Recent high profile case involving treatment scams in ohio, and investigations and partnership with the fbi and Law Enforcement generally, leading to the indictment of six people this year, all six pled guilty to medicaid fraud. Some have called for developing more by which the public could evaluate the effect in the Treatment Programs. Our last witness, has gone a step further not only identifying it core standards, he believes are key to any successful program, but also launching quality rating systems. This is uncharted area treatment sector, and we look forward to hearing from him, the progress thats been made there, with his Non Profit Organization. We are here today because two Many Americans have lost too many loved ones to addiction. Americas Opioid Crisis has left a trail of broken hearts and homes across our country. We are here to help communities get on a path towards health and wellness. Millions of americans are desperately seeking a path forward. Working together, we can save tax dollars and save lives. Senator . Mister chairman, i want to thank you because this is an exceptionally important issue, and i think we do need to have our committee tackle it in a bipartisan way. And i also want to thank you for moving this mornings start time to 9 am, because we both know there are members who want to attend the Memorial Service to chairman cummings. Todays hearing is going to spotlight the pitfalls americans face when they try to find quality treatment for a Substance Use disorder. An american battling this disease is often jostled and pushed around from one end of the Health Care System to the other. The last thing you need when you are suffering from this disease is yet more obstacles. Rip off artists, empty promises, or just out and out abuse. The last thing you need is that, when all you want to do is get better. Too often, people travel across the country expecting to arrive at a legitimate Treatment Facility only to find that they have fallen prey to a scheme. The goal of which is to train their bank account and just milk their insurance for every thing it is worth, in some instances, on scrupulous operators are working to lure patients by paying a for plane tickets and promising free rent. Once the patients arrive, what they end up getting is lousy care or no care at all and then the fraud stirs just go out and build the Insurance Companies for Health Care Companies that may never been performed. One of the biggest problems involves facilities that treat Substance Abuse disorders but are actually set up to rip off taxpayers, they illegally recruit patients using bribes and kickbacks and then they milk the taxpayer by building the Patients Health plan for medically unnecessary drug tests, schemes like this, im very pleased to have this terrific group of witnesses today, they are going to outline in these schemes in detail and of course these schemes as well medicare, medicaid, cost them hundreds of millions of dollars a, rare justice on six people operating fragile and Treatment Centers pled guilty to submitting 130,000 medicaid claims that totaled more than 48 Million Dollars for medically assisted treatment and other services i would never legitimately provide, part of the reason this is so common is there is no way for a patient or family to learn about the quality of a Treatment Facility before they enroll. So today we are going to hear from an organization that is saying hey, wake up everybody, this has to change, shatter proof is currently developing public databases in multiple states that if successful will allow the public to identify, evaluate, and compare value substance Treatment Programs. This kinds of transparency is the type of information that American Families deserve to have and they deserve to have it now because itll be a key tool to find quality treatment and avoid sham operators trying to make a quick buck. One other point that occurred to me is that we were preparing for this preparing hearing, is that it is particularly important now to set in place a kind of concrete policies to rip off, to make sure that these programs are not ripped off and that the patients are not taken advantage of because when you read in the morning newspaper, the fact is that states and communities may now be on the cusp of receiving tens of billions of dollars from the companies that help seed the epidemic, i can just look down the road because i have heard about this from virtually all of my colleagues, so if youre talking about a fund of tens of billions of dollars, a some of that size is going to be a magnet for the fraudster and rip off artists, so this will highlight the need to make sure that there are rules of the road so that those dollars actually go to help patients get proper care and all that new money doesnt just find its way into the roof off artists, i think the witnesses and miss chairman again we will work on this in a bipartisan way, and i look forward to the witnesses and colleagues hearings. Thank you mister chairman, thank you for giving me this courtesy, its a real pleasure to welcome all of our witnesses today, particularly welcome the syrian general doctor jerome adams, he hails from maryland, a proud son of maryland and had a glowing career, first winning the prestigious scholarship to county where he received both in a bachelor of science and biochemistry and a bio of bachelor of arts, i say it is because we had conversation before with doctor freemen at you nbc, he calls doctor adams is most accessible failure, thats because the Scholarship Program is a program that has been extremely successful and African Americans obtaining their phds and going on a two extraordinary successful lives, well doctor adams does not have a ph. D. But he does have a masters degree and an empty degree and of course is had very successful career, i want to congratulate him for his leadership in our country, the service to our nation, he attended Indiana University school of medicine and was a Company Scholar before serving as the United StatesSurgeon General, he was appointed by the Indiana State Health commissioner, he has found his time focusing on combatting the Opioid Epidemic, he has been an advocate of behalf of Public Health in our country and we are very proud of his service and very proud to have him hail from our state of maryland. Well the three of you if i can just go to the testimony on it. I have talked to all of you in my Opening Statement because of the time constrains, i want to start with the Surgeon General, will you start and then what we will do is, go in the order that you are sitting there in the table and then we will have questions after you all get done. Fantastical, good morning chairman, my wife says to tell barbara i and we cant wait to bring the kids out to the farm, i hope she told you about that. Everybody knows a bow my wife, does anybody know about me . Ranking member wide in and swedish members of the committee, will you give me a few minutes to acknowledge the flags flying at half mast and lift up the examples of representative cummings, his life was the very definition of Public Service and my condolences go to his family that are all blessed to know him. For my testimony today i would like to begin by thanking all of you mister chairman for passing the support act, which has enabled our country to make progress in the fight against the Opioid Epidemic, i am pleased to be here today on the one year anniversary, americas overdose an addiction crisis is one of our most daunting Public Health challenges, recognizing its scale and scope it launched the five point strategy in 2017 and under that strategy we are achieving better addiction, prevention and Treatment Services, better data, better paid management, better targeting of overdose drugs and Better Research. Ive been engaged on this policy, and as you heard from senator nick cardin, dealing with an unprecedented hiv outbreak, but my work on the Opioid Epidemic is very personally. Younger brother philippe struggled with the addiction, he struggled again with untreated depression, getting to self medication and opioid use. And like many with Health Issues he has support in and out of course ration, he is currently serving a tenyear mark this guy can happen to anyone even in the brother of the United StatesSurgeon General and when stigma keeps people and shadow, it mps our collective recovery. To address this epidemic, my Office Released a spotlight on huawei its, a digital postcard which you can find at Surgeon General dog in which you have in front of me janet senators, and an advisory on opioids, i want to leave you with five key messages at a detail on these publications. Number one Early Intervention is critical, Evidence Based prevention screening programs work but they need to be initiated early in life, we can wait until someone is in a high school or college to talk about the dangers of opioid issues. Number two must be integrated into mainstream health, care as an example medicare assistant treatment is the Gold Standard but in the course of the year only one in four people with opioid use disorder receive special treatment. Number three having the bloc zone, can save a life and me i hope you know about, this i carry this wherever i, go its literally that easy to save a life. Since it was published, almost 3 million to davos units have been distributed, but too many needlessly die. Fourth comprehensive Communities Support Services are essential, and i saw this firsthand when we visited the industries and indiana, they came up with pathways to recovery, and where failed drug test offer drug counseling and participants that state have assured jobs, and this is also vital to the degree in new york that provides Employment Services for out judgment, no, resume no work history, no background check is required, at the bakeries model which i love is, we dont hire people to bake brownies we bake brownies to hire people. And when it comes to opioid uses, this inside he must to continue u. S. Front can criminal justice used to a Partnership Based run, stigma and judgment are keeping people from disease of, addiction people like my brother from getting the help they need and is in my opinion is killing more people than overdoses. In conclusion, under this administration and through your support, a historic investment has been made in combatting the Opioid Crisis, by the end of 2019, hhs will have awarded nine billion dollars to states and tribes and local communities to combat addiction. This includes nearly one billion across 375 projects and 41 states as part of their and for ending addiction long term hell initiative. And if these funds expand access to agreement, and surveillance, insist artisan ministration, we have seen the amount of opioids nationally drop in terms of prescriptions, we have seen a number of americans receiving treatment grow, now nearly 1. 2 7 million americans are receiving treatment and we have doubled the number of providers who have their data waiver. And the drug quo provisional death drop by 5 , our first draw wage many, years we are making progress, but challenges remain including the resurgence of meth amphetamines, we need to increase support for comprehensive support programs and to support assisted Treatment Programs with warm me and in, care we also must expand the behave real workforce and we talk about that before the hearing, i promised you, i promise you that hhs in my office will continue to focus on this critical Public Health issue and i thank you for the opportunity to testify and i look forward to your questions. Doctor before you began, with a lawyer background and animal science, how did you end up doing this . As you probably are aware there is a nexus between Animal Health and Public Health and i think they recognize that. Well i needed that explanation. Sure. Proceeds these. And chairman grassley and members of the committee, i am pleased to discuss on the oversight of recovering homes, Substance Abuse and drug use is a problem that is ruined families and take analyze the da reports that since 2011 Drug Overdose has allowed alone ive been leading cause of death in the United States, outnumbering deaths by, guns car crashes, suicide, and homicide, recovering homes can offer safe and supporting houses, unfortunately bad actors have use these homes to take advantage of individuals during the time of need. Today i would like to highlight two key findings from our report, first g eight oh found that all five states have received complaints of fraud related to recovery homes, four of the five, florida, massachusetts, ohio, and utah had or were in the process of conducting investigations. For example, officials told gao, that fraud was extensive in southeastern florida, a Task Force Found that operators were lowering individuals using deceptive marketing techniques, such as promising of free airfare and rent. Recruiters then broker these individuals to providers who builds their and sirens for hundreds and thousands of dollars for unnecessary drug testing, home operators were then paid 300 or more per week for every patient they referred. At the time of our arm hurt some arrests had been made, and mass since two since they found that some owned recovery homes and referred patients to, labs other labs are paying kickbacks to home for a patient referral for testing that was not medically necessary and between 2007 and 15 they settled with an iron labs in 4 Million Dollars of restitution, and the time of our report ohio was investigating fraud at the recovery center, this monday reported that six people planning guilty on for building medicaid more than 40 Million Dollars in drug and Alcohol Recovery Services that were not provided or not medically necessary. To increase over saint, florida, massachusetts, and utah establish either a licensed or or a voluntary Certification Program that included incentives for recovery homes to participate. Our other two states, ohio and texas, do not have similar programs but we are providing programs and resources such as training to recovery homes. Despite such efforts fraud continues, for example the Pennsylvania Attorney officers recently completed an 18 month investigation looking into Insurance FraudTreatment Centers, charges included kickbacks for unnecessary drug testing and billing Insurance Companies at exorbitant rates. Those charges actually got them working in unlicensed recovery homes where the houses were sometimes unsafe, employees and patients were engaged in sexual relationships and there are opportunities to realize, this is the case of the bad guys getting caught and that is what raised me to my second point. We do not know the total number of recovery homes and therefore we dont know the extent to which this is happening. In addition no federal agency oversees the operations of these homes to provide a nationwide perspective, in closing when run properly recovery homes are an important part two nations path to serve right in combatting the Opioid Crisis. Our work on recovery homes as part of the gao broader work on drug misuse, we have explored federal oversight in medicare, we also have ongoing work on identifying accessing important overweight misuse, much of our work is as a result of mandates from the support act which was signed one year ago from, today we highlight this another work in our latest highrisk report where we identified as federal efforts to prevent drug misuse as an issue requiring very close attention. Thank you chairman and grassley, Ranking Member widen, and members of the committee for holding this committee, this concludes my remarks, im happy to answer any questions you may have. Good morning chairman grassley and member widen and other distinguished members of the committee, i am the deputy neill or i appreciate you coming here for you to combat the Opioid Crisis, our ongoing work is taking a multi