Ted Kaufman - United States Senator for Delaware

Kaufman Joins Fellow Freshmen Democratic Senators to Announce Health Amendments

Package includes Kaufman provision on health care fraud

December 8, 2009

WASHINGTON – Sen. Ted Kaufman (D-DE) joined ten of his fellow freshmen Senators today to introduce a package of amendments that will broaden and accelerate efforts to encourage innovation and lower costs for consumers across the U.S. health care system. The package includes a Kaufman provision to increase penalties for health care fraud and enhance enforcement against its perpetrators.

Since Labor Day, these freshmen Democrats have gathered six times to deliver back-to-back Senate floor speeches on the need for common-sense health reform. The eleven Democratic freshmen are Sens. Kaufman, Mark Begich (AK), Michael Bennet (CO), Roland Burris (IL), Kay Hagan (NC), Paul Kirk (MA), Jeff Merkley (OR), Jeanne Shaheen (NH), Mark Udall (NM), Tom Udall (CO) and Mark Warner (VA).  

“So much of what is broken in our present health care system revolves around basic inefficiencies that drive up costs, while simultaneously driving down quality,” said Kaufman in a speech on the Senate floor. “Even worse – inefficiencies in the system often give way to the waste, fraud and abuse that drains somewhere between $72 and $220 billion annually from doctors, patients, private insurers and the state and federal government – significantly increasing health care costs for Americans.”

Below is a summary of the specific amendments:

Working More Closely with the Private Sector on Cost Containment

These amendments transform payment systems and improving quality to require the public and private sectors to move forward together on the shared goals of cost containment, improved quality, and delivery system reform.

·          CMS Innovation Center:  We give the new Innovation Center explicit authority to work with private plans to align Medicare, Medicaid and private sector strategies for improving care.
·          Independent Medicare Advisory Board: We broaden the scope of the new Independent Medicare Advisory Board to look at total health system spending and make nonbinding, system-wide recommendations.
·          Quality and Value in Private Insurance: We require the Secretary to consult with relevant stakeholders to develop a methodology for measuring health plan value, which would include the cost, quality of care, efficiency, actuarial value of plans.  Developing the tools to assess health plan value will help consumers and employers make better apples-to-apples comparisons when they shop for health insurance and get the best value for their health care dollar.

 Stepping-up the Commitment to Reduce Regulatory Barriers and Fight Fraud

These amendments require the U.S. Secretary of Health and Human Services (HHS) to aggressively pursue streamlined regulations and anti-fraud initiatives to ensure that all sectors of the health care system work together to improve value.

·          Administrative Simplification: We require HHS to develop standards that will allow efficient electronic exchange and streamlining of information among patients, providers and insurers.
·          Health Care Fraud Enforcement: We direct HHS to better utilize technology to prevent health care fraud. We direct the U.S. Sentencing Commission to increase penalties and enhance enforcement of health care fraud.

  • Eliminating Legal Barriers to Care Improvement:  In tandem with this package, the freshman Senators will be requesting that the U.S. Government Accountability Office study current laws and regulations to identify barriers to implementing innovative delivery system reforms.  We also will request that the U.S. Department of Justice and the Federal Trade Commission work together to provide clearer guidance to providers who wish to enter into innovative collaborative arrangements that promote patient-centered, high quality care.

Aggressively Moving Toward Delivery System Reform

These amendments allow HHS to experiment with promising new models to further lower costs, increase quality and improve patient health.

·          Value-Based Purchasing: We require Medicare to implement pay-for-performance for more providers sooner, adding hospices, ambulatory surgical centers, psychiatric hospitals and others.
·          Broader Payment Innovation:  We allow a broader, more flexible transition to new payment models for Accountable Care Organizations (ACO).
·          Medicare System Upgrades:  We require HHS to modernize data systems so that valuable Medicare data can be shared in a reliable, complete, and timely manner.
·          Good Quality Everywhere:  We promote greater access to tele-health services, strengthen the provider workforce and the availability of high-quality hospital services to bolster health care access for Americans in underserved and rural regions.  

Sen. Kaufman’s full remarks, as prepared for delivery:

I appreciate the opportunity to join my freshmen colleagues again to discuss the unique opportunity we have to finally enact meaningful health care reform.

And make no mistake, we need health reform now.

From rising premiums to insurers denying coverage for people with pre-existing conditions, the health care system is failing individual Americans.

It is also threatening the fiscal solvency of our country, with Medicare and Medicaid swallowing up more and more of our federal spending.

The time for reform is now.

Thanks to the hard work of Senators Reid, Baucus, Dodd, Harkin and their staffs, we have a bill before us that can finally reform our health care system.

It is a good bill.

It is a bill that truly protects what works in our system and fixes what is broken.

No longer will Americans be denied coverage on the basis of pre-existing conditions.

Nor will their coverage be revoked when they get sick and need it the most.

It will help protect seniors by offering new preventive and wellness benefits and it will extend the solvency of the Medicare Trust Fund by an additional five years.

It will also help our economy by significantly cutting healthcare costs and reducing the nation’s deficit by $130 billion.

It makes quality, affordable health care within reach for all Americans.

But there is always more we can do.

Today I am pleased to rise in support of a promising amendment my freshman colleagues and I are introducing.

So much of what is broken in our present health care system revolves around basic inefficiencies that drive up costs, while simultaneously driving down quality.

Even worse – inefficiencies in the system often give way to the waste, fraud and abuse that drains somewhere between $72 and $220 billion annually from doctors, patients, private insurers and the state and federal government – significantly increasing health care costs for Americans.

These are inefficiencies that can and will be curbed.

By seeking creative ways to encourage innovation and lower costs even further – and more quickly – for Americans across the country, this amendment compliments the underlying health care bill.

It adopts the full spectrum of 21st century technologies and innovative methods of delivery to further cut through the red tape that continues to plague our system and stifle innovation.

It provides common-sense, practical solutions that help contain costs, improve value and increase quality.

It increases penalties for health care fraud and enhances enforcement against medical crooks, and utilizes the most sophisticated technology to better detect and deter fraud in the health care system.

It quickens the implementation of uniform administrative standards, allowing for more efficient exchange of information among patients, doctors and insurers.

It provides more flexibility in establishing Accountable Care Organizations that realign financial incentives and help ensure Americans receive high quality care.

And it provides greater incentives to insurers in the exchange to reduce health care disparities along racial lines.

These are just a few examples of the provisions in the amendment that I believe mesh well with the Patient Protection and Affordable Care Act.

As I have said before, it is time to gather our collective will and do the right thing during this historic opportunity by passing health care reform.

I think this amendment can help us reach that goal.

We can’t afford to wait any longer.

We need to act now.

We can do no less.

The American people deserve no less.

Thank you.


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