Schedule i want to get going and its going to be in operation because i have another meeting that have to make a form down the hall. Im going to start out, i know you want to introduce one person, are you under at times contrite push mark if you are all give you the courtesy of going ahead. I write. I welcome my panelist, today to our hearing on the oneyear anniversary of the support act this landmarks acute which many had a hand in developing, responded to the opioid activitc in crisis that is affected every corner of our nation was approximately 130 americans dying from an overdose everything all day. We devoted a lot of federal resources to tackling the crisis and look forward to hearing from the Surgeon General of this ministration effort to implement the support act on this oneyear anniversary, i also commend doctor adams for launching his initiatives to help raise a Public Awareness about the risk of the opioid issues, challenges remain because 20 million Americans Still struggle with substance disorder, addiction to other drugs including meth and heroin, equal or greater challenge to some communities and this is true in rural areas of america, another issue is to seek or receive treatment in another issue is even those who do seek help lock lacks the expe from the bad in solving this issue which is the second focus of the hearing. Its easier said than done. Theres extreme the bad in the extreme good actress but those are between, some for example have not updated their methods to incorporate the latest research about what works best for recovering people, also state requirements for addiction counselors and recovery homes very. Example, some states require licensing and recovery home operators while others might only use voluntary certification, that is why we have invited to government watchdog agencies and in Addiction Treatment advocate to our committee to share expertise. We welcome back doctor who testify before the Committee Last year, we have all seen the media reports about socalled sober homes in florida, pennsylvania, massachusetts and a few other states that exploited addicts with private insurance benefits, we look forward to hearing from her on that subject how geos worked there. I also extend a warm welcome to harry who has the Inspector General investigative team, his investigators worked on a recent highprofile case who bombing treatment scams in ohio, that investigation a partnership with the fbi in Law Enforcement led to the indictment of six people shthis year, all six pleaded guilty for medicaid fraud some have called for more measurable Addiction Treatment standards by which the public would evaluate the effectiveness of Substance Abuse, treatment programs, the last, gary mindel has gone a step further to not only identifying standards that he believes are key to any Successful Program but launching quality rating systems, this is unchartered area and treatment sector and we look forward to hearing from him with the progress that has been made with the Nonprofit Organization that has been approved. We are here because too Many Americans have lost too many loved ones to addiction an overdosed deaths, americans owe pure crisis has left a trail of broken hearts and homes across the country and we are here to help communities get on a path towards health and wellness and millions of americans are seeking a path forward. Co working together we can save tax dollars and save lives. Thank you very much, i want co thank you this is an important issue and we do need to have our committee tackled in a bipartisan way. I also want to thank you for moving this morning start came to 9 00 a. M. Because we both know there are members that want to attend the Memorial Service of chairman cummings. Todays hearing will spotlight s the pitfall americans face when they try to find quality treatment for substance youth disorder prudent american battling this disease is often jostled and pushed around from one end of the Healthcare System to the other. The last thing you need when youre suffering from this disease, yet more obstacle, ripoff artists, pharmacist or out and out abused, the last thing you need is that when all you want to do is get better. Too often people expecting to arrive at a legitimate Treatment Facility only to find that they have fallen prey to his scheme which to drain their bank account and milk their insurance for everything it is worth. In some instances, some operators are working to lure patients by paying for plane tickets and promising free rent. Once the patients arrive, what they end up getting his lousy care or no care at all. And then the fraudsters go out and build the Insurance Company for Healthcare Services that may never have even been performed. One of the biggest problems involves facilities that allegedly treat Substance Abuse disorders but set up to ripoff taxpayers. The fraudsters illegally recruit patients using bribes and kickbacks and then they milk the taxpayer by billing the Patients Health plan for medically unnecessary drug test. Schemes like this and were grateful to have this terrific group of witnesses today, they will outline these schemes in detail and of course these schemes cost medicare, medicare, private insurance, hundreds of millions of dollars every year. Just as month six people operating and network and Treatment Centers in ohio played guilty to submitting 130,000 medicaid claims, this totaled more than 48 million to medically assisted treatment and other services that were never legitimately provided. Part of the reason this fraud is so common because theres no way for a patient and their families to learn about the quality of a Treatment Facility before they enroll. So today, were going to hear from an organization that says wake up we have to change. Public databases and multiple states have successful allow a public to identify and compare Substance Use treatment program. This database and transparency is a type of information that American Families deserve to have and they deserve to have it now because it will be a key tool, a fine quality treatment and operators trying to make a quick buck. One other point that occurred to me as we were preparing for this hearing, it is particularly important now to set in place the concrete policies to ripoff and to make sure these programs are not ripped off in the patients are not taken advantage of because when you read the morning newspaper, the factors the state and communities may well be on the cusp of receiving tens of billions of dollars from the companies that help see the epidemic. And i can look down the road because of her about this from virtually all of my colleagues. If you are talking about a fund, of tens of billions of dollars, a sum of that size is going to be a magnet for the fraudster in the ripoff artists. This hearing is going to highlight needs to make sure the rules in the road vigorous oversight so those dollars actually go to help patients get the proper care and all the new money does not just find its way into the ripoff artist thank you witnesses. And again, thank you for your leadership will work on this in a bipartisan way and i look forward to hearing from the witnesses. The senator from maryland to introduce. Thank you, mr. Chairman. I thank you for giving me this courtesy. Its a pleasure to welcome all of our witnesses. But particularly a well of doctor jerome adams. Hes a proud son of maryland and a glowing career. He is first winning the procedures scholarship to university of maryland where he received both a bachelor of science and biochemistry and a bachelor of arts from biopsychology. I say that because we had a conversation before the president calls doctor adams the most successful failure, thats because the Scotia Program is a program that is extremely successful in africanamericans obtaining their phds and going on to extraordinarily successful lives. Doctor adams does not have a phd, but he does have a masters degree in md degree and of course a successful career, i want to congratulate him for his leadership in our country, the service to our nation, he attended the school of medicine and a Company Scholar for serving as United StatesSurgeon General he was appointed as the Indiana State Health commissioner as a u. S. Surgeon general, he spends his time focusing on combating the Opioid Epidemic. He has been on behalf of the intercountry and were very proud of his service and proud to have him heal from the state of maryland. Just go through the testimony i wont feel bad for introducing. I talked to all of you about my Opening Statement because of the tim constraint. Would you start, and what we cowill do is go in the order tht youre sitting at the table and then will have questions after you all get done. Good morning chairman grassley, i wife says to tell barbara hi and we cant wait to bring the kids to the farm. Everybody knows about my wife does anybody know about me . Ranking member and distinguished member of the committee if you allow me 20 extra seconds i want to acknowledge the flag flying at halfmast over the capital to lift up the example and accomplishments thatst representative cummings, his life is a definition of Public Service and my condolences go to his family and ive been blessed to know him. My testimony today, id like to begin by thanking all of my colleagues for passing the support act which is enabled hhs intercountry to make progress in the fight against the Opioid Epidemic. I am pleased to be here today on the oneyear anniversary. Americans overdosed in addiction crisis in one of the most daunting and complex challenges ever. Recognizing the scale and scope, hhs launch the strategy in 2017 and under the strategy were to be better addiction, preventing and Treatment Services to better data and better management, better targeting of overdose reversing drugs and Better Research. Ive been engaged on this problem as an anesthesiologist with chronic Pain Management and as you heard, as ahead of the state Health Department dealing with the unprecedented opioid fueled hiv outbreak but by work is also very, very personal. My younger brother philip struggles with addiction, his struggle began with untreated depression he needed help medication and opioid issue. With Mental Health and substance issues he has cycled in and out of incarceration, he is currently serving a ten Year Prison Sentence for crimes committed to support his addiction. This epidemic is blind and color to your average class and it can happen to anyone even the brother of the United StatesSurgeon General. And when stigma keeps people in the shadows, and impedes our collective recovery. To address though. Epidemic, my office relieves a spot on opioids, a digital postcard which you can find as Surgeon General. Gov in an advisory on opiate overdose. I want to leave you with five key messages i detail in the publications. Number one, Early Intervention is critical. Prevention, screening and programs work but they need to be initiated early in life. We cannot wait until someone is in high schoolt or college befoe we talk about them about the oakwood issue. Number two treatment is effective but must be integrated in the mainstream healthcare. Medication treatment physical standard but in the course of year only one in four peoplenu with opioid receive specialty treatment. Number three, having the loss can save a life through treatment and recovery and hope all of you know about this and carry it, i carry it everywhere we go, it is that easy to save a life. Since my book was published almost 3 million have been disturbed into communities but too many still need this. Comprehensive communitybased support services are essential. I saw this firsthand with second lady pens and i visited the industries in indiana. They developed the Pilot Project pathways to recovery and who failed drug tests are offered drug counseling and participant to stay in the Recovery Program our short job. Recovery support services are vital to bakery in new york, the bakery provides employment and support Services Without judgment, no resume, no work history, no back contract is required. The bakerys model which i love, we dont hire people to bake brownies, we baked brownies to hire people. More than 60 of bakeries and employees were formerly incarcerated. My fifth point, when it comes to opioid use disorder, society must move from a criminal justice based approach to Public Health and Partnership Based stigma and judgment are qbeo people with the disease of addiction, people like my brother from getting the help that they need in the semi opinion is killing more people than overdose. In conclusion, under this ministration and threeyear support in a stork investment has been made in combating opioid crisis. By the end of 2019 hhs will have awarded 9 billion in grants to states, tribes and local communities to combat addiction. This includes 1 billion across 375 projects and 41 states part of nih helping to an addiction longterm or heel initiative. It also includes 1. 8 billion in the cdc funding states announced last month. These funds expand access to treatment and strengthen dataa and surveillance. Since the start of the ministration, weve seen the opioid nationally drop 31 in terms of prescription. Weve seen the number of americans receiving treatment girl. Now nearly one point to 7 million americans are riers receiving medication and e doubled the number of providers who have the data waiver to prescribe. The prescriptions have risen 378 and provisional drug overgrowth death have dropped by 5 . The first drop in over 20 years. We are making progress but challenges remain including the resurgence of methamphetamine and need to increase companies and programs and to support Emergency Department medication treatment programs. We also finally must expand the behavioral workforce senator and i talked about that before the hearing. I promise you, i promise you the hhs and my office will continue our commitment and a focus on the Critical Health issue, i thank you for the opportunity to testify and i look forward to your question. Before you begin the background on animal science, how did you end up here. Theres prior to gap between Animal Health and Public Health. I needed the explanation. Sure. Proceeded please. Chairman grassley, Ranking Member widened and members of the committee, im pleased to be here to discuss the recent report on the oversight of recovery. Drugance abuse and illicit use is a problem that has ruined families and takener lives. The dea reports since 2011 drug overdoses alone have been cause of death by injury in the United States outnumbering deaths by guns, car crashes, suicide and homicide. Recovery homes can offer safe housing. Rtive unfortunately bad actors have used these homes to take advantage of individuals during their time ofnd need. Today i would like to highlight two key findings from mydv repo. First we found all five states and a review have received complaints of the fraud related to recovery homes. In four of the five florida, massachusetts, ohio in utah had or in the process of conducting investigation. Foro, example, officials told jl was extensive afforded a Task Force Found operators were luring individuals to homes with marketing techniques. Such as promises of free airfare in rent. Recruiters broke with individuals and providers who build the insurance hundreds and thousands of dollars in unnecessary drug testing. Home operators were paid 300 or more for every patient they refer. At the time of our report some arrest had been made. In massachusetts the medicaid Fraud Control unit found some laboratories recovery referred revisiresidents to their own lar drug testing and other labs for kickback and referral when it was not necessary in between s 2017 they settled with 40 million. At the time of our report ohio was investigated fraud at the breaking Point Recovery center. This month senator whiting mentioned, the Attorneys Office recorded six people from breaking point to healthcare fraufraud conspiracy for billing medicaid more than 48 million in drug and Alcohol Recovery Services that wereng not providd are not medically necessary. To increase oversight, florida, massachusetts and utah establish a licensor or voluntary Certification Program that included incentives for recovery homes to participate