartels a kidnapping and murdering, legalizing drugs is not going to make the situation better. we need to be more vigilant to preserve our values and culture.

[applause] >> [inaudible] >> this is the beginning. this was the elimination of certain agencies been ordered to return to dismantle government. it starts with education, energy. it starts with housing and urban development. we have to win the battle. did this is an ideological battle. this is not come with more

taxes and a growth in government. well we have seen in washington over the past years, republicans are sharing the blame for growing the size of the federal government. we have to recognize the portion of the budget is over 60%. while we are working to restore constitutional spending, there are areas of education and elsewhere. when to give states back the power. >> it is a pleasure to have you

here. >> thank you. >> dr. martin luther king, at no time in his life did he hold a public office pictur. he never had much money. while he lived, he was reviled as much as he was celebrated. they are leading the people to freedom. he had the task of festering

wounds. >> now nearly five years later, at the memorial will be dedicated in washington, d.c. it is surrounding the dedication on the c-span network picturs. >> that pretty amber color is on theming from the char

inside of the bourbon. that is where the burbank get all of the color and a lot of the flavor. >> this week thing, we highlight frankfort, ky. a visit to the distillers. is one of the only four. the first two state houses burned to the ground. book tv and american history

television this weekend on c- span2 and c-span3. >> we return to the annual red state political blog conference. he is a ceo of action for america. he spoke for 20 minutes. it is our job to make sure the washington establishment has sex -- does not have a good night's sleep from now until the election. it is not just the elected officials feared it is the elected bureaucrats. they have been there for 45 years. we are big fans of the heritage

action. we know that d.c. is broken. it is broken because of the establishment. it is broken because of the congress that is not doing their job. the only solution is active citizens. this is a leading place that it happens. thank you for what you are doing. it is great to be in south carolina. i want to talk about the congressional delegation. you have five republicans in the house who are among the best congress then we have in washington, d.c. right now. the referenced the scorecard. let me flip the lid on it.

you would not believe the crying that happens in washington, d.c. when you do is corporate less defund the corporation. but at a report card on those. we sit here is the percentage of those 23 votes that each member voted for. the wailing we endured is indescribable. one said how can you give me a 53%. we did i give you a 53%. you voted 453% of them and we

pointed it out. he looked at me like i said the moon was made of cheese. he did not understand. their only 26 out of 435 members to god and 85% on the scorecard. -- that got an 85% on the scorecard. all five from virginia were there. there is an evil party and a stupid party. occasionally they get together and do something that is both evil and stupid to make it.

outside of the south carolina republicans predict all five of the south carolina -- all five of the south carolina republicans voted against it. i met here to set up to politicians. i'm here to thank you. this would have been really tough. they have a refusal to go along. there is nothing these guys will say yes to. these are the far right guys -- there is nothing that they would say yes to. they were going to be in transit and no matter what.

it was all from people who were supposedly on our side of the fight. it would have been very easy to buckle under this pressure. it would have been very easy to bend and break. single one of you, i admire you in thank you for that principle. let's be clear. there is a bipartisan political establishment that thrives on the consolidation of power to its supporters. as conservatives, we want to focus on our careers in communities. our country is at a tipping point right now. it only be saved by staying actively engaged in telling the washington establishment that they need to get their act in

line. this is what we are trying to do. i want to thank you for your engagement. i want to stress five diseases that afflict washington, d.c. there is a team mentality in washington beses their only two teams. -- that says there are onyl tnly teamwo teams. more americans and not identify with either party. the president of his united states and not use the veto pen in the first six years of his administration. why had he not vetoed a bill?

you do not understand. the same team. they agree with the legislation. in essence, the presidents of the united states in the republican leadership decided that the constitutional principle of the clash that needs to happen was going to be subservient to a team mentality. this is the philosophy they gave us out of control spending and no child left behind. this is the concept the game as medicare. we have a congress that has given up this constitutional power to legislate.

all of us have seen that when president obama and cannot get his plan that he decided who's going to try to get the epa to enforce it. it is literally hundreds of of regulations that are being written by bureaucrats. they have been elevated above the constituents. they are the people who some politicians to washington. you have the labor union taking care of. they were investing in the companies. all you need to ask is are the labor unions treated the same

way as every single one of us? the labor unions are part of the establishment. politicians are part of the establishment. the fourth is the rise of a plan that sets bass lines that make aslan no sense to any of us. -- that make absolutely no sense to any of us. you have a system in washington that is a large -- allegedly the largest spending cut in history despite the fact that spending went up this year. that does not make any sense. because the debt is only gone up by $7 trillion, we have done historic spending cuts that we can go back. none of this would be possible if we had a media that saw the truth and some of the horse race -- instead of the horse

race. [applause] i hear stories of the media that action affected the influence. they are that. their stories. too often there they get away -- they are the get away drivers. there is the rise of a permanent and lucrative campaign consultants whose livelihoods depend on the next election. in march became a rallying site.

this is designed with the mayor. they went through this to kill the program. if you get the social security aside for social security was a bold the lead, they looked over their soldier. all of their colleagues were leaving them alone. these all bring this back to the claims of the tea party. earlier, the explain the high bids for the good guys. they were the guys you want to be on their side. the high bids did not exist in the real world. that is the way washington, d.c. works in the real world.

we need imagination. saving the country from the tsunami of spending is what we should want and what we need to be doing. they are being weakened by in excess of government in washington. business as usual in washington leads to a slow decline. if you do not accept the premise that western civilization can handle the clash of america, it could be far worse. the american people have the imagination. all of you who are involved have the imagination to save it.

it is reported that $20 billion will be spent by lobbyists in washington, d.c. bill continue to grow government year after year. it is a very important fight. thank you for being engaged. this fight will never be boring. thank you. [applause] >> our e to sit around and

answer some questions. when ever i go to washington and think i have a target on my back, i think it is there. questions? >> we had a conversation. you are not conservative enough, for the tea party. he said i have the best voting record of anyone. >> and republican senator in georgia pointed out that he was recently named one of the most conservative senators in the senate, even ahead of jim demeemint.

i just wanted to point out one of the things he said about how their so few people who scored so well. most republicans are very well almost four cards because it is designed for them. they do this based on legislation. >> there is one scorecard in washington that is perceived by a gold standard. 76 that a 100 term score. jim demint does not even have a 100. >> i love that even he does not have won hundreds term.

>> [inaudible] >> sunshine is the best on this. everyone should be able to give as much as they want. if they did that, if they would pick up a score card. i think this transparency has been there. when you point out that you are a member of congress from a lan lot state, you voted for a punishment project.

you can excuse him. if you are from a launcelot state, there is absolutely no project. you should be held accountable. if the information is out there, if you can put the information out there, all of us are held accountable. that is the way i would go about campaign finance reform. >> that is outrageous. john kerry has five beach houses. right there.

>> [inaudible] >> we have looked at this and about 45 votes that have happened. this is the type of thing that downgrades it. they did it all the fire s.partment i they found no difference in outcomes. all.tcomes at even if you think they should, this does not work.

we decided it would be smart to put an amendment to double the funding. they look at this. it showed the difference. you also need to have a scope scorecard a stand against unfai. we look for these type of thing .pi there is no excuse for the program. >> no. have to cut it short. we have to give folks out of the room.

if you've not been to their web site, please go. >> dr. martin luther king was not a president of the united states. at no time in his life did he hold public office. he was not a hero of foreign wars. he never had much money. while he lived he was reviled as much as he was celebrated. by his own account, he was a man not without flaws, a man who more than once questioned why he had been chosen f s