Medicare Data Access for Transparency and Accountability Act

Mr. President, I rise to speak on an issue that is critical to our constitutional rights and our national security. The revelation and subsequent declassification of the National Security Agency's intelligence gathering programs have shocked Americans in ways that I long ago had telegraphed. We are having a spirited and critical debate about what the right balance between privacy and security ought to be. With regards to NSA activity, I am introducing bipartisan legislation today, with several senators of both parties, designed to narrow Section 215 of the USA PATRIOT Act, known also as the ``business records'' provision, to better balance the authorities we give the federal government while protecting our constitutional rights. More specifically, my legislation would prevent the federal government from collecting millions of law-abiding Americans' phone call records without first establishing some nexus to terrorism. We all expect the NSA to target terrorists, but the revelations in the past few weeks have made clear that the information of millions of law-abiding Americans is being swept up in the process.

Let me start by saying that I continue to feel that a number of the permanent PATRIOT Act provisions

should remain in place to give our intelligence community important tools to fight terrorism. But I also believe, as I stated two years ago when offering this same legislation as an amendment to the PATRIOT Act reauthorization bill, that Section 215 of this Act fails to strike the right balance between keeping us safe and protecting the privacy rights of Americans. Indeed, my concerns about this provision of the law have only grown since I was first briefed on its secret interpretation and implementation as a member of the Senate Intelligence Committee.

From the recent leaks and information since declassified about the Section 215 collection program, we know that the Foreign Intelligence Surveillance Court has interpreted this provision of the PATRIOT Act to permit the collection of millions of Americans' phone records on a daily, ongoing basis. As a member of the Senate Intelligence Committee, I have repeatedly expressed concern that the interpretation of this provision of the PATRIOT Act, which allows the government to obtain ``any tangible thing'' relevant to a national security investigation, is at odds with the plain meaning of the law. This secrecy has prevented Americans from understanding how these laws are being implemented in their name. That is unacceptable.

Even before the nature of the bulk phone records collection program was declassified, there was support for narrowing the language of Section 215 from many in Congress and many Americans who feel strongly about their constitutional right to privacy. In fact, the PATRIOT Act reauthorization that passed the Senate in 2005 by unanimous consent included language that would limit the government's ability to collect Americans' personal information without a demonstrated link to terrorism or espionage. While that language did not prevail in conference, it demonstrated that bipartisan agreement on reforms to Section 215 is possible.

In 2011, as the Senate took up the extension of a number of expiring provisions of the PATRIOT Act, I offered an amendment drawn directly from language in the 2005 Senate-passed bill to narrow the application of this provision. That amendment unfortunately did not receive a vote. But today, along with my colleague Sen. Wyden and others, I am back at it again--introducing bipartisan legislation drawn from that same language.

Our bipartisan bill would narrow the PATRIOT Act Section 215 collection authority to make it consistent with what most Americans believe the law allows. While this legislation would still allow law enforcement and intelligence agencies to use the PATRIOT Act to obtain a wide range of records in the course of terrorism- and espionage- related investigations, it would require them to demonstrate that the records are in some way connected to terrorism or clandestine intelligence activities--which is not the case today. I don't think it is unreasonable to ask our law enforcement agencies to identify a terrorism or espionage investigation before collecting the private information of American citizens.

Many Coloradans share my belief that we need to place common-sense limits on government investigations and link data collection to terrorist- or espionage-related activities. If we cannot assert some nexus to terrorism, then the government should keep its hands off the phone data of law-abiding Americans.

Let me be very clear: our government must continue to diligently and aggressively combat terrorism. We all agree with that critically important goal. But I do not think that it is unreasonable to ask that collection of phone data be limited to investigations that are actually related to terrorism or espionage. And I do not believe that we need to sacrifice national security to strike this balance. In fact, as a member of the Intelligence Committee who has studied our surveillance programs closely, it has not been demonstrated to me that the bulk phone records collection program has provided uniquely valuable information that has stopped terrorist attacks, beyond what is available through less intrusive means. But if we are going to continue providing this authority to collect phone data from Americans' communications, let's at least limit it to require a link to terrorism or espionage. This is a commonsense step that we can take to strike a better balance between keeping our country safe and respecting constitutional rights.

I thank my colleagues who have cosponsored this legislation, and ask other colleagues to give it a close look. I will continue to press for the PATRIOT Act to be reopened for debate, and when that occurs, I will push for passage of this bipartisan bill that strikes a better balance between keeping our nation safe and unduly trampling our constitutional rights.

Mr. President, I rise today to introduce the Infrastructure Facilitation and Habitat Conservation Act of 2013.

This legislation will make it easier for communities across the Nation to improve their public infrastructure by providing access to cost-effective Federal loan guarantees to mitigate the impacts of growth on the environment and endangered species.

This bill authorizes a 10-year pilot program, to be administered jointly by the Secretaries of the Interior and Treasury, making credit more readily available to eligible public entities which are sponsors of Habitat Conservation Plans, HCPs, under section 10 of the Endangered Species Act of 1973.

Habitat Conservation Plans were authorized by an amendment to the Endangered Species Act in 1982 as a means to permanently protect the

habitat of threatened and endangered species, while facilitating the development of infrastructure, through issuance of a long-term ``incidental take permit''.

Equally important, HCPs can be very effective in avoiding, minimizing and mitigating the effects of development on endangered species and their habitats. HCPs are an essential tool, as Congress intended, in balancing the requirements of the Endangered Species Act with on-going construction and development activity.

In California, the Western Riverside County multiple-species HCP is a prime example of effective habitat management. The Western Riverside MSHCP covers an area of 1.26 million acres, of which 500,000 will be permanently protected for the benefit of 146 species of plants and animals. To date, more than 347,000 acres of public land and 45,000 acres of private land have been protected, at a cost of $420 million. In the case of the Western Riverside MSHCP, as with other HCPs nationwide, this strategy for advance mitigation of environmental impacts has facilitated the development of much-needed transportation infrastructure. To date, the Western Riverside MSHCP has resulted in expedited environmental approval of 25 transportation infrastructure projects, which have contributed 32,411 jobs and $2.2 billion to the county's economy.

Riverside has been one of the Nation's fastest growing counties, with a rate of growth during the last decade of 42 percent. Unless the development of infrastructure can be made to keep pace with this explosive population growth, neither environmental or livability goals will be attained.

In recent years, the economic downturn has slowed the pace of habitat acquisition in Western Riverside and other similarly-situated communities. Revenue which had been generated by development fees to finance acquisition of habitat has also slowed.

Now, ironically, signs of economic recovery in the region also signal increasing real estate prices that will make the acquisition of mitigation lands more challenging. That's why it is important to provide communities like Western Riverside ready access to capital now to help fund habitat conservation projects while real estate costs remain relatively low, saving them and other communities implementing HCP's billions of dollars.

Under this bill, loan guarantee applicants would have to demonstrate their credit-worthiness and the likely success of their habitat acquisition programs. Priority would be given to HCPs in biologically rich regions whose natural attributes are threatened by rapid development. Other than the modest costs of administration, the bill would entail no federal expenditure unless the local government defaulted--a very rare occurrence.

These Federal guarantees will assure access to commercial credit at reduced rates of interest, enabling participating communities to take advantage of temporarily low prices for habitat. Prompt enactment of this legislation will provide multiple benefits at very low cost to the Federal taxpayer: protection of more habitat more quickly, accelerated development of infrastructure with minimum environmental impact, and reduction in the total cost of HCP land acquisition.

A broad coalition of conservation organizations and infrastructure developers supports this legislation. In fact, the Senate also expressed support for this concept when it approved a similar, albeit more narrowly defined innovative financing program as part of the Water Resources Development Act, WRDA, last month. But where the WRDA provisions would be applicable to mitigate the environmental impacts related to the development of water infrastructure, this legislation would broaden that eligibility to transportation and other public infrastructure.

I urge my colleagues to support this legislation. I believe it will encourage infrastructure development and habitat conservation at minimal Federal risk. It is exactly the kind of partnership with local government that should be utilized to maximize efficient use of Federal dollars.

Mr. President, I ask unanimous consent that the text of the bill be printed in the Record.

Mr. President, today, Senator Wyden and I reintroduced the Medicare Data Access for Transparency and Accountability Act. This collaborative effort includes two ideas for making Medicare billing and spending more transparent.

The first provision comes from a bill I introduced in 2011 to enhance the government's ability to combat Medicare and Medicaid fraud. It would require the Secretary of Health and Human Services to issue regulations making Medicare claims and payment data available to the public, similar to other federal spending disclosed on www.USAspending.gov.

That website was created by legislation sponsored by then-Senator Obama and Senator Coburn. It lists almost all federal spending, but it doesn't include payments made to Medicare providers.

That means virtually every other government program, including some defense spending, is more transparent than the Medicare program.

Omitting Medicare spending is especially alarming when you consider the portion of Federal spending that goes through the Medicare program. In 2011, the Federal Government spent $549 billion on Medicare.

Taxpayers have a right to see how their hard-earned dollars are being spent. There should not be a special exception for hard-earned dollars that happen to be spent through Medicare.

Transparency will restore that taxpayers' right.

Also, if doctors know that each claim they make will be publicly available, it might deter some wasteful practices and overbilling.

Our bill accomplishes this by requiring the Secretary of Health and Human Services to make available a searchable Medicare payment database that the public can access at no cost.

The second provision in our bill clarifies that data on Medicare payments to physicians and suppliers do not fall under a Freedom of Information Act, FOIA, exemption.

In 1979, a U.S. District Court ruled that Medicare is prohibited from releasing physicians' billing information to the public.

For over three decades, third parties that tried to obtain physician specific data through the FOIA process have failed. Taxpayers have been denied their right.

Another recent court decision lifted the injunction, but it does not go far enough.

Our bill would make Congress' intent clear and provide the public with the tools to finally gain access to important Medicare data.

I would like to provide one example of how valuable access to Medicare billing data can be.

In 2011, using only a small portion of Medicare claims data, the Wall Street Journal was able to identify suspicious billing patterns and potential abuses of the Medicare program.

The Wall Street Journal found cases where Medicare paid millions to a physician sometimes for several years, before those questionable payments stopped.

That was only one organization using a limited set of Medicare data. When it comes to public programs like Medicare, the Federal Government needs all the help it can get to identify and combat fraud, waste and abuse, and that is why a searchable Medicare claims database should be made available to the public.

I have often quoted Justice Brandeis, who said, ``Sunlight is the best disinfectant.'' That is what Senator Wyden and I are aiming to accomplish with the Medicare Data Act.

Mr. President, today, Senator Wyden and I reintroduced the Medicare Data Access for Transparency and Accountability Act. This collaborative effort includes two ideas for making Medicare billing and spending more transparent.

The first provision comes from a bill I introduced in 2011 to enhance the government's ability to combat Medicare and Medicaid fraud. It would require the Secretary of Health and Human Services to issue regulations making Medicare claims and payment data available to the public, similar to other federal spending disclosed on www.USAspending.gov.

That website was created by legislation sponsored by then-Senator Obama and Senator Coburn. It lists almost all federal spending, but it doesn't include payments made to Medicare providers.

That means virtually every other government program, including some defense spending, is more transparent than the Medicare program.

Omitting Medicare spending is especially alarming when you consider the portion of Federal spending that goes through the Medicare program. In 2011, the Federal Government spent $549 billion on Medicare.

Taxpayers have a right to see how their hard-earned dollars are being spent. There should not be a special exception for hard-earned dollars that happen to be spent through Medicare.

Transparency will restore that taxpayers' right.

Also, if doctors know that each claim they make will be publicly available, it might deter some wasteful practices and overbilling.

Our bill accomplishes this by requiring the Secretary of Health and Human Services to make available a searchable Medicare payment database that the public can access at no cost.

The second provision in our bill clarifies that data on Medicare payments to physicians and suppliers do not fall under a Freedom of Information Act, FOIA, exemption.

In 1979, a U.S. District Court ruled that Medicare is prohibited from releasing physicians' billing information to the public.

For over three decades, third parties that tried to obtain physician specific data through the FOIA process have failed. Taxpayers have been denied their right.

Another recent court decision lifted the injunction, but it does not go far enough.

Our bill would make Congress' intent clear and provide the public with the tools to finally gain access to important Medicare data.

I would like to provide one example of how valuable access to Medicare billing data can be.

In 2011, using only a small portion of Medicare claims data, the Wall Street Journal was able to identify suspicious billing patterns and potential abuses of the Medicare program.

The Wall Street Journal found cases where Medicare paid millions to a physician sometimes for several years, before those questionable payments stopped.

That was only one organization using a limited set of Medicare data. When it comes to public programs like Medicare, the Federal Government needs all the help it can get to identify and combat fraud, waste and abuse, and that is why a searchable Medicare claims database should be made available to the public.

I have often quoted Justice Brandeis, who said, ``Sunlight is the best disinfectant.'' That is what Senator Wyden and I are aiming to accomplish with the Medicare Data Act.

Mr. President, I rise today with Senator Grassley to introduce the Medicare Data Access for Transparency and Accountability Act. I would like to begin by thanking my friend and esteemed colleague for his unwavering commitment to greater transparency and accountability in government. This Medicare DATA Act advances that goal.

Sunshine continues to be the greatest disinfectant. In that light, the Medicare DATA Act ensures all taxpayers have access to Medicare Claims Database, both to aid them in making medical decisions, and in understanding what their money is paying for in this vital, yet enormous, health program. The Medicare Claims Database is an important resource for public and private stakeholders as it captures healthcare provider payment and claims information for roughly one-third of the United States healthcare system. But why isn't this information already available?

In 1978, the Department of Health Education and Welfare attempted to release this information, upon request, under the premise that accessibility to the source data was in the public interest and therefore should be made available for public consumption. An injunction by a Florida court, however, ordered otherwise.

I am pleased that the Florida court has reevaluated that decision and recently lifted the injunction. This is a step in the right direction, but the decision still leaves access to this data ``opaque.'' Data requests are still subject to the Freedom of Information Act and can be denied by Health and Human Services. Passage of the Medicare DATA Act would put an end to that loophole.

Information affecting the American taxpayer should be part of the public domain in a free society. With this principle in mind, I join with Senator Grassley in changing ``business as usual.''

I urge my colleagues to support this legislation so that Medicare data is finally fully transparent and available to Medicare beneficiaries and taxpayers alike. I look forward to working with my colleagues in this effort.