[Congressional Record Volume 144, Number 98 (Tuesday, July 21, 1998)]
[Senate]
[Pages S8658-S8659]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. FAIRCLOTH:
  S. 2332. A bill to limit the ability of prisoners to challenge prison 
conditions; to the Committee on the Judiciary.


                      crime doesn't pay prison act

 Mr. FAIRCLOTH. Mr. President, today I am introducing the Crime 
Doesn't Pay Prison Act, a bill to curb the flood of frivolous prisoner 
lawsuits over prison conditions.
  The primary purpose of this act is to articulate an objective 
national standard for measuring the minimum decency of prison 
conditions. The Constitution does not dictate a minimum standard of 
living for inmates, much less an enjoyable comfortable level of living. 
This should be Congress' job.
  In addition to the initial goal of a national prison standard, this 
bill has other purposes. It would ensure that State governments are 
required to spend only that amount necessary to achieve the minimum 
standard for conditions of confinement mandated by the Constitution. It 
would further ensure that the Federal courts require only that prison 
conditions do not constitute the unnecessary infliction of pain or 
neglect upon inmates, such that they are deprived of the minimum 
civilized measure of life's basic necessities.
  Absent a national standard, convicted criminals enjoy a standard of 
living higher than that of the law-abiding, working poor. According to 
the federal government, the standard of living for the law-abiding poor 
is $8,000 a year. Yet for a convicted criminal, the average expenditure 
per prisoner amounts to an unbelievably high $23,000 a year.
  Absent a national standard, the standard of living in prison will 
continue to escalate. Since 1960, the average total state expenditure 
per inmate has increased almost twice as fast as median income, and 
more than twice as fast as the poverty threshold. This is unacceptable.
  Many unnecessary amenities, such as regulation softball fields, video 
games, and premium pay cable channels are provided to criminals, 
contribute to the increasing standard of living in prisons. Other 
amenities include expensive musical instruments for traveling 
``choirs,'' not to mention martial arts training and boxing. Perhaps 
here is a primary cause of prison violence. How can one counter the 
violence if taxpayers' dollars are being spent on the very classes 
which teach and encourage it?
  Absent a national standard, criminals will continue to fight for 
their ``right'' to amenities in prison, claiming that denial of same 
``violates'' their Eighth Amendment right against ``cruel and unusual 
punishment.'' Any violation of our Bill of Rights is, most assuredly, a 
vital concern and should not be tolerated.
  Nor, however, should frivolous claims which do nothing but clog our 
court systems and deny our citizens speedy access to justice for 
legitimate cases. Several actual cases demonstrate this. One includes a 
Utah criminal who claimed that his Eighth Amendment rights were 
violated when he was provided with Converse tennis shoes, rather than 
L.A. Gear or Reebok. Another case dealt with an Arkansas criminal who 
was appalled that he was given paper napkins during meals instead of 
cloth napkins. Yet another ludicrous example involves a Missouri 
criminal, who claimed cruel and unusual punishment when he was not 
provided with salad bars or brunches on weekends. This is absolutely 
preposterous.
  The benefits of this ``Crime Doesn't Pay Prison'' Act are extensive. 
As of right now, 25% of the state and federal courts' civil dockets are 
comprised of inmate challenges to conditions of confinement. This bill 
would reduce this number considerably. It also frees state Attorneys 
General to pursue litigation on behalf of the citizenry.
  The bill would drastically reduce the increasing cost of 
incarceration, allowing the money saved thereby to be used instead for 
the expansion of existing prisons.
  It puts an end to the injustice of convicted criminals enjoying a 
higher standard of living, by mere virtue of their imprisonment, than 
the law-abiding working poor.
  In addition to giving the prison administrators the flexibility to 
find that medium of good order and discipline within the prisons, 
perhaps most importantly, this bill would demonstrate to prisoners that 
criminal behavior will not be rewarded with luxuries beyond the reach 
of law-abiding, poor Americans.
  I strongly urge my colleagues to support this bill.


                MEDICARE WASTE TAX REDUCTION ACT OF 1998

 Mr. HARKIN. Mr. President, today I am introducing with my 
colleague from South Carolina, Senator Hollings, an important piece of 
legislation that will help to protect and preserve Medicare. The bill 
is entitled the Medicare Waste Tax Reduction Act of 1998.
  For nearly ten years now, I have worked to combat fraud, waste and 
abuse in the Medicare program. As Chairman and now Ranking Member of 
the Senate Appropriations Subcommittee with oversight of the 
administration of Medicare, I've held hearing after hearing and 
released report after report documenting the extent of this problem. 
While virtually no one was paying attention to our effort for many 
years, we've succeeded in bringing greater attention and focus to this 
problem in the past several years.
  Part of our effort has been to try to quantify the scope of the 
problem. Several years ago, the General Accounting Office reported that 
up to 10 percent of Medicare funds could be lost to fraud, waste and 
abuse each year.

[[Page S8659]]

  Many questioned that estimate as too large. They said the problem 
existed, but it wasn't nearly as big as 10 percent. Then, as you know, 
last year the Inspector General conducted the first-ever detailed audit 
of Medicare payments. That Chief Financial Officer Act audit found that 
fully 14 percent of Medicare payments in 1996, or $23 billion, had been 
made improperly.
  That's a $23 billion ``waste tax'' on the American people. And the 
purpose of today's summit to figure out the best way to cut that tax. 
So, how do you cut this tax? I know there are no ``magic-wand'' 
solutions--this is a complex problem with many components. But 
basically, you need four things: well thought out laws, adequate 
resources, effective implementation and the help of seniors and health 
providers. We've made progress on each of these fronts over the last 
couple of years, but much more remains to be done.
  First, the reforms embodied in the Health Insurance Portability Act 
and the Balanced Budget Act must be effectively implemented. Effective 
implementation of these new reforms are vital and must be given high 
priority. And, Medicare, the Inspector General and the Justice 
Department must continue to aggressively use new authority to crack 
down on Medicare fraud.
  The Medicare Waste Tax Reduction Act I am introducing today will take 
a number of important steps to stop the ravaging of Medicare.
  This Bill for example, would direct HCFA to double and better target 
audits and reviews to detect and discourage mispayments. Currently only 
a tiny fraction of Medicare claims are reviewed before being paid and 
less than 2 percent of providers receive a comprehensive audit 
annually. We must have the ability to separate needed care from bill 
padding and abuse.
  It would also require Medicare to aggressively use it's newly 
improved ``inherent reasonableness'' authority. It is vitally important 
that Medicare carriers be held accountable for their performance in 
protecting the program from abuse. Preventing abuse and other 
inappropriate payments should be the most important performance 
criteria these entities are measured by.
  Our bill would also expand the Medicare Senior Waste Patrol 
Nationwide. Seniors are our front line of defense against Medicare 
fraud, waste and abuse. However, too often, seniors don't have the 
information they need to detect and report suspected mistakes and 
fraud. By moving the Waste Patrol nationwide, implementing important 
BBA provisions and assuring seniors have access to itemized bills we 
will strike an important blow to Medicare waste.
  The bill would also give Medicare the authority to be a more prudent 
purchaser. As passed by the Senate, the Balanced Budget Act gave 
Medicare the authority to quickly reduce Part B payment rates (except 
those made for physician services) it finds to be grossly excessive 
when compared to rates paid by other government programs and the 
private sector. In conference, the provision was limited to reductions 
of no more than 15 percent. This bill would restore the original Senate 
language. In addition, to assure that Medicare gets the price it 
deserves given its status as by far the largest purchaser of medical 
supplies and equipment, Medicare would pay no more than any other 
government program for these items. Finally, overpayments for 
prescription drugs and biologicals would be eliminated by lowering 
Medicare's rate to the lowest of either the actual acquisition cost or 
95% of the wholesale cost.
  The Medicare Waste Tax reduction Act of 1998 would also ensure that 
Medicare does not pay for claims owed by other plans. Too often, 
Medicare pays claims that are owed by private insurers because it has 
know way of knowing a beneficiary is working and has private insurance 
that should pay first. This provision would reduce Medicare losses by 
requiring insurers to report any Medicare beneficiaries they insure. 
Also, Medicare would be given the authority to recover double the 
amount owed by insurers who purposely let Medicare pay claims they 
should have paid.
  Additionally, coordination between Medicare and private insurers 
would be strengthened. Often, those ripping off Medicare are also 
defrauding private health plans. Yet, too little information on fraud 
cases is shared between Medicare and private plans. In order to 
encourage better coordination, health plans and their employees could 
not be held liable for sharing information with Medicare regarding 
health care fraud as long as the information is not false, or the 
person providing the information had no reason to believe the 
information was false.
  Another critical component of any successful comprehensive plan to 
cut the Medicare waste tax is to focus on prevention. Most of our 
efforts now look at finding and correcting the problem after they 
occur. While this is important and we need to do even more of it, we 
all know that prevention is much more cost effective. The old adage ``A 
stitch in time saves nine'' was never more true. A major component of 
an enhanced prevention effort would be the provision of increased 
assistance and education for providers to comply with Medicare rules.
  A good deal of the mis-payments made by Medicare are the result not 
of fraud or abuse, but of simple misunderstanding of Medicare billing 
rules by providers. Therefore, this bill provides $10 million a year to 
fund a major expansion of assistance and education for providers on 
program integrity requirements. This bill would also ensure the 
reduction of paperwork and administrative hassle that could prove 
daunting to providers. Health professionals have to spend too much time 
completing paperwork and dealing with administrative hassles associated 
with Medicare and private health plans. In order to reduce this hassle 
and provide more time for patient care, the Institute of Medicine would 
be charged with developing a comprehensive plan by no later than June 
1, 1999. Their recommendations are to include the streamlining of 
variations between Medicare and other payers.
  Mr. President, while we have made changes to medicare in attempts to 
extend its solvency thru the next decade, we urgently need to take 
other steps to protect and preserve the program for the long-term. We 
should enact the reforms in this bill to weed out waste, fraud and 
abuse as a first priority in this effort. I urge all my colleagues to 
review this proposal and hope that they will join me in working to pass 
it yet this year.
  Mr. President, I also ask unanimous consent a summary of my bill be 
printed in the Record.
                                 ______
                                 
      By Mr. HARKIN (for himself and Mr. Hollings):
  S. 2335. A bill to amend title XVIII of the Social Security Act to 
improve efforts to combat Medicare fraud, waste, and abuse; to the 
Committee on Finance.
  There being no objection, the summary was ordered to be printed in 
the Record, as follows:

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