cms, the oig office, the gao. hope the three of you and the three of your entities in the office will see this committee in a very positive partnership manner because that is what the intent of this hearing is. again, you reference not playing dhaka that's certainly not what mr. towns and -- i sometimes forget the reference because i've been chairman with him as my ranking member on two occasions now he's been the chairman with me on his ranking member. the bottom line is we have a shared focus which is just to have good government and to partner with all of our colleagues in the government to achieve that and so that is clearly what comes through our intent of this hearing in going forward for the partner and how we can further partner in the months and years to come especially if there is legislative issues, and one that was mentioned for the statutory language with the power wheelchair's and we have to start there. and if there are issues that you identify at cms that perhaps the intent of congress is not fulfi

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. s

larsen, i appreciate the work you are doing and trying to do at cms. they recently published a national expenditures report for 2010 and found that the health insurance premiums will increase by 9.4% in 2014 as a result of the president's health law. you discussed two tools as i view it in your testimony that the administration is using to decrease the rate of premium increases, however, the central promise of the law was that it would reduce premiums, not reduce the rate of growth in premiums. now, in the light of the new report issued by your agency, how can the law keep its central promise of reducing premiums by $2500? >> well, first, my understanding of the report was it showed the rate of health care spending for last year was at the lowest that it had been in many, many years. in fact, the rate was moderating, and i think that's a significant point. i apologize i'm not able to speak, i guess, to the estimates by the cms actuary. i know that -- i guess it's the difference between what rates would have been with or without the aca, but we continue

torrential rain and hail stones 1 cm wide. >> powerful winds tore across the festival site, sending hundreds running for safety, but some could not escape. a staging gave way and lighting rigs were tossed aside. the storm passed quickly, but the carnage had rescue workers slithering in the mud caused by the downpour. >> there are three patients critical, fighting for their bucks. >> is one of the biggest open- air festivals with some 60,000 people on site when the storm hit. organizers have described the storm as exceptional, saying weather forecasters had not predicted its intensity. sec officials learn how investigating why so many structures buckled and collapsed in the wind -- safety officials are now investigating. you are watching bbc news there has been another day of fierce fighting in libya. thousands of foreigners could be evacuated to escape the violence. activists in serious a security forces have opened fire on an anti-government demonstration, killing at least 20 people. to our top story, the fighting in libya, where rebels have taken control of much of the city of zawiya. than

report and it said that in 1997, it presented the director with $925,000 for the rapid development of a cms replacement plan, and then it states, the fiscal year 2007- 2008, a product will have cost more than $5.5 million. it is difficult for us here to draw any other conclusions. >> exactly. i have seen that in the report. i am speaking about it -- before i was closely involved, 1997 -- that was the initial funding to bring in a consultant to the that the project and to preliminary work on it. that was not the final justis budget that would fund all of the case management systems through each of the member departments and would build the hub. less than a million dollars is not, in anyone's imagination, enough to buy a case management system, install them, and build a hub. those numbers are out there and they are constantly compared and we should do a better job of providing you with accuracy on what this has cost. >> i appreciate that, but in 1997, i do think that that would have brought new a bid. who is in charge here? if not the city of visitors of this or you, the co-chair of justis? >

. >> the cms will make dana's marketing easier. >> i've been listening to you. didn't ask you for anybody's address. you need to start collecting them so you can put them in the system. if you want to push out a special, you can't sit there and call every client and say, hey, we're having a deal. you can push it out with an e-mail blast. >> reiva ace she has to pack them up. if everything is stored in the cloud, you don't have to worry about it. if it's on the laptop, as well, you can access your cyst blas it's not here in the computer. it's where you are. >> and finally reiva says the scheduling board has to go. she has to find a program that caters to her contractor. >> jackie loves doing that. >> i'm excited. i now have a really good excuse to really push connie forward and say, we got to get this done. >> sure, connie has a little bit of work ahead of her but she as a goal in mind and she wants to achieve it. >> you could go on forever working with the system. >> i could but i'm very tired of it. >> absolutely time to move on. >> think of all the things you'

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larsen and thank you for the work you are trying to do at cms. you recently published your annual national health expenditures report for 2010. the report found the insurance premiere's will increase by 9.4% in 2014 as a result of the president's health law. you discussed the administration using decrease in premium increases. the central premise of the promise of all law was that it would reduce premiums, not reduce the rate of growth in premiums. in light of the new report issued by your agency, how can the law keep its central promise of reducing premiums by $2,500? >> my understanding of the report was that it showed that our rate of health care spending for last year was at the lowest it had been in many, many years. the rate was moderating. that is a significant point. i am not able to speak to the estimates by the cms actuary to is the difference between what rates would have been with or without the aca but we continue to believe that the affordable care act will modified significantly premiums. how it will do that in different markets de

they÷pjhi@ therh government havene3cthañdueflint0 >> theemullahxs% suggested theygsuz such@cm# )Ñíbydanw is that the reality? >> well, no, i think it's exactly the opposite actually. mean, i think the more military action you have -- >> the less successful, and therefore the less willing the taliban are to talk, because they think they're winning on the battlefield? >> yeah. >> rose: you hear that?yeah. i think it's pretty troubling right now. look at 2010. i mean, we're at the end of the surge now. the0,000 addional troops were now going home. >> rose: right.last year the am, by their own measure, they took off the basketsfield about 10,000 taliban. they killeabout 5,000 and captured about 5,000 oops. the violence is higher now than it was a year ago. so it's not working. and so at the same time i think -- i think the danger of these -- of these talks -- or the potenti danger there's if you're the taliban, you know, you're just looking at your watch. you know, they're just going to run the clock out. i mean, i think the americans aren't in a position where they can really -- it's jus

our cm save was arrested with them but was released last year on a half million dollars bail. she recently led this loudly outside the iranian mission to the u.n. >> the fear for them and the unknown, the uncertainty. it really just gets heavier and heavier. >> the families had also appealed here to the united nations calling for the u.n. special investigator on human rights in iran to look into the case. >> the state department said shane and josh have been imprisoned too long and it is time to reunite them with their families. the americans attorney felt a pardon would come during the islamic holy and not. now senator cloture is hoping the arabian government will overturn it. >> there are cases in the past where the sentence has been handed out in the iranian government or the judiciary has shown compassion. >> no word yet if the two years men have been behind bars will count toward their 8-year sentences. cbs news, new york. >> as he mentioned, the hikers or deal is now in its third year are you the first -- the first detained the trio back in july of 2009. their mothers ha

and you know, we can keep on, as i said scouting and counter citing, but there's enough inerrancy cms, which can be easily seized upon and used that anyone who wishes to follow the path of tolerance, nine planets, reconciliation. the most famous conan the koran to make dealing with religion is that once that can. there is no compassion. those who wish may wish, otherwise who disbelieve. severally this in the koran. for example, sites in the way of god. but do not begin hostilities. god does not like the aggressor. then there is, god forgave you to fight those who fight match her faith and do not trade bureau. the just and kind, for god loves the chest. so you know, tyrannous passages that came across in the koran itself that muslims towards all people and of course it is the concept of the people of the book in the koran, which includes christians and muslims also believe in the world testament. so there is this interfaith motion. muslims follow it in the daily packed dais. depends of course from individual to individual. there is a comparative religion scholar and i love the quote th

these are radio telescopes operating at cm wavelength. if you imagine a radio wave the distance between peaks is on the order of centimeters for these particular telescopes. they could be separated as far from one another as 25 miles. i have forgotten the exact number. nobody remembers anything in the age of google including me or maybe it is a. in any event there's a picture of what happens and we discussed our these telescopes have been used to probe disks that are forming planners. national radio astronomy observatory involved with european and japanese collaborators to develop an array of telescopes in chile called the large millimeter array. it operates at millimeter wave lengths and can resolve disks around young stars 300 light years away. here's what we think happens when a planet forms in such a desk. on the left hand side is a picture of the gap in the disk and the right hand side gives you high-resolution images of those disks. you can detect those gaps. that is where the planets are forming and the sizes of those gaps tell you

to answer it simply, what you have inside cms provided by journalists repeated side of about 30 key financiers the set command that provide the money for admission, which might range from 20 to $50,000. not that much money. there is invariably local business men who move in and out of the country. just like somali business then. he spent six months in the attack attack the homeland, had business connections outside and have the money to finance it. this has been played in the media as international crime syndicate. i've heard that a chris suggestions that american businesses are financing it for american businessmen to supply $50,000 permission, which not only are there plenty of that kind of money at somalia, if some apache may seem to suggest that some always could be doing it themselves. they need american corporate backing to get this done. the fact is there's not that much money imposed. the local businessmen i think had the face of transnational privacy claims and then came the media have seen no direct evidence that they are non-somali foreigners finance thing. there's not one shred of

byf order of the president focusedod on my discussion of the largerry history of the camp, which is cm something i have not done. i did not want to be praised org blamed for something i did not do that was not original with me. the tragedy of democracy is in much more of ambitious work which attempts to synthesize a great deal of new information onf the experience ofexperi japanese americans and canadians and mexicans andns americans, al different countries and in differentht languages.ag at the same time it brings together histories in different countries, histories that have up to now the been studied inhis isolation.n ironically, even though the story that i set out to tell was so familiar, there is more original research in treasury -e "a tragedy of democracy" then there was skin by order of the t president. part of it is the fact i have the good fortune to be aroundt c for the explosion of internet's original documents as a researcd tool. working on the internet, including the website of frenchmen delano rooseveltigit library, i'm glad to say, icume. found a great number of source

direction causing a bit of a backup on the freeway as well and in fact chp and caltrans have activated the cms traffic lights there to warn people as they exit ygnacio valley. traffic will be backed up on the on-ramp. fast speeds on some parts of six six. ace train number 3 is 12 to 14 minutes late. so give yourself some extra time. the rest of mass transit is on time. earlier problems with bart, now everything good-looking systemwide. muni and caltrain problem-free. elsewhere, here's a closer look at the bay bridge. metering lights are off but some slight delays in the cash lanes at the toll plaza. golden gate bridge problem- free. some slight delays southbound 101 out of marin county. 11 minutes, 37 to 580. typical this time of the morning. don't forget though this weekend you're going to see some substantial delays near golden gate park. the outside lands festival will take place today. up until sunday they will have closures around the area. muni extended service so that may be a good way to get there. that's a look at traffic. back to you guys. >> thank you. >>> in a month we'll mark the

. >>> the effort to bring cm to london includes the idea of shutting down facebook and twitter. we'll take a a bit. >>> well, b.a.r.t. needs your help figuring out how they will get their new fleet looking these days. check this out. there are three interior design choices you can vote on. b.a.r.t. will hold a series of open house events in the next few weeks to get your feeb feedback. if you can't make it, still voice your choice by going to b.a.r.t..gov and submitting your opinion. >>> a well-known former golden state warrior is getting ready for his induction into the basketball hall of fame. not easy for kris mullen drafted back in 1985, then battled alcohol addiction in his first few years in the league and he says his last drink was way back in 1987. after that, went on to become a five-time all-star and two-time olympian. he's now working as a basketball analyst. >>> also getting inducted in the hall today, stanford women's basketball coach tara van did he veer. she says she and mullen worked together in his early years. he would apparently stop by stanford to run drills

neil, i'll begin with a response from cm sergeant davis who asks this. about l the downgrade affect those of us with current mortgage interest rates we've had for years. >> sunt affect you if you have an existing mormg. the risk is not for existing mortgages. the risk is for people taking out new mortgages. if rates rise across the board, that would be -- make it more expensive to buy a house if that were to happen. >> from this point going forward, ron here's a twitter response from bathped who writes it may discourage foreign investors to invest in the su sa. that may have long lasting effects of unemployment. can you put those two together? does he have a point? >> you can't -- if there were a buyer strike here. if china not only stopped buying u.s. treasuries, japan stopped, other countries stopped buying u.s. treasuries and started. you could see an interest rate spike. if we see an interest rate spike, that will weaken an already soft economy that, as neil suggested, is to the tottering on the brink of recession again, and that would lead to higher

cms recently published its report for 2010. the report found the premiums will increase by 9.4% in 2014 as a result of the president's health law. you discussed the tools the ministration is using to decrease the number of increases. the central premise of a law was that it would reduce premiums, not the rate of growth. in light of the new report issued by your agency, how can the law keep its central promise of reducing premiums? my understanding was that the report showed the rate of health care spending was at the lowest it had been in many years. in fact to the rate was moderating. i think that is a significant point. i apologize i am not able to speak to the estimates by the cms actuary. it is the difference between what rates would have pinned but we continue to believe the affordable care act is going to moderate premiums. how would is going to do that depends a with respect to health insurance exchanges. for small businesses, it will have opportunities to do not have today. they're going to get efficiencies that they do

one on the matter of retaining current health plan, cms has issued regulations outlining how firms can maintain so-called grandfather status. the regulation provides latitude for firms to make changes because of rising prices. it also clarifies for firms what they need to do to keep their plan despite aca changes. while protecting small businesses' ability to retain plans is important, the reality is many firms will make changes. historically, small firms change plans due to rising prices or different benefit needs. now small firms will be afforded better service and choice when choosing a new plan. the affordable care act not only creates new incentives but maintain laws that encourage employers to purchase insurance. most notably, the employer provided benefits remain tax-free and employees can still pay premiums on a pretax basis. since 2010, small firms have been eligible for a new health insurance tax credit. one of my constituents, miss williams, provides a great example of how firms are using this successfully. she owns a private health clinic in new orleans and was able to avai

guest: the cms. these are pretty well known out there. it collects thousands of dollars and in benefits. host: michael tanner, the senior fellow at cato institute. the republicans on your screen into the democrats as well. one is james cliburn in his 10th term. yburn.v let's hear what he has to say about negotiations to medicare and medicaid. >> it is to make sure that as we y this country as antr nation that we also protect those men and women who gave so much to bring us where we are and make sure that they have some dignity as they live out their lives with the assistance of medicare, medicaid, as well as their children and grandchildren, who must have opportunities to have a good life in this great country of ours. that has been the hallmark. host: what does that tell you about the prospect of a deal to tackle entitlements? guest: i am not enthusiastic about the chances that this committee will come up with anything. committees in washington have a history of not reaching agreement. i do not see why this one would be any different. .h

did, have a centralized cms and published after lots of different places. and now you can import your identity, and you can even -- and now people are saying screw it, we don't even need to own our land. we are going to rent in this small basically and all the services will be provided for us and we are just going to exist in a much higher level, which makes a lot of sense from an entrepreneurial standpoint. it can be a lot more effective, but that means you're very dependent on the land owner. >> and what's the downside? >> maybe the land owners get too much control. >> so the change the rules or the service. >> like when we started this was a little bit different, but when we started odio is was a podcast service that you record in to your browser and out to anyone who had an iphone and they would think it was their iphone and abel said we are podcast and on all itunes and i said that's crumbly a good place for it. probably better than our website. and so once they made that decision, we were kind of -- you know, we had to pitch. that's a little bit diffe

specific details are ones that, again, the people in cms are working and the question is how to do it most efficiently. host: is it too early to tell how the recent effort is working? other cost savings attached to that? -- are there cost savings attach to that? guest: one of the things with computer systems is they are able to screen for claims before they are paid nationwide. if not been able to do that. they have been paid in phoenix and in new york and miami. now they are beginning to be in a national system so they can find a double billing and fraudulent claims. host: mike, republican for dr. brian biles. caller: hey, i'm not a republican. i'm just an independent conservative. that was just like i got in on. i am a recent graduate from college. the college, graduate from has a close relationship -- the college i graduated from has a close relationship with the fact book, the most correct, i guess you would call it, demographic research website. the population of the united states under 30 is the only about 20-25% of the population, while 55 and older is 60%-plus. now, with those

cms, the center for medicare and medicaid services, has clamped down on those and now there is more protectionnerally, you should be able to get things, but like anything else, everyone's situation is different and it is important to consider the specific health plan you are in and talk to your doctors and other providers to see what plan is likely to be best for your situation. there is an open enrollment. coming up in the fall, that is a good opportunity to. host: we're talking about medicare advantage in our guest is marsha gold from the mathematics of. what is a mathematical policy research? guest: we are a nonpartisan group that does research on public policy issues. host: frank become republican, from ohio. caller: if medicare's their privately run plan, why is it when i go to the veterans administration that they do not pay anything towards any benefits i have or for any care? they charge my medicare instead of v.a. and i am 100% disabled from world war ii. years ago, they took over everything. now they charge everything, medicare, to my v.a. guest: when there are a lot of these program

. >> do you foresee cms and given authority under the law? going to -- >> well, i mean, when we get to the exchanges in 2014, competition is kind of the cornerstone of what we're trying to accomplish in the exchanges. and we will be working actively with the states as they set up their state exchanges and to the extent that we're operating a federally facilitated exchange we will do everything we can to make sure that there's competition among insurers. the exchanges are among competition among private carriers for the benefit of small businesses and individuals. >> and last question, madam chair, since 2010, eligible small firms have had the ability to obtain a health care tax credit and according to the nfib, information provided to this committee, 1.1 million small businesses are eligible for either a partial or full credit. while i realize the irs administers the credit does cms have an estimate. estimate for employers taking advantage of the credit and how it's lowering their costs? >> i know there's varying estimates of the variability

it's kind of stop there, but you could import your cms. that is what blogger did. now you can import your identity. now people are saying, screw it. we do not need to own land. we will be in the mall and the services will be provided. that makes a lot of sense from an entrepreneurialism standpoint. -- of entrepreneurial standpoint. maybe the land owners get too much control. that is the downside. when we started odio, a podcasting service that lets you record into your browser and send that recording out to anyone within i fophone. apple said we have podcasting in itunes. once they made a decision, we had to give it. >> if you are doing app-based , it is not as searchable and likable. >> it is not a part of the greater internet. in many ways, apps are a step backwards from the web because they are not compatible. >> do you remember a l l and top reserve? >> of course it -- aol and compuserve? >> of course. daylighting just got different. >> they got more ominous. [laughter] >> what else do you worry about? what's you should ask jason. he is the more cynical one. we

it's being addressed, and the specific details, i think, are really ones that, again, the people in cms are working on, and the question is how to do it simply most efficiently. >> host: is it too early to tell how that most recent effort is working, and is there potential cost savings attached 20 that deal? >> guest: there's large cost savings, and one of the things again with these big computer systems, they are now able to screen for claims before they are paid nationwide, and they have not been able to do that. they have been paid in phoenix or new york or in miami, and now they are all beginning to be in a big national system so they can find double billing and fraudulent claims. >> host: let's hear from cleveland, mike, republican for dr. brian biles. good morning. >> caller: i'm not a republican, just an independent conservative. it's just the line i got in on. i'm a recent graduate from college, and the college i graduated from, we have a close relationship with the cia fact book which is the world's most correct i would call it demographic research website, and the population i

as a final picture for you, you know the chief actuary at the cms has raised concerns, not just about sgi, but also about the ability of the nation to adhere to the constraints that are part of the affordable care act and has provided in supplementary material an alternative projection that has replaced by the medical economic index and has the medical adjustments to the provider payments, as included to the affordable care act. the results of that is backed there is a substantial difference in medicare if we are not able to adhere to these fiscal discipline that the congress has enacted over the course of the past few years. on that happy note, i will step down. >> thank you very much. [applause] we are almost out of time, but why don't we take a few questions for dr. reischaur and track. -- chuck. i just want you to know how valuable that document is that is put out with the trustee's report. >> i am a consulting actuary. i have a specific question for the doctor. why do you think the media suppress the name of mr. foster during the health-care debate? he was hardly heard from a lot

just as a final picture for you, as you know the chief actuary at cms has raised concerns, not just about the sgr but also about the ability of the nation to adhere to the constraints that are part of the affordable care act and has provided in supplementary material an alternative projection that has the sgr replaced by the medical economic index and the gradual phaseout of the productivity adjustment to provider payments that is included in the affordable care act. and the result of that is that there is a substantial difference in long-run out look for medicare if we are not able to adhere to these fiscal disciplines that the congress has enacted over the course of the past few years. so on that happy note let me stop. >> thank you very much. [applause] we're almost out of time but why don't we take about two or three questions for dr. reischauer and chuck. and just while somebody is getting a microphone, any questions? i just want to make sure that you know how valuable that summary document is that's put out with the trustees report. in some sense you don't need to mess with the trus

and it kind of stopped there, but there's, you know, you could import your cms because that's what bloggerid really, published out to lot of different places. and now you can import your identity, and you can even -- now people are saying, screw it, we don't even need to own our land. we're just going to go rent, and it's nice, and we're going to rent in this mall, and all these services will be provided for i, and we're just going to exist at a much higher level which makes a lot of sense from an entrepreneurial standpoint. it can be a lot more effective, but that mean you're dependent on that land ore owner. >> and what's the downside? >> maybe the landowners give too much control. >> so facebook changes or apple changes -- >> yeah. like, i mean, when we started odio, this is a little bit different, but when we started with a podcasting service that let you record into your browser and send that recording out to anyone who had an iphone and they would sync it with their iphone, and then apple said we have podcasting on itunes, and we said that's probably a good place for it. that's proba