[Congressional Record Volume 140, Number 138 (Wednesday, September 28, 1994)]
[Senate]
[Page S]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: September 28, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
  DISTRICT OF COLUMBIA APPROPRIATIONS ACT, 1995, DISTRICT OF COLUMBIA 
   SUPPLEMENTAL APPROPRIATIONS AND RESCISSIONS ACT, 1994--CONFERENCE 
                                 REPORT

  The Senate continued with the consideration of the conference report.
  Mr. GRASSLEY. Madam President, I desire to speak on the pending 
business before the Senate.
  The PRESIDING OFFICER. The Senator has that right.
  Mr. GRASSLEY. Madam President, I support the Gramm amendment. I am a 
cosponsor of the legislation that forms the basis for the amendment 
because I believe that if we are going to actually reduce crime, tough 
provisions like these are needed.
  This amendment will strike the Local Partnership Act. The Local 
Partnership Act has nothing to do with fighting crime. It never had and 
it never will. The program was designed to be an economic stimulus. 
Now, it has been dressed up as an effort to prevent crime, but this is 
a hoax.
  This money is for education, drug prevention, and jobs, all in the 
name of fighting crime. The vague language of this program provides no 
guidance on what this money can be spent for. We do not know exactly 
how the money will be used, but most likely we will pour money into the 
same old programs that have never worked.
  In any other area of human endeavor, if something is tried and paid 
for, and does not work, and then more money is spent and it does not 
produce results, we try another approach. This Local Partnership Act 
rests on a different theory: Federal programs can only fail because the 
Government has just not spent enough to make them succeed. This makes 
no sense.
  Vice President Gore's Reinventing Government report criticized the 
Government's redundant jobs programs. It concluded that there needs to 
be a better focus for these programs, and that they should be 
consolidated. I agree with the Vice President that Government needs to 
be reinvented.
  And I see no reason why we should create additional jobs programs in 
a crime bill that would just increase the problems the Vice President 
discussed.
  We need to set the right priorities for our crime bill. Social 
spending is exactly the wrong priority.
  There is no evidence that any of the programs that will be cut by the 
Gramm amendment will reduce crime. Philosophically, the parties have a 
strong disagreement: Democrats believe that society is responsible for 
crime. Republicans believe that individuals lacking a sense of right 
and wrong commit crimes.
  These individuals must be punished to keep us safer, and be held 
responsible, so as to discourage others from committing crimes.
  We should also vote to eliminate the $625 million waste that is the 
Model Intensive Grant Program. Under this program, 15 cities that are 
hand-picked by the administration would receive the grants.
  The cities have complete discretion on how to spend this money, and 
it may be spent on anything to reduce crime. Anything but punishment or 
law enforcement.
  That is a lot of money to spend on 15 cities. And I am sure that Iowa 
will not receive its share of this money.
  I do not see any good reason why Iowa, with the lowest unemployment 
rate in decades, should be punished from receiving its share of this 
money. The entities that would be aided by this money are already 
involved in preventing crime.
  Of course, if these organizations are unable to prevent crime using 
the techniques they are using, there is no reason to think that merely 
increasing the amount of money they spend on these failed programs will 
cause them to succeed. We should focus on crime control, not poorly 
thought out boondoggles based on earlier failed efforts.
  The Gramm amendment will cut the pork out of the crime bill. There is 
plenty of pork in the crime bill that we should eliminate, and the 
Family and Community Endeavor Schools Program is a good place to cut. 
This money is to be applied toward sports programs, cultural 
activities, arts and crafts, dance, and health services. The money can 
be spent on a wide variety of activities. About the only thing that the 
money cannot be spent on is religious instruction. That is expressly in 
the language. So, in other words, the money can be spent to give 
children condoms, but not to teach them the Ten Commandments. Teaching 
morality and personal responsibility is real crime prevention. The 
Family and Community Endeavor Schools Program has nothing to do with 
crime.
  Do not just take my word for it. Look at the legislation the 
President signed. At least the Local Partnership Act had the fig leaf 
of saying that it was education to prevent crime. But this section does 
not even mention the word ``crime.''
  It has nothing whatsoever to do with crime by its own admission. This 
is pork barrel social spending plain and simple. And it has no place 
being on a crime bill. On the merits, even its sponsors admit that.
  The pork in the crime legislation is not limited to the $7 billion in 
here that is expressly labeled as prevention pork. We were told how 
tough this law supposedly is. We were told how so much of the bill is 
really for law enforcement, especially prisons.
  We should take a close look at the prison money.
  What a close look shows is that the prison money is mostly pork, too. 
The language governing the prison money will not ensure that any money 
at all will be spent on prisons. The bill permits the money to be spent 
entirely on alternatives to prison. The grants can be used for boot 
camps, halfway houses, or alternative facilities to free up prison 
space.
  I believe that people think that the prison money in this law is 
designed to incarcerate new prisoners. But it will merely make more 
existing prison space available.
  It is bad enough that the law does not require that money be used for 
prisons. Worse, the prison language requires that as a condition of 
receiving money, States enact further social spending. The States must 
include drug diversion programs, community corrections programs, 
prisoner rehabilitation, and jobs skills programs. This is social 
spending, not prison spending.
  Additionally, there is no truth in the truth-in-sentencing language. 
Under truth-in-sentencing, a criminal serves the length of time to 
which he is sentenced. This has been accomplished in the Federal 
system, and the Senate bill was designed to provide incentives for 
States to do the same.
  Today, States make their prisoners serve only about 40 percent of the 
time for which they are sentenced.
  The bill the President signed cut back substantially on the truth-in-
sentencing portion of the Senate crime bill. The incentives for States 
to abolish parole now only take effect for imprisonment of second-time 
violent offenders. And while the bill supposedly makes a 50-50 split in 
prison grants between general grants and truth-in-sentencing grants, 
this is not the case. The law contains a reverter clause. Money not 
used for truth-in-sentencing will be shifted to the general 
grants. Obviously, if States know they can get the prison money even if 
they do not enact truth-in-sentencing, then the incentive we created to 
create truth-in-sentencing will disappear. The Gramm amendment 
substitutes tough language to override these misguided approaches that 
the American people know will not make anyone safer.

  We also need to be tough by restoring tough Senate crime provisions 
that were knocked out in conference. We should include mandatory 
minimum sentences for those who sell illegal drugs to minors or who use 
minors in drug trafficking activities. A person over 21 who distributed 
drugs to a minor would face a 10-year mandatory minimum sentence. A 
second offense would mean life imprisonment.
  This amendment would also restore Senate language imposing mandatory 
minimum sentences for carrying firearms during commission of a crime of 
violence or drug trafficking crime.
  For a first offense, the mandatory minimum is 10 years, 20 years if 
the firearm is discharged. Second offenses carry mandatory 20-year, 30-
year, and life sentences.
  These sentences are sorely needed. Drug use is a leading factor in 
crime. Surveys of inmates show that 50 percent committed their crime 
while under the influence of illegal drugs or alcohol. Strict penalties 
are necessary to punish those who distribute these drugs, particularly 
when the buyer is a juvenile.
  Young people are especially vulnerable to drug use. We need to enact 
tough penalties to prevent drug dealers from hooking young people into 
a life of addiction, crime, despair, and possibly death.
  This mandatory minimum, which this body has already adopted once, 
will serve to prevent drug dealers from taking advantage of young 
people, and the threat of life imprisonment for subsequent offenses 
will make all drug dealers take notice.
  Too often, persons have sought to avoid tough drug penalties by 
employing minors to do the dirty work for them. Mandatory minimum 
sentences are appropriate for those who seek to avoid punishment by 
putting children in harm's way.
  To me, there is no close question: The interests of our children are 
far more important than the interests of those who profit from 
involving them in a life of crime.
  The crime legislation that recently became law will not accomplish 
nearly enough to address the overriding public concern about crime. The 
Gramm amendment will cut the wasteful social spending contained in that 
bill, and it will make sure that tough penalties are enacted. I 
strongly support its adoption.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. COHEN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Wellstone). Without objection, it is so 
ordered.
  Mr. COHEN. Mr. President, I ask unanimous consent that the pending 
amendment be laid aside.
  The PRESIDING OFFICER. Is there objection?
  Without objection, it is so ordered.


      Amendment in Disagreement to the Senate Amendment Numbered 6

  The PRESIDING OFFICER. The clerk will report the next amendment in 
disagreement.
  The legislative clerk read as follows:
       Resolved, That the House recede from its disagreement to 
     the amendment of the Senate numbered 6 to the aforesaid bill, 
     and concur therein with an amendment as follows:
       In lieu of the matter proposed by said amendment, insert: 
     ``: Provided, That the District of Columbia shall provide to 
     the Committees on Appropriations of the House of 
     Representatives and the Senate quarterly reports by the 15th 
     day of the month following the end of the quarter showing how 
     monies provided under this fund are expended with a final 
     report providing a full accounting of the fund due October 
     15, 1995 or not later than 15 days after the last amount 
     remaining in the fund is disbursed.''
       And
       On page 13 line 9 of the House engrossed bill, H.R. 4649, 
     strike the period at the end of the line.


Amendment No. 2594 to Amendment in Disagreement to the Senate Amendment 
                               Numbered 6

   (Purpose: To provide for enhanced penalties for health care fraud)

  Mr. COHEN. Mr. President, I now send to the desk an amendment and ask 
for its immediate consideration.
  The PRESIDING OFFICER. The clerk will report.
  The legislative clerk read as follows:

       The Senator from Maine [Mr. Cohen] proposes an amendment 
     numbered 2594 to the amendment of the House to the amendment 
     of the Senate numbered 6.

  Mr. COHEN. Mr. President, I ask unanimous consent that reading of the 
amendment be dispensed with.
  The PRESIDING OFFICER. Without objection it is so ordered.
  (The text of the amendment is printed in today's Record under 
``Amendments Submitted.'')
  Mr. COHEN. Mr. President, yesterday, during the Senate's 
consideration of the Labor, HHS, and Education appropriations bill, I 
offered an amendment to crack down on fraud that is rampant throughout 
our health care system. And while I believe that the amendment that I 
offered yesterday and have now reoffered today enjoys broad bipartisan 
support, I agreed with the managers of the bill to withdraw that 
amendment in order to allow for the expeditious acceptance of the 
conference report on Labor and HHS yesterday by the House.
  I am now back on the floor, Mr. President, with the same amendment, 
because I believe we cannot afford to delay any longer the risks to our 
health care system by the fraud that is being perpetrated against it.
  I know that there are pundits and politicians who are still arguing 
about who killed health care reform for this year. But one thing is 
certain. We should not wait a single minute longer to crack down on 
health care fraud.
  There is strong agreement between Republicans and Democrats on the 
need to address this issue that is costing taxpayers dearly, is driving 
up the cost of the entire health care system for all of us.
  As I told my colleagues on the floor yesterday, a year-long 
investigation of health care fraud and abuse that was conducted by my 
staff on the Senate Special Committee on Aging found that health care 
fraud and abuse is rampant throughout the Federal, State, and private 
health care programs. Losses to health care fraud and abuse over the 
past 5 years are almost four times the total cost to date of the entire 
savings and loan crisis.
  What is perhaps most shocking is how easy, how shockingly easy, it is 
to defraud both the Federal programs, Medicare and Medicaid, and 
private insurers; that all of us are leaving wide open the doors to 
abuse, inviting scam artists to rip off the system.
  According to the General Accounting Office--the GAO--and the FBI, as 
much as 10 percent of the entire health care budget is being lost to 
fraud and abuse each year. That amounts to roughly $100 billion a year. 
If we start calculating out the numbers it means we are losing $275 
million a day; $11.5 million an hour in health care dollars lost to 
fraud and abuse. While I must say the overwhelming majority of health 
care providers are honest individuals, the vulnerabilities to fraud 
exist throughout the entire health care system, and defrauding the 
system itself has become a routine way of doing business for many of 
the unscrupulous providers.
  There are major patterns of abuse that plague the system and they are 
in the form of overbilling or billing for services not rendered; 
unbundling--for example you take a wheelchair and you unbundle the 
components by billing separately for the tires, the spokes as such, the 
seat, the arm rests, the back. And you suddenly build up the entire 
cost for that one wheelchair--unbundling is a very common practice for 
many, many devices sold to the Federal Government and private insurers; 
and upcoding services to receive higher reimbursements. In other words, 
if you have a product which you furnish, you simply upcode it to get a 
much higher level of reimbursement from the insurer or the Federal 
Government; or even providing inferior products to patients. There are 
other widespread scams involving the payment of kickbacks and 
inducements for referrals of patients, falsifying claims and medical 
records or fraudulently certifying an individual for Government 
benefits, billing for ghost patients, and even paying drug addicts or 
other patients to have their blood drawn or have unnecessary medical 
tests performed so the fraudulent doctor or clinic can be reimbursed by 
Medicaid or private health care insurance.
  So, our health care system is filled with abuse and Medicare/Medicaid 
and private insurers are simply ill-equipped and understaffed to deal 
adequately with the extent of this health care fraud. The formula for 
fraud is a very familiar one. There are too few investigators and 
overseers, a complex and unwieldy and burdensome system that is easily 
manipulated, there are big dollars at stake, and a very small chance 
that these unscrupulous providers, the professional patients, and the 
other scam artists are going to be caught.
  To give an example, there are more than 4 billion claims that are 
processed annually. The two major law enforcement agencies with primary 
jurisdictions over health care fraud, the FBI and the Health and Human 
services IG, however, have combined just under 450 full-time positions 
devoted to investigating health care fraud. That translates to one 
full-time investigator for every 8 million claims.
  Think about that. One full-time investigator to oversee, investigate 
8 million claims. The effect is that Federal, State, and private health 
plans are sorely outnumbered when it comes to detecting and protecting 
against fraudulent practices. I would like to share just a few examples 
of fraud against the health care system.
  Two durable medical equipment owners stole $1.4 million from the New 
York Medicaid Program by repeated billing for expensive orthotic back 
supports that were never prescribed by the physicians. The supplies 
were rarely delivered. An aggressive telemarketing campaign that 
offered inducements was a part of this scheme in order to obtain 
beneficiary Medicaid numbers.
  A durable medical equipment company billed Medicaid for expensive 
incontinence liners when in fact it was providing only simple 
disposable wash cloths. Another example of upcoding. The company 
misrepresented the products in order to receive that higher 
reimbursement. The owner of a rehabilitation service operated a scheme 
to defraud Medicare by providing false claims for speech therapy 
provided to patients at nursing homes. The employees of the service 
were accused of falsifying billing, including certification by doctors 
that patients needed continuous speech therapy and they also falsified 
the patients' medical records.
  A physician used fake diagnoses to justify billings for treatments 
never provided to patients. The billing practices included billing for 
treatment of appendicitis in a patient who previously had his appendix 
removed; billing for office visits that never took place; and billing 
for laboratory tests that were never performed.
  These are just a very few samples, just the tip of a very large 
iceberg that is lurking below the surface. It is freezing out millions 
of Americans from affordable health care coverage.
  There are many other examples that I could provide. They are all 
documented in this report that I filed on July 7, 1994. It is called 
``Gaming the Health Care System.'' From pages 12, 13--on through--we 
have given more examples of the kinds of abuse. I talked about them 
yesterday. I talked about the pad, the transparent dressing. I have a 
chart that I can perhaps demonstrate that transparent dressing with, 
but it is a waterproof transparent dressing. Basically it is a 
waterproof pad. There was an elderly lady who fell down in a boarding 
home in Maine. A local supplier found out that she had injured herself. 
She had received a cut of less than an inch long in her forearm. It did 
not require the services of a doctor.
  That local supplier sent up these pads, waterproof pads. There is an 
example of it here. They are worth about $2.50--that is the cost. She 
received and used 14 of these. The supplier continued to send them, 
over 50 of them, to her. In addition to the pads he sent up gels and 
other volumes of these pads.
  Do you know what the bill was? Mr. President, at $2.50, I think she 
used 14--let us say at a maximum $40. The bill came close to $3,800 for 
this one-inch cut that required no doctor's services.
  I mentioned these orthotic body jackets: A piece of plastic that is 
wrapped around patients who have some spinal surgery. I think they cost 
somewhere between $30 or $40 to manufacture. You could probably acquire 
them from a catalog for a little more than that price. Yet they were 
billed at $550 or $560 apiece.
  I also mentioned yesterday the most glaring example of the 
prosthesis. It looked like it was taken off one of the dummies in a 
department store window--just a piece of plastic--a piece of plastic. 
It was supposed to be from the knee down, to cover people who had lost 
their leg in an accident or through disease. What was fascinating about 
this one prosthesis is that it had a right calf on a left foot--a right 
calf and a left foot. The supplier of that particular device billed you 
and me and all the American taxpayers $8,800. HCFA then said it could 
not possibly be worth that much money--how about $1,400 as a reasonable 
price for that?
  As I said yesterday, it was not worth 14 cents. It was completely 
useless to anyone. But this is what is going on day after day after 
day, to the tune of $11.5 million an hour; $275 million a day; or $100 
billion a year.
  I mentioned, again yesterday, that I offered an amendment to the 
crime bill dealing with criminal activity, title 18. It was agreed to 
without even a vote because I think it enjoys broad support in this 
Chamber. It was dropped in the House of Representatives because the 
House said: No, no, we cannot possibly take this up on a crime bill 
even though we are trying to combat crime in this legislation because 
it really belongs on a health care bill, health care reform. So let us 
strip it out of the crime bill and wait until we get health care 
reform.
  Of course, here we stand at the end of September and we have no 
health care reform bill, not for this year. It will be months before we 
ever agree--here, then in the other body, then with the President. We 
are looking at months of debate and negotiation before we finally have 
health care reform that is a reality for the Nation.
  So we are told it does not belong here--right church, wrong pew. It 
is crime but not on the crime bill, wait until we get on health care 
reform. So I waited to get to health care reform and we have no health 
care bill. Now I am told do not put it on anything coming from 
appropriations, wait until next year. Just wait another year, wait 
until we lose another--by the way, we have lost about $85 billion since 
I offered the amendment to the crime bill and we passed the crime bill 
in the Senate and it was stripped out in the House. So we have lost 
roughly $85 billion to date. By the end of the year it will also total 
up to $100 billion. And we are told once again, let us just wait a few 
more months. We will be back at it again in January.
  Of course, we all know we do not come in until the end of January. We 
go out almost immediately for the Lincoln Day recess. We come back in 
the latter part of February and we do not begin serious debate on 
legislation--we have to go through the committees once again with 
hearings after hearings and joint referrals to other committees, 
sequential referrals. We finally may get a bill to the floor and then 
we have to go through the same process in the House, then we have a 
conference, we come back and maybe by this time next year we will 
finally have a health care bill and we will say we finally dealt with 
health care fraud.
  I do not think we can wait that long. I do not think it is fair to 
the American people. I think they are justifiably outraged when they 
look to us and say: We have a problem; you have identified the problem. 
Frankly, the President agrees. This legislation was in the President's 
health care bill. This amendment was in Senator Mitchell's bill. This 
amendment was in Senator Dole's bill. This amendment was in the so-
called mainstream coalition group. Everybody agrees; everybody agrees 
we have a major problem. This will help fix the problem.
  But because of procedural requirements we cannot take any action. 
Because those in the House say, ``It does not belong on a crime bill, 
let us put it on health care.'' We do not put it on health care, we 
have no health care bill. We cannot put it on Health and Human Services 
appropriations because, after all, that will clutter up the 
legislation. It will have to go back to the House. So let us just wait 
until next year.
  The amendment I am offering today will:
  Give prosecutors stronger tools and tougher statutes to combat 
criminal health care fraud. It would, for example, provide a specific 
health care offense in title 18 so that prosecutors are not forced to 
prosecute under the mail and wire fraud statutes;
  Allow injunctive relief and forfeiture for criminal health care 
fraud; allow health care plans and the Government to kick the bad 
apples out of the system entirely through authority to exclude 
violators from Medicare and other health care programs; create tougher 
civil penalties and remedies for fraud and abuse;
  Coordinate enforcement programs and beef up investigative resources, 
which are now woefully inadequate.
  The amendment does this by financing additional health care fraud 
enforcement resources with proceeds derived from forfeiture, fines, and 
other health care fraud enforcement efforts.
  This amendment also gives guidance to health care providers and 
industries on how to comply with fraud rules, so that they will know 
what is and what is not prohibited activity.
  There is broad agreement on both sides of the aisle on the changes 
proposed by this amendment in order to stop fraudulent providers from 
bleeding billions of dollars from our health care system.
  The provisions of this amendment, for example, were included in 
legislation I first introduced last year. They are also included in the 
so-called mainstream coalition health care reform bill and very similar 
provisions are included in Senator Dole's health care reform bill and 
Senator Mitchell's reform plan. Many of these provisions are also 
included in the administration's health care reform package.
  Many of the proposals I am offering in this amendment are based on 
recommendations of a Health Care Fraud Task Force convened by the Bush 
administration, and have been endorsed by the current administration, 
numerous law enforcement agencies, and many health care provider 
groups.
  In addition, as the distinguished chairman of the Judiciary 
Committee, Senator Biden, indicated on the floor yesterday, some of the 
provisions included in this amendment were passed as part of the Senate 
crime bill. Unfortunately, those amendments were dropped in conference 
by the House because House conferees argued that we should wait until 
health care reform to deal with this problem.
  They are back here now in this amendment.
  Federal and State law enforcement is making some progress in cracking 
down on health care fraud, but the current enforcement scheme has 
resulted in a system whereby the mouse has outsmarted the mousetrap. 
Those defrauding the system are ingenious and motivated, while the 
Government and private sector responses cannot keep pace with the 
sophistication and cunning of those they pursue.
  I expect this amendment is going to be opposed by those who argue we 
have to wait until next year once again because this is really outside 
the scope of the pending bill. I must agree. D.C. appropriations--this 
is not where this legislation belongs. But I have run out of 
opportunities. I have nowhere else to bring this up. I tried on crime. 
I wanted it on health care. I wanted it on Health and Human Services 
and Education appropriations. Everywhere I turned they say, ``Not 
here.'' You all agree, the President agrees, Senator Mitchell agrees, 
Senator Dole agrees, everybody on both sides of the aisle--we all 
agree, but we cannot attach it here.
  So, it is a point of frustration with me. There is anger out there 
amongst the American people. They say why are you not doing something? 
I stand up here on the floor and say, ``Here is something. Here is 
something that is noncontroversial.'' Everybody agrees: Justice agrees, 
the FBI agrees, Senator Biden agrees, everybody agrees, but we cannot 
pass it.
  So we have to watch another $100 billion being lost to these people 
who are simply bleeding us dry. If you had to call them--I was thinking 
of even a book entitled ``Fast Bucks.'' Boy, are people out there 
making fast bucks at our expense. Millions, billions of dollars that 
they are scamming, and we sit idly by waiting for the right procedural 
mechanism to come along so that we can do something about it.
  Mr. President, if I had my choice, I would not be offering it on the 
D.C. appropriations bill. I think D.C. appropriations is as important 
as any of the other appropriations bills. I thought it was more germane 
to the Health and Human Services appropriation. I thought it was more 
germane to the crime bill. Obviously it is germane to health care 
reform. But none of those are available. None are available. So this is 
a last resort.
  We are going out presumably next week or the week thereafter. I have 
heard rumblings about a lame duck session--which I think would be a 
mistake--but nonetheless, we do not have any more vehicles. We do not 
have another chance this session to pass legislation that will, 
hopefully, stem the tide. It cannot stop it altogether. But we can stem 
the tide of this kind of blatant, fraudulent activity, that is 
destroying our health care system in the sense that it is robbing 
people who need health care coverage, who cannot get it and we cannot 
afford to provide it.
  How many more ``60 Minutes,'' ``Prime Time Live,'' or other types of 
expose shows are we going to have to watch, where they reveal how easy 
it is to rip off the health care system and have taxpayers just simply 
sit by and watch Congress fiddle up here while nothing gets done?
  How much longer can some health care providers' groups delay in 
cracking down on health care fraud by this jurisdictional shell game? 
Do not put health care fraud in the crime bill, it is a health care 
issue. Do not address health care fraud until you pass health care 
reform. Do not fix the enforcement holes in the current system now, 
just wait until next year. And do not put these fraud measures on the 
appropriations bills.
  Mr. President, I think we have got to stop hiding behind these 
jurisdictional arguments that justify doing nothing now. The only ones 
that benefit from this delay on this important issue are the ones that 
bilk billions of dollars from the system.
  The very big losers will be the American taxpayers, the patients, the 
families who cannot afford health care coverage, because premiums and 
health care costs are being padded to cover the exorbitant costs of 
fraud and abuse.
  So Mr. President, I hope that my colleagues who have had an 
opportunity to look at the legislation will agree that it is worthwhile 
and worthy of their support. I hope in time that we have a chance to 
vote on it and to vote in favor of it now.
  I would now yield the floor, and I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. BUMPERS. Mr. President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER (Mr. Conrad). Without objection, it is so 
ordered.
  Mr. BUMPERS. Mr. President, I ask unanimous consent that I be 
permitted to proceed for up to 15 minutes as if in morning business, 
and that the pending business be set aside and immediately taken back 
up at the conclusion of my remarks.
  The PRESIDING OFFICER. Without objection, it is so ordered.

                          ____________________