it appeared in the house schip bill. i guess it was a year or two ago. it's probably due today. and basically would involve a better process for updating physician work values because that process which is done by cms with advice with their relative value update kennedy called rvuc which because of productivity gains over time have become relatively overvalued or overvalued compared to the other services. there's also the need for much more accurate estimates of facilities costs. and their needs to be frequent updating some reflect declining costs associated with technology probably even considering projections of unit cost. but if you an example with problems of lack of data. for those that have followed this, cns assumes a piece of equipment and maybe this is specific to imaging is run 25 hours a week. when i asked what's the basis of that assumption well, we didn't have any data so we just chose that number presumably not to offend too many people. they've recently urged that number based on some data that they have reviewed the increase to 45 hours per week. just based on th

this is easy, it appeared in a -- in the house schip bill, i guess it was a year or two ago. it's probably doable today. and basically involves a better process for updating physician work values, because that process, which is done by cms, with advice from the relative value update committee, called the ruck, has not succeeded in identifying those services, which because of productivity gains over time have become relatively overvalued or overvalued compared to the other services. there's also a need for much more accurate estimates of facility. -- facility costs. and there needs to be frequent updating to reflect declining costs associated with technology, probably even considering projections of unit costs. let me give you an example of the problems with the lack of data. for those that have followed this, cms assumes that a piece of equipment, and maybe it's specific to imaging, is run 25 hours a week. when i asked, what's the basis of that assumption? well, we didn't have any data, so we just chose that number, presumably not to offend too many people. net pack has recen

schip? that's the bill the public plan that allows our children to be covered, our poor kids. why don't they come here and say, our children shouldn't be covered. let's repeal it? how about our military? they get free health care through the public domain. should we now cancel that? and contract out? look, i'm for a robust debate. i'm for a bipartisan bill. i want to work toward that, madam president, but let me tell you this: if we don't get 60 votes for something, we can't quit around here. we cannot allow a terrible crisis toward the end of life to bankrupt our families, and more than half of our families who file bankruptcy, file bankruptcy because of a crisis in their health. we can't afford it. and the fact is, we are on the verge of being able to do something, but not if the party of "no" comes here every day and bashes every idea. and starts frightening the american people. so they'll have their chance. but i hope we won't stop. we'll have to figure out a way to do it with a majority vote. that's my feeling, because this is too important and issue. and our families can

clarifies senior adviser for health care fraud established under this bill will focus also on fraud in medicare, medicaid and schip. my second amendment requires the senior adviser for health care fraud created under title five of this bill to report to congress on federal efforts regarding the detection and prevention of health care waste, fraud, and abuse. my third amendment requires school based health centers and those employed under or under contract to follow state law requiring the reporting of child abuse, child molestation, sexual abuse, rape and incest. funding authorized in title iii is discontinued and the provider of services fails to report this information in accordance with state law. n deferment program, also known as the 220 rule. this rule was eliminated in the college cost reduction and access act and has had a negative effect on the ability of medical residents to repay their student loans. we're going to increase the pot, we better increase the providers. my fifth amendment requires school based health center program to provide age appropriate care to children. my sixth amendment requires the

bill to pay for that. we had it at 350% because that was sort of the schip guidelines in two of our more populous states, as i might say. >> right. but should we be going to the most populated states and using that as our criteria, or is it not more reasonable to go with the criteria that we see more of our states utilizutilizing, whi around 200% of poverty? >> well, if we're going off that group of people, obviously they live in the most populous states. so that's -- >> you've only got two states, my understanding, new jersey and new york, that are higher than 350. >> that's right. >> but those -- >> are they higher than 350? >> yeah. i believe they had requested the waiver so they are in excess of that. but all the other states are below 350% of poverty level. so, again, why would we take the highest number and say, okay, this is the level that we would set, if most of your states in looking at the chip program are looking and saying, well, somewhere between 200% and 300% is where they are landing? why are we going to the highest level of poverty that only two states have? now, as far as your comment abou