mr. schatz: thank you, mr. president. i ask consent to set aside the pending motion and call up my motion to instruct which is at the desk. the presiding officer: without objection, the clerk will report the motion. the clerk: the senator from hawaii mr. schatz, moves that the managers on the part of the senate at the conference on the disagreeing votes of the two houses on the house amendment to the resolution senate concurrent resolution 11 be instructed to insist that the final conference report include the deficit-neutral reserve fund relating to ensuring all legally married same-sex spouses have legal access to social security and medical benefits they have earned and receive equal treatment under the law pursuant to the constitution of the united states in the concurrent resolution as agreed to by the senate. mr. schatz: mr. president three weeks ago the senate held an important vote on an amendment to the budget resolution. 56 of our colleagues, including 11 republicans joined me in affirming the need for legislati

mr. schatz. >> thank you mr. chairman. i know va is working with dod so that the two can share servicemembers medical records electronically but progress as you know has been slow p.. >> gao cited the lack of progress is an issue and added va to its 2015 high-risk list. according to gao quote the two departments have engaged in a series of initiatives intended to achieve electronic health record interoperability but accomplishment of this goal has been continuously delayed and has yet to be realized. the ongoing lack of electronic health records interoperability limits of va clinicians ability to access records and so on. what kind of progress are you going to be making and when can we expect for you to be off of the gao high-risk list? >> first of all when i met with ahead of the gal isp put on that list. they run the largest largest health care system the country and the crises that occurred i thought it was appropriately run the list. i think the transparency and visibility is important to improvement. secondly we have

mr. schatz. >> thank you secretary burwell. i have a question about telehealth. i'm a.i'm a big believer in telehealth telehealth and i believe the va has been -- has done a lot of good work. private health care providers are expanding their services. it's a way to improve clinical outcomes in a way to save money in systems. i just want to know what medicare in particular is doing what you think you can do additionally within the confines of 1834m and whatever statutory restrictions you may have been could you just sort of divide the question into those two categories, where you think the law needs to be changed and what you think it could be doing within the confines of the statute that you are not quite doing at? >> i think the places we can do more art in our innovation centers of the funding we receive for the innovation and i was part of the affordable care care act that we have been given there we are seeing and doing a number of innovative projects that are including telehealth pray that's one place where we are acting. we have several of the things we have funde

thoughts go out to his sons, jacob edward, steven and our colleague senator brian schatz, his nine grandchildren and his family. mr. president, i'd like to speak on a separate topic very briefly. the presiding officer: without objection. mr. durbin: mr. president the moment is finally going to arrive in just a few minutes when we are going to, i hope, approve by a bipartisan vote the nomination of loretta lynch to be our next attorney general. this is a milestone in the history of the united states, the first african-american woman to become attorney general of this country. i would like to say i'm sorry and i am, for the delay in bringing this nomination before the united states senate. it should have been done long ago. she is an extraordinary person from an extraordinary family. we have been blessed with her public service for so many years, and now she has reached the top in her career to be able to serve as our next attorney general. i will with a great deal of admiration and respect be voting in favor of this nomination. mr. leahy: mr. president. the presiding officer: the senator from vermont. mr. leahy: mr

mr. cassidy and senator cochran. senator mikulski, senator schatz senator baldwin and senator merkley. senator lankford: i thank you for being here and thanks for the engagement on this. let me go through a couple of questions. there is a lot of conversation about the process. that's not a new conversation. in your testimony you even note that starting in 2009, there is a 1,300% increase in medicare and the auditing and what is happening in the appeals process. there is a problem that has happened. while you are accelerating the appeals process i would like to get down to the root causes. what is pending right now to continue to reform the process in the days ahead beyond the appeals process, which we can talk about separately. secretary burwell: i think it's important to step back what was put in place and work on program integrity issues in terms of medicare spending. this is something dr. coburn and others helped us focus on and this was put in place so we could track. it has tracked many and returned quite a bit of money in terms of what goes back in the trust fund. there were nega