c.m.s., h.h.s., seniors ht with the about all of their health care federal ith the government not favoring one type of medicare over another. state, which like the chairman's, has a high level of we're the vantage, third highest. medicare advantage may not be he most attractive option in all corners of the state. medicare and for edicaid services cannot become an advertising arm of private insurance or any other type of the role is to seniors get t straight talk about all of their options. the days lot to do in that and i'll tell you, hen the finance committee convenes in 2019, and chairman worked on d i have lots of issues, pharmaceutical issues and the like, and he gavel, i'm going to hink about my long-time friend chairman orrin hatch. this is some kind of public ervice career that we are honoring this morning, and ted kennedy used to tell me all the ted kennedy and chris dodd used to tell me all the time, well, you know, we're to orrin.king you should keep that up. ell, that's one of the

you can see here key criteria that are measured by c.m.s. so then deliver what the star rating for the given plan is. that includes helping members stay healthy, managing their conditions and so forth, and obviously, deliver outstanding customer service as part of that. you know, what i'm happy to report on on page 29 is that the fact that there's a range of star ratings across the country from various plans, but you align with two partners, one has the maximum star rating in kpsa, and one with a very height rating, especially for a national p.p.o. program, with u.h.c. so both are delivering high star ratings, which then helps to maximize that reimbursement from the federal government and in teurn helps to manage the premiums that are passed onto sfhss. so where i'll close on 30 and 31 and then happy to open up for additional questions, the important to think about how medicare advantage plans fit into the strategic plan and the five goals of the strategic plan, i mean, i'll certainly right off the bat, you want to keep these programs afford

now a range of mobile phone packages has to be rolled out as well as say the c.m.s. app i did the last or children december the sixth at eight am we will have a very specific set time for this the internet service will open for mobile phones this is been something that the people have long been anticipating. many cubans complain about having to brave insects on the elements at the public hot spots which also like pretty. well when the water is great imagine being at home and already being connected i don't have to get up and go to a park and find a hot spot. however thirty dollars for a thirty day four gigabyte package the new network will be beyond the reach of many even if the government says it will boost the economy and help the country defend its revolution online. today is a favorite day of the year for kids and adults alike in many countries here in europe the sixth of december nicholas day the figure on which santa claus is based is not here in germany nikolaus and celebrated with a frenzy of sugary gift giving throughout the country now the confectionery ind

made connectivity a priority now a range of mobile phone packages has to be rolled out as well it's a c.m.s. i did that last for children december the sixth at eight am we will have a very specific set time for this the internet service will open for mobile phones . this is been something that the people have long been known to as a paid thing as many cubans complain about having to brave insects and the elements of the public hot spots which also like privacy. when the world is great imagine being at home and already being connected i don't have to get up and go to a park and find a hot spot. however thirty dollars for a thirty day four gigabyte package the new network will be beyond the reach of many even if the government says it will boost the economy and help the country defend its revolution online. record imports in october the u.s. trade deficit to the highest level in a decade commerce department says the deficit hit fifty five and a half billion dollars in october the fifth straight monthly increase the deficit a good straight with china alone varies just a the seven percent to a

congress should also require c.m.s. to improve transparency regarding the total amount of drugs purchased by health care programs so we can stop these programs. and to combat the underlying factors affecting addiction, congress has to do more here. we should put in place a three-day limit on prescription pain medication for acute pain, not for chronic or cancer, but acute. it should require all states to utilize prescription monitoring programs. there's reason to be optimistic, as i said earlier about the direction our country is heading to in overcoming the opioid epidemic. we committed ourselves here at the government to be better partners with state government, local government, and nonprofits, that's good, and i'm proud of the work that this congress has done. but the tragedy of overdoses has created the opportunity for companies like kaleo to exploit or capitalize on this public health crisis. that's wrong. it's shame full. i'm proud of the investigative work weef done. -- we've done. i will continue to do what we

and 12 really touch on this aspect of flexibilities that are being sustained by advancements that c.m.s. is providing, the center for medicare services. the concept of supplemental benefits are being expanded -- [inaudible] >> -- the notion of value-based insurance design, so targeting design features that can provide an enhanced level of benefit to members to meet their needs, and then some examples that we show on slide 12, some of which have been implemented, and some of the sfhss plans, you know, you can see the listing here, including items that were touched on earlier by the public comments. and then on slide 14, the sources of savings versus original medicare really fall into three primary sources. one is trying to optimize reimbursement that's being provided by the federal government into the program. two is tied to the provider relationships and emphasizing provider collaboration and the delivery of care and the resulting compensation for care, and then, improving member health through enhanced preventative benefits and other notions that help to enhance the care environment. a

in august, c.m.s. is beginning to require hospitals to post the amount they charge for services online and to keep that information up-to-date. these are the types of specific recommendations i'm looking for. now, i had some success working with experts to ask them for recommendations in priority order and then turning those recommendations into legislation. in 2005, i stopped by a meeting -- i was a member of the budget committee then, and i had become increasingly concerned about the rapid increase in the federal debt and how it was squeezing out some of the essential programs that make our country competitive. so i stopped by a meeting of the national academy of sciences on american competitiveness and i said to them, most ideas fail in washington, d.c., for lack of the idea. i believe that if you, the academy, will give congress ten specific ideas in priority order to improve american competitiveness, i believe congress will enact those ideas. the academies got busy and recruited norm august is ste

it is called the c.m.s., contract management system. we provide -- we ask the nonprofit agencies to submit surveys to us and that is done by transportation. we also do fiscal monitoring and partnerships with the controller 's office. and then we foot do focus groups and interviews of participants and key stakeholders in the community. i do want to integrate that this whole monitoring process is truly part of an iterative, continuous improvement process for us. we firmly, firmly believe that with additional support, the nonprofit agencies will be able to provide the highest quality of programs and services for our community. we came up with performance measures to -- through a process called results based accountability where we ended up identifying 26 unique performance measures across 24 different strategies within six different service areas. and in a nutshell, it helps us to answer these three top questions. how much programming is the agency providing, how well are they doing it, and if anyone at the end of the date is better off? a

now a range of mobile phone packages has to be rolled out as well it's a c.m.s. i did the last or children december the sixth at eight am we will have a very specific set time for this the internet service will open for mobile phones this is been something that the people have long been anticipating. many cubans complain about having to brave insects on the elements at the public hot spots which also like privity. but when the water is great imagine being at home and already being connected i don't have to get up and go to a park and find a hot spot. however thirty dollars for a thirty day full gigabyte package the new network will be beyond the reach of many even if the government says it will boost the economy and help the country defend its revolution online. mayday mayday mayday is o'grady an o.b. and o.b. over a scene there from the film six that has won the german human rights film prize this year the ward ceremony will take place in the city of nuremberg this saturday but the winners in all the categories are already know it so let's find out more about so

the bill strengthsens c.m.s. and congressional oversight of the program to prevent this from happening again. i want to thank mr. welch, senators widen and grassley, grassley, and and mr. weldon. i urge all members to support the bill. i yield back. the speaker pro tempore: the gentleman from texas, mr. barton. mr. barton: i'd like to recognize the gentleman from florida, mr. bilirakis, for one minute. the speaker pro tempore: the gentleman is recognized for one minute. mr. bilirakis: thank you, mr. speaker. thank you, mr. chairman. i rise in support of h.r. 7217, the improve act, which includes several important medicaid provisions, including the ace kids act. i have been a co-sponsored this act since the first introduction, mr. speaker. and the tampa area we have st. joseph's children's hospital. they run a chronic complex clinic for children. this medical home is a great model that ace kids is trying to build on. this integrated care model where the care is built around the needs of the patient, has made it a

appropriated to effectively treat and find a cure for alzheimer's with the hope for alzheimer's act we got c.m.s. to provide coverage for comprehensive care planning services to medicare beneficiaries and their caregivers following a diagnosis. these care planning visits are a critical tool for families struggling for answers and hope to lessen the burden of this disease. we are taking another huge step forward with the passage of the bold infrastructure for alzheimer's act, legislation that will invested in public health strategies for tackling alzheimer's disease. e know that in 2018, alzheimer's will cost our country $277 billion. by smartly investing in a public health infrastructure for this disease, we can reduce this cost burden on local, state and federal governments and improve care for those who received this diagnosis. the bold act will enhance our public health infrastructure in three main ways. it will increase public health centers of excellence and will be dedicated to promoting ffective intersentions and educating the public on alings i'mer's disease and brain health. these cente

it does this by requiring c.m.s. to enforce penalties on drug companies that knowingly misclassify drugs in this medicaid program. the legislation also provides remedies for states that are shortchanged by drug companies. it requires an annual report to congress by c.m.s. to make sure the agency is doing all that it can to protect taxpayer dollars and keep drug expenditures down. this is commonsense legislation. it would close a loophole used by drug companies to keep prices artificially high, much higher than they should be, and it grants the secretary of h.h.s. the authority to properly enforce the law. the right rebates act is only one step in the fight against high prescription drug costs, but it is the right step -- and there are a lot of other steps that must be taken. i look forward to working with senator wyden in the 116th congress on many issues important to americans, including the high cost of prescription drugs. i yield the floor. mr. casey: mr. president? the presiding officer: the senator from pennsylv