in addition to this cms policy, the dme macs also have a local policy. this policy pulls together both the statutory and national policy requirements, organizes the nearly 60 individual power mobility codes into five groups of similar products, sets out the criteria for each group and explains the documentation requirements and coding guidelines. in other words, the other local policy takes information from various sources, adds additional details for proper claim submission and incorporates those into one document. the major concern i hear raised by suppliers is whether dme macs will be able to review the request volume in a timely manner. these requirements have been in place unchanged since 2006 when cms' regulation took effect. all dme contractors have performed numerous reviews on power mobility devices since that time to identify problems. in addition to standard power wheelchair, we have all reviewed many complex rehabilitation power wheelchair requests under the advanced determination of medical cover average, usually referred to as admc. these c

-- corresponding with cms. what should be, and i know the error rate is different than the denial rate, but what should, what is the appropriate rate for this program once it gets refined? >> well, i hesitate to pick a number. um, our, our numbers from our recent audits are down to 50% from the oig study from a couple years ago. i don't think it'll ever be zero, but i certainly would like to see it down in single digits. >> and based on your experience of getting the error rate down in single digits, is that something that you think is achievable if we put the right processes in place? >> yes, sir, i do. partly because of what i had in my testimony is a substantial percentage of the errors are technical things, as mr. clark points out. but i believe many of those technical errors are able to be remedied by the supplier. and that will then leaf -- leave a nub of 20-30% of errors that have to do with the quality of the medical record. that gets to be subjective and, you know, but that's -- but, you know, a differ

we wanted to work with cms. we want to stay in good graces with them, if you will. >> yeah. >> we wanted to be a good partner, and it was 4% of our business. >> cms is 4% of your business? >> no, no, the overpayment was 4%. >> what is cms is percentage of your business because you brought it up? >> roughly 75% of our business. >> yeah. i would think the oig threatening to end a 75% relationship would cause you to voluntary want to close this. let me move on -- >> they filed authority to do that. >> for what it's worth, i'm glad they did. doctor, i just to get identities of interest, i -- i -- you sound like an outstanding physician and sound like you care greatly about the patients, and i'm sure that you do. when the physician fills out the forms for one of the pmds, is there any incentive for them to do that financially, or is that -- i mean -- >> it's -- you can charge medicare for a higher level of service. it's not a significant -- for the amount of time that it takes, the answer is no. >> yeah. >> there's n

more importantly cms has sent an unprecedented and unlawful $8 billion filling in over 70 percent of the cuts of 2012 alone because the agency was to mitigate the impact of the cuts required by the 2010 law. there is no real other explanation for what they're doing in this particular demonstration program. there is certainly no policy rationale that would justify it as the testimony from various government agencies as indicated once the artificial and temporary bump up in payments is terminated as it inevitably will be plans will be forced to pare back. my third point croplands are important for seniors. it's the population the hardest. lower income seniors are disproportionately represented because they find reduced kashering as attractive, especially a premiums and are well below the cost of medigap coverage. in the study i co-authored we used earlier findings to estimate beneficiaries between 10,800, to do a dozen 600, 19 percent more likely than the average beneficiary to enroll in a plan. important features for the future of the medicare program and can provide innovations and.

i read in your report that the cms m.a. quality of a spin a deposition will cover up nearly one-third of the obamacare cuts to plans over the life of the demonstration. is this correct? >> the the restoration would offset about one-third of the cuts, yes. >> can you please protect your estimate of how much of the cuts would be offset each year? >> this year, to c-span, just over 70 percent. next year, 2013, one-third. the final year, but 60 percent. >> this seems to be the administration is trying their hardest in using any means necessary to hide these cuts until after this election. as you well know, obamacare is cuts to medicare advantage are real, especially to the beneficiaries that are enrolled in these plans. in fact, not too long ago, cuts of the medicare health plans which were far less than those in obamacare resulted in millions of seniors losing access to their health plans. in fact, in some counties and in northern california to my district i represent, seniors lost all choice of private health plans after the

cms has the information it needs to systematically evaluate dsnip performance. hhs concurred with the recommendations. i would like to share some of our findings recommended to medicare cost plans. they differ from ma plans in that they're paid on reasonable cost for delivering medicare coverage services. cost plans have been a part of the medicare program since the 1970s. when we examined these plans in 2009 we found they tended to have higher quality cores than ma plans operating in the same area. enrollment of cost plans has been fairly low. as of march medicare had 20 contracts with cost plans and enrollment was just under 400,000. however this represents a 36% enrollment increase since tween. while cost plan enrollment is small compared to ma enrollment industry representatives told us cost plans provide a managed care option in areas traditionally have had few or no ma plans. over last three years of number ma options of beneficiaries enrolled in cost plans has declined. nonetheless we found in march '99% of the beneficiaries in enrolled in cost plans had

>> in your testimony before the government reform committee in july and again today, you know that cms enacted it demonstration that was seven times dodger than any since 1995, greater than the combined budgetary effects of the demonstration, no control group or waited does the of comes of the demonstration program and went so far as to suggest the demonstration should be cancelled. is that right? we did recommend. >> you know, president obama during the large discussions around the new health care law made much of the argument that if you like your plan you are going to be allowed to keep it. can you reflect on how the reality is of what your members are dealing with and their ability to offer products that existed before the enactment of the health care law and what they're dealing with now? .. from cbo, that gives you a window into the potential effects. and so, the honest answer is we don't know what the future will hold and we are going to work very commit very hard to do our part. sec decides about this that will come into effect, were very concerned. >> at yankee said concerned

chase near buchanan, that is the silver mercedes that the suspects were in, it slammed into the family cms sidewalk and crashed into three parked vehicles. go ahead and take a look at this video. police say this all started this afternoon when a woman was walking down the street in a pacific heights neighborhood with a ipad inside her backpack when one of three three robbery suspects grabbed her backpack and jumped into the silver mercedes suv. as it is officers caught up with the vehicle, a high-speed chase started. it only lasted a few minutes. after the crash of three suspects or arrested. this is video of one of the suspect being taken to hospital police capt explains how they tracked the suspect's. >> numerous witnesses called with descriptions of the suspects in the vehicle. office is located the car on center street and tasted down here. >> police have not said if these three suspects fled carved. for >>grant: for east idea of where the chase unfolded. >>pam: tonight, we are following a developing story out of antioch. that is where an elementary school student reportedly brought a

what is cms's role? >> we are looking at services that can be funded by medicaid and the types of services that cannot. we might either use samsa dollars or other federal -- federal dollars or state and local dollars. and then with hud, the housing, etc.. the three agencies are working together to think about how we can put together vouchers, medicaid funding, and non- medicaid funding to support a person in recovery in getting and maintaining housing. >> other media inquiries? the far back. >> from clinical psychiatry news. i had a question about synthetic drugs. definitely a concern in the last two or three years. where do they stand as far as concerns go? >> joe, do you want to comment on synthetic drugs? >> we do not have the data of the synthetic drugs. but what we are doing is monitoring through state authorities the presence of the synthetic drugs. mr. kolokowski has been active in working with the legal authorities on synthetic drugs. >> most recently in the minds during the future survey, it act

to negotiate the final details of our waiver and met with officials from the white house and cms and omb. i returned to oregon on may 3rd with a commitment from the federal government to invest $1.9 billion in oregon over the next phi years to -- five years to help us transform the delivery system. now, as a part of this agreement, oregon agreed to reduce the medicaid per member, per member inflation rate trend by two percentage points by the end of the second year down to 3.5% and to lock in that rate of growth going forward. these cost savings will fully pay back that $1.9 billion investment in five years and will save the state and federal government $11 billion over the next ten years. i would just add if every state in the country adopted that same program and had that same inflation rate, we would save over the next decade $1.5 trillion. the supercommittee was supposed to save 1.2. this would actually save 1.5 by actually making people healthier and creating a more rational system. in july 5th we received the final waivers from cms that allowed us to move forward, and as of sep

melissa: yeah, this cms community first choice option was authorized by the affordable care act and provides for states to expand medicaid coverage. the implementation of this would cost $5.7 billion. talk to me about the cost and benefit of that one. what does it really do? >> sure the big part, the cost side on that were directly on states. if you look at regulation, they had a direct itemized cost. obviously federal government wilt spend a lot of money implementing affordable care act but there is huge cost for states as well. if you look at entire affordable care act it is roughly $7 billion just on state impacts we found so far. on the private sector side roughly 20 billion. $27 billion tab so far and the law is still far from fully implemented. we won't see that until roughly 2014. there is still aways to go. melissa: what is staggering all these things and isolate break out what it is, sounds like a good idea and we need regulation. your point overall as we become regulation nation, somebody has to pay the price for this and it is always going to be the taxpayer, the consumer, either

one oak, coned, southern company, wisconsin energy, cms energy are actually leading utility players today that, let's send it over to sandra smith to take a look at some big movers she is watching from the cme. >> reporter: hey, cheryl. well, i said it in the last hit, there were some big movers, and a lot of the reason was we had a weaker euro hitting a two week low against the u.s. dollar, and that put a lot of pressure on those dollar-denominated commodities. natural gas prices surging more than 3% today. remember, a lot of those energy producers switching from coal and more expensive coal to cheaper natural gas. that's spurring demand for it. also we're heading into the winter heating season, arbob spiking today, there was a refinery explosion but a bullish report from the government on supplies, and silver getting a small bump despite gold heading south. here's your commodity losers on the session. again, that smaller u.s. dollar pressuring a lot of these prices. weak corn, soybeans -- wheat, corn, soybeans, all the grains getting hit. worldwide a lot of countries that import u.s. gr

in july 5 we received a final waiver from cms to allow us move forward and september 1 we have 13cco up and operatings covering about 0eu% of the medicaid population. when they become operational we'll be covering over 90% of the population. now before i go on, i want to take a moment and speak to the 3.5% inflation raid that we have agreed to. which may seem like a daunting task. but init's dawrchting only if we continue to think in terms of the old business model. let me give you an example. we know that the most common admission diagnose for people in medicare is congestive heart failure. we know that nationally about 40% of the people are readmitted within ninety days. the hospital gets paid for every person that comes in. there's no incentive to manage the people on day-to-day basis. that's an old business model. consider the hypothetical case of a 92-year-old with well managed heart congestive failure. there's a heat wave and the temperature guys up to 104 degrees. the increase in temperature in her apartment could put enough strain on the card vas vascular system. we probably

the other shower about to get to 234 just coming out of stafford county into southern prince cm. the showers down in charles county, very, very light at the moment. so that's it. locally probably going to see more in the next few hours. already 79 and a very muggy 79 at the patuxent river naval air station with easton and gaithersburg at 72. to the west we've got 73 in culpeper. winchester 68. and cumberland still a sticky 72 degrees. looking outside on our michael & son weather camera, not much to show you yet. we don't have sunrise for almost an hour at this point. 75 degrees. mostly cloudy skies and a light southeast wind this morning and the humidity, yeah, that is way, way up. i've been checking the visibilities. fog doesn't appear to be too much of an issue this morning. as far as isaac, this is the circulation i was alluding to earlier. you can clearly see the spin right there coming into southern indiana now, western kentucky. this thing barely moving. that's the problem. it's going to take a few days for it to get toward us. out ahead of it, we've got the moisture. you s

lunch" and the futures capital of the world, the chicago, the cm e-trading floor.s we start to see some of these headlines come out again, markets are moving in a way we kind of remember. what i'm talking about is italy coming over the wires, they're raising their outlook on deficits an lowering their outlook on gdp. boy, we've seen this movie before. look at the 24-hour chart of our 10-year. of course the early buying pushed rates down. it is creeping back but this dynamic is probably more a function of the big comeback from the day of equities. the safety of bunds is coming back. some of the lowest yields in 10s earlier and bunds today since the '13 fed statement. it is all about currencies, all about exporting. the big dynamic traders continue to talk about the most. the euro versus the dollar getting hit today but it is also getting hit versus the yen. we want to pay particular close attention to the euro-yen in the next come weeks. >> you covered a lot of bases there, include concerns about risks which are parentally putting the mergers on mergers an acquisiti

cm will probably reach an all-time high next year. >> you're comfortable with the size of the banks inuntry, this whole debate saying we should be breaking up the banks. give us your take on what you think about that and this too big to fail issue. >> well, i don't agree with sandy. i respect him, but i don't agree with him in a couple respects. first, i don't think the regulators would be wise to make a move like that. i'm also not sure they have the legal authority to make a move like that, given that the banks are further ahead than anyone thought they would be on capital and liquidity. you could only make a move like that if they were deficient and threatened. so i don't think they would make it. i don't think in some respects they could make it. i think it's an cademic. in terms of whether the banks are too big, i don't think they are. as jamie dimon has said, scale is really an asset. some banks are well run, and some banks areless well run. we all know that. but i think it's not a question of them being too big to manage in general. the recent episode notwithstanding. jpmorgan h

sn cm any stress.ut even within the romney campaign, i have to say there is another model for dealing with problems like this. this may come from the way mr. romney was beaten in 2008. teedhae not get stuck with the flip flopper label again. even though they leave the ads with the lies in them up and sometimes mr. romney goes on tv invents a brand new policy position he's never had before. after he does that, his staff follows behind hnd qly releasing statements faeg back his quotes. when mr. romney was asked in an interview last week about one of his immigration advisers. heaild not confirm whether kris kobch was part of his team. and they yes, he's a romney campaign adviser. so he tells an intviewe's neit him but his campaign says what he said was not true. same thing happened last month when mr. romney came out with a whole new policy position on abortion rights. >> i'm in favor of aion being legaln theasef r annct the health of the life of the mother. >> he says he believes abortion should be allow

cms energy, american water? >> yes, they all are.southern, on the utilities, i think what the market is having apprehension on the utilities is that at a 15 times earnings they're selling about 10% to 15% above their long-term average. the payout ratio on dividends for utilities is about 60%. with not much probability that it'll go higher. when the average stock in the s&p has a dividend payout ratio of about 38% and more dividend growth, which is what we're all coveting. and in the case of cms energy, 4% yield, but a better than 20% dividend growth. american water is a new jersey based water utility which i think water is one of the still bright spots in the utility area. that's why i still like those two names despite utilities not participating in this rally off the june 1st lows. >> interesting. david, a lot of the bears are saying the warnings are beginning to pile up. even beyond transports. you've got some retail warnings from burrberry and h & m. tech warnings from the likes of intel. on the other hand, bulls are arguing don'

these strengths they can't get there and it's been a lot of discussion about, for example, how to link cmsand soquel security data to link these issues are so that's how i think is going to look very different in a few years. so stay tuned for that. >> okay. that wraps up the program. i'd like to thank the speakers for excellent set of presentations. thank all of you for coming, and it also like to thank three aei staffers are making sure this event ran smoothly. you might want to stand up, veronica, brittney, and emma bennett. thanks very much and thanks to everybody. [applause] >> president obama will be campaigning in nevada and colorado this week. tonight the president holds a rally in las vegas. you can watch our live road to the white house coverage beginning at 8:25 p.m. eastern here on c-span2, and that c-span.org. >> former republican senator tom coburn yesterday predicted a downgrade of the u.s. credit rating. a former member of the simpson-bowles fiscal commission, senator coburn also said he's not worried about the so-called fiscal cliff, the series of tax increases and budget

in july 5, received a final waiver from cms that allowed us to move forward.eptember 1, we have 13 cco's up and operating, covering about 11% of our medicaid population. before i go, i want to take a moment and speak to this 3.5% inflation rate that we have agreed to. which may seem like a daunting task. i think it is daunting only if we continue to think in terms of the old business model. the me give you an example. we know the most common admission diagnosis for people in medicare consist of heart failure. about 40% of those people are readmitted with in 90 days for the same diagnosis. the hospital gets paid each time someone comes in for congestive heart failure but there is no incentive to manage those people on a day-to-day basis once they leave the hospital. that is the old business model. consider the hypothetical case of an 92-year-old woman with a well managed heart failure, living in a small apartment somewhere in america. there is a heat wave and the temperature goes up. the increase in temperature at the department could put enough strain on her s

simple data but because they can't bid get their there have been a lot of discussion about how the link cmsand social security data in order to be able to address some of these issues so i think that's going to look very different in a few years. >> okay so i've that wraps up this program. i would like to thank the speakers for an excellent set of presentations and i think all of you for coming and i would also like to thank the aie staffers to make sure the event ran smoothly. you might want to stand up, for on account, britney and emma bennett. thanks very much. thanks to everybody. [applause] the flag at the u.s. capital was lowered to half-staff in honor of the victims. the latest news in the latest developments by the "associated press" reporting the navy has launched to shift to the libyan coast. >> inspector general and the general services administration says steps taken by the new leader of that agency could present a scandal with the 2010 las vegas conference. this homeland security, send homeland security governmental affairs committee hearing happened today and it's an hour and

to negotiate the final details of our waiver and met with officials from the white house come the cms and no one being returned to work and on may 3rd with the clement and to invest $1.9 billion in oregon over the next five years to help us transfer in the delivery system. as a part of this agreement, oregon agreed to reduce the medicaid member -- per member inflation rate trend that two percentage points by the end to end a 3.5% and lock in the rate of growth going forward. these cost savings will fully pay back the $1.9 billion investment in five years and will save the state and federal government $11 billion over the next 10 years. if every state in the country adopted that same program at the same inflation rate, we would save $1.5 trillion. the super committee was supposed to save 1.2. this would actually save 1.5 and making people healthier and create a more rational system. july 5 we received to move forward in a september 1st through 13 cco's covering about 80% of our medicaid population. three additional certified and when they become operational but because the 90% of our p

we recommended the fbi siege funding for acquisition of new hardware for its tw as cms data base system which lacks the infrastructure to the spill system demands and also lacks alive disaster recovery backup. only two people, an fbi agent and analyst, were charged with reviewing information in the investigation. the crushing volume of the information they confronted, the lead the technology, and other factors forced those two people to review the 18 communications in the day to day context with 20,000 other items of electronic affirmation they're reviewed. we recommended that the fbi evaluate and acquire information technology that was automated and advanced that would assist personnel in reviewing in managing data. we also recommended that the fbi implement managed information reviewed protocols for these types of logic elections that would allow for case-specific review of the type that occurred in the investigation as well as strategic review by different review teams. important reminder is that congress, the justice department , and the fbi must assure the fbi governing authority s

rick santelli standing by at the cm negotiation chicago.. >> reporter: the numbers are initial claims move from a revised 377,000 shaved 12,000, we're now at 365,000. so we originally released that number at 374, up to 377, current read at 365. of course that's going to be perceived as an additional helping of good news, because we all know it's about jobs, jobs, jobs, and we've created more than we anticipated, revised last month to create more than we had previously released, and of course everybody's going to be cheating on their homework because everybody's estimates for tomorrow are going to rise a bit, not on their own research but on the momentum of adp and i'm not saying that's a bad thing but everything will be jostled and as i'm speaking i'm sure mario draghi is trying to clean out that bazooka and show us what was inside. if the euro currency is hovering at the best levels in seven or eight weeks, so at least from my vantage point it doesn't look like there's anything detrimental coming out of that press conference which probably

rick is at cm group in chicago. >> thank you.ould welcome europe to the same club the u.s. is in. lots of liquidity. maybe more liquidity coming. and a generally weak economy. welcome to the club. if you look at our charts, they pretty much reflect a lot of what central banking is doing to the marketplace. look at may 1st start chart on our ten-year. obviously, the rates are going up. we all know the reason why with regard to issues. long term maybe reflation but maybe the focus of where the next buying program would be. if you look at bunds, they are more defined in the higher yields. we're at the highest in the bunt, because of the safe harbors? the tide is moving out of funding issues in countries like spain, maybe italy. they're seeing funding costs move down. stretch out the problem a bit, liquidity is probably not going to be the issue. but the real question is, is it the problem? next chart, this is tens minus twos. continues to steepen in the u.s. that seems to be the trade every bond trader is talking about in lieu of to