Transcripts For CSPAN3 Politics And Public Policy Today 2016

President will attend his final white house Correspondents Dinner saturday, april 30th, starting at 6 00 p. M. On cspan. American history tv on cspan 3 this weekend. Saturday evening at 6 00 p. M. Weekend, the book the myth of the lost cause. Why the south fought the civil war and why the north won. Among the disputes, myths of the civil war, including why it started, and why it ended. They felt compelled to explain why it was this devastation occurred and why 25 of southern white men between the ages of 25 and 40 were dead. And then, the 1988 campaign of gary hart. Announcing his candidacy in denver, and then facing questions about an alleged extramarital affair, and then his announcement that hes leaving the race. Then, the life of dolores huerta. She was at the forefront of that effort for a reason. And among many of the participants of the farm workers movement, when you hear about them, they always talk about her. And then at 8 00 p. M. , on the presidency. He said, did any of them ever invite me to play golf, to their clubs . It just goes on and on. His lip was quivering. Thats one of the few times in the 3 1 2 years i was so close to him, he was a very wellcontained, disciplined man, but he erupted when he was talking to don. Just saying, not a goddamn time. And he hated them for that. Reflecting on the former president s policies from watergate to vietnam. This sunday night on q and a, ron chernow talks about hamilton. He said, i was reading your book on vacation and as i was reading it, hiphop songs started rising off the age. And he said, hamiltons life is a classic hiphop narrative. And i was thinking, what is this guy talking about . I think lin quickly picked up, he had a worldclass hiphop ig ignoramus on his hands. And he started educating me. He said, hiphop, you can pack more information into the form than any others because its dense. It has rhymed endings, internal rhyme, word play. Started educating me on all these very, very devices that are very important to the success of the show. Sunday night at 8 00 p. M. Pa terrififp pacific. Next, a look at waste in the u. S. Jason chaffetz of utah chairs the House Oversight committee. Committee on oversight of government reform will come to order. Appreciate the group that we have assembled today. This is always of keen interest, the duplication report. Government is so big, wide, expansive. Talking about trillions in expenditures. We are always seeking ways to make governments dollars more effective and efficient. This morning the Government Accountability Office Released the sixth annual report on opportunities to reduce fragmentation t, duplication, in the federal government to achieve financial and other benefits. Over the course of the six years the gao highlighted 250 areas of the federal government and recommended more than 600 corrective actions. We cannot thank enough the men and women who serve on the gao, the good work they do. Doing hard work, looking under the hood. Really coming up with important recommendations that we as members of congress desperately need to do our jobs properly. 41 of the recommended actions have been addressed and closed which will save about 125 million. This report has ways to resolve wasteful spending. With only 41 of actions addressed more obviously needs to be done. Taking action at just three agencies the department of defense, health and Human Services and the Internal Revenue service if we just did those three we would save billions of dollars. Combined they account for more than half of all federal spending in fiscal year 2015. More than half of all corrective actions in reports are directed at these three agencies. Yet all three agencies have more than 60 of the recommended actions still open. For example, the gao estimates the irs could save hundreds of millions in revenue by enhancing online services. In 2013, the gao recommended they develop a methodology for enforcement resources. The irs developed a methodology but has chosen not to implement it, costing taxpayers time and money. The irs needs to explain refusal to take the action. In a new area highlighted in this years report the irs is using a paper based system to recieve and track tips on public Referral Programs in nine different offices. Gao estimates the coordination and information sharing could help the irs identify and collect billions of dollars in tax revenue. It shouldnt take a gao report to point out that coordinating investigations prevent duplicative work and ensures taxpayer resources are used efficiently and effectively. In 2015 gao recommended the centers for medicare and Medicaid Services should ensure states report accurate and complete data on state sources of funds. Seems reasonable. Gao estimates it could save taxpayers hundreds of millions but they have not taken action. In 2013 the gao recommended the department of defense implement a plan to guide joint basing meaning multiple military Services Using a single base to achieve efficiencies. The dod has yeet to complete the action though it could save 2. 3 billion over a 20year period. Why do we need to come back year after year to discuss the same actions . Thats in part what well be discussing today. Obviously the federal government has an obligation not to waste taxpayer dollars. We are pulling money out of somebodys pocket and trying to give it to somebody else and use that. We have to be very, very cognizant of this wasteful taxpayer spending. All federal workers should consider it part of their Job Description and should embrace the role as fiduciaries for the public. Disagreements over policy can lead to disagreements over appropriate spending. But the imperative to prevent waste is something we can all agree on on both sides of the aisle. When we know it is about waste inefficiency we have to act. This gao annual report provides a road map to tackling the known waste and inefficiency out there. So we have a lot of questions. A host of questions here. But we do look forward to maximizing the time for member input. With that i would like to recognize the Ranking Member, mr. Cummings of maryland for his opening statement. Thank you very much. Once again for owning the tradition to the committee and making sure gaos report gets the attention it warrants. This type of oversight is one of the Core Functions of the committee. Today we will focus on the sixth annual report and Duplicative Programs and opportunities for cost savings in the federal government. This report allows the executive branch and congress to Work Together to identify critical areas where we can reduce waste and make federal programs more efficient and effective. This report is interesting because it focuses on both the executive branch and congress. Since 2011 gaos reports have consistently shown that congress has been doing far worse than the executive branch in implementing gao recommendations. Todays report is no different. It shows that congress could be doing much more to foster an efficient, effective and accountable government. According to gao the executive branch has completed 81 of gaos recommendations. 81 . Thats an impressive success rate in light of the budget ts agencies have endured in recent years. Congress, on the other hand, has implemented only about 46 of gaos recommendations. Even with that 46 its generous because gao gives Congress Credit for taking partial action by just moving a bill through Committee Even if it has gotten past the house or senate. Mr. Chairman, during last years hearing you thanked the gao for provides congress and the executive branch for a road map to achieve needed savings. According to gao the administration has done a much better job of following the road map than we here in congress. Specifically gao made 459 recommendations for the executive branch and 372 have now been fully or partially completed. In contrast gao has made 85 recommendations. Only 37 of those have been fully or partially completed. The new report highlights areas where congress could legislate right now to eliminate waste and duplication. For example, gao recommended Congress Pass legislation to protect private citizens who report tax fraud to the irs from retaliation by their employers. Thats why we introduces introduced the warren act. Our bill would increase incentive for including misrepresentation of tax liabilities and public filings. The bill has been endorsed by americans for financial reform, the aflcio and communication workers of america. I Hope Congress will consider the bill this year. Gao also recommended that Congress Lower the threshold requiring employers to be electronically filing w2s to help the irs detect fraudulent claims. Gao 2016 report also recognizes improvements by federal agencies and includes recommendations for those going forward. For example, gao highlighted a number of successful stories at the centers for medicare and Medicaid Services including eliminating duplicative contracts and processes for identifying improper payments. Through improvements to Medicaid Integrity Program there would be the recovery of 657 million of improper medicaid payments in 2015 according to gao. On the flip side the department of defense still has 79 major Weapons Systems programs for a total acquisition cost of over 14 trillion dollars. Dod spends 100 billion each year on the systems but has failed to strategically manage the investments resulting in inefficiency and waste. Taxpayers and the troops deserve better than that. I want to thank our witnesses today. Providing Critical Service to the American People with this annual report. As well as with the work you do every day to help ensure our tax dollars are spent wisely. I hope that you will share with all of your employees how grateful we are for their pursuit of excellence and for them helping to provide us with road maps to make a difference. With that, mr. Chairman, i yield back. Ill hold the record open for five legislative days for those who would like to submit a written statement. Well now recognize our panel of witnesses. We have quite a few people to swear in. We are pleased to welcome the honorable gene dadaro, comptroller general of the United States accountability office. Sir, we are pleased to have you come before the committee. You are one of the more important people that we have come here given your insight and commitment to these issues. I cant thank your staff enough for the great work they do behind the scenes. A number of those key staff people are here. We want to maximize the opportunity for members to dive deeper into some of the issues. Purr surnt pursuant to Committee Rules, well swear them in as well. The experts include Kathleen Barrett managing director for defense capabilities. Mr. Paul francis, managing director, acquisition and sourcing management team. Mr. Chris mimm, managing director, Strategic Issues team. Ms. Nicky clowers, managing director Health Care Team. Ms. Oris williams brown, managing director of Financial Markets and Community Investment team. Mr. Philip herr manging director of physical infrastructure team. Ms. Barbara bober, managing director, education work force and income security team. Mr. Seto bagdojan. I hope i pronounced that correctly. Forensic audits and Investigative Services team. And mr. Dave powner of Information Technology team. I apologize if i dont get all the names proper. We have mr. John dalrymple from the irs at the United States department of treasury, mr. Tillitson from the United States department of defense and dr. Patrick conway. Youve got a title here. Acting Principal Deputy administrator, deputy chief administrator for innovation equality and chief medical officer at the centers for medicare and Medicaid Services at the United States department of health and Human Services. I thank you again for your good work and for being here. Pursuant to Committee Rules all witnesses are to be sworn before they testify. Those on the panels and those that accompany, if you rise and raise your right hand. Do you swear or affirm the testimony you are about to give will be the truth, the whole truth and nothing but the truth . Thank you. You may be seated. Let the record reflect all witnesses answered in the affirmative. We would ask the four panelists here at the table to please limit your oral testimony to five minutes and members should have ample time to answer questions. Mr. Dadaro, your discretion if you want to yield time to a particular individual as we get into the questions. We have a seat there if need be. Mr. Dadaro, you are recognized for five minutes. Thank you very much, mr. Chairman. Good morning to you, members of the committee. We are pleased to be here today to discuss the sixth annual report on overlap duplication and also other opportunities to achieve cost savings and revenue enhancements. In ts report we introduced 92 new actions the congress and executive branch can take in 37 different areas. To give examples in the overlap duplication area we highlight 12 areas. For example, we found that the Defense Department is procuring commercial services for satellites and about 30 was spent outside their Central Procurement Agency by the Different Services and other agencies throughout the department. As a result in this Central Agency the costs were about 15 less than purchasing it outside the central office. We think there is better money to be saved there. Tens of billions. We also found nine Referral Programs at irs for whistleblowers and others to report improper activities that would give irs tips to follow up with tax enforcement purposes and potentially produce billions of dollars in additional revenue owed the government. These systems were manually operated, fragmented. They werent coordinated and there were a lot of opportunities to streamline and provide better communication to the people providing tips. Also, we found there was potential for duplicative Health Care Spending between people on medicaid or in the state exchanges. There is some amount of transfer time that could be made if income levels change. Or they become eligible for medicaid or the services. But we find activities outside that normal transition period and we recommended that in order to minimize duplicate federal spending better coordination would need to take place and better oversight over the Medicaid Programs at the state level and with the exchanges. In areas of cost savings, revenue enhancements, we have a number of recommendations that are new. There are billions to be saved. Revamping some of the payment policies that guide medicare spending. Millions could be saved by greater oversight over medicaid spending and the states activities. Theres also millions that could be saved by the federal agencies having better access to excess personal property at dod and ammunition thats discarded but could be used by other federal agencies. So we dont have to buy it twice in that process. There are fees that could be raised that havent been raised in over 20 years to help provide more resources and in particular to deal with deferred maintenance in the national parks. To date, as mr. Chairman mentioned in the opening comments, to date, about 120 million that will be saved over the coming years. We are pleased that the congress has taken action. A lot of the large Dollar Savings have come from congressional action. And also, a number of areas where the agencies have taken action its because of congressional urging as well. There is a lot more that could be done. Im pleased to be here today to talk about the opportunities. In addition to the new areas that we have added to the list. Thank you for holding this annual hearing. It makes a big difference in getting support. I will pass on to our staff your thanks and appreciation for their hard work. Mr. Chairman, congressman cummings. Thank you for your comments. Be happy to answer questions at the appropriate point. Thank you. Mr. Dalrymple, you are recognized for five minutes. Chairman chaffetz, Ranking Member cummings, members of the committee. Im here to discuss findings of the Government Accountability Office Related to the sixth annual review of Duplicative Programs. We appreciate gao studies of the irs and programs. Their findings, insights and recommendations are invaluable to us as they help assure we are successful in accomplishing our mission of collecting over 3 trillion annually. Without independent auditors and evaluators we simply could not be effective. Since fiscal year 2013 the irs has taken action to address more than 82 of all of gao recommendations including those highlighted in this report. Between fiscal year 2011 and 2015, the irs received more than 2,100 recommendations from gao and our Correspondents Dinner<\/a> saturday, april 30th, starting at 6 00 p. M. On cspan. American history tv on cspan 3 this weekend. Saturday evening at 6 00 p. M. Weekend, the book the myth of the lost cause. Why the south fought the civil war and why the north won. Among the disputes, myths of the civil war, including why it started, and why it ended. They felt compelled to explain why it was this devastation occurred and why 25 of southern white men between the ages of 25 and 40 were dead. And then, the 1988 campaign of gary hart. Announcing his candidacy in denver, and then facing questions about an alleged extramarital affair, and then his announcement that hes leaving the race. Then, the life of dolores huerta. She was at the forefront of that effort for a reason. And among many of the participants of the farm workers movement, when you hear about them, they always talk about her. And then at 8 00 p. M. , on the presidency. He said, did any of them ever invite me to play golf, to their clubs . It just goes on and on. His lip was quivering. Thats one of the few times in the 3 1 2 years i was so close to him, he was a very wellcontained, disciplined man, but he erupted when he was talking to don. Just saying, not a goddamn time. And he hated them for that. Reflecting on the former president s policies from watergate to vietnam. This sunday night on q and a, ron chernow talks about hamilton. He said, i was reading your book on vacation and as i was reading it, hiphop songs started rising off the age. And he said, hamiltons life is a classic hiphop narrative. And i was thinking, what is this guy talking about . I think lin quickly picked up, he had a worldclass hiphop ig ignoramus on his hands. And he started educating me. He said, hiphop, you can pack more information into the form than any others because its dense. It has rhymed endings, internal rhyme, word play. Started educating me on all these very, very devices that are very important to the success of the show. Sunday night at 8 00 p. M. Pa terrififp pacific. Next, a look at waste in the u. S. Jason chaffetz of utah chairs the House Oversight<\/a> committee. Committee on oversight of government reform will come to order. Appreciate the group that we have assembled today. This is always of keen interest, the duplication report. Government is so big, wide, expansive. Talking about trillions in expenditures. We are always seeking ways to make governments dollars more effective and efficient. This morning the Government Accountability<\/a> Office Released<\/a> the sixth annual report on opportunities to reduce fragmentation t, duplication, in the federal government to achieve financial and other benefits. Over the course of the six years the gao highlighted 250 areas of the federal government and recommended more than 600 corrective actions. We cannot thank enough the men and women who serve on the gao, the good work they do. Doing hard work, looking under the hood. Really coming up with important recommendations that we as members of congress desperately need to do our jobs properly. 41 of the recommended actions have been addressed and closed which will save about 125 million. This report has ways to resolve wasteful spending. With only 41 of actions addressed more obviously needs to be done. Taking action at just three agencies the department of defense, health and Human Services<\/a> and the Internal Revenue<\/a> service if we just did those three we would save billions of dollars. Combined they account for more than half of all federal spending in fiscal year 2015. More than half of all corrective actions in reports are directed at these three agencies. Yet all three agencies have more than 60 of the recommended actions still open. For example, the gao estimates the irs could save hundreds of millions in revenue by enhancing online services. In 2013, the gao recommended they develop a methodology for enforcement resources. The irs developed a methodology but has chosen not to implement it, costing taxpayers time and money. The irs needs to explain refusal to take the action. In a new area highlighted in this years report the irs is using a paper based system to recieve and track tips on public Referral Program<\/a>s in nine different offices. Gao estimates the coordination and information sharing could help the irs identify and collect billions of dollars in tax revenue. It shouldnt take a gao report to point out that coordinating investigations prevent duplicative work and ensures taxpayer resources are used efficiently and effectively. In 2015 gao recommended the centers for medicare and Medicaid Services<\/a> should ensure states report accurate and complete data on state sources of funds. Seems reasonable. Gao estimates it could save taxpayers hundreds of millions but they have not taken action. In 2013 the gao recommended the department of defense implement a plan to guide joint basing meaning multiple military Services Using<\/a> a single base to achieve efficiencies. The dod has yeet to complete the action though it could save 2. 3 billion over a 20year period. Why do we need to come back year after year to discuss the same actions . Thats in part what well be discussing today. Obviously the federal government has an obligation not to waste taxpayer dollars. We are pulling money out of somebodys pocket and trying to give it to somebody else and use that. We have to be very, very cognizant of this wasteful taxpayer spending. All federal workers should consider it part of their Job Description<\/a> and should embrace the role as fiduciaries for the public. Disagreements over policy can lead to disagreements over appropriate spending. But the imperative to prevent waste is something we can all agree on on both sides of the aisle. When we know it is about waste inefficiency we have to act. This gao annual report provides a road map to tackling the known waste and inefficiency out there. So we have a lot of questions. A host of questions here. But we do look forward to maximizing the time for member input. With that i would like to recognize the Ranking Member<\/a>, mr. Cummings of maryland for his opening statement. Thank you very much. Once again for owning the tradition to the committee and making sure gaos report gets the attention it warrants. This type of oversight is one of the Core Functions<\/a> of the committee. Today we will focus on the sixth annual report and Duplicative Program<\/a>s and opportunities for cost savings in the federal government. This report allows the executive branch and congress to Work Together<\/a> to identify critical areas where we can reduce waste and make federal programs more efficient and effective. This report is interesting because it focuses on both the executive branch and congress. Since 2011 gaos reports have consistently shown that congress has been doing far worse than the executive branch in implementing gao recommendations. Todays report is no different. It shows that congress could be doing much more to foster an efficient, effective and accountable government. According to gao the executive branch has completed 81 of gaos recommendations. 81 . Thats an impressive success rate in light of the budget ts agencies have endured in recent years. Congress, on the other hand, has implemented only about 46 of gaos recommendations. Even with that 46 its generous because gao gives Congress Credit<\/a> for taking partial action by just moving a bill through Committee Even<\/a> if it has gotten past the house or senate. Mr. Chairman, during last years hearing you thanked the gao for provides congress and the executive branch for a road map to achieve needed savings. According to gao the administration has done a much better job of following the road map than we here in congress. Specifically gao made 459 recommendations for the executive branch and 372 have now been fully or partially completed. In contrast gao has made 85 recommendations. Only 37 of those have been fully or partially completed. The new report highlights areas where congress could legislate right now to eliminate waste and duplication. For example, gao recommended Congress Pass<\/a> legislation to protect private citizens who report tax fraud to the irs from retaliation by their employers. Thats why we introduces introduced the warren act. Our bill would increase incentive for including misrepresentation of tax liabilities and public filings. The bill has been endorsed by americans for financial reform, the aflcio and communication workers of america. I Hope Congress<\/a> will consider the bill this year. Gao also recommended that Congress Lower<\/a> the threshold requiring employers to be electronically filing w2s to help the irs detect fraudulent claims. Gao 2016 report also recognizes improvements by federal agencies and includes recommendations for those going forward. For example, gao highlighted a number of successful stories at the centers for medicare and Medicaid Services<\/a> including eliminating duplicative contracts and processes for identifying improper payments. Through improvements to Medicaid Integrity Program<\/a> there would be the recovery of 657 million of improper medicaid payments in 2015 according to gao. On the flip side the department of defense still has 79 major Weapons Systems<\/a> programs for a total acquisition cost of over 14 trillion dollars. Dod spends 100 billion each year on the systems but has failed to strategically manage the investments resulting in inefficiency and waste. Taxpayers and the troops deserve better than that. I want to thank our witnesses today. Providing Critical Service<\/a> to the American People<\/a> with this annual report. As well as with the work you do every day to help ensure our tax dollars are spent wisely. I hope that you will share with all of your employees how grateful we are for their pursuit of excellence and for them helping to provide us with road maps to make a difference. With that, mr. Chairman, i yield back. Ill hold the record open for five legislative days for those who would like to submit a written statement. Well now recognize our panel of witnesses. We have quite a few people to swear in. We are pleased to welcome the honorable gene dadaro, comptroller general of the United States<\/a> accountability office. Sir, we are pleased to have you come before the committee. You are one of the more important people that we have come here given your insight and commitment to these issues. I cant thank your staff enough for the great work they do behind the scenes. A number of those key staff people are here. We want to maximize the opportunity for members to dive deeper into some of the issues. Purr surnt pursuant to Committee Rules<\/a>, well swear them in as well. The experts include Kathleen Barrett<\/a> managing director for defense capabilities. Mr. Paul francis, managing director, acquisition and sourcing management team. Mr. Chris mimm, managing director, Strategic Issues<\/a> team. Ms. Nicky clowers, managing director Health Care Team<\/a>. Ms. Oris williams brown, managing director of Financial Markets<\/a> and Community Investment<\/a> team. Mr. Philip herr manging director of physical infrastructure team. Ms. Barbara bober, managing director, education work force and income security team. Mr. Seto bagdojan. I hope i pronounced that correctly. Forensic audits and Investigative Services<\/a> team. And mr. Dave powner of Information Technology<\/a> team. I apologize if i dont get all the names proper. We have mr. John dalrymple from the irs at the United States<\/a> department of treasury, mr. Tillitson from the United States<\/a> department of defense and dr. Patrick conway. Youve got a title here. Acting Principal Deputy<\/a> administrator, deputy chief administrator for innovation equality and chief medical officer at the centers for medicare and Medicaid Services<\/a> at the United States<\/a> department of health and Human Services<\/a>. I thank you again for your good work and for being here. Pursuant to Committee Rules<\/a> all witnesses are to be sworn before they testify. Those on the panels and those that accompany, if you rise and raise your right hand. Do you swear or affirm the testimony you are about to give will be the truth, the whole truth and nothing but the truth . Thank you. You may be seated. Let the record reflect all witnesses answered in the affirmative. We would ask the four panelists here at the table to please limit your oral testimony to five minutes and members should have ample time to answer questions. Mr. Dadaro, your discretion if you want to yield time to a particular individual as we get into the questions. We have a seat there if need be. Mr. Dadaro, you are recognized for five minutes. Thank you very much, mr. Chairman. Good morning to you, members of the committee. We are pleased to be here today to discuss the sixth annual report on overlap duplication and also other opportunities to achieve cost savings and revenue enhancements. In ts report we introduced 92 new actions the congress and executive branch can take in 37 different areas. To give examples in the overlap duplication area we highlight 12 areas. For example, we found that the Defense Department<\/a> is procuring commercial services for satellites and about 30 was spent outside their Central Procurement Agency<\/a> by the Different Services<\/a> and other agencies throughout the department. As a result in this Central Agency<\/a> the costs were about 15 less than purchasing it outside the central office. We think there is better money to be saved there. Tens of billions. We also found nine Referral Program<\/a>s at irs for whistleblowers and others to report improper activities that would give irs tips to follow up with tax enforcement purposes and potentially produce billions of dollars in additional revenue owed the government. These systems were manually operated, fragmented. They werent coordinated and there were a lot of opportunities to streamline and provide better communication to the people providing tips. Also, we found there was potential for duplicative Health Care Spending<\/a> between people on medicaid or in the state exchanges. There is some amount of transfer time that could be made if income levels change. Or they become eligible for medicaid or the services. But we find activities outside that normal transition period and we recommended that in order to minimize duplicate federal spending better coordination would need to take place and better oversight over the Medicaid Programs<\/a> at the state level and with the exchanges. In areas of cost savings, revenue enhancements, we have a number of recommendations that are new. There are billions to be saved. Revamping some of the payment policies that guide medicare spending. Millions could be saved by greater oversight over medicaid spending and the states activities. Theres also millions that could be saved by the federal agencies having better access to excess personal property at dod and ammunition thats discarded but could be used by other federal agencies. So we dont have to buy it twice in that process. There are fees that could be raised that havent been raised in over 20 years to help provide more resources and in particular to deal with deferred maintenance in the national parks. To date, as mr. Chairman mentioned in the opening comments, to date, about 120 million that will be saved over the coming years. We are pleased that the congress has taken action. A lot of the large Dollar Savings<\/a> have come from congressional action. And also, a number of areas where the agencies have taken action its because of congressional urging as well. There is a lot more that could be done. Im pleased to be here today to talk about the opportunities. In addition to the new areas that we have added to the list. Thank you for holding this annual hearing. It makes a big difference in getting support. I will pass on to our staff your thanks and appreciation for their hard work. Mr. Chairman, congressman cummings. Thank you for your comments. Be happy to answer questions at the appropriate point. Thank you. Mr. Dalrymple, you are recognized for five minutes. Chairman chaffetz, Ranking Member<\/a> cummings, members of the committee. Im here to discuss findings of the Government Accountability<\/a> Office Related<\/a> to the sixth annual review of Duplicative Program<\/a>s. We appreciate gao studies of the irs and programs. Their findings, insights and recommendations are invaluable to us as they help assure we are successful in accomplishing our mission of collecting over 3 trillion annually. Without independent auditors and evaluators we simply could not be effective. Since fiscal year 2013 the irs has taken action to address more than 82 of all of gao recommendations including those highlighted in this report. Between fiscal year 2011 and 2015, the irs received more than 2,100 recommendations from gao and our Inspector General<\/a> auditors. With gao recommendations accounting for roughly 30 of those. Given the sheer number and scope of recommendations the irs receives on a wide variety of areas, the irs has to look at total universe of recommendations across the enterprise through a larger lens and make Strategic Decisions<\/a> about actions most important to address the audit findings. To that end, we very much appreciate the initiative gao started this year where they review and prioritize the universe of open recommendations. This helps us better understand what they think are the most critical. Overwhelmingly gao and irs are on the same page. Our Top Priorities<\/a> are generally the same as theirs. This increases our confidence that we are acting on the most important recommendations first. The two irs programs highlighted in this years gao Duplicative Program<\/a> study referrals and Identity Theft<\/a> are illustrative of the value we get from gao recommendations and the actions we take. Irs Referral Program<\/a>s which involve individuals and businesses reporting alleged noncompliance with tax laws, gao study reported several areas needing improvements and we got to work. We now have a team in place tasked with reengineering parts of the process to be more streamlined and effective. In fiscal year 2012 through 2015 about 93 of information referrals didnt lead to audits but about 7 did. This is a much higher overall audit rate which is hovering around 0. 7 from the general population. Whats more, the audits based on those referrals yielded over 209 million in additional tax assessments recommended. These figures reveal the screening process is effectively identifying productive referrals for audit. It is making an important contribution to Tax Administration<\/a>. With the improvements we plan to make as a result of the gao recommendations our referral processes are being streamlined and will be more efficient and effective. While unique relative to other referrals the gao report on irs Whistleblower Program<\/a>s offers a snapshot in time for a program under scrutiny for its processes that are continually refined. Even before gao began its most recent evaluation on the irs Whistleblower Program<\/a> we had begun addressing the major issues that were identified. The gao findings confirmed we were taking the right actions and streamlining the process for claims making dramatic reductions to the inventory of cases at particular phases of the process instilling new leadership with a strong background in bringing about operational efficiency. Another irs program highlighted in this years gao Duplicative Program<\/a> report is Identity Theft<\/a> which gao has almost continually reviewed in recent years and prompted Important Program<\/a> improvements. As we confront the growing problem of stolen identity refund fraud the irs is using a multipronged approach to protect taxpayers and their information. The irs has made this area a high priority and is making steady progress. The additional 290 million in fiscal year 16 funds afforded by congress had allowed us to allocate more resources to combat this insidious crime. About 2,000 individuals have been convicted on federal charges related to refund fraud involving Identity Theft<\/a> using our improved filters, we stopped 1. 4 million returns last year. We kept criminals from collecting 1. 7 billion in fraudulent refunds. Gao has been helpful in identifying areas where improvements can be made. Take at the proper time. Thank you. Thank you so much for your testimony. Mr. Tilletson, you are recognized for five minutes. Thank you, mr. Chairman. First of all, good morning to the chair, Ranking Member<\/a> can you pull the mike a little bit closer to you . Thank you. Certainly. Is that better . Very good. Thank you to the chair and the Ranking Member<\/a> cummings, members of the committee, thank you for the tune to discuss the departments progress on addressing the general accountabilitys Office Findings<\/a> related to duplication and fragmentation and overlap in the department. I also want to add my thanks to the honorable mr. Gene dedaro and the. Ao for the work they do candidly while one is not always happy to be hear we could be doing things better, the truth is we can do things better. In fact, as acting chief managing officer for the department of defense, thats my Job Description<\/a> is to find those things. So to be perfectly honest, having assistance and identifying opportunities bothers me not at all so we look forward to our continued work with the Government Accountability<\/a> office. As the adcmo, our assistant deputy chief management officer, i provide direction and advice on improvements to business processes and practices in the department with a particular emphasis on finding efficiencies in overhead and missions support. So clearly our intent of my office and mr. Dedaro align very well. Last year the deputy secretary asked the dcmo office to put together a series of efficiency initiatives that would help free up needed funds to meet emerging needs within the top line of the department. Initiatives we are leading include headquarters reduction, Service Contract<\/a> requirements reviews, Information Technology<\/a> optimization and business optimization to include exchanges in commissaries. Weve also been working on select business processes to include the hiring process, conference approvals and the process for coordinating and promulgating issue anticipates. When completed these will result in 7. 7 billion in forecasted savings over the period from fy 17 to 21 and a further reduction of 25 of headquarters costs. Several of these topics are areas that were identified either in previous gao reports or in the current 2016 report. The department appreciates the gaos work in this area. The gao identified a total of 0 101 recommendations directed solely to the department from 2011 to 2014. And we have fully address or partially addressed 87 of these recommendations. The gao identified additional 19 recommendations in 2015 for the department and weve partially fully or partially addressed 47 of those. I fully acknowledge that means we have more to do. And we will continue to make progress. One specific area in which weve made significant progress is in the area of d. O. D. Contract management for broad acquisitions. In its highrisk series update report published in february 2015, the gao recognized progress made regarding the management and oversight of contracting techniques, noting that departmental leadership has taken significant steps to plan and monitor progress over the last several years. As a result, the gao made a decision to remove contracting techniques and approaches from the scope of the d. O. D. Contract management highrisk areas. Another example of the departments progress and it aligns with the recommendation made in the 2016 report involves the management of lease space. In 2014, the department using a baseline of 5. 4 million square feet of d. O. D. Occupied space in the National Capitol<\/a> region set out to reduce that space. Our initial plan calls for a reduction of 1. 2 million square feet prior to 2020. To date weve eliminated 267,000 square feet of lease space used in the capitol region by making better use of government space and we intend to get an additional 886,000 square feet out of lease or reductions in lease space used by 2020. Which will save 43 million a year. In addition to those 14 efforts, we are going to look more broadly across the entirety of d. O. D. Property and broadly across the country. So i anticipate more progress in that area. Mr. Chairman, Ranking Member<\/a>, the department looks forward to continuing to work both with this committee and with the gao to continue to implement recommended actions. We take our duty to be a steward of the taxpayers dollars very seriously, and we look forward to continuing to work on the opportunities identified in the 2016 report. Thank you. Thank you for your testimony. Dr. Conway, you are recognized for five minutes. Thank you. Chairman chaffetz, Ranking Member<\/a> cummings and members of the committee, thank you for the operation of the medicare and Medicaid Programs<\/a>. We share this committees commitment to serving beneficiaries and protecting taxpayers dollars. As stewards of medicare, medicaid, marketplace and the Childrens Health<\/a> insurance programs, cms is serving almost 140 million americans and we want these programs to be as effective and efficient as possible. We view the gao as an important partner and appreciate and take seriously gaos work and their recommendations. And are working to address and implement them. We are making important progress in all our efforts to reduce duplication and protect taxpayer dollars all while providing our been firries are high quality care. Last year we have implemented 38 gao recommendations and have submitted approximately 100 additional recommendations to the gao for their review and closure. One of our driving forces at cms is changing the way health care is delivered in this country, moving towards paying providers based on quality rather than the quantity of care they give patients. As a practice physician, i know how important this work is. Now an estimated 30 of medicare payments are tied to alternative payment models and millions of american patients are benefiting from better coordinated, improved quality of care. Our work to reduce hospital conditions such as ulcers and infections and traumas represents over 87,000 lives saved and an estimated 20 billion in cost savings. Weve seen an estimated 565,000 fewer Hospital Readmissions<\/a> meaning that beneficiaries didnt have to experience an extra hospital stay and medicare did not face expenses for extra care. Consistent with the recommendations from the gao, cms has taken several steps over the past years to improve transparency in medicaid and around the section 1115 research and demonstration programs used for states to pursue innovations. We are collecting annual upper payment limit data which includes providerspecific information and continue to review payment methodology to determine compliance with statutory requirements. All section 1115 demonstrations are available publicly and include specific terms and conditions that must be followed as a result of the demonstration. Weve also identified and made publicly available the criteria we are using. As Health Care Delivery<\/a> system moves towards more integrated care and away from fee for service, more states are using managed care to serve medicaid beneficia beneficiaries. Recognizing these changes in gaos work, we proposed improvements to medicaidmanaged care, aligning it with Medicare Advantage<\/a> and private coverage plans, supporting state Delivery System<\/a> reform, promoting quality of care, strengthening program and fiscal integrity, incorporated best practices, Longterm Service<\/a> reports and enhancing the beneficiary experience. A commitment to Program Integrity<\/a> underpins all our work. Cms is moving away from a socalled pay and chase Program Integrity<\/a> model towards one focused on prevention. Today we are utilizing sophisticated predictive analytic technology, Fraud Prevention<\/a> system to identify investigative leads to further protect the Medicare Program<\/a> from inappropriate billing practices. In the first three years of its implementation, it identified and prevented 820 million in inappropriate payments and in calendar year 2014 alone, the fbs had a 101 return on investment. At the direction of congress, cms is using riskbased screening of providers and suppliers to enhance our ability to screen providers upon enrollment and identify those that may be at heightened risk for committing fraud. These new tools have saved the Medicare Program<\/a> approximately 2. 4 billion in avoided costs. We have deactivated billing privileges for more than 540,000 providers and suppliers that do not meet medicare requirements and revoked an additional 34,000 plus providers and suppliers since 2011. Perhaps most importantly, increased screening effortses have allowed cms to deny over 7,000 applications in the last 12 months preventing these providers and suppliers from ever submitting a claim. We are also increasing our site visits to medicareenrolled providers and suppliers. Cms is dedicated to promoting better care, protecting patient safety, reducing health care costs, and providing people access to the right care at the right time when and where they need it. This includes continually strengthening improving medicare and Medicaid Programs<\/a> that provide Vital Services<\/a> to millions of americans. We look forward to, whoing with both the gao and this committee towards our mutual goals of providing value and quality to all the beneficiaries we serve and taxpayers. Thank you. Thank you, dr. Conway. I thank each of you for your testimony. Im going to recognize the gentleman from tennessee for a series of questions. But before i do that, i think its important as we look at this particular issue and duplicative services and efficiencies to recognize really one of the greatest assets the federal government has, and thats its federal employees. And in doing that, its very easy to start looking at the inefficiencies and the problems and undermine really our federal work force. I wanted to go on record to say thank you to the 99. 5 of the federal work force that does an outstanding job each and every day. And sometimes we focus on that 0. 5 and paint a very broad brush, and i dont want this hearing to do that as we really look at meaningful ways to make sure that we have a cost savings. And so with that, i would recognize the gentleman from tennessee, my good friend, mr. Duncan, for five minutes. Well, thank you. Thank you very much, mr. Chairman. And thank you and chauirman chaffetz for calling this hearing, an annual hearing that i think is one of the most important hearings that we hold each year. Mr. Dedaro, i think the work that your agency does is extremely important and valuable for us. I have several different questions. I wont have time to get into all of them, but we have Background Information<\/a> from the staff that says that the department of defense now has weapons acquisition programs that total 1. 3 trillion, spending over 100 billion annually on weapons system acquisition. I know youve put out several recommendations over the years and especially in 2011, a report saying it was very inefficient to their weapons acquisition program, and there were duplications and so forth. Do you think that the department of defense has done enough in regard to your recommendations that youve made on that in the pastor could there be Additional Savings<\/a> in that area . I think they can definitely do more. Weve appreciated what theyve done. Theyve adopted some of the best practices, recommendations that weve suggested. Theyve begun looking at things, but im concerned that some of the reforms havent been implemented very consistently over time. Ill ask mr. Francis whos our expert in this area to give you a more thorough answer. But theres more that could be done. All right. Morning, mr. Duncan. Yes, i think one of the things that weve talked about is portfolio management, which is basically an approach for the department to look at its weapons system portfolio as a whole because one of the looming problems for defense is when you get beyond the next fiveyear plan, theres much more demand for money for Weapons Systems<\/a> than theres money available. And so the department has to take a more holistic look across Weapons Systems<\/a> to see what the best mix of investments are for them. And right now the department has multiple processes that are fragmented for budgeting, requirements and acquisitions, and the services all do their own thing. So we pretty much have a process that optimizes for individual Weapons Systems<\/a>. But we need to look more across the board. All right. Well, thank you very much. Week before last i was on a trip with three senators and another member of the house, and we met with admiral harris who is the head of the pacific command. And we were talking about the problems the Defense Department<\/a> is facing in acquiring some of the more expensive weapons and things that they need. And we talked about how that the costs have been shooting way up have been in the pay and benefits and so forth. And many top leaders have talked about that problem, how its cutting into being able to buy the equipment that they want. And admiral harris said that he thought that they needed we needed to have another brack. Mr. Tillotson, do you have any opinion on that, and also mr. Dadaro, if yall looked into that . Surely. It is the departments position that another round of brack would be appropriate. Mr. Dodaros findings about the underutilization of government space relates to making better use of the space that we have, and we certainly agree we should do that. But having said that, theres a large amount of space that is more industrial and involves a lot of bases that are at this point largely underutilized, and we do believe theres excess capacity that could be reviewed, so we would endorse another round of brack. Theres definitely excess property, and our work, though, focused on reviewing past brack rounds have shown that the Department Needs<\/a> to make additional improvements in its methodology for estimating brack savings and actually bringing those savings to realization. The initial estimates are far in excess of what d. O. D. Eventually achieves through the brack rounds due to continual changes in requirements and other things. So our opinion, if the congress decides to grant them their requests for another round of brack, they really need to implement our recommendations so that congress has assurance that there really, at the end of the day, will be the savings that should be achieved through any process in this nature. We have many outstanding recommendations that the department has not yet implemented in this regard. Another area before my time rubs out, you mentioned potentially saving billions on Social Security<\/a> disability payments. Will you tell us about the what needs to be done in that area . Yes. Right now people can receive full disability benefits and Unemployment Benefits<\/a> at the same time. Now, theres some ability if somebodys on disability, they can get permission to try to work. Because obviously we want them to get back to work. But if they take a job and then theyre eventually laid off from that position, they could collect both benefits, and we dont think that this is a prudent use of the federal governments money to get both full disability benefits and Unemployment Benefits<\/a> at the same time. Cbo has estimated i believe they could save 1. 3 billion over a fewyear period if this change is made. All right. Thank you very much, mr. Chairman. I thank the gentleman. The chair recognizes the gentleman from pennsylvania, mr. Cartwright, for five minutes. I thank chairman meadows and chairman chaffetz for calling this important hearing. Mr. Tillotson, one of the issues gao included in this years duplication report is d. O. D. s storage of occupational and environmental Surveillance Data<\/a>. Am i correct in that . Yes, thats correct. Can you explain what the term means, occupational and environmental Surveillance Data<\/a> . Surely. As the department conducts its industrial activities, theres a requirement commensurate with both law and osha standard that we collect information on any conditions that may eventually cause us to have to go back and look at impacts on the work force or impacts on the work environment. And so this has an impact on activeduty service men and women and also veterans, am i correct in that . That is correct. All right. So d. O. D. Uses this information to track biological, chemical and physical Health Hazards<\/a> to our servicemen and servicewomen, right . That is correct. All right. What benefit does d. O. D. Get from collecting that type of information . So two benefits come out of it. First of all, we collect it if we link Environmental Issues<\/a> with impacts on activeduty or Service Members<\/a> or even civilian workers, then it allows us to take corrective action to ensure that the condition does not continue. It also allows us to position ourselves to provide appropriate compensation should that condition actually emerge. And i think the department is moving aggressively in the totality of its medical community to look at a better way to manage its medical information across both the activeduty and civilian force. So this is an activity area thats got great attention in the department with significant investment. I thank you for that. I think you just touched on it. The department of Veterans Affairs<\/a> also makes use of this type of environmental and health information. To establish disability benefits for veterans, am i correct in that . That is correct. So its critical this kind of information be accurate and usable to help protect our activeduty Service Members<\/a> and our veterans, right . Yes, sir. Mr. Dodaro, thank you for being here as well and all your good work. According to gao, its not clear that the quality of the data thats being collected is reliable and a report issued in may 2015, gao said, and i quote, some of the military services have developed their own guidance, resulting in inconsistent approaches and levels of effort which has reduced d. O. D. s ability to be confident that the data are sufficiently reliable. Have i read that correctly . Thats correct. So does it concern you that d. O. D. Does not know if the data it is collecting is accurate . Yes, it does. Mr. Tillotson, gao recommended that in that 2015 report the d. O. D. Establish clear policies and procedures for performing Quality Assurance<\/a> reviews of the data collected, d. O. D. Responded to gao that it would need Additional Resources<\/a> to clarify its policies. Is d. O. D. Taking any actions to improve the quality of the data it is collecting . Yes, we are, in fact, doing that. New policies are, in fact, in draft. Theyre due to be issued this year. And we did make the Resources Available<\/a> to do this because we, like you, felt that this was important, undertaking to put in place. Weve tied that into our broader issues of increasing standardization of medical practices across the department. The establishment of the Defense Health<\/a> agency, the establishment of the Defense Health<\/a> program appropriation have all been valueadded activities. This body, this congress, has acted on those in prior years. Thank you for that. But separate from the question of quality is how the information is processed and whether thats being done efficiently. According to the gao report, oehs data is stored in two different database systems. Mr. Dodaro, did gao identify problems with the use of two separate systems . Im go to ask ms. Clowers whos head of our Health Care Team<\/a> to respond, please. Yes, we did. As you mentioned, there was two different systems referred to as measles and doors in which the data is stored. We found both duplication and entry of data but importantly that you couldnt get a comprehensive sense of all the issues being raised by the data. So two separate systems. Mr. Tillotson, why is d. O. D. Using two separate systems . So this is part of the corrective actions we have under way in the broader medical community. Prior to establishment of the Defense Health<\/a> program, prior to more integration across the department, medical practices were run largely in the military departments. Well, i want to jump in here. We are toward the ten years since gao first highlighted the issues of problems with d. O. D. s management of Occupational Health<\/a> data, mr. Tillotson, why is it taking so long to fix these problems . I cant give you a satisfactory answer to that. I can tell you we are working on it, and we are looking to resolve the issue. Well, look. We owe it to our Service Members<\/a>, activeduty men and women and our veterans to collect this information accurately, to fix these problems, and i urge you to give it your every attention. Thank you, congressman. We will. I yield back. I thank the gentleman. The chair recognizes the gentleman from florida, mr. Micah, for five minutes. Thank you, mr. Chairman, and thank you for holding this hearing again. Some of the waste and inefficiency at the federal government is identified annually by gao, and i appreciate what youve done, mr. Dodero, of bringing this to our attention. A couple of areas. First, some of d. O. D. s youre probably you probably have one of the biggest hawks in congress. I vote for everything i voted for the omnibus because we cut, cut, cut d. O. D. But i sit in these hearings, and im the senior person on a National Security<\/a> subcommittee on the panel. Ive been on it since the beginning of time. And i see more and more waste. I see another report, mr. Dodero, that d. O. D. In fact, its inventory of properties and assets is almost nonexistent, is that correct . Yeah, weve been very concerned about the lack of good information yeah, they dont have a good inventory even of their properties and their assets, and this report highlights it again. And thats a concern. We have billions of dollars worth of assets, both domestically and internationally. We cant even account for it. So, again, i think this is troubling. Now, the other thing, too, is work with some of the folks in we work with some of the folks in the d. O. D. Committee, authorization committee. We did substantially acquisition reform, and you talk about the procurement and acquisition. Thats part of the problem, isnt it, sir . Is the procedures, theyre cumbersome, theyre outdated, theyre bureaucratic, theres red tape, and sometimes you dont get the best buy for the taxpayers, right . Well, thats a problem, but its also a problem, as you point out, if you dont know what you have, what condition its in but acquiring new assets, its just as bad. And one of the things that concerns me, as we pass these reforms now, i know it takes a while to implement, and i met with some of the folks i have one of the biggest acquisition activities in the assimilation and army down in my district. I sit with the folks. We passed the stuff last year. Well, first, theres no secretary of army in place, or there hasnt been. Then theres no chief of staff. Then theres no one over the programs. Youve got these vacancies which is part of the problem. And i ask, have you implemented the acquisition reforms . No. Thats sort of no, no, no i get. Or are they in place . No, no, no. Or decisions are somewhere in the chain of command. Maybe mr. Tillotson, you could tell us whats happening there. Certainly. So let me address kind of all three of your issues. On the inventory, i agree with mr. Dodaro, the inventory is not as it should be. It is part of the broader audit status of the department. And in fact, mr. Dodaro, i and the omb folks are meeting this afternoon to talk about progress on it which will include inventory. Its an area we are aware of. Inventory we really cant even audit. Correct. You have to have full existence. Its troubling. We agree. On the issue of acquisition reform, mr. Kendall has moved out quickly with the new guidance to put some of those new procedures in place. I would respond a little bit to mr. Dodaros remarks about strategic portfolio management. We agree. And in fact over the last three years the deputy secretary of defense has led a strategic portfolio review on an annual basis. So not only are the reviews done within the military departments across their business space, but then it comes to a departmental level where the vice chairman of the joint chiefs, the deputy secretary of defense and all the heads of the agencies do a Strategic Review<\/a> of all the investments and investment plans so that to your point and to mr. Dodaros point, we can rationalize investments going forward. We have a bill actually that deals with some property disposal and management. How many people in the audience own property . Raise your hand. Almost everybody, right . Okay. Would you have the federal government manage that property . Hell, no. Youd be nuts. We do that. And the biggest Property Owner<\/a> is probably the biggest one is d. O. D. You cant get anyone to make a decision to dispose of property. Ive been trying we have 177,000 acres at nasa sitting there, an extra 16,000 acres with the air force. Im trying to get 400 acres of Surplus Property<\/a> to transfer to do a commercial cargo center next to our port in canaveral. Not in even my district, 5,000 jobs it would create. Ive been working on it for four years. The other thing, too, youve got to do is get some permanency to some of these military people. Im now on my third commander. They change them every two years. Youve got to we need to get these guys three years at least, maybe four, some stability in the process, is dealing with incompetent people in the past. Then i get someone competent and a second competent, but theyre there and gone. How can you manage anything with the turnover that we have . So just a little frustration, mr. Chairman, but it drives me battie. Just one thing for the members. Did you see what the private sector did this past week in landing that booster rocket on the barge in youve got to look at that and see what the private sector can do when we unleash the private sector. God forbid, we should give them a lease on doing things with private property and moving projects ahead. Thank you. I yield back the balance of my time. I thank the gentleman from florida. I know that excess properties has been something that has been a priority for the gentleman from florida for a long time. Mr. Chairman, incidentally, the bill that were passing i dont know if i said it, does not apply to d. O. D. Right. The one that everyones been working on. And thats something we need to look at. The chair recognizes the gentlewoman from illinois, ms. Kelly, for five minutes. Thank you, mr. Chair. And welcome to the witnesses. Dr. Conway, last year the United States<\/a> spent over a trillion dollars on medicare and healthrelated expenditures. I think we can all agree that there are opportunities to increase efficiency and reduce waste of medicare and medicaid spending. Im the chair of the Congressional Black Caucus<\/a> held brain trust. This is something im very interested in. I meet with a lot of people that are concerned with the future of medicaid and medicare. I want to start by clarifying what is covered by the term improper payments. Improper payments covers both overpayments and underpayments, is that correct . That is correct. So improper payments is both overpayments and underpayments. Okay. And improper payments can include payments made to fraudulent claims, but it also can include legitimate claims that include mistakes, is that right . Yes. It can a portion is fraudulent claims but the majority of improper payments are actually due to documentation or other errors in the submission of the claim that was for, on further review, often a legitimate medical service. One area gao identified for potential duplication is in Health Care Coverage<\/a> for people who are hovering around the poverty line and moving between medicaid and the federally subsidized coverage provided through the Affordable Care<\/a> act exchanges. In the report gao released today, it said that hhs concurred with gaos recommendations and highlighted the actions the department has already taken to ensure the accuracy of medicaid eligibility, determinations made through the exchanges. What steps has cms taken to ensure the recipients of medicaid or federal subsidies are not receiving duplicative coverage . Yes, we appreciate gaos work here. One, the account transfer process, we have accounts transferring between marketplace and medicaid, working closely with our states and private health plans on a daily basis. We now review account transfers on a weekly ba lly basis. In terms of duplicative coverage either by medicaid and marketplace and the most common reason for this, to give you a tangible example, somebody may have marketplace, for example, coverage, lose their job, then qualify for medicaid. We do whats called data matching. With the states. Weve been working closely with the states as they have a Critical Role<\/a> here. We are doing periodic data matching now. So we continue to work through the set of issues both Testing Systems<\/a> with states in private health plans, both at the federal and state level and through data matching and using data, reducing any people that may have coverage both in marketplace and medicaid at the same time. Okay. Another area was how cms verifies the eligibility of medicare providers and suppliers. And they found without stronger controls and better verification, cms may be making payments to providers without a legitimate address whose licenses have expired or have been revoked or in some cases who have actually died. One recommendation made was to upgrade the software. Yes. Thank you for that question. We are doing that with we agree with the recommendation. Were updating the software. Were doing four major actions in this area. One, the Software Updates<\/a> for data verification for address verification and other verification modalities. Two, increase site visits so that we are visiting sites at an increased frequency. Three more Continuous Monitoring<\/a> of data and checking with postal data and other sources in terms of the enrollment process. We are updating our systems and using data to address these Program Integrity<\/a> issues. Do you have enough people and the right people in place to carry this out . Thank you for the question. You know, managing resources in the federal government ive managed both in the private sector and the federal government is incredibly challenging. We have, you know, in total approximately 6,000 cms employees trying to manage a program of huge scope and complexity. I think whether its Program Integrity<\/a> or quality arenas or other policies or marketplace medicaid, we have a staff and i appreciate the comments earlier that i think is mentioned deliver and wants to deliver on that mission. When you look at our Employee Viewpoint<\/a> surveys, that comes across clearly. The other thing that comes across is a feeling that they dont always have the resources and the training and the ability to improve the system as much as they would want. And just quickly, mr. Dodaro, any comments about what youve just heard or anything you want to add . No, im very pleased that the cms has taken action on a number of our recommendations in these areas. There are still some outstanding recommendations, particularly as it relates to medicaid. Im very concerned that weve not had a good oversight over the managed care portion of medicaid at the state level. Cms is in the process of instituting a process that will provide more audits of whats going on in the managed care portion of medicaid at that level. Im still concerned, though, that we have a disagreement with them about the definition of budget neutrality for demonstration projects. The ones that weve looked at, we dont believe have been budget neutral. And its costing the federal government tens of billions of dollars in additional money. They made their criteria more transparent, as dr. Connolly said, but we dont agree with the implementation of the criteria that weve seen in those areas. Theres also many things that weve recommended that congress could do to streamline spending in medicare and Medicaid Program<\/a> as well. So were meesed. Weve had ongoing dialogue with cms. We plan to continue that and to press for full implementation of our outstanding recommendations. Okay. Thank you. And i yield back. I thank the gentlewoman. The chair recognizes the gentleman from michigan, mr. Wahlberg, for five minutes. Thank you, mr. Chairman. And thanks to the panel for being here. And mr. Dodaro, thanks for heavy lifting and sharp pencilling and pinpointing that you continue to do. One mans opinion and an overlarge federal government, but nonetheless. One area that im interested in is the unobligated balances that are out there. Some staggering in nature. At least to my opinion. Is there any value to allowing agencies to hold excess appropriations to the next fiscal year . And i guess i would add quickly to that, at what point does it become a problem . Yeah. I think, you know, agencies need and it depends on the program and activity. And so its variable. They need to have a little bit of a potential buffer depending on the nature of the programs. But the ones we looked at, they had set criteria for what they thought they needed to hold an appropriations. They were well above their own criteria. And thats why we called it excess. You know, so the amount of unobligated balances that we had pointed out in those areas are ones that in our view should be deobligated or rescinded by the congress. How did and specifically, let me get to a specific one here in the state department. One area ive been, in fact, dealing with back in the district. The counselor and Border Security<\/a> programs was 440 million over its target for unobligated balances in fiscal year 2014. How did that account end up almost half a billion dollars over target . Well, sir as mr. Dodaro mentioned is that very often these types of programs, the Counselor Service<\/a> that you mentioned over at state Department Environment<\/a> or department of energy was another will have spending obligations or needs that will cross fiscal years. Our point to this is is that they have had targets that they have put in place, the amount of money that they need to have each year to handle that type of flexibility or to understand that their spending will cross years. When this is way out of whack as it was with Counselor Service<\/a>s, as it was with parts of the department of energy, they need to be able to roll that back or at least they need to have Greater Transparency<\/a> and understanding as to what money they actually need, how theyre going to spend it, and then be publicly reporting on where they are on that. But i guess my concern would be, if that be the case, and they set a 25 , why not fix the problem by next year to saying were going to set at 40 . That doesnt seem to get in touch with reality of trying to live within ones means and truthfully set those targets. Well, setting it you know, they could flux move it each year and say were going from 25 to 40 or even down beyond that. What the goals and again, these are goals that they have set for themselves. These are based on historically what they think they need to carry over from year to year. And they have to justify it . Well, yes, but not at the level that we think that there should be that level of transpearncy. Transparency. And thats the whole point on this. One of the things we do every year, congressman, is we scrub a lot of these accounts and provide the information to the appropriation committees. And in some cases the appropriation committees will not approve additional money if there are large carryover balances. And so we keep an eye on these activities quite a bit. And the agencies have to justify it. But we try to flag these for the appropriators so that they can focus on whether or not to take action. Have any customs and Border Patrol<\/a> officials been held accountable for as i see here, 2012, 2013, 2014, right around 40 has been where theyve ended up over target. Any accountability thus far . Not there typically isnt accountability on an individual level on this or even an institutional level. What were talking about is improving management processes that get a better transparency and better management over time. So that you dont there will be fluctuations. There is exactly what youre seeing, and thats to be expected. What we do want to see is if you set your own targets, you ought to be able to pretty consistently hit those targets and if not, have good explanations to the congress and others as to why a particular year was an anomaly. Well, another problem and thank you for that answer another problem that state, for instance, in their area of Fraud Prevention<\/a>, they claim that they had that level of balance develop because Fraud Prevention<\/a> activities, fees could only be spent on antifraud activities. They didnt have enough fraud to spend it on . Do they have that significant problem and not being able to use the funds at other portions of their budget or their processes . Well, what we found, sir, is that when we look at all agencies across government and state is no different than this is that there are very often internal control weaknesses that are in place and opportunities for agencies to tighten up their antifraud activities. Certainly we think if, you know, within the parameters of the 25 that thats something that state or any other agency ought to be able to improve internal controls with that amount of resources. I see my time has expired. I yield back. I thank the gentleman from michigan. The chair recognizes the gentleman from arizona, mr. Gozar, for five minutes. Thank you, mr. Chairman. In your own written testimony, you state that the irs is making steady progress on a vast majority of actions recommended by the gao. However, in 2013, the treasury Inspector General<\/a> for Tax Administration<\/a> recommended the wage and Investment Division<\/a> of the irs assess the value of the information referral process. Why has the irs not acted on this recommendation yet . Push your button, please. Thank you. We have begun acting on the gao recommendation. We literally have a team of folks from across our various organizations looking at the Referral Program<\/a>. We intend, within the 60 days from the date of the report, to actually put together a time line. Our intentions at this point in time are to limit the number of organizations that have referrals. In other words, we intend to bring the referral process down to, you know, one centralized activity. And our intention is to at some point in time, in the very near future, have an online opportunity for taxpayers to make referrals. So were looking at all of the recommendations that have been made both by the gao and the treasury Inspector General<\/a> for Tax Administration<\/a>. And i believe were going to be quite responsive to the issues that have been raised. Trust is a series of promises. Irs is behind the eight ball on that one. Can you explain why the irs has to better coordinate and share information between programs . Well, a lot of these programs grew up over time. So, for example, we well, i know, but what is happening is that you should have a constant evaluation and, you know, predication as an ongoing exercise. And we havent seen that. Well, in this particular instance, we had a series of Referral Program<\/a>s that grew up in each individual operating division over a period of time. Now, should we have looked at that and addressed it earlier . Yeah, i think we should have. The fact is that my view of this is that the auditors were very helpful in terms of focusing our attention on this. And now that we focused attention on it, were taking action. And so we can expect some results here shortly. Absolutely. Okay. Mr. Dodaro, as you may know, fraud within and throughout the v. A. Is rampant. With regards to Unemployment Benefits<\/a>, why doesnt the v. A. Use irs data to verify applicants selfreported earnings . Im not sure. I dont know ill have to give you an answer for the record for that. I appreciate that. Im going to go to a second one. What does the v. A. Need to do to make sure that the process for determining unemployment eligibility is applied uniformally . Yeah. No, im sorry, on this one, on the v. A. One, im going to have to get back to you. You know, this is this is critical. I love you guys, but the v. A. Is a mess. An absolute disgusting mess. And we need some actions in regards to this. And, you know, it behooves us to have those ideas, the facts so that congress can address those. We will get you the facts. Ill get you an answer today. You know, we agree in terms of the predicality of the v. A. I added them to the list of health care that needs to be addressed. Wed also like to have models that we can follow so that were not reinventing the wheel for them. I think they need some parenting outright. Im going to bring up another one is the prevailing wage. I believe in a fair wage for a fair job thats fair to the taxpayers. But weve seen a huge rise in the number of businesses going out of business because of the department of labor in regards to the calculation of prevailing wage. This is a huge issue across the country. Do you see an equitable aspect of just recalculating this in a very transparent fashion . Yeah. Weve we havent looked at that issue in a while. So id have to id have to go back and take a look. We did a long time ago, but its been a number of years since weve had the resources to be able to look at it again. We would love you to because, you know, i think from the standpoint as long as its a transparent schedule, which has been the major complaint for particularly smaller business along the lines with in my district, in my state, weve had a lot of subcontractors, small contractors put out of business in regards to working with the department of defense. And this would be something that i think that i think both sides could go along with, making shower that its a transparent schedule, that its a fair wage for a fair job, fair to the taxpayer. We will take a look at this. I understand your concern. I appreciate it. Thank you for what you do. I yield back. I thank the gentleman. The chair recognizes the gentleman from north carolina, mr. Walker, for five minutes. Thank you, mr. Chairman. Thank you, gentlemen and others for being here today. Ive got a couple questions. I would like to start with mr. Dodaro. Why is the referral process being conducted by hand and through the mail . Isnt this an archaic kind of outofdate process . Can you speak to that for a minute . Yes, it is archaic. And particularly given the volume of complaints, i think the one Information Referral Office<\/a> had 87,000 referrals one year. And so theyre manually reading them. But then when they refer it to another part of irs, they manually look at it again as well. So im very pleased, as mr. Dalrymple indicated, theyre going through an online electronic process, but this is outdated. So mr. Dalrymple, you did talk about the plans to move it online. Can you give us a little more specificity on what it looks like in a time line . Well, were just in the planning stages right now, so i really cant give you any more specificity about exactly what its going to look like. We have to, you know, engineer that process, et cetera. But its pretty clear to us that our process isnt working for either the taxpayers or for us at this point in time. So were going to make some major changes to that program. I hear that sounds like youve got some great intentions there, but in your forecasting, is there any kind of time line . I know you said youre talking about some plans . Can you be a little bit more specific . Well be responding to the gao report in may. And at that point in time, well have a time line together that will actually lay out what were going to do and the time line for getting it done. Okay, i look forward to seeing that in may. Mr. Dodaor, how might greater coordination between Referral Program<\/a>s and increased savings for the irs and american taxpayer . Can you talk about that for a minute . Sure, sure. I mean, first of all, i think it will increase the timeliness. A lot of the information that it gets, you know, they need to react quickly in order to be able to move and investigate, evaluate the referral, whether its legitimate or not and apply resources properly. Secondly, it will enable them to get back to whoever made the lead if they identified themselves in a way that will encourage people to send Additional Information<\/a> in there as well. As mr. Dalrymple mentioned, the percentage of returns that irs has been auditing on their own has been going down. So theyre auditing less returns. So that makes the ability to get leads and referrals all that more important and put it at a greater premium. So this will enable them to move more quickly. It will enable them to ferret out which ones they should spend time on and dedicate time on. So i believe this has hypo high potential. What are we doing to improve this failure of leadership over programs that have the potential to reduce the tax gap . Can you speak to that . Sure. Well, thank you, sir, for the question. As mr. Dalrymple noted in his conversation on an earlier question is that the problem with the Referral Program<\/a>s is they grew up over time on a singular basis. And so one Division Within<\/a> our Business Unit<\/a> within irs would have a Referral Program<\/a> versus another one would have a Referral Program<\/a>. And so they were viewed as Referral Program<\/a>s rather than an integrated set of initiatives that are under way. Very similar to what local governments do when they have a 311 number where you dont have to know what your problem is when you call. Theres no wrong door. Thats what needs to happen with the Referral Program<\/a>. We shouldnt make someone that has an issue to be referred understand and have to navigate the various processes and programs that are existing within irs. And i know from mr. Dalrymple and his colleagues that has something that theyre committed to. One more question. Its a little lengthy so stay with me here. When whistleblowers contact the irs, they are potentially taking considerable risk. I think we would agree with that part. Despite this the irs takes years to process claims with Poor Communications<\/a> that goes back to these whistleblowers. Why are we not taking steps to evaluate the effectiveness of the Whistleblower Pilot Program<\/a> and other steps to improve communication with these people that come forward . Weve looked at the Whistleblower Program<\/a> and made a number of recommendations. They need to more timely get back. Irs has the Pilot Program<\/a> under way. They need to evaluate whether or not thats going to be successful and meet the needs of the people who are providing the information. But communication here is really important. The other thing we point out in our evaluation is there are monetary awards for whistleblowers. And so far the irs has only issued about 31 specific monetary awards. So they have to look at whether or not they are providing enough incentives for people, both in communication and into awards. Thank you, mr. Dodaro. Mr. Chairman, i yield back. I thank the gentleman. The chair recognizes the gentleman from oklahoma, mr. Russell, for five minutes. Thank you, mr. Chairman. And thank you for all of our witnesses that are here today. We do appreciate what you do. Im a big fan of our government accounters and also our inspectors general and others that help us ferret out waste and have responsible government. Mr. Dodaro, the gao found that the Commerce Department<\/a>s new Innovative Technologies<\/a> in manufacturing or itm Loan Guarantee<\/a> program was essentially performing the same function as four other federal Loan Guarantee<\/a> programs. The program was set up as you, im sure, are aware as a result of the 2010 reauthorization of the america competes act. And congress specifically directed commerce to avoid duplication. Was there more that commerce could have done to avoid the now duplicate existing programs . We think theres more that could be done, and weve made a recommendation to commerce to work with sba and National Institutes<\/a> of standards and technologies. I think what congress was trying to do here was to deal with a niche that may be some gaps in the Capital Markets<\/a> for innovation for this particular purpose. And its going to be very difficult, though, i think to find what that niche is going to be and to avoid duplication with the other programs. I think that congress was also, quite frankly, frustrated with the sbas lack of timeliness in meeting these needs. And so weve recommended that commerce work with them to identify what these Capital Needs<\/a> are. Im pleased that they havent made any Loan Guarantee<\/a>s yet until they can find out and make sure theyre not duplicating. Were going to stay on this. We have a regular requirement to review it. The report also shows that itms program is copying the forms and application process used by the Small Business<\/a> administration for its own loan program. How does this contribute to duplication and the issuance of loans . Well, its going to duplicate it. Unless they follow our recommendation and find the right niche that the focus on, inevitably, it will result in duplication, my opinion. The gao also recommended in the report that the Commerce Department<\/a> create targeted marketing materials and coordination with the National Institute<\/a> for standards and technology so that the Program Offers<\/a> guarantees to manufacturers who do not currently have access to federal Loan Guarantee<\/a>s. If nist has the best overall idea of which borrowers could benefit most from the program, would you recommend or the gao that the Loan Guarantee<\/a> program simply be consolidated under nist, or would one of the other agencies with a preexisting program, and if not, why not . I think thats a possibility that has to be identified once commerce does their homework and that theres a proper plan. I think at that point, somebody ought to reassess. Now, i also would note, my understanding is commerce has talked to other federal departments and agencies about carrying out the program. And so far there have been no takers in that regard. So i think that, you know, ill be very interested to see what commerce does with our recommendation. And once it has, the marketing materials and once its identified potential capital you know, gaps in the Capital Markets<\/a>, whether or not it could be done by another existing program or whether we really need another program. Thank you for that. I think the jurys out on that. I appreciate that. And mr. Chairman, being a true conservative, i will yield back the balance of my time. Well, i thank the gentleman from oklahoma. The chair recognizes the gentleman from alabama, mr. Palmer, for five minutes. Thank you, mr. Chairman. Mr. Dodaro, i really appreciate the work you guys do. I hate to say it, but i enjoy reading your reports. That probably speaks volumes about my personality, but i do want to go back to this issue of unobligated balances. And i know that you may or may not be in a position to make a judgment on whether or not this is sound fiscal policy, but i dont think we could make the case that it is absolutely necessary to hold almost 900 billion in unobligated balances. Would you agree with that . Yes. Okay. My point here, then, is that were in a debate over our budget in which were being asked to increase spending by 30 billion. If we were to reduce the unobligated balances by approximately 3. 5 , that would more than cover the increase in spending. Does it not make sense to do that, and particularly in the context of if were Holding Money<\/a> in onobligated balances and then having to borrow money to fund other agencies, isnt there an interest cost incurred in addition to the additional spending . Well, its definitely not its not an efficient way to operate. I would say, though, that i dont believe it would be probably prudent to do an acrosstheboard kind of reduction there. I think you have to look at targeted areas in agencies, and thats why we focused on specific areas. We do that every year for the congress, you know, because in some cases it may make sense to have that. And other cases not. But in no case should it be in excess of what the needs are. Right. And i just use that as a generalization, not in specific. I think you would have to look at each agency individually. But the point is is its not sound fiscal management. That is correct. Thats why we focus on it. Mr. Dalrymple, i want to direct some questions to you about the tax gap. And the Inspector General<\/a> for the Tax Administration<\/a>, the treasury Inspector General<\/a>, issued a report. And in his report, he said there needs to be more timely and more accurate estimates of the tax gap. Currently the irs reports this about every five years. Has the irs acted on the Inspector General<\/a>s recommendations . We intend to have the new tax gap report out later this month, as a matter of fact. So we are acting on it as we speak. Can you tell me how much the irs collected, what was the Revenue Total<\/a> collected for 2015 fiscal year . Its over 3 trillion, wasnt it . It was over 3 trillion, yes. Based on a report from the urban institute and the Brookings Institution<\/a> over the past 30 years, the tax gap has ranged from 16 to 20 . Lets just say its 16 . And if 3 trillion came into the irs last year, that means 16 , thats 84 of what should have been collected. Now, i wont get into the math, but ill just give you an idea. That means that somewhere in the range of 500 billion to 550 billion went uncollected. What is the irs doing to collect the taxes that are owed it . Well, we have a number of initiatives. I mean, the tax gap itself, one of the things that needs to be completely understood about the tax gap is that its made up of a lot of different monies owed. And if we were going to go after every sort of last cent of the tax gap, it would be an incredibly intrusive process. Having said let me suggest this. 84 of it is underreporting. 10 s underpayment. 6 is just flat nonfiling. And the point im trying to make sheer, and this may not be the proper form to do it, but even when you do collect some of the taxes, you still have a net gap of somewhere between 380 billion and 400 billion. And im on the budget committee. This is one of these things that makes me want to pull my hair out, and at my age i dont need to be doing that. We do everything in a tenyear window. And if its 380 billion a year, thats 10year window, okay . And then weve got improper payments that another one of your reports i read, mr. Dodaro, if thats the average, thats 1. 25 trillion over that 10year window and were looking at a 19 trillion debt . And we just identified 5 trillion, okay . It seems to me that it begs for a flat tax or a consumption tax, some way of collecting every dime thats owed the government. So i just want to see if the irs can be more diligent in making sure that we collect the revenue thats owed us. Because weve got some serious fiscal issues facing the country. Thank you for your indulgence, mr. Chairman. I yield back. I thank the gentleman. The chair recognizes the gentleman from texas for five minutes. Thank you, mr. Chairman, for saving the best to second last. Mr. Dodaro, its always a pleasure to see you, sir. I want to shift gears a little bit talking about internet availability on tribal lands. The gao report on tribal Internet Access<\/a> noted a lack of coordination between the fcc and usda in their efforts to increase Internet Access<\/a> on tribal lands. What risks of duplication or efficiency are presented by this lack of coordination . Ask mr. Herd who led that work to respond. Thanks for the question. One of the challenges we saw there is they were not doing coordinated training and one of the challenges for the tribal group is getting to the training and having the administrative staff to take advantage of some of those programs. Have the agencies made any progress on increasing their coordination . We did the report last year. Well be following up with them this year. Its, they concurred with the recommendations so hopefully theyre taking some steps forward. Is this lack of coordination creating a risk that fcc and usda is going to offer conflicting advice to folks seeking to increase access on their lands . I think its possible, yes. Im curious, as you continue with this, so please keep us informed on that. We will, thank you. Mr. Dodaro, to you and your team, commercial Satellite Communications<\/a> procurement, something im interested in. And mr. Tillotson, were get to you on some questions on this. Mr. Dodaro first for you or whoever on your team, how has d. O. D. Commercial satellite procurement strategy changed over the past decade . Theyve become more reliant on purchasing commercial satellite services. Has, was d. O. D. Procurement policy willfully ignored, in your opinion . Well it definitely wasnt followed. Ill leave it at that. And has d. O. D. Or was d. O. D. Procurement policy effectively communicated to the various components . Ill ask mr. Francis to respond to that. Who led the work. Mr. Hurd, my understanding is it was effectively communicated. Theres a couple of things that get in the way. The two agencies that enforce the procurement policy for sat com is the Defense Intelligence<\/a> security agency, disa and the u. S. Strategic command. While they have authority, they dont necessarily have enforcement powers, so theres some weaknesses there. And then the funding for Satellite Communications<\/a> actually is done through the supplemental budget. So the incentives arent as strong, to be upfront about that. And then when agencies or components go around the normal procurement regulations, its for reasons of exigency, it becomes harder to enforce. Mr. Tillotson, why has the d. O. D. Ignored recommendations for more strategic commercial satellite procurement strategy . Sorry, i forget to hit my button. So i would not agree that weve ignored the policy. In fact, let me start with a couple facts and figures. Since 2011 weve reduced expenditures on commercial satellite usage by 571 million. Right now, disa, the defense Information Services<\/a> agencagenc, manages about 90 of commercial Satellite Communications<\/a>. I think at the time the criticism was rendered or the findings were rendered there were certainly issues in how coherent that policy should have been implemented. Since that time, the department has put more energy and effort into this. Gao correctly identifies that there are two agencies involved. One is the defense Information Services<\/a> agency, disa, who does largely kind of the commercial backbone kind of work and then theres the strict Strategic Command<\/a> and the associated military departments, space agencies, that do the military Satellite Communications<\/a>. The department has established a Defense Space<\/a> council so we can look at have all of those entities been educated on what d. O. D. Procurement policy is . Yes. So then why have some components independently procured Satellite Communications<\/a> as opposed to following the Department Policy<\/a> . So with the establishment of the Defense Space<\/a> council in some cases weve deliberately allowed some of those contracts to continue because its cheaper to continue the contract than simply to reissue the contract. Again, ill go back and point out, weve actually reduced commercial Satellite Communications<\/a> use by 571 million since 2011. In my remaining 15 seconds, mr. Dodaro, dhs and their Human Resources<\/a> i. T. Investments, whats the best next action there . I think that this is a classic case for good congressional oversight. To find out exactly what their current plan is. This to me was a classic case of mismanagement. Of this effort over a number of years. There are 422 different systems over there. There was lack of attention by management. Theyve supposedly now focused more on it and coming up with a validating the Business Case<\/a> against in the model but i think congressional oversight would be very appropriate and prudent at this point to make sure that they right the ship here. Mr. Dodaro, i do know someone that sits on the government form and Homeland Security<\/a> committee. So ill make sure he follows up on it. I thank the gentleman for his personal interest on that particular topic, and the chair recognizes the gentleman from california, mr. Desaulnier. Thank you for your good work, mr. Dodaro. Its always interesting and thrilling to be here in this committee and see a Government Agency<\/a> doing so well. Not that a lot of Government Agencies<\/a> dont do well. I want to ask you a couple questions just about our sort of segues from the last comment about oversight, but the comparison between the executive branch implementing your recommendations and how you measure that versus us in congress. Im told this is a partisan issue, it just happens between the administration and congress, irrespective of who holds control over the levels of power. For instance, the gao has made 459 recommendations of the executive branch and 372 have now been fully or partially completed by your analysis. In contrast, the gao has made 85 recommendations for congress, but only 37 have been fully or partially completed. Thats 46 as opposed to 81 . So over time, have you or your predecessors given friendly suggestions as to how we could be more successful . Or is it just part of our role as a deliberative process that makes it difficult . I give friendly suggestions all the time. As often as i can. Well hopefully theyre received in that way. And they are. And they are. But its you know, i pointed out in my opening statements, although the numbers, the percentages are different, where the big Dollar Savings<\/a> have come from is through the congress actions. I also pointed out that congress has encouraged and indeed directed, for example, the Defense Authorization<\/a> bill certain acts by d. O. D. To implement our recommendations. So congress has a little bit of a hand in the executive branch implementation as well. But ive got a long list of specific legislative recommendations for the congress to act on. That would save billions of dollars. For i can give examples now if you like. For example, in medicare, the number of hospitals have moved to do what they call vertical integration. Which is to have Physician Practices<\/a> operate as affiliates of the hospital. So people get Certain Services<\/a> there, the same as they could in a doctors office. But right now the hospital, if they go to one of these hospitalaffiliated outpatient services, the government reimburses them much more than if you go to a physician office. We think it ought to be equalized. There are billions of dollars that could be saved there. There certain cancer hospitals that were originally deemed special rate payment hospitals in 1980s when there werent that many hospitals providing cancer services. That if their payment rates are equalized, other hospitals for similar treatments, you could save 500 million right there. On Medicare Advantage<\/a>, theres an annual adjustment factor thats supposed to be made to compare it to fee for service. We dont think cms is using the most up to date information to make that adjustment, and we think that they could last time we looked at it we thought it could be several billion dollars. At least 2 billion to 3 billion could be saved perhaps on an annual basis going forward. Were recommending that the Congress Take<\/a> action to lower the requirement for Electronic Filing<\/a> from 250 down to about 5 for employers. This will help irs have better ability to match and prevent Identity Theft<\/a> refund fraud which last year by irs estimates the government lost about 3 billion and could be more in that area","publisher":{"@type":"Organization","name":"archive.org","logo":{"@type":"ImageObject","width":"800","height":"600","url":"\/\/ia600207.us.archive.org\/25\/items\/CSPAN3_20160420_211500_Politics_and_Public_Policy_Today\/CSPAN3_20160420_211500_Politics_and_Public_Policy_Today.thumbs\/CSPAN3_20160420_211500_Politics_and_Public_Policy_Today_000001.jpg"}},"autauthor":{"@type":"Organization"},"author":{"sameAs":"archive.org","name":"archive.org"}}],"coverageEndTime":"20240624T12:35:10+00:00"}