place it's incumbent upon cms to have a second line of defense. >> and do you think cms is doing enough to encourage that? >> i think cms made significant strides in response to many recommendations and we outline the nine in our report that we believe are important to be included in their ongoing effort to improve integrity. >> what about the fraud detection in the programs themselv themselves, are the planned sponsors doing enough? >> if we had more data about the fraud and abuse they are detecting as well as the data how they are responding we would be able to answer that question with more authority. we don't have the visibility we think is necessary to hold them accountable. >> is that something, doctor, you think you could provide? >> we are getting some data from planned sponsors and in particular we are focussed on where we give them a clear lead such as an outlier prescriber or pharmacy, and what we have found is certain planned sponsors are good at following up so we have been able to see hundreds of pharmacies be excluded from networks because of the leads we give them, and w

place it's incumbent upon cms to have a second line of defense. >> and do you think cms is doing enough to encourage that? >> i think cms made significant strides in response to many recommendations and we outline the nine in our report that we believe are important to be included in their ongoing effort to improve integrity. >> what about the fraud detection in the programs themselves, are the planned sponsors doing enough? >> if we had more data about the fraud and abuse they are detecting as well as the data how they are responding we would be able to answer that question with more authority. we don't have the visibility we think is necessary to hold them accountable. >> is that something, doctor, you think you could provide? >> we are getting some data from planned sponsors and in particular we are focussed on where we give them a clear lead such as an outlier prescriber or pharmacy, and what we have found is certain planned sponsors are good at following up so we have been able to see hundreds of pharmacies be excluded from networks because of the leads we give them, and we have co

microphone please. >> we have not spent outside any written authority from cms. >> mr. kissle?>> we have one item that we are trying to reconcile with our auditors before spending it. it's in a segregated account. >> mr. lee? >> we are spending establishment funds to continue the final establishment of our exchange, federal dollars, but no operational funds. >> mr. wadleigh? >> no. >> can i ask each of you what your operational costs are this year for the exchange, mr. allen? >> for the current state fiscal year which began july 1st, our operational costs are about $12 million. >> ms. o'toole? >> thank you, mr. chair, sorry, i'm having trouble with the microphone. we are about the same, and i'm happy to provide the committee with a full balance sheet of our budget. >> thank you. mr. gutierrez? >> we are still in a very much a build year. our operation and billed expenses within the kerkt are on the order of about $65 million. >> mr. kiss el? >> a little over $8.5 million. >> our total budget is about $330 million. i don't have it off the top of my head >> and mr. wadleigh, woul

and where an exchange has decided to shut down has cms tried to recoup any federal grand dollars? lastly, are the exchanges doomed to fail? hopefully we will get answers to these important questions so i thank the witnesses for testifying today and i recognize the ranking member from colorado for five minutes. >> thank you, mr. chairman. i think we can all stipulate that some states have struggled with the technological hurdles of setting up their own marketplaces. we all knew the affordable care act would face challenges in some aspects of implementation and i've been saying for a long time that it's this committee's role to conduct oversight and improve that process so i'm glad we're having the hearing today. i hope we're not hoping the state exchanges fail. i hope we're hoping that we can improve it and we can make itlá better. i think despite the fact that we had a rough start in many places, the aca is working and has greatly approved access to high quality lelt insurance coverage. in the last five years, we've made preprogress in helping millions of americans throughout the

that's how cms is funding things. i know additional items other than i will be out of the country the next two weeks. mitchell, who will hopefully be back tomorrow, will be in charge. april financial officer will be in charge of all things finance. i'm fairly confident over that amount >> thank you, director.get any questions from the board regarding any aspect of the report? is there any public comment? hearing none, we will accept the report as given. we will move to discussion item number five. >> item 5, discussion item ages just financial reporting as of ages just financial reporting as of may 31, 2015. pamela levin. >> i would like to take this public opportunity to knowledge the tremendous work effort of catherine and her team. in preparation of the budget and its submissions and all the interactions that go on to get that monster done. i thank you for that. i commend you for your hard work. i'm pretty a pretty positive outcome after we went through it all. so thanks. >> thank you. payment of 11 deputy director

they've been blocked from doing that by cms. they are seeking help from us. this is a way to make that happen. we have four states that currently are in litigation. >> one moment please. which part of the bill. i take it your amendment or the bill you're referring to? >> the amendment. >> and which lines? >> page two, line three and reading to the end. >> exception, okay. in fact, what you will see is that this allows a state to choose to establish criteria regarding the participation in its medicaid program. whether it's institutions, agencies, entities. this is something that states have said to us, y we'd like to have this flexibility and it gives the state a maximum flexibility so they can come in and set these programs, work with these providers. in texas, dr. burgess gave us a great example of when they did the decoupling in texas. we know it worked and that access to care increases when you allow the states that flexibility. and the stats that come from texas certainly are proof of that. you can look at some of the faith-based and community clinics tha

dgers: i am unaware of any cms officials contacting us on this.'m in agreement with a comment that the former commissioner of the fda made that as an agency we should work together on this entire scheme. very recently, we held a diabetes interagency coordinating committee which niddk chair story presented weormation -- chairs and presented information about glucose monitoring, particularly in older bundles, and the proposals that came out of that meeting were presented to a group of experts and a uniformly agreed that this is really a high area for research priority. they think that this is very important to move forward with tara reid chairman collins: thank you. i think it is absolutely incredible -- forward with. you.man collins: thank i think it is also incredible that they did not consult with fda which approved the device before deciding that it was just a precautionary or safety device and was considered non-medical. mr. amato, it sounds like it was certainly medical for you and literally a lifesaver, would you agree with that? -- amato: ye

clinton:we; -- cm we obviously pay for those services.ded is -- we needed his technical assistance. kellye: he said he will invoke his fifth amendment right against self-incrimination if they call him to testify as part of their investigation into the e-mail server. supporters of the county clerk who was jailed for refusing to issue marriage licenses to same-sex couples in kentucky are calling for her release. a couple hundred supporters rallied to demand that jim davis be freed. -- that kim davis be freed. it is her third way in jail. if you were looking for great weather this labor day weekend, you got it. devon: everybody rallies a

. >> has anyone from cms or hhs contacted you or any of your board members or staff? >> since the videos surfaced. >> july 14th has anyone from the health and human services or cms contacted you or anyone on your staff or board? >> i don't know. it's a -- we have a very big staff. >> has anyone from the inspect general's office at hhs contacted you, anyone of your board, anyone of your staff? >> if you're going to ask me about everything, we have a big board and we've got a very big staff so i'm happy -- i can't really answer. >> has the attorney general of the united states loretta lynch contacted you? >> no. >> anyone in planned parenthood? >> i don't know. >> you don't know? >> i have hundreds of staff and we have a very large board. >> anyone from the justice department contacted planned parenthood since the video surfaced? >> i don't know if you are asking about everybody in planned parenthood. >> if the justice department would contact planned parenthood it seems the person in charge of planned parenthood would know the answer to that question. >> we have a very

this is all happening while, in the middle of this crisis, the federal government approved, cms approves, an 11% cut for puerto rico, while giving other territories a 3% increase. we need the federal government, we need this administration, the obama administration, to react immediately and to redecide the formula in how much reimbursement puerto rico is getting. >> it can't continue the way it is. it just can't. >> it cannot. it cannot. >> it just can't. a lot of the people who are heading to central florida, brain drain. we mentioned it earlier. engineers, doctors, lawyers, are they not? yes? >> absolutely, yes. that's the largest influx that we're seeing in central florida. we're all concerned about the issues around equity and absolutely the impact, losing talent, right? and folks that don't feel that they can survive in puerto rico. it's absolutely an issue for local governments in orlando, in orange county, in osceola, where most of the folks are settling. we're looking at, you know, the need to build new schools, right? we have thousands of children being registered, new children

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i am unaware of any cms officials contacting us on this. i'm in agreement with the comment that former commissioner hamburg of the fda made, that really other agencies should work together on this entire scheme. very recently we held a coordinating committee, which niddk chairs. we presented information about glucose monitoring, particularly in older adults. the proposals that came out of that meeting were presented to a group of experts and they uniformly agreed that this is really a high airy up for research priority. i think this is important to move forward with. chairman collins: thank you. i think it is absolutely incredible that medicare officials did not consult with you -- the foremost expert that we have at nih overseas -- overseeing this research, nor did they consult with the fda, which approved the device, before deciding that it was just a precautionary or safety device and therefore was considered nonmedical. amato, it something it certainly was medical for you, and literally a lifesaver. would you agree with that? >> yes. i

as you will remember, back in that many states went to the cms waiver process in order to be able to do is fermentation with the delivery systems for health care interstate. ms. slaughter: but that does not have anything to do with the constitutional question. rep. blackburn: what this has to do with is the determination of how the states utilize their funds that they are receiving. ms. slaughter: you do restrict it to people who are providing services for women's reproductive health. rep. blackburn: there's nothing in this that restricts a woman's right or access to abortion. absolutely nothing. ms. slaughter: it doesn't if you take away people can provide it. if you shut down a hospital or health care clinic -- you don't think so? rep. blackburn: unique position. the funds.sition that is exactly what we have done. the community health centers -- planned parenthood. ms. slaughter: let me reclaim my time. there's no question that community health centers have made it clear that they cannot take this on. 99 for sunday work done by 99% of theenthood -- work done by planned parenthood h

. >> reporter: he says he's not a cm. he worked hard to support his family. now he wants to go home. living in poverty is better than living in fear. >> to lebanon, where protesters are demonstrating outside the parliament. the m.p.s are meeting to address the issue that led to a protest movement called you stink. that has been campaigning over piles of rubbish. as reported, it's a growing movement against corruption. like thousands of young lebanese. yousef is unemployed. he's not enrolled in a school or college, blaming the government, afusing officials of trying to get rich. yousef is one of several activists. they have been camped outside the ministry of environment. they are part of a movement demanding the resignation of the minister. now, with wider themes of corruption and incompetence. six days into the hunger strike. yousef was in hospital. >> police paid him a visit. >> translation: i lost consciousness. i got to the hospital, they put me on a drip. the police came and questioned me, telling me i should end it because it's a waste of time. >> repor

the fact that people use the name maria sharapova in the same sentence as serena williams,cm has beaten her many times. it's ludicrous to put them in the same sentence. >> tomorrow, what do you think, who comes out with a victory. >> serena williams is the favourite. venus williams is under sold. last time they played was in edmonton, venus won that. venus is 35 years old, has not won a us open since 2001. this might be the last time they face each other in a grand slam. venus williams is 24-10. people should not necessarily think serena williams will win there. >> always a pleasure. dave zirin, sported for for the nation. that's all we have time for in this newshour. thank you for being with us. david shuster is coming up in a couple of moments. have a great evening. >>> hello everyone, this is al jazeera america, live from new york city. i'm david shuster. just ahead. the promise... >> we are proposing that britain resettle up to 20,000 syrian refugees. >>> european nations say they'll take in thousands of refugees, will the united states do the same. action and act ability in this gr

organized delivery system of medi-cal waiver so the state amended the state plan and made a parole to cms approved this august to show it if they increased the services covered by drug medi-cal that they could by organizing the system and having smooth trisz from levels of care and using evidence based practices they could improve the care and overall costs of medicaid would not go up you can opt in or not opt the community likes a demonstration waiver they should we we already do so we're coming in and the bay area was chosen as phase one so there are several tasks for substance abuse services i'm in charge of one to have the implement plan with the timelines for everything and another one to set rates we negotiate with the state and make a new contract we want the rates to be realistic because if you compare grants the drug medal there is a huge increase in accountability and recordkeeping required for the providers as you may know substance abuse is contracted out and so the main task we already have in the orchid delivery system almost all the services described it is just we have to

they've been blocked from doing that by cms. they are seeking help from us. this is a way to make that happen. we have four states that currently are in litigation. >> one moment please. which part of the bill. i take it your amendment or the bill you're referring to? >> the amendment. >> and which lines? >> page two, line three and reading to the end. >> exception, okay. in fact, what you will see is that this allows a state to choose to establish criteria regarding the participation in its medicaid program. whether it's institutions, agencies, entities. this is something that states have said to us, y we'd like to have this flexibility and it gives the state a maximum flexibility so they can come in and set these programs, work with these providers. in texas, dr. burgess gave us a great example of when they did the decoupling in texas. we know it worked and that access to care increases when you allow the states that flexibility. and the stats that come from texas certainly are proof of that. you can look at some of the faith-based and community clinics tha

managing director of cm research. now as we discussed earlier, of course apple pushing into that business space and we have been asking you, would your boss spend a thousand dollars for everyone in the house in order to have an ipad pro. we said wishful thinking for those of us. he tweeted in saying not everyone needs a desktop computer. an ipad is cheaper and mobile and has less viruss. >> i don't know about that. >> they crash less than a desktop don't they? >> i don't know. >> i agree with him. >> probably because people use ipad less. less than their iphones because everyone is glued to their mobile devices. >> as you were pointing out with the accessories, with the keyboard it looks so like the surface pro and they're morphing into what we used to call a desktop. >> do you find it interesting that they are asking other companies to join in the event? adobe and microsoft and all of these outside players for collaborati collaboration. i stick with what he was saying as well. i was hoping apple tv would be a game ch

the have been blocked from doing that by cms. they are seeking help from us. this is a way to make that happen. we have four states that currently are in litigation. rep. polis: which part of the bill were you directing? your amendment or the bill? rep. blackburn: on the amendment. rep. polis: which lines? rep. mcgovern: page two, line three. yes for what you will see is that this allows the state to choose to establish criteria regarding the participation and its medicaid program. it is institutions, agencies, entities, this is something they have said to us, yes, we would like to have this flexibility. and maximum state flexibility so that they can come in and set these programs, work with these providers. in texas, dr. burgess just give us a great example of when they did the decoupling's in texas -- we know it works. access to care increases when you allow the states that the stats that come from texas are certainly proof of that. you can look at some the faith-based and community clinics that have provided necessary outreach and the way their numbers have

. >> has anyone from cms or hhs contacted you or any of your board members or staff? >> since the videos surfaced. >> july 14th has anyone from the health and human services or cms contacted you or anyone on your staff or board? >> i don't know. it's a -- we have a very big staff. >> has anyone from the inspect general's office at hhs contacted you, anyone of your board, anyone of your staff? >> if you're going to ask me about everything, we have a big board and we've got a very big staff so i'm happy -- i can't really answer. >> has the attorney general of the united states loretta lynch contacted you? >> no. >> anyone in planned parenthood? >> i don't know. >> you don't know? >> i have hundreds of staff and we have a very large board. >> anyone from the justice department contacted planned parenthood since the video surfaced? >> i don't know if you are asking about everybody in planned parenthood. >> if the justice department would contact planned parenthood it seems the person in charge of planned parenthood would know the answer to that question. >> we have a very

$28 million to one firm please use than $605 million, the ig report finds there are still people at cms contracts so there is the huge amount of money being wasted and cms has not got people up to speed to make sure your money is being spent appropriately. stuart: was it $600 million spent or $600 million wasted? >> probably one and the same. we spent $580 million but we are obligated to spend $605 million because people are not certified to approve these contracts approved the man they come with a full peace of the u.s. government and they violated their own health and human services regulations and standard code of ethics. they don't know what they are doing. stuart: that is what happens. >> we are here to help. stuart: you are terrible, worse than i am. >> i don't know about that. stuart: rand paul still relevant in this political race? his message, you got to say, is not resonating. who will libertarian's back instead to give back in a moment. i've smoked a lot and quit a lot, but ended up nowhere. now i use this. the nicoderm cq patch, with unique extended release technology, helps

cms recently or hhs said they want 80% of payment models to be in some kind of amoulternate sym or awe see this push, seeing it even on lower extremity, cms had proposals on lower extremity payments, bundles for outcomes of care. i think we'll start seeing new models of parents tied to value basis. i think models are in process, and over the next 20 years, that's something we'll move towards. one last thing about the waste talked about earlier. we have hot spots in the system where we have huge waste, and one is transition of care. that moment, for example, that moment of discharge is a critical moment. you know, where does that patient go, how are they followed up, and so as cardinal, we have taken some steps to work in that area, so we have, if you heat mapped what's going on in health care, there are certain areas of waste that are attack differently by different parts. >> visiting nurses or -- >> do they go to long term care, assisted living, or do they go home with a follow-up nurse? those decisions are very important because what's happened very frequently is the patients wind

and yesterday a study was published from cms as a result of rate increases. rates will decrease by 31 krents per month for seniors across the united states next year. we continue to see a decrease in pricing, a broader benefit structure for seniors and we view the product as high quality and very affordable. a vast majority of our members in both humana and aetna are low income members so we believe we're providing a valuable product and service to seniors. >> mr. swedish, from your point of view? >> very important question with respect to how we're going to engage in the marketplace regarding the combination of these two great companies. anthem believes that there are three core pillars with respect to how we engage in the marketplace, focusing on provider collaboration, focusing on building out affordability for all of our customers, and then finally recognize that this truly is a locally driven pursuit in terms of creating true value for customers. having said that, we believe that the sinner jis that we've identified will translate to benefits for the con

iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.melealth. stnger, healy enamel. >> mark: as congress comes back into recess, the democrats will vote in succeed on passing a dealer ron deal--on iran. >> darya: we will have been in and day out areas. even places that you usually get a little bit of break will not get any. >> george: the worst is right here the bay bridge. it is much worse than this camera shows. it reaches well be on highway 24 in to the macarthur maze. the drive time is 65 minutes from the east bay into downtown san francisco . more next >> mark: a new rolls royce is on the market which is being called the sexiest car ever made. >> darya: some people over a share on facebook. there are some even minor details that you should leave off your profile. >> mark: we will talk about the super bowl champion who is supporting a certain gop candid it. >> george: here is one bit of good news: barked is back gone --on. 65 minutes now is the average trip time out of the macarthur maze. it is hard to gauge the to time over the bri

john brown our medical director of cms those are broken down into 3 models the fierce the phases of disaster response and the disaster service workers and the roll specifically of primary care and in a disaster as noted it delves into the basic structure of i c s one the gaps we've noticed the gap in terms of psychological triage and assessment and moved that to the forefront not an afterthought but psychological assessment is being delivered in the acute phase of a responded the second model has nothing to do with with the clinic stabilization of the things that clinics should be prepared and model 3 looks at the allocation of resources we've excused ethical considerations and common needs and reacts is to survivors as well as disaster recovery currently, we measure there are 6 hundred of ambulatory staff that have had all trainings but 14 clinics have had all 14 trainings moving i don't understand the training we thought it it very important in this last half of the calendar year to focus on hands on moving from the didact to hands on training two methods this first are tabletop experience

iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.coate enamelealth. >> darya: your eggs in your morning at st. much from mcdonald's will be coming from the tree chickens cage free chickens. the transition will be over the next 10 years. slow and steady wins the race. >> james: here's a quick look at where we're going in concord where temperatures are warm up >> james: here's a quick look at where we're going in concord where temperatures are warm up to 105 and more next. [female announcer] through sunday, during sleep train's mattress price wars, >> james: here's a quick look at where we're going in concord whersave up to $400 on warm up tobeautyrest and posturepedic. get interest-free financing until 2018 on tempur-pedic. plus, helpful advice from the sleep experts. but mattress price wars ends sunday at sleep train. >> mark: is a call morning here but can't start to the day. >> james: gradually beginning tomorrow we will see a little relief on the coast and the next day a little relief in the bay and then the week and we'll get som

iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.oate enamelealth. stnger, healy enamel. >>james: gaggles the odder whose name is miss them and posted these videos on the korea log they're using food to teach the one your order to push her nose on the sale and take a deep breath the latest updates on the damage in the cleanup and signs of life is one school reopening will be there live the big store with a wise is going to be a big weekend warm-up will return in just two minutes. beest ndwi?bwafootng yodo. 'cau it'all outyourhoic ofresh bak bre. tendereatsmeltchees, and evythi in twee the hacrafd suay ftlon it'sot yr na allver . hodid bece sentindeypned snaing? eating o aft theext,aftethe xt? so pdictle a sounsasfyi? what aut plingp a air,a stl, a bebag,nd aualltastg r fo. we a a camy eesehatstilbelies in t beay of kni, inhe eganswip of a . . spe. coue, at dsn'tean you n't nk uor sop u up enjoy ery ngle soi-tay bi. the laugng c. inve snaing. >>male announcer:this is the bay area news station,kron 4 morning news starts now >>james: we

out the door soon could sit back of the bay bridge and that is a destination where minutes away from cmunless activated them have just been turned on to consider the back of very quickly now starting to form for the worst bomb ride for the ride out of the east bay come from hayward over to san sale the bridge is getting a little more clout with the drive times are still good 11 minutes with a trip out of the east of the heading to moran no delays yet at the richmond bridge but expected sooner than you're used to and we seem bigger than usual back of for this was about ride. >>darya: continuing our breaking news story the valley fire and our coverage as the continued threat to homes is happening to us still thousand of hone their concern about 67,000 a. have burned like napa and sonoma county the fire is 30 percent contained 9000 structures and all still threatened this morning. >>darya: get a glimpse of whether the homestand and if they look ok were with families as they drove to their homes and had a lack of balance the family that we spoke with said they did not know what to expect th

cms, is an effort with centers for medicaid and medicare services, groups trying to come in and put bundles of payments together. withy, that is hospitals physicians, hospitals with postacute care, or home care order nursing facilities -- home care, or skilled nursing facilities. part of it is seeing that it is improving care to the patient, improves patient satisfaction, and also reduces costs. those are baby steps toward a integrated delivery system. getting physicians and hospitals to work together to agree to combine surfaces -- services and efforts. and if they can show some savings and quality metrics, very important, then we get to show the savings with medicare. one of the problems we need to recognize is that the pilot projects that we are trying -- a very good idea. try before you roll it out toward all hundred three 6 million seniors -- 446 million -- all 46 million seniors. the groups that are being the most entrepreneurial and organized, -- jackie: and probably the most frail. gail: whether the populations are more or less frail can be measured. there are risk adjustments. is,,

iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.elealth. the >> darya: concord police are investigating an arson fire. around midnight to people were seen running from a s e v and then the fire started right after. the firefighters were able to of put it out quickly. >> darya: in the lake sonoma and valleys county areas 67,000 a. it earned haag. it has burned 585 homes and hundreds of other buildings. the 13,000 people had to run out of their homes and now in the evacuation centers. the fire is only 15 percent contained happen. there is a ranch in upper now that has opened their doors to evacuees at some livestock and pets. >> we're community appear and we need to help out. you need to take care of everybody. it's the right thing to do. as cabins for people this day and in the stables for horses and cattle. another evacuation center has been set at. >> mark: there are other huge wildfires is it the rough fire. has burned up to 20--200 square miles. we have more on the wildfires including the latest information on our web site at kro

i am here with the organization cm or smarter purchases to marijuana which was founded by an advisor for three administration, clinton, bush in a bomb and the only senior adviser to the bush an obama administration. congressman patrick kennedy. i'm going to start out here. my thoughts on marijuana just in general have developed immensely over the last few years. to be honest and 25 right now, but a few years ago i did not have a conclusive view of the marijuana issue. i knew it wasn't something that i wanted to do personally as a personal choice, but on the legality of it all the things i had no concrete position. i began to do some research for myself on the issue and that has led me to be staunchly against legalization in general for recreational use. we are not talking about that tonight. i'm going to explain my reasons for why i think we shouldn't rush into medical marijuana that it seems that the tide today, the momentum is to the local medical marijuana. i will bring up a few reasons why we might want to put on the brakes and slow down before we welcomed us with open arms. i wo

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iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.>>male announcer:this is the bay area news station,kron 4 morning news starts now >>darya: american heroes as 911 in the city of sacramento and getting ready for one of the biggest parade and that is honoring the three young men to stop the terrorist attack on a train in france last month that happen all this while they were there on vacation and the government entering the time. >>will tran: thousand people will be in attendance was the right to the picture of these men the toast of sacramento northern california of the world for what they did last month when they jump all over the terrorist who orders of the centers have an ak-47 son of ammunition of boxcar these men along with another american justice action according to france's present said the massacre on the train so many people turn out because they had been waiting to sit thinking of you to come in san francisco give yourself plenty of time because our be an issue in the ghost getting around downtown sacramento be very tough a

he decided that every leader from every country that came into cm would be asked to join in an effort -- that came into s ee him would be asked to join in an effort. the president put together an incredible coalition because we have learned long ago unilateral sanctions aren't worth much, but if you can bring many nations around the world to a common purpose of putting the pressure on a country, it can have a positive impact. the coalition the president put together was amazing. i witnessed the negotiations themselves were china and russia were sitting at the same side of the table as the united states and the european union -- england, france -- and then the other countries join does in opposing these economic sanctions when they had little to gain and a lot to lose when it came to the oil resources of iran. so the president determination -- president's determination to put the sanctions on iran -- that systematic gathering would literally have been the first meeting in 35 years between iran and the united states. of timeting that period when our relationship with iran had reached it

iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.healy enamel. because at&t and directv are offering yesterday's technology, today. tv from space. [whispered] space as long as it's not too rainy. [whispered] rainy or windy. [whispered] windy or there isn't a branch in the way. [whispered] branchy welcome to the moment no one's been waiting for. the fastest internet and the best tv experience is already here with x1. only from xfinity. today we're gonna talk about trucks. works for me. which truck brand do you think offers best in class hd towing? ford. i would say the ram. ok, lets move to the second door. best v8 horsepower. the ram. i say ford on the v8. chevy. what about this year's motortrend truck of the year? chevy. what do you think? the ford. there's no reason why they shouldn't be. let's see how you did. oohh! that's the chevy silverado hd, the chevy silverado, and the chevy colorado. no way?! chevy, chevy, chevy. wow. that's a clean sweep. >>> happening tomorrow, the city of sacramento will honor the three men who stop a te

so, how does cms plan to address the results to truly target the bad actors we want to get to without hitting guys who are just trying to serve their customers? this came up earlier as part of a complaint because one of my rural pharmacies has a supplier for medicines and one point got cut off and they have to tell their customers, i can't fill it today, come back at the end of the week when we change months. that's hard when-f you're a senior citizen. you need that pain medication. in fact, a friend of mine's wife was told that, who had just gone through surgery. she had to wait three days. they managed. that's that's really not the way it ought to work. whether you're in the rural areas or -- how do we fix it? >> you make a good point. this kind of data analysis is a starting point. as to the specific methodology, i'll defer to the oig, but data analysis is the beginning point of our investigations. now, i had shared earlier on a month -- on a quarterly basis we send lists of concerning or high-risk pharmacies to part "d" plan spon source. our methodology takes 16 variables into acc

. >> that's the cms. >> i believe under the irs. >> the irs. >> form 990. >> yeah. part of government does talk about talk to the right maybe they do. >> and before we precede i thought that since also everybody has brought into the conversation it would be good to recollect where this came in from thank you, again, for the report you highlighted this is a fine report the attachments are so valuable it helps to table for us and prepares prepares for any future dialogue what the landscape is in terms of the reporting for the various entities i want to thank staff for working it has to have been very difficult the ordinance is in there and this couldn't have been prepared without the help of the entire hospital council communities not only from the mandatory side that submits data but not anywhere as valuable without the benefit side as complete a picture as the county can have the reason that charity care reports started from this commission and from the board of supervisors to be sure there is value to a nonprofit status that would have to be part of the work that w

on the other hand in a republican primary the most conservative cms addressing conservative and if you go into the evangelical community homeschool community groups like that give a lot of trust a lot of trust and that's how ended up winning iowa last time. he ended up winning in iowa.on caucus night that eventually. >> let me hit you with two lightning round style questions at the end that i hope to ask everyone. what is the one moment, the one move from another campaigner candidates so far that has made you think wow that's good and i wish i would have thought of that. and two what is the most endearing quality of rick santorum that all of us on the outside may not be privy to but you are? >> first of all trump signing the pledge as a third-party. i believe two weeks ago there was a shift in the trump campaign if you watch it carefully. for the first time they started to believe they could win and they have tried to become more credible. i thought in the debate he tried to be more careful in how he chose his words and i think he understands he has popularity but he has to prove he ca

iteplenisheseak otswith natal cm to sengtn enamel fourimesetter. y coate amel health.'re back. new this morning, it could take more than luck now to win at the slots in vegas. we have arcade-style slot machines that sort of combine skill and luck together to win money. this could be in nevada casinos as early as next year perhaps at least according to state regulators. the companies the nevada board is looking to have more of these slot machines. it's not just pushing the button anymore and just watching the rollers roll, which has been the case. and -- and people getting board with that. >> people like no, you have to have the handle. >> you gotta -- >> so they've had gaming rev new are in the slots -- revenue in the slot machines go down 20%. how do we change this so the younger players get involved? everybody's playing games on their phone. what if candy crush those points were dollars? >> i guess. >> put a game control are out there, that will put the young folks there. >> games swapping out those whole... -- >> i have one backing up in favor of the house. >>> list

there's an everyday with cms, centers for medicare and medicaid services, trying to encourage groups to come in and put bundles of payments together. mainly that's hospitals with physicians, hospitals with post-acute care, home care, or skilled nursing facilities. sometimes all of the above together and to see whether or not this improves value that is the clinical outcome to the patient. improves patient satisfaction and reduces cost. there are these accountable care organizations which are kind of baby steps toward a more integrated delivery system getting physicians and hospitals that work together to agree to combine services and efforts and if they can show some savings and meet quality metrics, very important, then they get to share the savings with medicare. one of the problems we need to recognize is that the pilot projects that we're trying, very good idea, try it before you roll it out to all 44, 46 million seniors are voluntary, that means there's a big self-selection bias. the groups that come in to try it may be the most innovative. the most entrepreneurial, the most org