SCREEN Act of 2013

Mr. President, today I am pleased to introduce the Electronic Communications Privacy Act Amendments Act of 2013--a bill to strengthen the privacy protections for email and other electronic communications. Last year, the Judiciary Committee favorably reported substantially similar legislation with strong bipartisan support. I thank Republican Senator Mike Lee for cosponsoring this important privacy bill. Senator Lee and I understand that protecting Americans' privacy rights is something that is important to all Americans, regardless of political party or ideology. I hope that all Senators will support this bill and that

the Senate will pass this privacy legislation this year.

Like many Americans, I am concerned about growing and unwelcome intrusions into our private lives in cyberspace. I also understand that we must update our digital privacy laws to keep pace with these threats and the rapid advances in technology.

When I led the effort to write ECPA 27 years ago, email was a novelty. No one could have imagined the way the Internet and mobile technologies would transform how we communicate and exchange information today. Three decades later, we must update this law to reflect the realities of our time, so that our Federal privacy laws keep pace with American innovation and the changing mission of our law enforcement agencies.

My bill takes several important steps to improve Americans' digital privacy rights, while also promoting new technologies, like cloud computing, and accommodating the legitimate needs of law enforcement. First, the bill requires that the government obtain a search warrant based on probable cause to obtain the content of Americans' email and other electronic communications, when those communications are requested from a third-party service provider. There are balanced exceptions to the warrant requirement to address emergency circumstances and to protect national security under current law.

Second, the bill requires that the government promptly notify any individual whose email content has been accessed via a third-party service provider, and provide that individual with a copy of the search warrant and other details about the information obtained. The bill permits the government to seek a court order temporarily delaying such notice in order to protect the integrity of ongoing government investigations. In addition, the bill permits the government to ask a court to temporarily preclude a service provider from notifying a customer about the disclosure.

The bill contains several important provisions to ensure that the reforms to ECPA do not hinder law enforcement. The bill adds a new notice requirement to the law that requires service providers to notify the government of their intent to inform a customer about a disclosure of electronic communications information at least three business days before giving such notice. Furthermore, to help law enforcement investigate and prosecute corporate wrongdoing, the bill adds civil discovery subpoenas to the existing tools that the government may use to obtain non-content information under ECPA.

In addition, the bill makes clear that the government may also continue to use administrative, civil discovery and grand jury subpoena to obtain corporate email and other electronic communications directly from a corporate entity, when those communications are contained on an internal email system. Lastly, the bill also provides that the search warrant requirement in the bill does not apply to other Federal criminal or national security laws, including Title III of the Omnibus Crime Control and Safe Streets Act of 1986, commonly known as the Wiretap Act, and the Foreign Intelligence Surveillance Act of 1978, 50 U.S.C. Sec. 1801, et seq., commonly known as FISA.

Since I first put forward proposals to update ECPA in early 2011, I have worked to make sure that these updates carefully balance privacy interests, the needs of law enforcement and the interests of our thriving American tech sector. During the past 2 years, I have consulted with many stakeholders from the Federal, state and local law enforcement communities, including--the Department of Justice, the Federal Trade Commission, the Securities and Exchange Commission, the International Association of Chiefs of Police, the Federal Law Enforcement Officers Association, the Association of State Criminal Investigative Agencies, and the National Sheriffs Association. I have also consulted closely with many leaders in the privacy, civil liberties, civil rights and technology communities who support these reforms.

The 113th Congress has an important opportunity to address the digital privacy challenges that Americans face today. We should do so by enacting the commonsense privacy reforms contained in this bill.

When the Senate Judiciary Committee favorably reported the Electronic Communications Privacy Act on September 19, 1986, it did so with the unanimous support of all Democratic and Republican Senators. At the time, the Committee recognized that protecting Americans' privacy rights should not be a partisan issue.

In that bipartisan spirit, I am pleased to join with Senator Lee in urging the Congress to enact these important privacy reforms without delay. Senator Lee and I are joined in this effort by a broad coalition of more than 50 privacy, civil liberties, civil rights and tech industry leaders from across the political spectrum that have also endorsed the ECPA reform effort. I thank the Digital Due Process Coalition, the Digital 4th Coalition and the many other individuals and organizations that have advocated for ECPA reform for their support. I hope that all Members of the Senate will follow their example, so that we can enact this digital privacy bill with strong, bipartisan support.

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

Mr. President, I rise today to introduce the Supporting Colorectal Examination and Education Now, SCREEN, Act. This legislation promotes access to colon cancer screenings in an effort to help prevent colorectal cancer, save lives, and reduce costs for families, the Medicare program, and the health care system. I strongly urge my colleagues to support this critical piece of legislation.

Colorectal cancer affects far too many Americans. The rate of colon cancer deaths is shocking--taking the lives of over 50,000 people this year alone, according to the American Cancer Society.

Fortunately, colorectal cancer is highly preventable with screening, and colon cancer screening tests rank among the most effective preventive screenings available. A recent study in the New England Journal of Medicine found that removal of precancerous polyps during a screening colonoscopy may reduce colon cancer deaths by over 50 percent. Early detection and intervention are key to preventing colon cancer. Colonoscopy screenings are different from other types of preventive or screening services because pre-cancerous polyps found during a screening are removed during the same visit, thus preventing a potential cancer from developing and helping to ensure detection, intervention, and prevention.

Congress recognized the value of colon cancer screenings and, through bipartisan legislation that I authored in 1998, established a Medicate benefit for screening. The problem is that only half of individuals coveted by the Medicare program receive a screening colonoscopy, even though a Medicate

colorectal cancer screening benefit is available. According to the Centers for Medicare & Medicaid Services, CMS, Medicare claims show that only 52 percent of beneficiaries have had a colorectal cancer screening test. Many barriers account for this, including patient education on screenings and operational issues within the Medicare program, but colorectal cancer has become too widespread and we have reached the time to take action to promote prevention and save lives. Ensuring that individuals receive colorectal cancer screening tests is critical to this goal.

In addition, detection and intervention through proper colonoscopy screening should reduce costs to the Medicare program and health care system overall. Once colon cancer develops, the direct costs of treating colon cancer are starting--reaching $4 billion in 2010. A recent study published in the New England Journal of Medicine concluded that colorectal cancer screening has been shown to reduce Medicare long-term costs.

Congress must help promote access to colorectal cancer screenings and help increase the number of persons receiving these life-saving screening tests. The SCREEN Act takes many steps to increase the rate of colorectal cancer screenings and help prevent colon cancer, while also reducing Medicare costs.

The SCREEN Act first waives cost sharing for Medicare beneficiaries receiving colorectal cancer screenings where precancerous polyps are removed during the visit. Currently, Medicare waives cost-sharing for any colorectal cancer screening recommended by the U.S. Preventive Services Task Force, USPSTF. Colorectal cancer screens have a grade ``A'' recommendation by USPSTF. However, if the doctor finds and removes a precancerous polyp during the visit, the procedure is no longer considered a ``screening'' for Medicare purposes--and the beneficiary would be forced to pay the Medicare coinsurance. In February 2013, the Administration announced that private insurers participating in State-based health insurance exchanges must waive all cost sharing for colon cancers screenings where a polyp is removed. This bill promotes a similar policy by waiving Medicare cost sharing for diagnostic and screening colorectal cancer tests.

Additionally, the SCREEN Act extends Medicare coverage to include an office visit or consultation so that a Medicare beneficiary may sit down and discuss the screening with a doctor prior to the colonoscopy procedures. One of the major barriers to increasing colorectal cancer screening rates is a patient's lack of knowledge and the ``fear of the procedure.'' This pre-procedure visit is not only good clinical practice but also would help increase patient utilization of colorectal cancer screening. This visit allows the individual to ask questions about the procedure, assures selection of the proper screening test, and increases beneficiary education and test preparation. There is no reason for a Medicare beneficiary to be seeing his or her physician for the first time only just before being sedated for the procedure.

The SCREEN Act also provides incentives for Medicare providers to participate in nationally recognized quality improvement registries so that our Medicare beneficiaries are receiving the quality screening they deserve. Congress and other organizations can look to the SCREEN Act as a model for Medicare reimbursement reform as the bill reimburses providers in a budget neutral manner based on the quality of the procedure and not volume of services.

Promoting access to colorectal cancer screening will help ensure detection and intervention of this highly preventable disease and reduce costs to the health care system. I ask my colleagues to join in support of this fight to end colorectal cancer by cosponsoring this important legislation.

Mr. President, I rise today to introduce the Supporting Colorectal Examination and Education Now, SCREEN, Act. This legislation promotes access to colon cancer screenings in an effort to help prevent colorectal cancer, save lives, and reduce costs for families, the Medicare program, and the health care system. I strongly urge my colleagues to support this critical piece of legislation.

Colorectal cancer affects far too many Americans. The rate of colon cancer deaths is shocking--taking the lives of over 50,000 people this year alone, according to the American Cancer Society.

Fortunately, colorectal cancer is highly preventable with screening, and colon cancer screening tests rank among the most effective preventive screenings available. A recent study in the New England Journal of Medicine found that removal of precancerous polyps during a screening colonoscopy may reduce colon cancer deaths by over 50 percent. Early detection and intervention are key to preventing colon cancer. Colonoscopy screenings are different from other types of preventive or screening services because pre-cancerous polyps found during a screening are removed during the same visit, thus preventing a potential cancer from developing and helping to ensure detection, intervention, and prevention.

Congress recognized the value of colon cancer screenings and, through bipartisan legislation that I authored in 1998, established a Medicate benefit for screening. The problem is that only half of individuals coveted by the Medicare program receive a screening colonoscopy, even though a Medicate

colorectal cancer screening benefit is available. According to the Centers for Medicare & Medicaid Services, CMS, Medicare claims show that only 52 percent of beneficiaries have had a colorectal cancer screening test. Many barriers account for this, including patient education on screenings and operational issues within the Medicare program, but colorectal cancer has become too widespread and we have reached the time to take action to promote prevention and save lives. Ensuring that individuals receive colorectal cancer screening tests is critical to this goal.

In addition, detection and intervention through proper colonoscopy screening should reduce costs to the Medicare program and health care system overall. Once colon cancer develops, the direct costs of treating colon cancer are starting--reaching $4 billion in 2010. A recent study published in the New England Journal of Medicine concluded that colorectal cancer screening has been shown to reduce Medicare long-term costs.

Congress must help promote access to colorectal cancer screenings and help increase the number of persons receiving these life-saving screening tests. The SCREEN Act takes many steps to increase the rate of colorectal cancer screenings and help prevent colon cancer, while also reducing Medicare costs.

The SCREEN Act first waives cost sharing for Medicare beneficiaries receiving colorectal cancer screenings where precancerous polyps are removed during the visit. Currently, Medicare waives cost-sharing for any colorectal cancer screening recommended by the U.S. Preventive Services Task Force, USPSTF. Colorectal cancer screens have a grade ``A'' recommendation by USPSTF. However, if the doctor finds and removes a precancerous polyp during the visit, the procedure is no longer considered a ``screening'' for Medicare purposes--and the beneficiary would be forced to pay the Medicare coinsurance. In February 2013, the Administration announced that private insurers participating in State-based health insurance exchanges must waive all cost sharing for colon cancers screenings where a polyp is removed. This bill promotes a similar policy by waiving Medicare cost sharing for diagnostic and screening colorectal cancer tests.

Additionally, the SCREEN Act extends Medicare coverage to include an office visit or consultation so that a Medicare beneficiary may sit down and discuss the screening with a doctor prior to the colonoscopy procedures. One of the major barriers to increasing colorectal cancer screening rates is a patient's lack of knowledge and the ``fear of the procedure.'' This pre-procedure visit is not only good clinical practice but also would help increase patient utilization of colorectal cancer screening. This visit allows the individual to ask questions about the procedure, assures selection of the proper screening test, and increases beneficiary education and test preparation. There is no reason for a Medicare beneficiary to be seeing his or her physician for the first time only just before being sedated for the procedure.

The SCREEN Act also provides incentives for Medicare providers to participate in nationally recognized quality improvement registries so that our Medicare beneficiaries are receiving the quality screening they deserve. Congress and other organizations can look to the SCREEN Act as a model for Medicare reimbursement reform as the bill reimburses providers in a budget neutral manner based on the quality of the procedure and not volume of services.

Promoting access to colorectal cancer screening will help ensure detection and intervention of this highly preventable disease and reduce costs to the health care system. I ask my colleagues to join in support of this fight to end colorectal cancer by cosponsoring this important legislation.

Mr. President, today I join my colleague, Senator Kirsten Gillibrand, to introduce the Social Security Number Protection Act of 2013, a bill that would remove Social Security numbers from Medicare cards to address a leading cause of identity theft among our Nation's seniors.

It is estimated that 11.6 million Americans were victims of identity theft in 2011, up from 10.2 million in 2010. We know that the misuse of Social Security numbers is one of the primary drivers of this crime. In many of these cases, identity thieves obtain them from Medicare cards.

Today, over 49 million beneficiaries carry their Medicare cards with them in their purses and in their wallets. These cards display a Medicare identification number, which consists of their Social Security number with a one- or two-digit code at the end, leaving beneficiaries particularly vulnerable to identity theft should a card be lost, stolen, or left in plain sight.

With identity theft on the rise, we can't make it this easy for thieves. Unfortunately, the Centers for Medicare and Medicaid Service, CMS, has fallen behind many other public and private organizations in better protecting seniors from identity theft by continuing to display Social Security numbers on Medicare cards. The Department of Defense, the Veterans Administration, and private insurers have all figured out how to transition to individual identification cards that don't include Social Security numbers.

In 2005, I offered an amendment to the Fiscal Year 2006 Labor-HHS- Education appropriations bill to require CMS to remove Social Security numbers from Medicare cards. Although my amendment was adopted with a rollcall vote of 98 to 0, the final bill directed CMS to report to Congress on the steps necessary to remove the numbers. CMS provided that report in October 2006.

Six and a half years have passed since CMS first explored taking steps to remove Social Security numbers from Medicare cards. The Inspector General of the Social Security Administration took CMS to task in 2008 for its inaction and confirmed the risk that display of the numbers on Medicare cards poses to seniors. The Social Security inspector concluded that ``immediate action is needed to address this significant vulnerability.'' CMS has since issued another report, but it has failed to take action.

The Social Security Number Protection Act of 2013 establishes a reasonable timetable--3 years--for CMS to begin removing Social Security numbers from Medicare cards. It also gives CMS flexibility in determining the method by which it makes this change, enabling it to pursue an option that minimizes burdens while maximizing cost effectiveness. The bill also prohibits CMS from displaying Social Security numbers on all written and electronic communications to Medicare beneficiaries.

I urge my colleagues to cosponsor this important legislation and work with me to advance this long overdue change. CMS already requires that beneficiaries receiving benefits through Medicare Part C and Part D do not display individuals' Social Security numbers. Further, it has 6 years' worth of reports and cost data that it can use as tools to make these changes happen. We should extend this protection to all beneficiaries and help safeguard our Nation's seniors from becoming victims of identity theft in the future as quickly as possible.

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