E PL UR UM IB N U U S Congressional Record th of America PROCEEDINGS AND DEBATES OF THE 113 CONGRESS, SECOND SESSION

Vol. 160 , FRIDAY, MARCH 14, 2014 No. 43 House of Representatives The House met at 9 a.m. and was Pursuant to clause 1, rule I, the Jour- What is sad is that this is just one of called to order by the Speaker pro tem- nal stands approved. many things that has made this Presi- pore (Mr. RIBBLE). f dent and his administration an abso- lute failure. What is unfortunate is the f PLEDGE OF ALLEGIANCE American people are the ones that are DESIGNATION OF THE SPEAKER The SPEAKER pro tempore. Will the having to pay for his mistakes. I, for PRO TEMPORE gentleman from Oklahoma (Mr. one, have had enough. MULLIN) come forward and lead the The SPEAKER pro tempore laid be- f fore the House the following commu- House in the Pledge of Allegiance. Mr. MULLIN led the Pledge of Alle- HONORING THE LIFE OF ERNEST nication from the Speaker: giance as follows: J. REYES WASHINGTON, DC, I pledge allegiance to the Flag of the ´ March 14, 2014 (Mr. CARDENAS asked and was United States of America, and to the Repub- I hereby appoint the Honorable REID J. given permission to address the House lic for which it stands, one nation under God, RIBBLE to act as Speaker pro tempore on this indivisible, with liberty and justice for all. for 1 minute and to revise and extend day. his remarks.) JOHN A. BOEHNER, f Mr. CA´ RDENAS. Mr. Speaker, I rise Speaker of the House of Representatives. ANNOUNCEMENT BY THE SPEAKER today in honor of the life and legacy of f PRO TEMPORE a very positive man, my friend, Ernest PRAYER The SPEAKER pro tempore. The J. Reyes, who passed away recently at Chair will entertain up to 5 requests the age of 73. Though Mr. Reyes is sore- The Chaplain, the Reverend Patrick ly missed by friends and family, I know J. Conroy, offered the following prayer: for 1-minute speeches on each side of the aisle. his legacy will endure. Compassionate and merciful God, we Ernest J. Reyes was a native of give You thanks for giving us another f Madera, . He was dedicated day. WE ALL KNOW THAT OBAMACARE to the California real estate commu- During the upcoming week of con- IS AN ABSOLUTE FAILURE nity and used his knowledge to help stituency visits, give the Members of (Mr. MULLIN asked and was given families thrive and realize the Amer- this assembly insight, inspiration, and permission to address the House for 1 ican Dream of homeownership. industry to work for the good of our minute.) He cofounded the National Associa- country. Sustain our citizens with Mr. MULLIN. Mr. Speaker, time and tion of Hispanic Real Estate Profes- Your power, that they might be true to time again, we have been reassured by sionals and advocated for Spanish lan- the highest and best they know and are this administration that ObamaCare is guage services and documents for His- able to achieve. working, but when I talk to my con- panic homeownership. Mr. Reyes was As Members visit with those whom stituents in Oklahoma’s Second Dis- also an exceptional public servant, they represent, may solutions that trict, this is not the case. When I read holding various roles throughout his work toward the betterment of all in the news headlines and discover yet an- long career. our Nation emerge in open and respect- other delay in ObamaCare, this is not I extend my sincerest condolences to ful conversation. the case. his wife of 50 years, Patricia Pedregon May the assurance of Your love and Even this week, this administration Reyes, along with his children, Denise the presence of Your truth abide in all was unable to provide—you know, I am Johnson and Daren Reyes, and his our hearts and all our homes. up here, and I am reading talking three grandchildren. And may all that is done be for Your points to you that you have heard over Mr. Reyes was an inspiration, and I greater honor and glory. and over and over again, and yet we all know his loss will be felt by many, in- Amen. know that ObamaCare is an absolute cluding the 29th Congressional Dis- f failure. trict. We all know that. The media knows f THE JOURNAL that. This President knows that; and The SPEAKER pro tempore. The yet, he continues to force it down the POLAR PLUNGE FOR SPECIAL Chair has examined the Journal of the throat of the American people, just be- OLYMPICS last day’s proceedings and announces cause it is his signature piece of legis- (Mr. PAULSEN asked and was given to the House his approval thereof. lation. permission to address the House for 1

b This symbol represents the time of day during the House proceedings, e.g., b 1407 is 2:07 p.m. Matter set in this typeface indicates words inserted or appended, rather than spoken, by a Member of the House on the floor.

H2437

.

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00001 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.000 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2438 CONGRESSIONAL RECORD — HOUSE March 14, 2014 minute and to revise and extend his re- Mr. FLEISCHMANN. Mr. Speaker, Time and time again, we have seen marks.) today, I rise to honor America’s teach- President Obama stretch the constitu- Mr. PAULSEN. Mr. Speaker, last ers. I do that because I spoke with my tional limits of the office. When Presi- Saturday, I had the opportunity to cel- 17-year-old son, who is a junior at dent Obama simply disagrees with a ebrate the cold winter in by Silverdale Baptist Academy, and he law, he just ignores it. Mr. Speaker, no getting together with hundreds of oth- was asking me about teachers. person is above the law. ers and jumping through a hole in the Now, most of you all know I had two The House of Representatives is com- ice and into a freezing lake. elementary schools, three middle mitted to living by the Constitution Now, while some may think that schools, and two high schools in my and holding the administration ac- many Minnesotans consider this nor- own career. I told my son how impor- countable. The ENFORCE Act will give mal recreational activity in the winter, tant teaching is. Just think about it: Congress the ability to bring a lawsuit it actually was to raise money for a all across America today and in all of against the President for failing to exe- very worthwhile cause. our 50 States, teachers are teaching cute our laws. The Polar Plunge, which takes place and inspiring our children. The Faithful Execution of the Law throughout Minnesota and other areas Education is critically important, Act will require any Federal official of the country all winter long, raises whether it is in the private sector or in who is not enforcing a Federal law to millions of dollars for the Special the public sector. It is so critically im- report to Congress on the reason for Olympics programs. This important portant that we get it right, and teach- nonenforcement. Mr. Speaker, the EN- funding allows more than 7,200 Special FORCE Act and the Faithful Execution Olympics athletes in Minnesota to ing is such a noble profession. I wanted to rise today, Mr. Speaker, of the Law Act uphold the Constitu- grow and thrive through a variety of tion. competitions. and just say thank you to our Nation’s teachers. Keep up the great work. Keep These bills send a clear message that I want to thank our State’s law en- no one is above the law, and we will forcement for organizing the plunges, inspiring our young minds, so that we can continue to move ahead as a great not have the Constitution be dis- Channel 9’s Ian Leonard for giving his regarded. selfless time and energy to support this Nation. f cause and events, to all those who f pledged their support for the partici- THOMSON PRISON TUBEROUS SCLEROSIS COMPLEX pants, and of course, those who are (Mr. MCNERNEY asked and was (Mrs. BUSTOS asked and was given crazy enough to jump in the middle of given permission to address the House permission to address the House for 1 the winter through a hole in the ice. for 1 minute.) minute.) Mr. Speaker, I want to offer and con- Mr. MCNERNEY. Mr. Speaker, I ask Mrs. BUSTOS. Mr. Speaker, I rise gratulate the support for the Special my colleagues to join me in supporting today to talk about the Thomson Cor- Olympics, an organization that is truly the important research being done at rectional Center, a facility that has sat life-changing for its participants and the Department of Defense into treat- vacant in the town of Thomson, a their families. ing tuberous sclerosis complex or TSC. f small village in northern , since Individuals with TSC experience tu- it was built by the State of Illinois in GIRL SCOUTS mors in the brain and other vital or- 2001. gans, which can result in seizures, kid- (Mr. TONKO asked and was given For more than a decade, the people of ney failure, and other serious health permission to address the House for 1 my region have been thirsting for the problems. I have had the opportunity minute and to revise and extend his re- jobs and the economic opportunity to meet with people affected by this ill- marks.) that the opening of this facility would ness and understand how critical it is Mr. TONKO. Mr. Speaker, I rise bring. today to celebrate and honor the serv- to continue medical research into Yesterday, we received the very good treatments while scientists develop a ice of our Nation’s Girl Scouts. news that we had been waiting for, for On this week, more than 100 years cure for TSC. a long time. This was delivered to us Funding the DOD TSC research pro- ago, Juliette ‘‘Daisy’’ Gordon Low offi- from the Bureau of Prisons, which an- cially registered the Girl Scouts’ first gram is essential in developing new nounced that they will designate the clinical treatments and medical break- 18 members. Since that time, the Girl funding to activate the Thomson Cor- Scouts experience has enriched the throughs for the disorder. In addition, rectional Center. lives of millions of girls, their families, this research has applications for other This investment means construction and our communities. medical conditions, such as traumatic I am especially proud to highlight can soon begin. It means that workers brain injuries, which are common in the hard work of Felicia Dodge, a Girl can soon begin competing for good-pay- combat and sports injuries. TSC re- Scout from Glenville, New York. ing jobs, and it means that northern Il- search breakthroughs will likely also Felicia is currently working on her linois will no longer be home to an have applications to some specific can- Gold Award project to help create a empty prison. cers. sustainable sewing program at a local When fully open, the Thomson Cor- By committing support and funding school in Haiti. rectional Center will add 1,100 jobs to for this important research, we give Felicia’s project empowers the com- our region and will add $200 million in hope to those living with TSC and munity to clothe themselves and hone annual economic impact. The prison’s other chronic illnesses to help them the skills to run a sustainable business. activation will not only be good for our live long and healthy lives. economy, but it will also generate a Her hard work and certainly her in- f volvement will send over 600 pounds of sense of pride among the people I serve SITES RESERVOIR materials and supplies to the school. I in the surrounding communities. We fi- applaud Felicia for her thoughtful and nally will see the dormant facility put (Mr. LAMALFA asked and was given certainly inspiring endeavor. to good use. permission to address the House for 1 On behalf of the citizens of the 20th f minute.) Congressional District of New York, I Mr. LAMALFA. Mr. Speaker, Cali- REINING IN EXECUTIVE fornia is suffering from its worst thank the Girl Scouts of northeastern OVERREACH New York for their commitment and drought in at least 35 years, maybe as for their service to our communities. (Mr. SMITH of Missouri asked and much as 400 years; though lately, the was given permission to address the f Good Lord has sought to bless us with House for 1 minute and to revise and about 5 inches of rain on my farm and EDUCATION IS CRITICALLY extend his remarks.) my neighborhood, we can’t let that be IMPORTANT Mr. SMITH of Missouri. Mr. Speaker, a cause for inaction. Indeed, the Good (Mr. FLEISCHMANN asked and was President Obama and the administra- Lord helps those who help themselves. given permission to address the House tion have taken the uber-Presidency to It is time to build. It has been time for 1 minute.) a whole new level. to build, for a long time, the type of

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00002 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.003 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2439 water storage that moves California Social Security Act to repeal the Medi- ‘‘(16) UPDATE FOR 2019 THROUGH 2023.—The ahead and supplies farms, cities, and care sustainable growth rate and im- update to the single conversion factor estab- environmental needs. prove Medicare payments for physi- lished in paragraph (1)(C) for 2019 and each We have this opportunity in a project cians and other professionals, and for subsequent year through 2023 shall be zero percent. that has long awaited our authoriza- other purposes to amend section 530D ‘‘(17) UPDATE FOR 2024 AND SUBSEQUENT tion, the Sites Reservoir in the western of title 28, United States Code, and ask YEARS.—The update to the single conversion part of Colusa and Glenn Counties, a for its immediate consideration in the factor established in paragraph (1)(C) for 2024 district that I used to represent in the House. and each subsequent year shall be— State legislature and which my col- The Clerk read the title of the bill. ‘‘(A) for items and services furnished by a league, JOHN GARAMENDI, now rep- The SPEAKER pro tempore. Pursu- qualifying APM participant (as defined in resents in Congress. ant to House Resolution 515, the section 1833(z)(2)) for such year, 1.0 percent; We will soon be introducing a piece of amendment printed in part B of House and ‘‘(B) for other items and services, 0.5 per- legislation to move forward on the Report 113–379 is adopted and the bill, cent.’’. Sites Reservoir with an authorization as amended, is considered read. (3) MEDPAC REPORTS.— for the funds needed to complete the The text of the bill, as amended, is as (A) INITIAL REPORT.—Not later than July 1, studies and get started. follows: 2016, the Medicare Payment Advisory Com- Some may say: Well, it will take 7 or H.R. 4015 mission shall submit to Congress a report on 10 years to get this done. Be it enacted by the Senate and House of Rep- the relationship between— Had we started 7 or 10 years ago, we resentatives of the United States of America in (i) physician and other health professional would be right near completion; so we Congress assembled, utilization and expenditures (and the rate of increase of such utilization and expendi- SECTION 1. SHORT TITLE; TABLE OF CONTENTS. need to start today, and the people will tures) of items and services for which pay- (a) SHORT TITLE.—This Act may be cited as thank us 7 or 10 years from now when ment is made under section 1848 of the Social the ‘‘SGR Repeal and Medicare Provider we get this done. This will be intro- Security Act (42 U.S.C. 1395w–4); and Payment Modernization Act of 2014’’. duced, hopefully, soon. (ii) total utilization and expenditures (and (b) TABLE OF CONTENTS.—The table of con- the rate of increase of such utilization and f tents of this Act is as follows: expenditures) under parts A, B, and D of title b 0915 Sec. 1. Short title; table of contents. XVIII of such Act. Sec. 2. Repealing the sustainable growth MILITARY TRANSITION SUPPORT rate (SGR) and improving Medi- Such report shall include a methodology to describe such relationship and the impact of PROJECT care payment for physicians’ services. changes in such physician and other health (Mr. PETERS of California asked and Sec. 3. Priorities and funding for measure professional practice and service ordering was given permission to address the development. patterns on total utilization and expendi- House for 1 minute.) Sec. 4. Encouraging care management for tures under parts A, B, and D of such title. Mr. PETERS of California. Mr. individuals with chronic care (B) FINAL REPORT.—Not later than July 1, needs. 2020, the Medicare Payment Advisory Com- Speaker, I rise today to highlight the mission shall submit to Congress a report on Military Transition Support Project, Sec. 5. Ensuring accurate valuation of serv- ices under the physician fee the relationship described in subparagraph an innovative program to ease the schedule. (A), including the results determined from transition for recently discharged vet- Sec. 6. Promoting evidence-based care. applying the methodology included in the re- erans as they return to civilian life, Sec. 7. Empowering beneficiary choices port submitted under such subparagraph. which I helped launch last month. through access to information (C) REPORT ON UPDATE TO PHYSICIANS’ SERV- Each year, over 15,000 servicemem- on physicians’ services. ICES UNDER MEDICARE.—Not later than July 1, bers are discharged in San Diego, and Sec. 8. Expanding availability of Medicare 2018, the Medicare Payment Advisory Com- data. mission shall submit to Congress a report around half will choose to stay there. on— Over the past year, we have worked Sec. 9. Reducing administrative burden and other provisions. (i) the payment update for professional with our local veteran leadership, our SEC. 2. REPEALING THE SUSTAINABLE GROWTH services applied under the Medicare program Navy and Marine commanders, and the RATE (SGR) AND IMPROVING MEDI- under title XVIII of the Social Security Act San Diego philanthropic community to CARE PAYMENT FOR PHYSICIANS’ for the period of years 2014 through 2018; create a central system to help service- SERVICES. (ii) the effect of such update on the effi- members navigate through their tran- (a) STABILIZING FEE UPDATES.— ciency, economy, and quality of care pro- sition process. (1) REPEAL OF SGR PAYMENT METHOD- vided under such program; OLOGY.—Section 1848 of the Social Security (iii) the effect of such update on ensuring a This unique effort will improve the Act (42 U.S.C. 1395w–4) is amended— sufficient number of providers to maintain quality of life for servicemembers (A) in subsection (d)— access to care by Medicare beneficiaries; and across San Diego. The program will (i) in paragraph (1)(A), by inserting ‘‘or a (iv) recommendations for any future pay- begin in the last year of service and subsequent paragraph’’ after ‘‘paragraph ment updates for professional services under will give these dedicated men and (4)’’; and such program to ensure adequate access to women access to resources and contin- (ii) in paragraph (4)— care is maintained for Medicare bene- uous support throughout the transition (I) in the heading, by inserting ‘‘AND END- ficiaries. process, beginning while they are still ING WITH 2013’’ after ‘‘YEARS BEGINNING WITH (b) CONSOLIDATION OF CERTAIN CURRENT 2001’’; and LAW PERFORMANCE PROGRAMS WITH NEW in uniform, by providing a central por- (II) in subparagraph (A), by inserting ‘‘and MERIT-BASED INCENTIVE PAYMENT SYSTEM.— tal for benefits, employment, and hous- ending with 2013’’ after ‘‘a year beginning (1) EHR MEANINGFUL USE INCENTIVE PRO- ing. with 2001’’; and GRAM.— This program has the potential to (B) in subsection (f)— (A) SUNSETTING SEPARATE MEANINGFUL USE serve as a model for military commu- (i) in paragraph (1)(B), by inserting PAYMENT ADJUSTMENTS.—Section nities around the country. It rep- ‘‘through 2013’’ after ‘‘of each succeeding 1848(a)(7)(A) of the Social Security Act (42 resents a groundbreaking, collabo- year’’; and U.S.C. 1395w–4(a)(7)(A)) is amended— rative effort where the military, non- (ii) in paragraph (2), in the matter pre- (i) in clause (i), by striking ‘‘or any subse- ceding subparagraph (A), by inserting ‘‘and quent payment year’’ and inserting ‘‘or profits, and private sector stakeholders ending with 2013’’ after ‘‘beginning with 2017’’; can come together in the cooperative 2000’’. (ii) in clause (ii)— spirit that is a hallmark of San Diego (2) UPDATE OF RATES FOR APRIL THROUGH (I) in the matter preceding subclause (I), to get our veterans to work. DECEMBER OF 2014, 2015, AND SUBSEQUENT by striking ‘‘Subject to clause (iii), for’’ and f YEARS.—Subsection (d) of section 1848 of the inserting ‘‘For’’; Social Security Act (42 U.S.C. 1395w–4) is (II) in subclause (I), by adding at the end SGR REPEAL AND MEDICARE PRO- amended by striking paragraph (15) and in- ‘‘and’’; VIDER PAYMENT MODERNIZA- serting the following new paragraphs: (III) in subclause (II), by striking ‘‘; and’’ TION ACT OF 2014 ‘‘(15) UPDATE FOR 2014 THROUGH 2018.—The and inserting a period; and update to the single conversion factor estab- (IV) by striking subclause (III); and Mr. PITTS. Mr. Speaker, pursuant to lished in paragraph (1)(C) for 2014 and each (iii) by striking clause (iii). House Resolution 515, I call up the bill subsequent year through 2018 shall be 0.5 per- (B) CONTINUATION OF MEANINGFUL USE DE- (H.R. 4015) to amend title XVIII of the cent. TERMINATIONS FOR MIPS.—Section 1848(o)(2) of

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00003 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.003 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2440 CONGRESSIONAL RECORD — HOUSE March 14, 2014

the Social Security Act (42 U.S.C. 1395w– ‘‘(C) CONTINUED APPLICATION FOR PURPOSES volume threshold measurement selected 4(o)(2)) is amended— OF MIPS.—The Secretary shall, in accordance under clause (iv). (i) in subparagraph (A), in the matter pre- with subsection (q)(1)(F), carry out subpara- ‘‘(iii) PARTIAL QUALIFYING APM PARTICI- ceding clause (i)— graph (B) for purposes of subsection (q).’’; PANT.—For purposes of this subparagraph, (I) by striking ‘‘For purposes of paragraph and the term ‘partial qualifying APM partici- (1), an’’ and inserting ‘‘An’’; and (ii) in paragraph (3), by adding at the end pant’ means, with respect to a year, an eligi- (II) by inserting ‘‘, or pursuant to subpara- the following: ‘‘With respect to 2018 and each ble professional for whom the Secretary de- graph (D) for purposes of subsection (q), for subsequent year, the Secretary shall, in ac- termines the minimum payment percentage a performance period under such subsection cordance with subsection (q)(1)(F), carry out (or percentages), as applicable, described in for a year’’ after ‘‘under such subsection for this paragraph for purposes of subsection paragraph (2) of section 1833(z) for such year a year’’; and (q).’’. have not been satisfied, but who would be (c) MERIT-BASED INCENTIVE PAYMENT SYS- (ii) by adding at the end the following new considered a qualifying APM participant (as TEM.— subparagraph: defined in such paragraph) for such year if— (1) IN GENERAL.—Section 1848 of the Social ‘‘(D) CONTINUED APPLICATION FOR PURPOSES Security Act (42 U.S.C. 1395w–4) is amended ‘‘(I) with respect to 2018 and 2019, the ref- OF MIPS.—With respect to 2018 and each sub- by adding at the end the following new sub- erence in subparagraph (A) of such paragraph sequent payment year, the Secretary shall, section: to 25 percent was instead a reference to 20 for purposes of subsection (q) and in accord- ‘‘(q) MERIT-BASED INCENTIVE PAYMENT SYS- percent; ance with paragraph (1)(F) of such sub- TEM.— ‘‘(II) with respect to 2020 and 2021— section, determine whether an eligible pro- ‘‘(1) ESTABLISHMENT.— ‘‘(aa) the reference in subparagraph (B)(i) fessional who is a MIPS eligible professional ‘‘(A) IN GENERAL.—Subject to the suc- of such paragraph to 50 percent was instead (as defined in subsection (q)(1)(C)) for such ceeding provisions of this subsection, the a reference to 40 percent; and year is a meaningful EHR user under this Secretary shall establish an eligible profes- ‘‘(bb) the references in subparagraph (B)(ii) paragraph for the performance period under sional Merit-based Incentive Payment Sys- of such paragraph to 50 percent and 25 per- subsection (q) for such year.’’. tem (in this subsection referred to as the cent of such paragraph were instead ref- (2) QUALITY REPORTING.— ‘MIPS’) under which the Secretary shall— erences to 40 percent and 20 percent, respec- (A) SUNSETTING SEPARATE QUALITY REPORT- ‘‘(i) develop a methodology for assessing tively; and ING INCENTIVES.—Section 1848(a)(8)(A) of the the total performance of each MIPS eligible ‘‘(III) with respect to 2022 and subsequent Social Security Act (42 U.S.C. 1395w– professional according to performance stand- years— 4(a)(8)(A)) is amended— ards under paragraph (3) for a performance ‘‘(aa) the reference in subparagraph (C)(i) (i) in clause (i), by striking ‘‘or any subse- period (as established under paragraph (4)) of such paragraph to 75 percent was instead quent year’’ and inserting ‘‘or 2017’’; and for a year; a reference to 50 percent; and (ii) in clause (ii)(II), by striking ‘‘and each ‘‘(ii) using such methodology, provide for a ‘‘(bb) the references in subparagraph (C)(ii) subsequent year’’. composite performance score in accordance of such paragraph to 75 percent and 25 per- (B) CONTINUATION OF QUALITY MEASURES with paragraph (5) for each such professional cent of such paragraph were instead ref- AND PROCESSES FOR MIPS.—Section 1848 of the for each performance period; and erences to 50 percent and 20 percent, respec- Social Security Act (42 U.S.C. 1395w–4) is ‘‘(iii) use such composite performance tively. amended— score of the MIPS eligible professional for a ‘‘(iv) SELECTION OF LOW-VOLUME THRESHOLD (i) in subsection (k), by adding at the end performance period for a year to determine MEASUREMENT.—The Secretary shall select a the following new paragraph: and apply a MIPS adjustment factor (and, as low-volume threshold to apply for purposes ‘‘(9) CONTINUED APPLICATION FOR PURPOSES applicable, an additional MIPS adjustment of clause (ii)(III), which may include one or OF MIPS AND FOR CERTAIN PROFESSIONALS VOL- factor) under paragraph (6) to the profes- more or a combination of the following: UNTEERING TO REPORT.—The Secretary shall, sional for the year. ‘‘(I) The minimum number (as determined in accordance with subsection (q)(1)(F), ‘‘(B) PROGRAM IMPLEMENTATION.—The by the Secretary) of individuals enrolled carry out the provisions of this subsection— MIPS shall apply to payments for items and under this part who are treated by the eligi- ‘‘(A) for purposes of subsection (q); and services furnished on or after January 1, 2018. ble professional for the performance period ‘‘(B) for eligible professionals who are not ‘‘(C) MIPS ELIGIBLE PROFESSIONAL DE- involved. MIPS eligible professionals (as defined in FINED.— ‘‘(II) The minimum number (as determined subsection (q)(1)(C)) for the year involved.’’; ‘‘(i) IN GENERAL.—For purposes of this sub- by the Secretary) of items and services fur- and section, subject to clauses (ii) and (iv), the nished to individuals enrolled under this part (ii) in subsection (m)— term ‘MIPS eligible professional’ means— by such professional for such performance (I) by redesignating paragraph (7) added by ‘‘(I) for the first and second years for which period. section 10327(a) of Public Law 111–148 as the MIPS applies to payments (and for the paragraph (8); and performance period for such first and second ‘‘(III) The minimum amount (as deter- (II) by adding at the end the following new year), a physician (as defined in section mined by the Secretary) of allowed charges paragraph: 1861(r)), a physician assistant, nurse practi- billed by such professional under this part for such performance period. ‘‘(9) CONTINUED APPLICATION FOR PURPOSES tioner, and clinical nurse specialist (as such ‘‘(v) TREATMENT OF NEW MEDICARE EN- OF MIPS AND FOR CERTAIN PROFESSIONALS VOL- terms are defined in section 1861(aa)(5)), and ROLLED ELIGIBLE PROFESSIONALS UNTEERING TO REPORT.—The Secretary shall, a certified registered nurse anesthetist (as .—In the case in accordance with subsection (q)(1)(F), defined in section 1861(bb)(2)) and a group of a professional who first becomes a Medi- carry out the processes under this sub- that includes such professionals; and care enrolled eligible professional during the section— ‘‘(II) for the third year for which the MIPS performance period for a year (and had not ‘‘(A) for purposes of subsection (q); and applies to payments (and for the perform- previously submitted claims under this title ‘‘(B) for eligible professionals who are not ance period for such third year) and for each such as a person, an entity, or a part of a MIPS eligible professionals (as defined in succeeding year (and for the performance pe- physician group or under a different billing subsection (q)(1)(C)) for the year involved.’’. riod for each such year), the professionals de- number or tax identifier), such professional (3) VALUE-BASED PAYMENTS.— scribed in subclause (I) and such other eligi- shall not be treated under this subsection as (A) SUNSETTING SEPARATE VALUE-BASED ble professionals (as defined in subsection a MIPS eligible professional until the subse- PAYMENTS.—Clause (iii) of section (k)(3)(B)) as specified by the Secretary and a quent year and performance period for such 1848(p)(4)(B) of the Social Security Act (42 group that includes such professionals. subsequent year. U.S.C. 1395w–4(p)(4)(B)) is amended to read as ‘‘(ii) EXCLUSIONS.—For purposes of clause ‘‘(vi) CLARIFICATION.—In the case of items follows: (i), the term ‘MIPS eligible professional’ and services furnished during a year by an ‘‘(iii) APPLICATION.—The Secretary shall does not include, with respect to a year, an individual who is not a MIPS eligible profes- apply the payment modifier established eligible professional (as defined in subsection sional (including pursuant to clauses (ii) and under this subsection for items and services (k)(3)(B)) who— (v)) with respect to a year, in no case shall furnished on or after January 1, 2015, but be- ‘‘(I) is a qualifying APM participant (as de- a MIPS adjustment factor (or additional fore January 1, 2018, with respect to specific fined in section 1833(z)(2)); MIPS adjustment factor) under paragraph (6) physicians and groups of physicians the Sec- ‘‘(II) subject to clause (vii), is a partial apply to such individual for such year. retary determines appropriate. Such pay- qualifying APM participant (as defined in ‘‘(vii) PARTIAL QUALIFYING APM PARTICI- ment modifier shall not be applied for items clause (iii)) for the most recent period for PANT CLARIFICATIONS.— and services furnished on or after January 1, which data are available and who, for the ‘‘(I) TREATMENT AS MIPS ELIGIBLE PROFES- 2018.’’. performance period with respect to such SIONAL.—In the case of an eligible profes- (B) CONTINUATION OF VALUE-BASED PAYMENT year, does not report on applicable measures sional who is a partial qualifying APM par- MODIFIER MEASURES FOR MIPS.—Section and activities described in paragraph (2)(B) ticipant, with respect to a year, and who for 1848(p) of the Social Security Act (42 U.S.C. that are required to be reported by such a the performance period for such year reports 1395w–4(p)) is amended— professional under the MIPS; or on applicable measures and activities de- (i) in paragraph (2), by adding at the end ‘‘(III) for the performance period with re- scribed in paragraph (2)(B) that are required the following new subparagraph: spect to such year, does not exceed the low- to be reported by such a professional under

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00004 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2441

the MIPS, such eligible professional is con- ‘‘(A) PERFORMANCE CATEGORIES.—Under the ‘‘(i) EMPHASIZING OUTCOME MEASURES UNDER sidered to be a MIPS eligible professional MIPS, the Secretary shall use the following THE QUALITY PERFORMANCE CATEGORY.—In ap- with respect to such year. performance categories (each of which is re- plying subparagraph (B)(i), the Secretary ‘‘(II) NOT ELIGIBLE FOR QUALIFYING APM ferred to in this subsection as a performance shall, as feasible, emphasize the application PARTICIPANT PAYMENTS.—In no case shall an category) in determining the composite per- of outcome measures. eligible professional who is a partial quali- formance score under paragraph (5): ‘‘(ii) APPLICATION OF ADDITIONAL SYSTEM fying APM participant, with respect to a ‘‘(i) Quality. MEASURES.—The Secretary may use meas- year, be considered a qualifying APM partic- ‘‘(ii) Resource use. ures used for a payment system other than ipant (as defined in paragraph (2) of section ‘‘(iii) Clinical practice improvement activi- for physicians, such as measures for inpa- 1833(z)) for such year or be eligible for the ad- ties. tient hospitals, for purposes of the perform- ditional payment under paragraph (1) of such ‘‘(iv) Meaningful use of certified EHR tech- ance categories described in clauses (i) and section for such year. nology. (ii) of subparagraph (A). For purposes of the ‘‘(D) APPLICATION TO GROUP PRACTICES.— ‘‘(B) MEASURES AND ACTIVITIES SPECIFIED previous sentence, the Secretary may not ‘‘(i) IN GENERAL.—Under the MIPS: FOR EACH CATEGORY.—For purposes of para- use measures for hospital outpatient depart- ‘‘(I) QUALITY PERFORMANCE CATEGORY.—The graph (3)(A) and subject to subparagraph (C), ments, except in the case of emergency phy- Secretary shall establish and apply a process measures and activities specified for a per- sicians. that includes features of the provisions of formance period (as established under para- ‘‘(iii) GLOBAL AND POPULATION-BASED MEAS- subsection (m)(3)(C) for MIPS eligible profes- graph (4)) for a year are as follows: URES.—The Secretary may use global meas- sionals in a group practice with respect to ures, such as global outcome measures, and ‘‘(i) QUALITY.—For the performance cat- assessing performance of such group with re- population-based measures for purposes of egory described in subparagraph (A)(i), the spect to the performance category described the performance category described in sub- quality measures included in the final meas- in clause (i) of paragraph (2)(A). paragraph (A)(i). ures list published under subparagraph (D)(i) ‘‘(II) OTHER PERFORMANCE CATEGORIES.— ‘‘(iv) APPLICATION OF MEASURES AND ACTIVI- for such year and the list of quality meas- The Secretary may establish and apply a TIES TO NON-PATIENT-FACING PROFES- ures described in subparagraph (D)(vi) used process that includes features of the provi- SIONALS.—In carrying out this paragraph, sions of subsection (m)(3)(C) for MIPS eligi- by qualified clinical data registries under with respect to measures and activities spec- ble professionals in a group practice with re- subsection (m)(3)(E). ified in subparagraph (B) for performance spect to assessing the performance of such ‘‘(ii) RESOURCE USE.—For the performance categories described in subparagraph (A), the group with respect to the performance cat- category described in subparagraph (A)(ii), Secretary— egories described in clauses (ii) through (iv) the measurement of resource use for such pe- ‘‘(I) shall give consideration to the cir- of such paragraph. riod under subsection (p)(3), using the meth- cumstances of professional types (or subcat- ‘‘(ii) ENSURING COMPREHENSIVENESS OF odology under subsection (r) as appropriate, egories of those types determined by prac- GROUP PRACTICE ASSESSMENT.—The process and, as feasible and applicable, accounting tice characteristics) who typically furnish established under clause (i) shall to the ex- for the cost of drugs under part D. services that do not involve face-to-face tent practicable reflect the range of items ‘‘(iii) CLINICAL PRACTICE IMPROVEMENT AC- interaction with a patient; and and services furnished by the MIPS eligible TIVITIES.—For the performance category de- ‘‘(II) may, to the extent feasible and appro- professionals in the group practice involved. scribed in subparagraph (A)(iii), clinical priate, take into account such circumstances ‘‘(iii) CLARIFICATION.—MIPS eligible pro- practice improvement activities (as defined and apply under this subsection with respect fessionals electing to be a virtual group in subparagraph (C)(v)(III)) under subcat- to MIPS eligible professionals of such profes- under paragraph (5)(I) shall not be considered egories specified by the Secretary for such sional types or subcategories, alternative MIPS eligible professionals in a group prac- period, which shall include at least the fol- measures or activities that fulfill the goals tice for purposes of applying this subpara- lowing: of the applicable performance category. ‘‘(I) The subcategory of expanded practice graph. In carrying out the previous sentence, the access, which shall include activities such as ‘‘(E) USE OF REGISTRIES.—Under the MIPS, Secretary shall consult with professionals of same day appointments for urgent needs and the Secretary shall encourage the use of such professional types or subcategories. after hours access to clinician advice. qualified clinical data registries pursuant to ‘‘(v) CLINICAL PRACTICE IMPROVEMENT AC- ‘‘(II) The subcategory of population man- subsection (m)(3)(E) in carrying out this sub- TIVITIES.— agement, which shall include activities such section. ‘‘(I) REQUEST FOR INFORMATION.—In ini- ‘‘(F) APPLICATION OF CERTAIN PROVISIONS.— as monitoring health conditions of individ- tially applying subparagraph (B)(iii), the In applying a provision of subsection (k), uals to provide timely health care interven- Secretary shall use a request for information (m), (o), or (p) for purposes of this sub- tions or participation in a qualified clinical to solicit recommendations from stake- section, the Secretary shall— data registry. holders to identify activities described in ‘‘(i) adjust the application of such provi- ‘‘(III) The subcategory of care coordina- such subparagraph and specifying criteria for sion to ensure the provision is consistent tion, which shall include activities such as such activities. with the provisions of this subsection; and timely communication of test results, time- ‘‘(II) CONTRACT AUTHORITY FOR CLINICAL ‘‘(ii) not apply such provision to the extent ly exchange of clinical information to pa- PRACTICE IMPROVEMENT ACTIVITIES PERFORM- that the provision is duplicative with a pro- tients and other providers, and use of remote ANCE CATEGORY.—In applying subparagraph vision of this subsection. monitoring or telehealth. (B)(iii), the Secretary may contract with en- ‘‘(G) ACCOUNTING FOR RISK FACTORS.— ‘‘(IV) The subcategory of beneficiary en- tities to assist the Secretary in— ‘‘(i) RISK FACTORS.—Taking into account gagement, which shall include activities ‘‘(aa) identifying activities described in the relevant studies conducted and rec- such as the establishment of care plans for subparagraph (B)(iii); ommendations made in reports under section individuals with complex care needs, bene- ‘‘(bb) specifying criteria for such activi- 2(f)(1) of the SGR Repeal and Medicare Pro- ficiary self-management assessment and ties; and vider Payment Modernization Act of 2014, training, and using shared decision-making ‘‘(cc) determining whether a MIPS eligible the Secretary, on an ongoing basis, shall es- mechanisms. professional meets such criteria. timate how an individual’s health status and ‘‘(V) The subcategory of patient safety and ‘‘(III) CLINICAL PRACTICE IMPROVEMENT AC- other risk factors affect quality and resource practice assessment, such as through use of TIVITIES DEFINED.—For purposes of this sub- use outcome measures and, as feasible, shall clinical or surgical checklists and practice section, the term ‘clinical practice improve- incorporate information from quality and re- assessments related to maintaining certifi- ment activity’ means an activity that rel- source use outcome measurement (including cation. evant eligible professional organizations and care episode and patient condition groups) ‘‘(VI) The subcategory of participation in other relevant stakeholders identify as im- into the MIPS. an alternative payment model (as defined in proving clinical practice or care delivery and ‘‘(ii) ACCOUNTING FOR OTHER FACTORS IN section 1833(z)(3)(C)). that the Secretary determines, when effec- PAYMENT ADJUSTMENTS.—Taking into ac- In establishing activities under this clause, tively executed, is likely to result in im- count the studies conducted and rec- the Secretary shall give consideration to the proved outcomes. ommendations made in reports under section circumstances of small practices (consisting ‘‘(D) ANNUAL LIST OF QUALITY MEASURES 2(f)(1) of the SGR Repeal and Medicare Pro- of 15 or fewer professionals) and practices lo- AVAILABLE FOR MIPS ASSESSMENT.— vider Payment Modernization Act of 2014 and cated in rural areas and in health profes- ‘‘(i) IN GENERAL.—Under the MIPS, the Sec- other information as appropriate, the Sec- sional shortage areas (as designated under retary, through notice and comment rule- retary shall account for identified factors section 332(a)(1)(A) of the Public Health making and subject to the succeeding with an effect on quality and resource use Service Act). clauses of this subparagraph, shall, with re- outcome measures when determining pay- ‘‘(iv) MEANINGFUL EHR USE.—For the per- spect to the performance period for a year, ment adjustments, composite performance formance category described in subpara- establish an annual final list of quality scores, scores for performance categories, or graph (A)(iv), the requirements established measures from which MIPS eligible profes- scores for measures or activities under the for such period under subsection (o)(2) for de- sionals may choose for purposes of assess- MIPS. termining whether an eligible professional is ment under this subsection for such perform- ‘‘(2) MEASURES AND ACTIVITIES UNDER PER- a meaningful EHR user. ance period. Pursuant to the previous sen- FORMANCE CATEGORIES.— ‘‘(C) ADDITIONAL PROVISIONS.— tence, the Secretary shall—

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00005 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2442 CONGRESSIONAL RECORD — HOUSE March 14, 2014

‘‘(I) not later than November 1 of the year ‘‘(vii) EXCEPTION FOR EXISTING QUALITY ‘‘(ii) ENCOURAGING USE OF CERTIFIED EHR prior to the first day of the first performance MEASURES.—Any quality measure specified TECHNOLOGY AND QUALIFIED CLINICAL DATA period under the MIPS, establish and publish by the Secretary under subsection (k) or (m), REGISTRIES FOR REPORTING QUALITY MEAS- in the Federal Register a final list of quality including under subsection (m)(3)(E), and URES.—Under the methodology established measures; and any measure of quality of care established under subparagraph (A), the Secretary ‘‘(II) not later than November 1 of the year under subsection (p)(2) for the reporting pe- shall— prior to the first day of each subsequent per- riod under the respective subsection begin- ‘‘(I) encourage MIPS eligible professionals formance period, update the final list of ning before the first performance period to report on applicable measures with re- quality measures from the previous year under the MIPS— spect to the performance category described (and publish such updated final list in the ‘‘(I) shall not be subject to the require- in paragraph (2)(A)(i) through the use of cer- Federal Register), by— ments under clause (i) (except under items tified EHR technology and qualified clinical ‘‘(aa) removing from such list, as appro- (aa) and (cc) of subclause (II) of such clause) data registries; and priate, quality measures, which may include or to the requirement under clause (iv); and ‘‘(II) with respect to a performance period, the removal of measures that are no longer ‘‘(II) shall be included in the final list of with respect to a year, for which a MIPS eli- meaningful (such as measures that are quality measures published under clause (i) gible professional reports such measures topped out); unless removed under clause (i)(II)(aa). through the use of such EHR technology, ‘‘(bb) adding to such list, as appropriate, ‘‘(viii) CONSULTATION WITH RELEVANT ELIGI- treat such professional as satisfying the clin- new quality measures; and BLE PROFESSIONAL ORGANIZATIONS AND OTHER ical quality measures reporting requirement ‘‘(cc) determining whether or not quality RELEVANT STAKEHOLDERS.—Relevant eligible described in subsection (o)(2)(A)(iii) for such measures on such list that have undergone professional organizations and other rel- year. substantive changes should be included in evant stakeholders, including State and na- ‘‘(C) CLINICAL PRACTICE IMPROVEMENT AC- the updated list. tional medical societies, shall be consulted TIVITIES PERFORMANCE SCORE.— ‘‘(ii) CALL FOR QUALITY MEASURES.— in carrying out this subparagraph. ‘‘(i) RULE FOR ACCREDITATION.—A MIPS eli- ‘‘(I) IN GENERAL.—Eligible professional or- ‘‘(ix) OPTIONAL APPLICATION.—The process gible professional who is in a practice that is ganizations and other relevant stakeholders under section 1890A is not required to apply certified as a patient-centered medical home shall be requested to identify and submit to the selection of measures under this sub- or comparable specialty practice pursuant to quality measures to be considered for selec- paragraph. subsection (b)(8)(B)(i) with respect to a per- tion under this subparagraph in the annual ‘‘(3) PERFORMANCE STANDARDS.— formance period shall be given the highest list of quality measures published under ‘‘(A) ESTABLISHMENT.—Under the MIPS, potential score for the performance category clause (i) and to identify and submit updates the Secretary shall establish performance described in paragraph (2)(A)(iii) for such pe- to the measures on such list. For purposes of standards with respect to measures and ac- riod. the previous sentence, measures may be sub- tivities specified under paragraph (2)(B) for a ‘‘(ii) APM PARTICIPATION.—Participation mitted regardless of whether such measures performance period (as established under by a MIPS eligible professional in an alter- were previously published in a proposed rule paragraph (4)) for a year. native payment model (as defined in section or endorsed by an entity with a contract ‘‘(B) CONSIDERATIONS IN ESTABLISHING 1833(z)(3)(C)) with respect to a performance under section 1890(a). STANDARDS.—In establishing such perform- period shall earn such eligible professional a ‘‘(II) ELIGIBLE PROFESSIONAL ORGANIZATION ance standards with respect to measures and minimum score of one-half of the highest po- DEFINED.—In this subparagraph, the term ‘el- activities specified under paragraph (2)(B), tential score for the performance category igible professional organization’ means a the Secretary shall consider the following: described in paragraph (2)(A)(iii) for such professional organization as defined by na- ‘‘(i) Historical performance standards. performance period. tionally recognized multispecialty boards of ‘‘(ii) Improvement. ‘‘(iii) SUBCATEGORIES.—A MIPS eligible certification or equivalent certification ‘‘(iii) The opportunity for continued im- professional shall not be required to perform boards. provement. activities in each subcategory under para- ‘‘(iii) REQUIREMENTS.—In selecting quality ‘‘(4) PERFORMANCE PERIOD.—The Secretary graph (2)(B)(iii) or participate in an alter- measures for inclusion in the annual final shall establish a performance period (or peri- native payment model in order to achieve list under clause (i), the Secretary shall— ods) for a year (beginning with the year de- the highest potential score for the perform- ‘‘(I) provide that, to the extent practicable, scribed in paragraph (1)(B)). Such perform- ance category described in paragraph all quality domains (as defined in subsection ance period (or periods) shall begin and end (2)(A)(iii). (s)(1)(B)) are addressed by such measures; prior to the beginning of such year and be as ‘‘(D) ACHIEVEMENT AND IMPROVEMENT.— and close as possible to such year. In this sub- ‘‘(i) TAKING INTO ACCOUNT IMPROVEMENT.— ‘‘(II) ensure that such selection is con- section, such performance period (or periods) Beginning with the second year to which the sistent with the process for selection of for a year shall be referred to as the perform- MIPS applies, in addition to the achieve- measures under subsections (k), (m), and ance period for the year. ment of a MIPS eligible professional, if data (p)(2). ‘‘(5) COMPOSITE PERFORMANCE SCORE.— sufficient to measure improvement is avail- ‘‘(iv) PEER REVIEW.—Before including a new ‘‘(A) IN GENERAL.—Subject to the suc- able, the methodology developed under sub- measure or a measure described in clause ceeding provisions of this paragraph and tak- paragraph (A)— (i)(II)(cc) in the final list of measures pub- ing into account, as available and applicable, ‘‘(I) in the case of the performance score lished under clause (i) for a year, the Sec- paragraph (1)(G), the Secretary shall develop for the performance category described in retary shall submit for publication in appli- a methodology for assessing the total per- clauses (i) and (ii) of paragraph (2)(A), shall cable specialty-appropriate peer-reviewed formance of each MIPS eligible professional take into account the improvement of the journals such measure and the method for according to performance standards under professional; and developing and selecting such measure, in- paragraph (3) with respect to applicable ‘‘(II) in the case of performance scores for cluding clinical and other data supporting measures and activities specified in para- other performance categories, may take into such measure. graph (2)(B) with respect to each perform- account the improvement of the profes- ‘‘(v) MEASURES FOR INCLUSION.—The final ance category applicable to such professional sional. list of quality measures published under for a performance period (as established ‘‘(ii) ASSIGNING HIGHER WEIGHT FOR clause (i) shall include, as applicable, meas- under paragraph (4)) for a year. Using such ACHIEVEMENT.—Beginning with the fourth ures under subsections (k), (m), and (p)(2), in- methodology, the Secretary shall provide for year to which the MIPS applies, under the cluding quality measures from among— a composite assessment (using a scoring methodology developed under subparagraph ‘‘(I) measures endorsed by a consensus- scale of 0 to 100) for each such professional (A), the Secretary may assign a higher scor- based entity; for the performance period for such year. In ing weight under subparagraph (F) with re- ‘‘(II) measures developed under subsection this subsection such a composite assessment spect to the achievement of a MIPS eligible (s); and for such a professional with respect to a per- professional than with respect to any im- ‘‘(III) measures submitted under clause formance period shall be referred to as the provement of such professional applied under (ii)(I). ‘composite performance score’ for such pro- clause (i) with respect to a measure, activ- Any measure selected for inclusion in such fessional for such performance period. ity, or category described in paragraph (2). list that is not endorsed by a consensus- ‘‘(B) INCENTIVE TO REPORT; ENCOURAGING ‘‘(E) WEIGHTS FOR THE PERFORMANCE CAT- based entity shall have a focus that is evi- USE OF CERTIFIED EHR TECHNOLOGY FOR RE- EGORIES.— dence-based. PORTING QUALITY MEASURES.— ‘‘(i) IN GENERAL.—Under the methodology ‘‘(vi) EXCEPTION FOR QUALIFIED CLINICAL ‘‘(i) INCENTIVE TO REPORT.—Under the developed under subparagraph (A), subject to DATA REGISTRY MEASURES.—Measures used by methodology established under subparagraph subparagraph (F)(i) and clauses (ii) and (iii), a qualified clinical data registry under sub- (A), the Secretary shall provide that in the the composite performance score shall be de- section (m)(3)(E) shall not be subject to the case of a MIPS eligible professional who fails termined as follows: requirements under clauses (i), (iv), and (v). to report on an applicable measure or activ- ‘‘(I) QUALITY.— The Secretary shall publish the list of meas- ity that is required to be reported by the ‘‘(aa) IN GENERAL.—Subject to item (bb), ures used by such qualified clinical data reg- professional, the professional shall be treat- thirty percent of such score shall be based on istries on the Internet website of the Centers ed as achieving the lowest potential score performance with respect to the category de- for Medicare & Medicaid Services. applicable to such measure or activity. scribed in clause (i) of paragraph (2)(A). In

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00006 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2443 applying the previous sentence, the Sec- measures described in paragraph (2)(B)(i), a year result in differential payments under retary shall, as feasible, encourage the appli- analysis of the performance category de- this paragraph reflecting that— cation of outcome measures within such cat- scribed in paragraph (2)(A)(i) may include ‘‘(I) MIPS eligible professionals with com- egory. data submitted by MIPS eligible profes- posite performance scores for such year at or ‘‘(bb) FIRST 2 YEARS.—For the first and sec- sionals with respect to items and services above such performance threshold for such ond years for which the MIPS applies to pay- furnished to individuals who are not individ- year receive zero or positive incentive pay- ments, the percentage applicable under item uals entitled to benefits under part A or en- ment adjustment factors for such year in ac- (aa) shall be increased in a manner such that rolled under part B. cordance with clause (iii), with such profes- the total percentage points of the increase ‘‘(I) USE OF VOLUNTARY VIRTUAL GROUPS sionals having higher composite performance under this item for the respective year FOR CERTAIN ASSESSMENT PURPOSES.— scores receiving higher adjustment factors; equals the total number of percentage points ‘‘(i) IN GENERAL.—In the case of MIPS eligi- and by which the percentage applied under sub- ble professionals electing to be a virtual ‘‘(II) MIPS eligible professionals with com- clause (II)(bb) for the respective year is less group under clause (ii) with respect to a per- posite performance scores for such year than 30 percent. formance period for a year, for purposes of below such performance threshold for such ‘‘(II) RESOURCE USE.— applying the methodology under subpara- year receive negative payment adjustment ‘‘(aa) IN GENERAL.—Subject to item (bb), graph (A)— factors for such year in accordance with thirty percent of such score shall be based on ‘‘(I) the assessment of performance pro- clause (iv), with such professionals having performance with respect to the category de- vided under such methodology with respect lower composite performance scores receiv- scribed in clause (ii) of paragraph (2)(A). to the performance categories described in ing lower adjustment factors; ‘‘(bb) FIRST 2 YEARS.—For the first year for clauses (i) and (ii) of paragraph (2)(A) that is ‘‘(iii) in a manner such that MIPS eligible which the MIPS applies to payments, not to be applied to each such professional in professionals with composite scores de- more than 10 percent of such score shall be such group for such performance period shall scribed in clause (ii)(I) for such year, subject based on performance with respect to the be with respect to the combined performance to clauses (i) and (ii) of subparagraph (F), re- category described in clause (ii) of paragraph of all such professionals in such group for ceive a zero or positive adjustment factor on (2)(A). For the second year for which the such period; and MIPS applies to payments, not more than 15 a linear sliding scale such that an adjust- percent of such score shall be based on per- ‘‘(II) the composite score provided under ment factor of 0 percent is assigned for a formance with respect to the category de- this paragraph for such performance period score at the performance threshold and an scribed in clause (ii) of paragraph (2)(A). with respect to each such performance cat- adjustment factor of the applicable percent egory for each such MIPS eligible profes- specified in subparagraph (B) is assigned for ‘‘(III) CLINICAL PRACTICE IMPROVEMENT AC- sional in such virtual group shall be based on a score of 100; and TIVITIES.—Fifteen percent of such score shall be based on performance with respect to the the assessment of the combined performance ‘‘(iv) in a manner such that— category described in clause (iii) of para- under subclause (I) for the performance cat- ‘‘(I) subject to subclause (II), MIPS eligible graph (2)(A). egory and performance period. professionals with composite performance ‘‘(IV) MEANINGFUL USE OF CERTIFIED EHR ‘‘(ii) ELECTION OF PRACTICES TO BE A VIR- scores described in clause (ii)(II) for such TECHNOLOGY.—Twenty-five percent of such TUAL GROUP.—The Secretary shall, in accord- year receive a negative payment adjustment score shall be based on performance with re- ance with clause (iii), establish and have in factor on a linear sliding scale such that an spect to the category described in clause (iv) place a process to allow an individual MIPS adjustment factor of 0 percent is assigned for of paragraph (2)(A). eligible professional or a group practice con- a score at the performance threshold and an ‘‘(ii) AUTHORITY TO ADJUST PERCENTAGES IN sisting of not more than 10 MIPS eligible adjustment factor of the negative of the ap- CASE OF HIGH EHR MEANINGFUL USE ADOP- professionals to elect, with respect to a per- plicable percent specified in subparagraph TION.—In any year in which the Secretary es- formance period for a year, for such indi- (B) is assigned for a score of 0; and timates that the proportion of eligible pro- vidual MIPS eligible professional or all such ‘‘(II) MIPS eligible professionals with com- fessionals (as defined in subsection (o)(5)) MIPS eligible professionals in such group posite performance scores that are equal to who are meaningful EHR users (as deter- practice, respectively, to be a virtual group or greater than 0, but not greater than 1⁄4 of mined under subsection (o)(2)) is 75 percent under this subparagraph with at least one the performance threshold specified under or greater, the Secretary may reduce the other such individual MIPS eligible profes- subparagraph (D)(i) for such year, receive a percent applicable under clause (i)(IV), but sional or group practice making such an negative payment adjustment factor that is not below 15 percent. If the Secretary makes election. Such a virtual group may be based equal to the negative of the applicable per- such reduction for a year, subject to sub- on geographic areas or on provider special- cent specified in subparagraph (B) for such clauses (I)(bb) and (II)(bb) of clause (i), the ties defined by nationally recognized multi- year. percentages applicable under one or more of specialty boards of certification or equiva- ‘‘(B) APPLICABLE PERCENT DEFINED.—For subclauses (I), (II), and (III) of clause (i) for lent certification boards and such other eli- purposes of this paragraph, the term ‘appli- such year shall be increased in a manner gible professional groupings in order to cap- cable percent’ means— such that the total percentage points of the ture classifications of providers across eligi- ‘‘(i) for 2018, 4 percent; increase under this clause for such year ble professional organizations and other ‘‘(ii) for 2019, 5 percent; equals the total number of percentage points practice areas or categories. ‘‘(iii) for 2020, 7 percent; and reduced under the preceding sentence for ‘‘(iii) REQUIREMENTS.—The process under ‘‘(iv) for 2021 and subsequent years, 9 per- such year. clause (ii)— cent. ‘‘(F) CERTAIN FLEXIBILITY FOR WEIGHTING ‘‘(I) shall provide that an election under ‘‘(C) ADDITIONAL MIPS ADJUSTMENT FACTORS PERFORMANCE CATEGORIES, MEASURES, AND such clause, with respect to a performance FOR EXCEPTIONAL PERFORMANCE.— ACTIVITIES.—Under the methodology under period, shall be made before or during the be- ‘‘(i) IN GENERAL.—In the case of a MIPS eli- subparagraph (A), if there are not sufficient ginning of such performance period and may gible professional with a composite perform- measures and clinical practice improvement not be changed during such performance pe- ance score for a year at or above the addi- activities applicable and available to each riod; tional performance threshold under subpara- type of eligible professional involved, the ‘‘(II) shall provide that a practice described graph (D)(ii) for such year, in addition to the Secretary shall assign different scoring in such clause, and each MIPS eligible pro- MIPS adjustment factor under subparagraph weights (including a weight of 0)— fessional in such practice, may elect to be in (A) for the eligible professional for such ‘‘(i) which may vary from the scoring no more than one virtual group for a per- year, subject to the availability of funds weights specified in subparagraph (E), for formance period; and under clause (ii), the Secretary shall specify each performance category based on the ex- ‘‘(III) may provide that a virtual group an additional positive MIPS adjustment fac- tent to which the category is applicable to may be combined at the tax identification tor for such professional and year. Such ad- the type of eligible professional involved; number level. ditional MIPS adjustment factors shall be and ‘‘(6) MIPS PAYMENTS.— determined by the Secretary in a manner ‘‘(ii) for each measure and activity speci- ‘‘(A) MIPS ADJUSTMENT FACTOR.—Taking such that professionals having higher com- fied under paragraph (2)(B) with respect to into account paragraph (1)(G), the Secretary posite performance scores above the addi- each such category based on the extent to shall specify a MIPS adjustment factor for tional performance threshold receive higher which the measure or activity is applicable each MIPS eligible professional for a year. additional MIPS adjustment factors. and available to the type of eligible profes- Such MIPS adjustment factor for a MIPS eli- ‘‘(ii) ADDITIONAL FUNDING POOL.—For 2018 sional involved. gible professional for a year shall be in the and each subsequent year through 2023, there ‘‘(G) RESOURCE USE.—Analysis of the per- form of a percent and shall be determined— is appropriated from the Federal Supple- formance category described in paragraph ‘‘(i) by comparing the composite perform- mentary Medical Insurance Trust Fund (2)(A)(ii) shall include results from the meth- ance score of the eligible professional for $500,000,000 for MIPS payments under this odology described in subsection (r)(5), as ap- such year to the performance threshold es- paragraph resulting from the application of propriate. tablished under subparagraph (D)(i) for such the additional MIPS adjustment factors ‘‘(H) INCLUSION OF QUALITY MEASURE DATA year; under clause (i). FROM OTHER PAYERS.—In applying sub- ‘‘(ii) in a manner such that the adjustment ‘‘(D) ESTABLISHMENT OF PERFORMANCE sections (k), (m), and (p) with respect to factors specified under this subparagraph for THRESHOLDS.—

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00007 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2444 CONGRESSIONAL RECORD — HOUSE March 14, 2014

‘‘(i) PERFORMANCE THRESHOLD.—For each ‘‘(II) SCALING FACTOR LIMIT.—In no case ‘‘(i) Information regarding the perform- year of the MIPS, the Secretary shall com- may be the scaling factor applied under this ance of MIPS eligible professionals under the pute a performance threshold with respect to clause exceed 3.0. MIPS, which— which the composite performance score of ‘‘(ii) BUDGET NEUTRALITY REQUIREMENT.— ‘‘(I) shall include the composite score for MIPS eligible professionals shall be com- ‘‘(I) IN GENERAL.—Subject to clause (iii), each such MIPS eligible professional and the pared for purposes of determining adjust- the Secretary shall ensure that the esti- performance of each such MIPS eligible pro- ment factors under subparagraph (A) that mated amount described in subclause (II) for fessional with respect to each performance are positive, negative, and zero. Such per- a year is equal to the estimated amount de- category; and formance threshold for a year shall be the scribed in subclause (III) for such year. ‘‘(II) may include the performance of each mean or median (as selected by the Sec- ‘‘(II) AGGREGATE INCREASES.—The amount such MIPS eligible professional with respect retary) of the composite performance scores described in this subclause is the estimated to each measure or activity specified in for all MIPS eligible professionals with re- increase in the aggregate allowed charges re- paragraph (2)(B). spect to a prior period specified by the Sec- sulting from the application of positive ‘‘(ii) The names of eligible professionals in retary. The Secretary may reassess the se- MIPS adjustment factors under subpara- eligible alternative payment models (as de- lection under the previous sentence every 3 graph (A) (after application of the scaling fined in section 1833(z)(3)(D)) and, to the ex- years. factor described in clause (i)) to MIPS eligi- tent feasible, the names of such eligible al- ‘‘(ii) ADDITIONAL PERFORMANCE THRESHOLD ble professionals whose composite perform- ternative payment models and performance FOR EXCEPTIONAL PERFORMANCE.—In addition to the performance threshold under clause ance score for a year is above the perform- of such models. (i), for each year of the MIPS, the Secretary ance threshold under subparagraph (D)(i) for ‘‘(B) DISCLOSURE.—The information made shall compute an additional performance such year. available under this paragraph shall indi- threshold for purposes of determining the ad- ‘‘(III) AGGREGATE DECREASES.—The amount cate, where appropriate, that publicized in- ditional MIPS adjustment factors under sub- described in this subclause is the estimated formation may not be representative of the paragraph (C)(i). For each such year, the decrease in the aggregate allowed charges re- eligible professional’s entire patient popu- Secretary shall apply either of the following sulting from the application of negative lation, the variety of services furnished by methods for computing such additional per- MIPS adjustment factors under subpara- the eligible professional, or the health condi- formance threshold for such a year: graph (A) to MIPS eligible professionals tions of individuals treated. ‘‘(I) The threshold shall be the score that is whose composite performance score for a ‘‘(C) OPPORTUNITY TO REVIEW AND SUBMIT equal to the 25th percentile of the range of year is below the performance threshold CORRECTIONS.—The Secretary shall provide possible composite performance scores above under subparagraph (D)(i) for such year. for an opportunity for a professional de- the performance threshold with respect to ‘‘(iii) EXCEPTIONS.— scribed in subparagraph (A) to review, and the prior period described in clause (i). ‘‘(I) In the case that all MIPS eligible pro- submit corrections for, the information to be ‘‘(II) The threshold shall be the score that fessionals receive composite performance made public with respect to the professional is equal to the 25th percentile of the actual scores for a year that are below the perform- under such subparagraph prior to such infor- composite performance scores for MIPS eli- ance threshold under subparagraph (D)(i) for mation being made public. gible professionals with composite perform- such year, the negative MIPS adjustment ‘‘(D) AGGREGATE INFORMATION.—The Sec- ance scores at or above the performance factors under subparagraph (A) shall apply retary shall periodically post on the Physi- threshold with respect to the prior period de- with respect to such MIPS eligible profes- cian Compare Internet website aggregate in- scribed in clause (i). sionals and the budget neutrality require- formation on the MIPS, including the range ‘‘(iii) SPECIAL RULE FOR INITIAL 2 YEARS.— ment of clause (ii) shall not apply for such of composite scores for all MIPS eligible pro- With respect to each of the first two years to year. fessionals and the range of the performance which the MIPS applies, the Secretary shall, ‘‘(II) In the case that, with respect to a of all MIPS eligible professionals with re- prior to the performance period for such year, the application of clause (i) results in spect to each performance category. years, establish a performance threshold for a scaling factor equal to the maximum scal- ‘‘(10) CONSULTATION.—The Secretary shall purposes of determining MIPS adjustment ing factor specified in clause (i)(II), such consult with stakeholders in carrying out factors under subparagraph (A) and a thresh- scaling factor shall apply and the budget the MIPS, including for the identification of old for purposes of determining additional neutrality requirement of clause (ii) shall measures and activities under paragraph MIPS adjustment factors under subpara- not apply for such year. (2)(B) and the methodologies developed under graph (C)(i). Each such performance thresh- ‘‘(iv) ADDITIONAL INCENTIVE PAYMENT AD- paragraphs (5)(A) and (6) and regarding the old shall— JUSTMENTS.—In specifying the MIPS addi- use of qualified clinical data registries. Such ‘‘(I) be based on a period prior to such per- tional adjustment factors under subpara- consultation shall include the use of a re- formance periods; and graph (C)(i) for each applicable MIPS eligible quest for information or other mechanisms ‘‘(II) take into account— professional for a year, the Secretary shall determined appropriate. ‘‘(aa) data available with respect to per- ensure that the estimated increase in pay- ‘‘(11) TECHNICAL ASSISTANCE TO SMALL formance on measures and activities that ments under this part resulting from the ap- PRACTICES AND PRACTICES IN HEALTH PROFES- may be used under the performance cat- plication of such additional adjustment fac- SIONAL SHORTAGE AREAS.— egories under subparagraph (2)(B); and ‘‘(bb) other factors determined appropriate tors for MIPS eligible professionals in a year ‘‘(A) IN GENERAL.—The Secretary shall by the Secretary. shall be equal (as estimated by the Sec- enter into contracts or agreements with ap- ‘‘(E) APPLICATION OF MIPS ADJUSTMENT FAC- retary) to the additional funding pool propriate entities (such as quality improve- TORS.—In the case of items and services fur- amount for such year under subparagraph ment organizations, regional extension cen- nished by a MIPS eligible professional dur- (C)(ii). ters (as described in section 3012(c) of the ing a year (beginning with 2018), the amount ‘‘(7) ANNOUNCEMENT OF RESULT OF ADJUST- Public Health Service Act), or regional otherwise paid under this part with respect MENTS.—Under the MIPS, the Secretary health collaboratives) to offer guidance and to such items and services and MIPS eligible shall, not later than 30 days prior to January assistance to MIPS eligible professionals in professional for such year, shall be multi- 1 of the year involved, make available to practices of 15 or fewer professionals (with plied by— MIPS eligible professionals the MIPS adjust- priority given to such practices located in ‘‘(i) 1, plus ment factor (and, as applicable, the addi- rural areas, health professional shortage ‘‘(ii) the sum of— tional MIPS adjustment factor) under para- areas (as designated under in section ‘‘(I) the MIPS adjustment factor deter- graph (6) applicable to the eligible profes- 332(a)(1)(A) of such Act), and medically un- mined under subparagraph (A) divided by 100, sional for items and services furnished by derserved areas, and practices with low com- and the professional for such year. The Secretary posite scores) with respect to— ‘‘(II) as applicable, the additional MIPS ad- may include such information in the con- ‘‘(i) the performance categories described justment factor determined under subpara- fidential feedback under paragraph (12). in clauses (i) through (iv) of paragraph (2)(A); graph (C)(i) divided by 100. ‘‘(8) NO EFFECT IN SUBSEQUENT YEARS.—The or ‘‘(F) AGGREGATE APPLICATION OF MIPS AD- MIPS adjustment factors and additional ‘‘(ii) how to transition to the implementa- JUSTMENT FACTORS.— MIPS adjustment factors under paragraph (6) tion of and participation in an alternative ‘‘(i) APPLICATION OF SCALING FACTOR.— shall apply only with respect to the year in- payment model as described in section ‘‘(I) IN GENERAL.—With respect to positive volved, and the Secretary shall not take into 1833(z)(3)(C). MIPS adjustment factors under subpara- account such adjustment factors in making ‘‘(B) FUNDING FOR IMPLEMENTATION.— graph (A)(ii)(I) for eligible professionals payments to a MIPS eligible professional ‘‘(i) IN GENERAL.—For purposes of imple- whose composite performance score is above under this part in a subsequent year. menting subparagraph (A), the Secretary the performance threshold under subpara- ‘‘(9) PUBLIC REPORTING.— shall provide for the transfer from the Fed- graph (D)(i) for such year, subject to sub- ‘‘(A) IN GENERAL.—The Secretary shall, in eral Supplementary Medical Insurance Trust clause (II), the Secretary shall increase or an easily understandable format, make Fund established under section 1841 to the decrease such adjustment factors by a scal- available on the Physician Compare Internet Centers for Medicare & Medicaid Services ing factor in order to ensure that the budget website of the Centers for Medicare & Med- Program Management Account of $40,000,000 neutrality requirement of clause (ii) is met. icaid Services the following: for each of fiscal years 2015 through 2019.

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00008 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2445 Amounts transferred under this subpara- Secretary) for which payment is made under with priority for such evaluation given to graph for a fiscal year shall be available this title and that are furnished to individ- practices located in rural areas, health pro- until expended. uals, who are patients of a MIPS eligible pro- fessional shortage areas (as designated in ‘‘(ii) TECHNICAL ASSISTANCE.—Of the fessional, by another supplier or provider of section 332(a)(1)(a) of the Public Health Serv- amounts transferred pursuant to clause (i) services during the most recent period for ice Act), and medically underserved areas; for each of fiscal years 2015 through 2019, not which data are available (such as the most and less than $10,000,000 shall be made available recent three-month period), such as the (iv) provide recommendations for opti- for each such year for technical assistance to name of such providers furnishing such items mizing the use of such technical assistance small practices in health professional short- and services to such patients during such pe- funds. age areas (as so designated) and medically riod, the types of such items and services so (B) STUDY TO EXAMINE ALIGNMENT OF QUAL- underserved areas. furnished, and the dates such items and serv- ITY MEASURES USED IN PUBLIC AND PRIVATE ‘‘(12) FEEDBACK AND INFORMATION TO IM- ices were so furnished. PROGRAMS.— PROVE PERFORMANCE.— ‘‘(II) Historical data, such as averages and (i) IN GENERAL.—Not later than 18 months ‘‘(A) PERFORMANCE FEEDBACK.— other measures of the distribution if appro- after the date of the enactment of this Act, ‘‘(i) IN GENERAL.—Beginning July 1, 2016, priate, of the total, and components of, al- the Comptroller General of the United States the Secretary— lowed charges (and other figures as deter- shall submit to Congress a report that— ‘‘(I) shall make available timely (such as mined appropriate by the Secretary). (I) compares the similarities and dif- quarterly) confidential feedback to MIPS eli- ‘‘(13) REVIEW.— ferences in the use of quality measures under gible professionals on the performance of ‘‘(A) TARGETED REVIEW.—The Secretary the original Medicare fee-for-service pro- such professionals with respect to the per- shall establish a process under which a MIPS gram under parts A and B of title XVIII of formance categories under clauses (i) and (ii) eligible professional may seek an informal the Social Security Act, the Medicare Ad- of paragraph (2)(A); and review of the calculation of the MIPS adjust- vantage program under part C of such title, ‘‘(II) may make available confidential feed- ment factor applicable to such eligible pro- selected State Medicaid programs under title back to each such professional on the per- fessional under this subsection for a year. XIX of such Act, and private payer arrange- formance of such professional with respect to The results of a review conducted pursuant ments; and the performance categories under clauses to the previous sentence shall not be taken (II) makes recommendations on how to re- (iii) and (iv) of such paragraph. into account for purposes of paragraph (6) duce the administrative burden involved in ‘‘(ii) MECHANISMS.—The Secretary may use with respect to a year (other than with re- applying such quality measures. one or more mechanisms to make feedback spect to the calculation of such eligible pro- (ii) REQUIREMENTS.—The report under available under clause (i), which may include fessional’s MIPS adjustment factor for such clause (i) shall— use of a web-based portal or other mecha- year or additional MIPS adjustment factor (I) consider those measures applicable to nisms determined appropriate by the Sec- for such year) after the factors determined in individuals entitled to, or enrolled for, bene- retary. With respect to the performance cat- subparagraph (A) and subparagraph (C) of fits under such part A, or enrolled under egory described in paragraph (2)(A)(i), feed- such paragraph have been determined for such part B and individuals under the age of back under this subparagraph shall, to the such year. 65; and extent an eligible professional chooses to ‘‘(B) LIMITATION.—Except as provided for in (II) focus on those measures that comprise participate in a data registry for purposes of subparagraph (A), there shall be no adminis- the most significant component of the qual- this subsection (including registries under trative or judicial review under section 1869, ity performance category of the eligible pro- subsections (k) and (m)), be provided based section 1878, or otherwise of the following: fessional MIPS incentive program under sub- on performance on quality measures re- ‘‘(i) The methodology used to determine section (q) of section 1848 of the Social Secu- ported through the use of such registries. the amount of the MIPS adjustment factor rity Act (42 U.S.C. 1395w–4), as added by para- With respect to any other performance cat- under paragraph (6)(A) and the amount of graph (1). egory described in paragraph (2)(A), the Sec- the additional MIPS adjustment factor under (C) STUDY ON ROLE OF INDEPENDENT RISK retary shall encourage provision of feedback paragraph (6)(C)(i) and the determination of MANAGERS.—Not later than January 1, 2016, through qualified clinical data registries as such amounts. the Comptroller General of the United States described in subsection (m)(3)(E)). ‘‘(ii) The establishment of the performance shall submit to Congress a report examining ‘‘(iii) USE OF DATA.—For purposes of clause standards under paragraph (3) and the per- whether entities that pool financial risk for (i), the Secretary may use data, with respect formance period under paragraph (4). physician practices, such as independent risk to a MIPS eligible professional, from periods ‘‘(iii) The identification of measures and managers, can play a role in supporting phy- prior to the current performance period and activities specified under paragraph (2)(B) sician practices, particularly small physi- may use rolling periods in order to make il- and information made public or posted on cian practices, in assuming financial risk for lustrative calculations about the perform- the Physician Compare Internet website of the treatment of patients. Such report shall ance of such professional. the Centers for Medicare & Medicaid Serv- examine barriers that small physician prac- ‘‘(iv) DISCLOSURE EXEMPTION.—Feedback ices under paragraph (9). tices currently face in assuming financial made available under this subparagraph ‘‘(iv) The methodology developed under risk for treating patients, the types of risk shall be exempt from disclosure under sec- paragraph (5) that is used to calculate per- management entities that could assist physi- tion 552 of title 5, United States Code. formance scores and the calculation of such cian practices in participating in two-sided ‘‘(v) RECEIPT OF INFORMATION.—The Sec- scores, including the weighting of measures risk payment models, and how such entities retary may use the mechanisms established and activities under such methodology.’’. could assist with risk management and with under clause (ii) to receive information from (2) GAO REPORTS.— quality improvement activities. Such report professionals, such as information with re- (A) EVALUATION OF ELIGIBLE PROFESSIONAL shall also include an analysis of any existing spect to this subsection. MIPS.—Not later than October 1, 2019, and Oc- legal barriers to such arrangements. ‘‘(B) ADDITIONAL INFORMATION.— tober 1, 2022, the Comptroller General of the (D) STUDY TO EXAMINE RURAL AND HEALTH ‘‘(i) IN GENERAL.—Beginning July 1, 2017, United States shall submit to Congress a re- PROFESSIONAL SHORTAGE AREA ALTERNATIVE the Secretary shall make available to each port evaluating the eligible professional PAYMENT MODELS.—Not later than October 1, MIPS eligible professional information, with Merit-based Incentive Payment System 2020, and October 1, 2022, the Comptroller respect to individuals who are patients of under subsection (q) of section 1848 of the So- General of the United States shall submit to such MIPS eligible professional, about items cial Security Act (42 U.S.C. 1395w–4), as Congress a report that examines the transi- and services for which payment is made added by paragraph (1). Such report shall— tion of professionals in rural areas, health under this title that are furnished to such in- (i) examine the distribution of the com- professional shortage areas (as designated in dividuals by other suppliers and providers of posite performance scores and MIPS adjust- section 332(a)(1)(A) of the Public Health services, which may include information de- ment factors (and additional MIPS adjust- Service Act), or medically underserved areas scribed in clause (ii). Such information may ment factors) for MIPS eligible professionals to an alternative payment model (as defined be made available under the previous sen- (as defined in subsection (q)(1)(c) of such sec- in section 1833(z)(3) of the Social Security tence to such MIPS eligible professionals by tion) under such program, and patterns re- Act, as added by subsection (e)). Such report mechanisms determined appropriate by the lating to such scores and adjustment factors, shall make recommendations for removing Secretary, which may include use of a web- including based on type of provider, practice administrative barriers to practices, includ- based portal. Such information may be made size, geographic location, and patient mix; ing small practices consisting of 15 or fewer available in accordance with the same or (ii) provide recommendations for improv- professionals, in rural areas, health profes- similar terms as data are made available to ing such program; sional shortage areas, and medically under- accountable care organizations participating (iii) evaluate the impact of technical as- served areas to participation in such models. in the shared savings program under section sistance funding under section 1848(q)(11) of (3) FUNDING FOR IMPLEMENTATION.—For 1899, including a beneficiary opt-out. the Social Security Act, as added by para- purposes of implementing the provisions of ‘‘(ii) TYPE OF INFORMATION.—For purposes graph (1), on the ability of professionals to and the amendments made by this section, of clause (i), the information described in improve within such program or successfully the Secretary of Health and Human Services this clause, is the following: transition to an alternative payment model shall provide for the transfer of $80,000,000 ‘‘(I) With respect to selected items and (as defined in section 1833(z)(3) of the Social from the Supplementary Medical Insurance services (as determined appropriate by the Security Act, as added by subsection (e)), Trust Fund established under section 1841 of

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00009 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2446 CONGRESSIONAL RECORD — HOUSE March 14, 2014

the Social Security Act (42 U.S.C. 1395t) to terest relating to such members. Members of ‘‘(iii) UPDATING.—The Secretary may up- the Centers for Medicare & Medicaid Pro- the Committee shall be treated as employees date the criteria established under this sub- gram Management Account for each of the of Congress for purposes of applying title I of paragraph through rulemaking. fiscal years 2014 through 2018. Amounts the Ethics in Government Act of 1978 (Public ‘‘(B) STAKEHOLDER SUBMISSION OF PHYSI- transferred under this paragraph shall be Law 95–521). CIAN FOCUSED PAYMENT MODELS.—On an ongo- available until expended. ‘‘(v) DATE OF INITIAL APPOINTMENTS.—The ing basis, individuals and stakeholder enti- (d) IMPROVING QUALITY REPORTING FOR initial appointments of members of the Com- ties may submit to the Committee proposals COMPOSITE SCORES.— mittee shall be made by not later than 180 for physician-focused payment models that (1) CHANGES FOR GROUP REPORTING OP- days after the date of enactment of this sub- such individuals and entities believe meet TION.— section. the criteria described in subparagraph (A). (A) IN GENERAL.—Section 1848(m)(3)(C)(ii)) ‘‘(C) TERM; VACANCIES.— ‘‘(C) TAC REVIEW OF MODELS SUBMITTED.— of the Social Security Act (42 U.S.C. 1395w– ‘‘(i) TERM.—The terms of members of the The Committee shall, on a periodic basis, re- 4(m)(3)(C)(ii)) is amended by inserting ‘‘and, Committee shall be for 3 years except that view models submitted under subparagraph for 2015 and subsequent years, may provide’’ the Comptroller General shall designate (B), prepare comments and recommendations after ‘‘shall provide’’. regarding whether such models meet the cri- (B) CLARIFICATION OF QUALIFIED CLINICAL staggered terms for the members first ap- pointed. teria described in subparagraph (A), and sub- DATA REGISTRY REPORTING TO GROUP PRAC- mit such comments and recommendations to TICES.—Section 1848(m)(3)(D) of the Social ‘‘(ii) VACANCIES.—Any member appointed to fill a vacancy occurring before the expira- the Secretary. Security Act (42 U.S.C. 1395w–4(m)(3)(D)) is ‘‘(D) SECRETARY REVIEW AND RESPONSE.— amended by inserting ‘‘and, for 2015 and sub- tion of the term for which the member’s predecessor was appointed shall be appointed The Secretary shall review the comments sequent years, subparagraph (A) or (C)’’ after and recommendations submitted by the only for the remainder of that term. A mem- ‘‘subparagraph (A)’’. Committee under subparagraph (C) and post ber may serve after the expiration of that (2) CHANGES FOR MULTIPLE REPORTING PERI- a detailed response to such comments and member’s term until a successor has taken ODS AND ALTERNATIVE CRITERIA FOR SATISFAC- recommendations on the Internet Website of office. A vacancy in the Committee shall be TORY REPORTING.—Section 1848(m)(5)(F) of the Centers for Medicare & Medicaid Serv- filled in the manner in which the original ap- the Social Security Act (42 U.S.C. 1395w– ices. 4(m)(5)(F)) is amended— pointment was made. ‘‘(3) RULE OF CONSTRUCTION.—Nothing in ‘‘(D) DUTIES.—The Committee shall meet, (A) by striking ‘‘and subsequent years’’ and this subsection shall be construed to impact inserting ‘‘through reporting periods occur- as needed, to provide comments and rec- the development or testing of models under ring in 2014’’; and ommendations to the Secretary, as described this title or titles XI, XIX, or XXI.’’. (B) by inserting ‘‘and, for reporting periods in paragraph (2)(C), on physician-focused (2) INCENTIVE PAYMENTS FOR PARTICIPATION occurring in 2015 and subsequent years, the payment models. IN ELIGIBLE ALTERNATIVE PAYMENT MODELS.— Secretary may establish’’ following ‘‘shall ‘‘(E) COMPENSATION OF MEMBERS.— Section 1833 of the Social Security Act (42 establish’’. ‘‘(i) IN GENERAL.—Except as provided in U.S.C. 1395l) is amended by adding at the end (3) PHYSICIAN FEEDBACK PROGRAM REPORTS clause (ii), a member of the Committee shall the following new subsection: SUCCEEDED BY REPORTS UNDER MIPS.—Section serve without compensation. ‘‘(z) INCENTIVE PAYMENTS FOR PARTICIPA- 1848(n) of the Social Security Act (42 U.S.C. ‘‘(ii) TRAVEL EXPENSES.—A member of the 1395w–4(n)) is amended by adding at the end Committee shall be allowed travel expenses, TION IN ELIGIBLE ALTERNATIVE PAYMENT the following new paragraph: including per diem in lieu of subsistence, at MODELS.— ‘‘(11) REPORTS ENDING WITH 2016.—Reports rates authorized for an employee of an agen- ‘‘(1) PAYMENT INCENTIVE.— under the Program shall not be provided cy under subchapter I of chapter 57 of title 5, ‘‘(A) IN GENERAL.—In the case of covered after December 31, 2016. See subsection United States Code, while away from the professional services furnished by an eligible professional during a year that is in the pe- (q)(12) for reports under the eligible profes- home or regular place of business of the riod beginning with 2018 and ending with 2023 sionals Merit-based Incentive Payment Sys- member in the performance of the duties of and for which the professional is a qualifying tem.’’. the Committee. APM participant, in addition to the amount (4) COORDINATION WITH SATISFYING MEANING- ‘‘(F) OPERATIONAL AND TECHNICAL SUP- of payment that would otherwise be made for FUL EHR USE CLINICAL QUALITY MEASURE RE- PORT.— such covered professional services under this PORTING REQUIREMENT.—Section ‘‘(i) IN GENERAL.—The Assistant Secretary part for such year, there also shall be paid to 1848(o)(2)(A)(iii) of the Social Security Act for Planning and Evaluation shall provide such professional an amount equal to 5 per- (42 U.S.C. 1395w–4(o)(2)(A)(iii)) is amended by technical and operational support for the cent of the payment amount for the covered inserting ‘‘and subsection (q)(5)(B)(ii)(II)’’ Committee, which may be by use of a con- professional services under this part for the after ‘‘Subject to subparagraph (B)(ii)’’. tractor. The Office of the Actuary of the preceding year. For purposes of the previous (e) PROMOTING ALTERNATIVE PAYMENT MOD- Centers for Medicare & Medicaid Services ELS.— sentence, the payment amount for the pre- shall provide to the Committee actuarial as- (1) INCREASING TRANSPARENCY OF PHYSICIAN ceding year may be an estimation for the full sistance as needed. FOCUSED PAYMENT MODELS.—Section 1868 of preceding year based on a period of such pre- ‘‘(ii) FUNDING.—The Secretary shall pro- the Social Security Act (42 U.S.C. 1395ee) is ceding year that is less than the full year. vide for the transfer, from the Federal Sup- amended by adding at the end the following The Secretary shall establish policies to im- plementary Medical Insurance Trust Fund new subsection: plement this subparagraph in cases where under section 1841, such amounts as are nec- ‘‘(c) PHYSICIAN FOCUSED PAYMENT MOD- payment for covered professional services ELS.— essary to carry out clause (i) (not to exceed furnished by a qualifying APM participant in ‘‘(1) TECHNICAL ADVISORY COMMITTEE.— $5,000,000) for fiscal year 2014 and each subse- an alternative payment model is made to an ‘‘(A) ESTABLISHMENT.—There is established quent fiscal year. Any amounts transferred entity participating in the alternative pay- an ad hoc committee to be known as the under the preceding sentence for a fiscal ment model rather than directly to the ‘Payment Model Technical Advisory Com- year shall remain available until expended. qualifying APM participant. mittee’ (referred to in this subsection as the ‘‘(G) APPLICATION.—Section 14 of the Fed- ‘‘(B) FORM OF PAYMENT.—Payments under ‘Committee’). eral Advisory Committee Act (5 U.S.C. App.) this subsection shall be made in a lump sum, ‘‘(B) MEMBERSHIP.— shall not apply to the Committee. on an annual basis, as soon as practicable. ‘‘(i) NUMBER AND APPOINTMENT.—The Com- ‘‘(2) CRITERIA AND PROCESS FOR SUBMISSION ‘‘(C) TREATMENT OF PAYMENT INCENTIVE.— mittee shall be composed of 11 members ap- AND REVIEW OF PHYSICIAN-FOCUSED PAYMENT Payments under this subsection shall not be pointed by the Comptroller General of the MODELS.— taken into account for purposes of deter- United States. ‘‘(A) CRITERIA FOR ASSESSING PHYSICIAN-FO- mining actual expenditures under an alter- ‘‘(ii) QUALIFICATIONS.—The membership of CUSED PAYMENT MODELS.— native payment model and for purposes of the Committee shall include individuals with ‘‘(i) RULEMAKING.—Not later than Novem- determining or rebasing any benchmarks national recognition for their expertise in ber 1, 2015, the Secretary shall, through no- used under the alternative payment model. payment models and related delivery of care. tice and comment rulemaking, following a ‘‘(D) COORDINATION.—The amount of the ad- No more than 5 members of the Committee request for information, establish criteria ditional payment for an item or service shall be providers of services or suppliers, or for physician-focused payment models, in- under this subsection or subsection (m) shall representatives of providers of services or cluding models for specialist physicians, be determined without regard to any addi- suppliers. that could be used by the Committee for tional payment for the item or service under ‘‘(iii) PROHIBITION ON FEDERAL EMPLOY- making comments and recommendations subsection (m) and this subsection, respec- MENT.—A member of the Committee shall pursuant to paragraph (1)(D). tively. The amount of the additional pay- not be an employee of the Federal Govern- ‘‘(ii) MEDPAC SUBMISSION OF COMMENTS.— ment for an item or service under this sub- ment. During the comment period for the proposed section or subsection (x) shall be determined ‘‘(iv) ETHICS DISCLOSURE.—The Comptroller rule described in clause (i), the Medicare without regard to any additional payment General shall establish a system for public Payment Advisory Commission may submit for the item or service under subsection (x) disclosure by members of the Committee of comments to the Secretary on the proposed and this subsection, respectively. The financial and other potential conflicts of in- criteria under such clause. amount of the additional payment for an

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00010 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2447 item or service under this subsection or sub- ‘‘(aa) quality measures comparable to home (with respect to beneficiaries under section (y) shall be determined without re- measures under the performance category title XIX) that meets criteria comparable to gard to any additional payment for the item described in section 1848(q)(2)(B)(i) apply; medical homes expanded under section or service under subsection (y) and this sub- ‘‘(bb) certified EHR technology is used; and 1115A(c). section, respectively. ‘‘(cc) the eligible professional (AA) bears ‘‘(3) ADDITIONAL DEFINITIONS.—In this sub- ‘‘(2) QUALIFYING APM PARTICIPANT.—For more than nominal financial risk if actual section: purposes of this subsection, the term ‘quali- aggregate expenditures exceeds expected ag- ‘‘(A) COVERED PROFESSIONAL SERVICES.— fying APM participant’ means the following: gregate expenditures; or (BB) is a medical The term ‘covered professional services’ has ‘‘(A) 2018 AND 2019.—With respect to 2018 and home (with respect to beneficiaries under the meaning given that term in section 2019, an eligible professional for whom the title XIX) that meets criteria comparable to 1848(k)(3)(A). Secretary determines that at least 25 percent medical homes expanded under section ‘‘(B) ELIGIBLE PROFESSIONAL.—The term of payments under this part for covered pro- 1115A(c). ‘eligible professional’ has the meaning given fessional services furnished by such profes- ‘‘(C) BEGINNING IN 2022.—With respect to that term in section 1848(k)(3)(B). sional during the most recent period for 2022 and each subsequent year, an eligible ‘‘(C) ALTERNATIVE PAYMENT MODEL (APM).— which data are available (which may be less professional described in either of the fol- The term ‘alternative payment model’ than a year) were attributable to such serv- lowing clauses: means any of the following: ices furnished under this part through an en- ‘‘(i) MEDICARE REVENUE THRESHOLD OP- ‘‘(i) A model under section 1115A (other tity that participates in an eligible alter- TION.—An eligible professional for whom the than a health care innovation award). native payment model with respect to such Secretary determines that at least 75 percent ‘‘(ii) The shared savings program under services. of payments under this part for covered pro- section 1899. ‘‘(B) 2020 AND 2021.—With respect to 2020 and fessional services furnished by such profes- ‘‘(iii) A demonstration under section 1866C. sional during the most recent period for 2021, an eligible professional described in ei- ‘‘(iv) A demonstration required by Federal which data are available (which may be less ther of the following clauses: law. than a year) were attributable to such serv- ‘‘(i) MEDICARE REVENUE THRESHOLD OP- ‘‘(D) ELIGIBLE ALTERNATIVE PAYMENT ices furnished under this part through an en- TION.—An eligible professional for whom the MODEL (APM).— tity that participates in an eligible alter- Secretary determines that at least 50 percent ‘‘(i) IN GENERAL.—The term ‘eligible alter- native payment model with respect to such of payments under this part for covered pro- native payment model’ means, with respect services. fessional services furnished by such profes- to a year, an alternative payment model— ‘‘(ii) COMBINATION ALL-PAYER AND MEDICARE sional during the most recent period for ‘‘(I) that requires use of certified EHR REVENUE THRESHOLD OPTION.—An eligible which data are available (which may be less technology (as defined in subsection (o)(4)); professional— than a year) were attributable to such serv- ‘‘(II) that provides for payment for covered ‘‘(I) for whom the Secretary determines, ices furnished under this part through an en- professional services based on quality meas- tity that participates in an eligible alter- with respect to items and services furnished by such professional during the most recent ures comparable to measures under the per- native payment model with respect to such formance category described in section services. period for which data are available (which may be less than a year), that at least 75 per- 1848(q)(2)(B)(i); and ‘‘(ii) COMBINATION ALL-PAYER AND MEDICARE cent of the sum of— ‘‘(III) that satisfies the requirement de- REVENUE THRESHOLD OPTION.—An eligible ‘‘(aa) payments described in clause (i); and scribed in clause (ii). professional— ‘‘(bb) all other payments, regardless of ‘‘(ii) ADDITIONAL REQUIREMENT.—For pur- ‘‘(I) for whom the Secretary determines, payer (other than payments made by the poses of clause (i)(III), the requirement de- with respect to items and services furnished Secretary of Defense or the Secretary of Vet- scribed in this clause, with respect to a year by such professional during the most recent erans Affairs under chapter 55 of title 10, and an alternative payment model, is that period for which data are available (which United States Code, or title 38, United States the alternative payment model— may be less than a year), that at least 50 per- Code, or any other provision of law, and ‘‘(I) is one in which one or more entities cent of the sum of— other than payments made under title XIX bear financial risk for monetary losses under ‘‘(aa) payments described in clause (i); and in a State in which no medical home or al- such model that are in excess of a nominal ‘‘(bb) all other payments, regardless of ternative payment model is available under amount; or payer (other than payments made by the the State program under that title), ‘‘(II) is a medical home expanded under Secretary of Defense or the Secretary of Vet- section 1115A(c). meet the requirement described in clause erans Affairs under chapter 55 of title 10, ‘‘(4) LIMITATION.—There shall be no admin- (iii)(I) with respect to payments described in United States Code, or title 38, United States istrative or judicial review under section item (aa) and meet the requirement de- Code, or any other provision of law, and 1869, 1878, or otherwise, of the following: scribed in clause (iii)(II) with respect to pay- other than payments made under title XIX ‘‘(A) The determination that an eligible in a State in which no medical home or al- ments described in item (bb); ‘‘(II) for whom the Secretary determines at professional is a qualifying APM participant ternative payment model is available under under paragraph (2) and the determination the State program under that title), least 25 percent of payments under this part for covered professional services furnished that an alternative payment model is an eli- meet the requirement described in clause by such professional during the most recent gible alternative payment model under para- (iii)(I) with respect to payments described in period for which data are available (which graph (3)(D). item (aa) and meet the requirement de- may be less than a year) were attributable to ‘‘(B) The determination of the amount of scribed in clause (iii)(II) with respect to pay- such services furnished under this part the 5 percent payment incentive under para- ments described in item (bb); through an entity that participates in an eli- graph (1)(A), including any estimation as ‘‘(II) for whom the Secretary determines at gible alternative payment model with re- part of such determination.’’. least 25 percent of payments under this part spect to such services; and (3) COORDINATION CONFORMING AMEND- for covered professional services furnished ‘‘(III) who provides to the Secretary such MENTS.—Section 1833 of the Social Security by such professional during the most recent information as is necessary for the Secretary Act (42 U.S.C. 1395l) is further amended— period for which data are available (which to make a determination under subclause (I), (A) in subsection (x)(3), by adding at the may be less than a year) were attributable to with respect to such professional. end the following new sentence: ‘‘The such services furnished under this part ‘‘(iii) REQUIREMENT.—For purposes of amount of the additional payment for a serv- through an entity that participates in an eli- clause (ii)(I)— ice under this subsection and subsection (z) gible alternative payment model with re- ‘‘(I) the requirement described in this sub- shall be determined without regard to any spect to such services; and clause, with respect to payments described additional payment for the service under ‘‘(III) who provides to the Secretary such in item (aa) of such clause, is that such pay- subsection (z) and this subsection, respec- information as is necessary for the Secretary ments are made under an eligible alternative tively.’’; and to make a determination under subclause (I), payment model; and (B) in subsection (y)(3), by adding at the with respect to such professional. ‘‘(II) the requirement described in this sub- end the following new sentence: ‘‘The ‘‘(iii) REQUIREMENT.—For purposes of clause, with respect to payments described amount of the additional payment for a serv- clause (ii)(I)— in item (bb) of such clause, is that such pay- ice under this subsection and subsection (z) ‘‘(I) the requirement described in this sub- ments are made under an arrangement in shall be determined without regard to any clause, with respect to payments described which— additional payment for the service under in item (aa) of such clause, is that such pay- ‘‘(aa) quality measures comparable to subsection (z) and this subsection, respec- ments are made under an eligible alternative measures under the performance category tively.’’. payment model; and described in section 1848(q)(2)(B)(i) apply; (4) ENCOURAGING DEVELOPMENT AND TESTING ‘‘(II) the requirement described in this sub- ‘‘(bb) certified EHR technology is used; and OF CERTAIN MODELS.—Section 1115A(b)(2) of clause, with respect to payments described ‘‘(cc) the eligible professional (AA) bears the Social Security Act (42 U.S.C. 1315a(b)(2)) in item (bb) of such clause, is that such pay- more than nominal financial risk if actual is amended— ments are made under an arrangement in aggregate expenditures exceeds expected ag- (A) in subparagraph (B), by adding at the which— gregate expenditures; or (BB) is a medical end the following new clauses:

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00011 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2448 CONGRESSIONAL RECORD — HOUSE March 14, 2014 ‘‘(xxi) Focusing primarily on physicians’ the Medicare program (such as to recognize incorporate information from quality and re- services (as defined in section 1848(j)(3)) fur- that less healthy individuals may require source use outcome measurement (including nished by physicians who are not primary more intensive interventions). The study care episode and patient condition groups) care practitioners. shall use information collected on such indi- into provisions of title XVIII of the Social ‘‘(xxii) Focusing on practices of 15 or fewer viduals in carrying out such program, such Security Act that are similar to the eligible professionals. as urban and rural location, eligibility for professional Merit-based Incentive Payment ‘‘(xxiii) Focusing on risk-based models for Medicaid (recognizing and accounting for System under section 1848(q) of such Act. small physician practices which may involve varying Medicaid eligibility across States), (B) ACCOUNTING FOR OTHER FACTORS IN PAY- two-sided risk and prospective patient as- and eligibility for benefits under the supple- MENT ADJUSTMENT MECHANISMS.— signment, and which examine risk-adjusted mental security income (SSI) program. The (i) IN GENERAL.—Taking into account the decreases in mortality rates, hospital re- Secretary shall carry out this paragraph act- studies conducted and recommendations admissions rates, and other relevant and ap- ing through the Assistant Secretary for made in reports under paragraph (1) and propriate clinical measures. Planning and Evaluation. other information as appropriate, the Sec- ‘‘(xxiv) Focusing primarily on title XIX, (ii) REPORT.—Not later than 2 years after retary shall, as the Secretary determines ap- working in conjunction with the Center for the date of the enactment of this Act, the propriate, account for identified factors with Medicaid and CHIP Services.’’; and Secretary shall submit to Congress a report an effect on quality and resource use out- (B) in subparagraph (C)(viii), by striking on the study conducted under clause (i). come measures when determining payment ‘‘other public sector or private sector pay- (B) STUDY USING OTHER DATA.— adjustment mechanisms under provisions of ers’’ and inserting ‘‘other public sector pay- (i) STUDY.—The Secretary shall conduct a title XVIII of the Social Security Act that ers, private sector payers, or Statewide pay- study that examines the impact of risk fac- are similar to the eligible professional Merit- ment models’’. tors, such as those described in section based Incentive Payment System under sec- (5) CONSTRUCTION REGARDING TELEHEALTH 1848(p)(3) of the Social Security Act (42 tion 1848(q) of such Act. SERVICES.—Nothing in the provisions of, or U.S.C. 1395w–4(p)(3)), race, health literacy, (ii) ACCESSING DATA.—The Secretary shall amendments made by, this Act shall be con- limited English proficiency (LEP), and pa- collect or otherwise obtain access to the strued as precluding an alternative payment tient activation, on quality and resource use data necessary to carry out this paragraph model or a qualifying APM participant (as outcome measures under the Medicare pro- through existing and new data sources. those terms are defined in section 1833(z) of gram (such as to recognize that less healthy (iii) PERIODIC ANALYSES.—The Secretary the Social Security Act, as added by para- individuals may require more intensive shall carry out periodic analyses, at least graph (1)) from furnishing a telehealth serv- interventions). In conducting such study the every 3 years, based on the factors referred ice for which payment is not made under sec- Secretary may use existing Federal data and to in clause (i) so as to monitor changes in tion 1834(m) of the Social Security Act (42 collect such additional data as may be nec- possible relationships. U.S.C. 1395m(m)). essary to complete the study. (C) FUNDING.—There are hereby appro- (6) INTEGRATING MEDICARE ADVANTAGE AL- (ii) REPORT.—Not later than 5 years after priated from the Federal Supplementary TERNATIVE PAYMENT MODELS.—Not later than the date of the enactment of this Act, the Medical Insurance Trust Fund under section July 1, 2015, the Secretary of Health and Secretary shall submit to Congress a report 1841 of the Social Security Act to the Sec- Human Services shall submit to Congress a on the study conducted under clause (i). retary to carry out this paragraph and the study that examines the feasibility of inte- (C) EXAMINATION OF DATA IN CONDUCTING application of this paragraph to the Merit- grating alternative payment models in the STUDIES.—In conducting the studies under based Incentive Payment System under sec- Medicare Advantage payment system. The subparagraphs (A) and (B), the Secretary tion 1848(q) of such Act $10,000,000, to remain study shall include the feasibility of includ- shall examine what non-Medicare data sets, available until expended. ing a value-based modifier and whether such such as data from the American Community (3) STRATEGIC PLAN FOR ACCESSING RACE modifier should be budget neutral. Survey (ACS), can be useful in conducting AND ETHNICITY DATA.—Not later than 18 (7) STUDY AND REPORT ON FRAUD RELATED the types of studies under such paragraphs months after the date of the enactment of TO ALTERNATIVE PAYMENT MODELS UNDER THE and how such data sets that are identified as this Act, the Secretary shall develop and re- MEDICARE PROGRAM.— useful can be coordinated with Medicare ad- port to Congress on a strategic plan for col- (A) STUDY.—The Secretary of Health and ministrative data in order to improve the lecting or otherwise accessing data on race Human Services, in consultation with the In- overall data set available to do such studies and ethnicity for purposes of carrying out spector General of the Department of Health and for the administration of the Medicare the eligible professional Merit-based Incen- and Human Services, shall conduct a study program. tive Payment System under section 1848(q) that— (D) RECOMMENDATIONS TO ACCOUNT FOR IN- of the Social Security Act and, as the Sec- (i) examines the applicability of the Fed- FORMATION IN PAYMENT ADJUSTMENT MECHA- retary determines appropriate, other similar eral fraud prevention laws to items and serv- NISMS.—If the studies conducted under sub- provisions of title XVIII of such Act. ices furnished under title XVIII of the Social paragraphs (A) and (B) find a relationship be- (g) COLLABORATING WITH THE PHYSICIAN, Security Act for which payment is made tween the factors examined in the studies PRACTITIONER, AND OTHER STAKEHOLDER COM- under an alternative payment model (as de- and quality and resource use outcome meas- MUNITIES TO IMPROVE RESOURCE USE MEAS- fined in section 1833(z)(3)(C) of such Act (42 ures, then the Secretary shall also provide UREMENT.—Section 1848 of the Social Secu- U.S.C. 1395l(z)(3)(C))); recommendations for how the Centers for rity Act (42 U.S.C. 1395w–4), as amended by (ii) identifies aspects of such alternative Medicare & Medicaid Services should— subsection (c), is further amended by adding payment models that are vulnerable to (i) obtain access to the necessary data (if at the end the following new subsection: fraudulent activity; and such data is not already being collected) on ‘‘(r) COLLABORATING WITH THE PHYSICIAN, (iii) examines the implications of waivers such factors, including recommendations on PRACTITIONER, AND OTHER STAKEHOLDER COM- to such laws granted in support of such alter- how to address barriers to the Centers in ac- MUNITIES TO IMPROVE RESOURCE USE MEAS- native payment models, including under any cessing such data; and UREMENT.— potential expansion of such models. (ii) account for such factors in determining ‘‘(1) IN GENERAL.—In order to involve the (B) REPORT.—Not later than 2 years after payment adjustments based on quality and physician, practitioner, and other stake- the date of the enactment of this Act, the resource use outcome measures under the el- holder communities in enhancing the infra- Secretary shall submit to Congress a report igible professional Merit-based Incentive structure for resource use measurement, in- containing the results of the study con- Payment System under section 1848(q) of the cluding for purposes of the value-based per- ducted under subparagraph (A). Such report Social Security Act (42 U.S.C. 1395w–4(q)) formance incentive program under sub- shall include recommendations for actions to and, as the Secretary determines appro- section (q) and alternative payment models be taken to reduce the vulnerability of such priate, other similar provisions of title XVIII under section 1833(z), the Secretary shall un- alternative payment models to fraudulent of such Act. dertake the steps described in the succeeding activity. Such report also shall include, as (E) FUNDING.—There are hereby appro- provisions of this subsection. appropriate, recommendations of the Inspec- priated from the Federal Supplementary ‘‘(2) DEVELOPMENT OF CARE EPISODE AND PA- tor General for changes in Federal fraud pre- Medical Insurance Trust Fund under section TIENT CONDITION GROUPS AND CLASSIFICATION vention laws to reduce such vulnerability. 1841 of the Social Security Act to the Sec- CODES.— (f) IMPROVING PAYMENT ACCURACY.— retary to carry out this paragraph $6,000,000, ‘‘(A) IN GENERAL.—In order to classify simi- (1) STUDIES AND REPORTS OF EFFECT OF CER- to remain available until expended. lar patients into care episode groups and pa- TAIN INFORMATION ON QUALITY AND RESOURCE (2) CMS ACTIVITIES.— tient condition groups, the Secretary shall USE.— (A) HIERARCHAL CONDITION CATEGORY (HCC) undertake the steps described in the suc- (A) STUDY USING EXISTING MEDICARE IMPROVEMENT.—Taking into account the rel- ceeding provisions of this paragraph. DATA.— evant studies conducted and recommenda- ‘‘(B) PUBLIC AVAILABILITY OF EXISTING EF- (i) STUDY.—The Secretary of Health and tions made in reports under paragraph (1), FORTS TO DESIGN AN EPISODE GROUPER.—Not Human Services (in this subsection referred the Secretary, on an ongoing basis, shall, as later than 120 days after the date of the en- to as the ‘‘Secretary’’) shall conduct a study the Secretary determines appropriate, esti- actment of this subsection, the Secretary that examines the effect of individuals’ so- mate how an individual’s health status and shall post on the Internet website of the Cen- cioeconomic status on quality and resource other risk factors affect quality and resource ters for Medicare & Medicaid Services a list use outcome measures for individuals under use outcome measures and, as feasible, shall of the episode groups developed pursuant to

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00012 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2449 subsection (n)(9)(A) and related descriptive ices an operational list of care episode and on the Internet website of the Centers for information. patient condition codes (and the criteria and Medicare & Medicaid Services an operational ‘‘(C) STAKEHOLDER INPUT.—The Secretary characteristics assigned to such code). list of patient relationship categories and shall accept, through the date that is 60 days ‘‘(H) SUBSEQUENT REVISIONS.—Not later codes. after the day the Secretary posts the list than November 1 of each year (beginning ‘‘(F) SUBSEQUENT REVISIONS.—Not later pursuant to subparagraph (B), suggestions with 2017), the Secretary shall, through rule- than November 1 of each year (beginning from physician specialty societies, applica- making, make revisions to the operational with 2017), the Secretary shall, through rule- ble practitioner organizations, and other lists of care episode and patient condition making, make revisions to the operational stakeholders for episode groups in addition codes as the Secretary determines may be list of patient relationship categories and to those posted pursuant to such subpara- appropriate. Such revisions may be based on codes as the Secretary determines appro- graph, and specific clinical criteria and pa- experience, new information developed pur- priate. Such revisions may be based on expe- tient characteristics to classify patients suant to subsection (n)(9)(A), and input from rience, new information developed pursuant into— the physician specialty societies, applicable to subsection (n)(9)(A), and input from the ‘‘(i) care episode groups; and practitioner organizations, and other stake- physician specialty societies, applicable ‘‘(ii) patient condition groups. holders, including representatives of individ- practitioner organizations, and other stake- ‘‘(D) DEVELOPMENT OF PROPOSED CLASSI- uals entitled to benefits under part A or en- holders, including representatives of individ- FICATION CODES.— rolled under this part. uals entitled to benefits under part A or en- ‘‘(i) IN GENERAL.—Taking into account the ‘‘(3) ATTRIBUTION OF PATIENTS TO PHYSI- rolled under this part. information described in subparagraph (B) CIANS OR PRACTITIONERS.— and the information received under subpara- ‘‘(A) IN GENERAL.—In order to facilitate the ‘‘(4) REPORTING OF INFORMATION FOR RE- graph (C), the Secretary shall— attribution of patients and episodes (in SOURCE USE MEASUREMENT.—Claims sub- ‘‘(I) establish care episode groups and pa- whole or in part) to one or more physicians mitted for items and services furnished by a tient condition groups, which account for a or applicable practitioners furnishing items physician or applicable practitioner on or target of an estimated 2⁄3 of expenditures and services, the Secretary shall undertake after January 1, 2017, shall, as determined under parts A and B; and the steps described in the succeeding provi- appropriate by the Secretary, include— ‘‘(II) assign codes to such groups. sions of this paragraph. ‘‘(A) applicable codes established under ‘‘(ii) CARE EPISODE GROUPS.—In estab- ‘‘(B) DEVELOPMENT OF PATIENT RELATION- paragraphs (2) and (3); and lishing the care episode groups under clause SHIP CATEGORIES AND CODES.—The Secretary ‘‘(B) the national provider identifier of the (i), the Secretary shall take into account— shall develop patient relationship categories ordering physician or applicable practitioner ‘‘(I) the patient’s clinical problems at the and codes that define and distinguish the re- (if different from the billing physician or ap- time items and services are furnished during lationship and responsibility of a physician plicable practitioner). an episode of care, such as the clinical condi- or applicable practitioner with a patient at ‘‘(5) METHODOLOGY FOR RESOURCE USE ANAL- tions or diagnoses, whether or not inpatient the time of furnishing an item or service. YSIS.— hospitalization is anticipated or occurs, and Such patient relationship categories shall ‘‘(A) IN GENERAL.—In order to evaluate the the principal procedures or services planned include different relationships of the physi- resources used to treat patients (with re- or furnished; and cian or applicable practitioner to the patient spect to care episode and patient condition ‘‘(II) other factors determined appropriate (and the codes may reflect combinations of groups), the Secretary shall— by the Secretary. such categories), such as a physician or ap- ‘‘(i) use the patient relationship codes re- ‘‘(iii) PATIENT CONDITION GROUPS.—In estab- plicable practitioner who— ported on claims pursuant to paragraph (4) lishing the patient condition groups under ‘‘(i) considers themself to have the primary to attribute patients (in whole or in part) to clause (i), the Secretary shall take into ac- responsibility for the general and ongoing one or more physicians and applicable prac- count— care for the patient over extended periods of titioners; ‘‘(I) the patient’s clinical history at the time; ‘‘(ii) use the care episode and patient con- time of each medical visit, such as the pa- ‘‘(ii) considers themself to be the lead phy- dition codes reported on claims pursuant to tient’s combination of chronic conditions, sician or practitioner and who furnishes paragraph (4) as a basis to compare similar current health status, and recent significant items and services and coordinates care fur- patients and care episodes and patient condi- history (such as hospitalization and major nished by other physicians or practitioners tion groups; and surgery during a previous period, such as 3 for the patient during an acute episode; ‘‘(iii) conduct an analysis of resource use months); and ‘‘(iii) furnishes items and services to the (with respect to care episodes and patient ‘‘(II) other factors determined appropriate patient on a continuing basis during an condition groups of such patients), as the by the Secretary, such as eligibility status acute episode of care, but in a supportive Secretary determines appropriate. under this title (including eligibility under rather than a lead role; ‘‘(B) ANALYSIS OF PATIENTS OF PHYSICIANS section 226(a), 226(b), or 226A, and dual eligi- ‘‘(iv) furnishes items and services to the AND PRACTITIONERS.—In conducting the anal- bility under this title and title XIX). patient on an occasional basis, usually at the ysis described in subparagraph (A)(iii) with ‘‘(E) DRAFT CARE EPISODE AND PATIENT CON- request of another physician or practitioner; respect to patients attributed to physicians DITION GROUPS AND CLASSIFICATION CODES.— or and applicable practitioners, the Secretary Not later than 180 days after the end of the ‘‘(v) furnishes items and services only as comment period described in subparagraph ordered by another physician or practitioner. shall, as feasible— ‘‘(i) use the claims data experience of such (C), the Secretary shall post on the Internet ‘‘(C) DRAFT LIST OF PATIENT RELATIONSHIP website of the Centers for Medicare & Med- CATEGORIES AND CODES.—Not later than 270 patients by patient condition codes during a icaid Services a draft list of the care episode days after the date of the enactment of this common period, such as 12 months; and and patient condition codes established subsection, the Secretary shall post on the ‘‘(ii) use the claims data experience of such under subparagraph (D) (and the criteria and Internet website of the Centers for Medicare patients by care episode codes— characteristics assigned to such code). & Medicaid Services a draft list of the pa- ‘‘(I) in the case of episodes without a hos- ‘‘(F) SOLICITATION OF INPUT.—The Sec- tient relationship categories and codes de- pitalization, during periods of time (such as retary shall seek, through the date that is 60 veloped under subparagraph (B). the number of days) determined appropriate days after the Secretary posts the list pursu- ‘‘(D) STAKEHOLDER INPUT.—The Secretary by the Secretary; and ant to subparagraph (E), comments from shall seek, through the date that is 60 days ‘‘(II) in the case of episodes with a hos- physician specialty societies, applicable after the Secretary posts the list pursuant to pitalization, during periods of time (such as practitioner organizations, and other stake- subparagraph (C), comments from physician the number of days) before, during, and after holders, including representatives of individ- specialty societies, applicable practitioner the hospitalization. uals entitled to benefits under part A or en- organizations, and other stakeholders, in- ‘‘(C) MEASUREMENT OF RESOURCE USE.—In rolled under this part, regarding the care cluding representatives of individuals enti- measuring such resource use, the Sec- episode and patient condition groups (and tled to benefits under part A or enrolled retary— codes) posted under subparagraph (E). In under this part, regarding the patient rela- ‘‘(i) shall use per patient total allowed seeking such comments, the Secretary shall tionship categories and codes posted under charges for all services under part A and this use one or more mechanisms (other than no- subparagraph (C). In seeking such comments, part (and, if the Secretary determines appro- tice and comment rulemaking) that may in- the Secretary shall use one or more mecha- priate, part D) for the analysis of patient re- clude use of open door forums, town hall nisms (other than notice and comment rule- source use, by care episode codes and by pa- meetings, or other appropriate mechanisms. making) that may include open door forums, tient condition codes; and ‘‘(G) OPERATIONAL LIST OF CARE EPISODE town hall meetings, or other appropriate ‘‘(ii) may, as determined appropriate, use AND PATIENT CONDITION GROUPS AND CODES.— mechanisms. other measures of allowed charges (such as Not later than 180 days after the end of the ‘‘(E) OPERATIONAL LIST OF PATIENT RELA- subtotals for categories of items and serv- comment period described in subparagraph TIONSHIP CATEGORIES AND CODES.—Not later ices) and measures of utilization of items (F), taking into account the comments re- than 180 days after the end of the comment and services (such as frequency of specific ceived under such subparagraph, the Sec- period described in subparagraph (D), taking items and services and the ratio of specific retary shall post on the Internet website of into account the comments received under items and services among attributed pa- the Centers for Medicare & Medicaid Serv- such subparagraph, the Secretary shall post tients or episodes).

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00013 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2450 CONGRESSIONAL RECORD — HOUSE March 14, 2014

‘‘(D) STAKEHOLDER INPUT.—The Secretary ‘‘(B) QUALITY DOMAINS.—For purposes of ‘‘(ii) With respect to the measures devel- shall seek comments from the physician spe- this subsection, the term ‘quality domains’ oped during the previous year— cialty societies, applicable practitioner orga- means at least the following domains: ‘‘(I) a description of the total number of nizations, and other stakeholders, including ‘‘(i) Clinical care. quality measures developed and the types of representatives of individuals entitled to ‘‘(ii) Safety. such measures, such as an outcome or pa- benefits under part A or enrolled under this ‘‘(iii) Care coordination. tient experience measure; part, regarding the resource use method- ‘‘(iv) Patient and caregiver experience. ‘‘(II) the name of each measure developed; ology established pursuant to this para- ‘‘(v) Population health and prevention. ‘‘(III) the name of the developer and stew- graph. In seeking comments the Secretary ‘‘(C) CONSIDERATION.—In developing the ard of each measure; shall use one or more mechanisms (other draft plan under this paragraph, the Sec- ‘‘(IV) with respect to each type of measure, than notice and comment rulemaking) that retary shall consider— an estimate of the total amount expended may include open door forums, town hall ‘‘(i) gap analyses conducted by the entity under this title to develop all measures of meetings, or other appropriate mechanisms. with a contract under section 1890(a) or such type; and ‘‘(6) IMPLEMENTATION.—To the extent that other contractors or entities; ‘‘(V) whether the measure would be elec- the Secretary contracts with an entity to ‘‘(ii) whether measures are applicable tronically specified. carry out any part of the provisions of this across health care settings; ‘‘(iii) With respect to measures in develop- subsection, the Secretary may not contract ‘‘(iii) clinical practice improvement activi- ment at the time of the report— with an entity or an entity with a sub- ties submitted under subsection (q)(2)(C)(iv) ‘‘(I) the information described in clause contract if the entity or subcontracting enti- for identifying possible areas for future (ii), if available; and ty currently makes recommendations to the measure development and identifying exist- ‘‘(II) a timeline for completion of the de- Secretary on relative values for services ing gaps with respect to such measures; and velopment of such measures. under the fee schedule for physicians’ serv- ‘‘(iv) the quality domains applied under ‘‘(iv) A description of any updates to the ices under this section. this subsection. plan under paragraph (1) (including newly ‘‘(7) LIMITATION.—There shall be no admin- ‘‘(D) PRIORITIES.—In developing the draft identified gaps and the status of previously istrative or judicial review under section plan under this paragraph, the Secretary identified gaps) and the inventory of meas- 1869, section 1878, or otherwise of— shall give priority to the following types of ures applicable under the applicable provi- ‘‘(A) care episode and patient condition measures: sions. groups and codes established under para- ‘‘(i) Outcome measures, including patient ‘‘(v) Other information the Secretary de- graph (2); reported outcome and functional status termines to be appropriate. ‘‘(B) patient relationship categories and measures. ‘‘(4) STAKEHOLDER INPUT.—With respect to codes established under paragraph (3); and ‘‘(ii) Patient experience measures. paragraph (1), the Secretary shall seek ‘‘(C) measurement of, and analyses of re- ‘‘(iii) Care coordination measures. stakeholder input with respect to— source use with respect to, care episode and ‘‘(iv) Measures of appropriate use of serv- ‘‘(A) the identification of gaps where no patient condition codes and patient relation- ices, including measures of over use. quality measures exist, particularly with re- ship codes pursuant to paragraph (5). ‘‘(E) STAKEHOLDER INPUT.—The Secretary spect to the types of measures described in ‘‘(8) ADMINISTRATION.—Chapter 35 of title shall accept through March 1, 2015, com- paragraph (1)(D); 44, United States Code, shall not apply to ments on the draft plan posted under para- ‘‘(B) prioritizing quality measure develop- this section. graph (1)(A) from the public, including ment to address such gaps; and ‘‘(9) DEFINITIONS.—In this section: health care providers, payers, consumers, ‘‘(C) other areas related to quality measure ‘‘(A) PHYSICIAN.—The term ‘physician’ has and other stakeholders. development determined appropriate by the the meaning given such term in section ‘‘(F) FINAL MEASURE DEVELOPMENT PLAN.— Secretary. 1861(r)(1). Not later than May 1, 2015, taking into ac- ‘‘(5) DEFINITION OF APPLICABLE PROVI- ‘‘(B) APPLICABLE PRACTITIONER.—The term count the comments received under this sub- SIONS.—In this subsection, the term ‘applica- ‘applicable practitioner’ means— paragraph, the Secretary shall finalize the ble provisions’ means the following provi- ‘‘(i) a physician assistant, nurse practi- plan and post on the Internet website of the sions: tioner, and clinical nurse specialist (as such Centers for Medicare & Medicaid Services an ‘‘(A) Subsection (q)(2)(B)(i). terms are defined in section 1861(aa)(5)), and operational plan for the development of ‘‘(B) Section 1833(z)(2)(C). a certified registered nurse anesthetist (as quality measures for use under the applica- ‘‘(6) FUNDING.—For purposes of carrying defined in section 1861(bb)(2)); and ble provisions. Such plan shall be updated as out this subsection, the Secretary shall pro- ‘‘(ii) beginning January 1, 2018, such other appropriate. vide for the transfer, from the Federal Sup- eligible professionals (as defined in sub- ‘‘(2) CONTRACTS AND OTHER ARRANGEMENTS plementary Medical Insurance Trust Fund section (k)(3)(B)) as specified by the Sec- FOR QUALITY MEASURE DEVELOPMENT.— under section 1841, of $15,000,000 to the Cen- retary. ‘‘(A) IN GENERAL.—The Secretary shall ters for Medicare & Medicaid Services Pro- ‘‘(10) CLARIFICATION.—The provisions of enter into contracts or other arrangements gram Management Account for each of fiscal sections 1890(b)(7) and 1890A shall not apply with entities for the purpose of developing, years 2014 through 2018. Amounts transferred to this subsection.’’. improving, updating, or expanding in accord- under this paragraph shall remain available through the end of fiscal year 2021.’’. SEC. 3. PRIORITIES AND FUNDING FOR MEASURE ance with the plan under paragraph (1) qual- DEVELOPMENT. ity measures for application under the appli- SEC. 4. ENCOURAGING CARE MANAGEMENT FOR cable provisions. Such entities shall include INDIVIDUALS WITH CHRONIC CARE Section 1848 of the Social Security Act (42 organizations with quality measure develop- NEEDS. U.S.C. 1395w–4), as amended by subsections ment expertise. (a) IN GENERAL.—Section 1848(b) of the So- (c) and (g) of section 2, is further amended by ‘‘(B) PRIORITIZATION.— cial Security Act (42 U.S.C. 1395w–4(b)) is inserting at the end the following new sub- ‘‘(i) IN GENERAL.—In entering into con- amended by adding at the end the following section: tracts or other arrangements under subpara- new paragraph: ‘‘(s) PRIORITIES AND FUNDING FOR MEASURE graph (A), the Secretary shall give priority ‘‘(8) ENCOURAGING CARE MANAGEMENT FOR DEVELOPMENT.— to the development of the types of measures INDIVIDUALS WITH CHRONIC CARE NEEDS.— ‘‘(1) PLAN IDENTIFYING MEASURE DEVELOP- described in paragraph (1)(D). ‘‘(A) IN GENERAL.—In order to encourage MENT PRIORITIES AND TIMELINES.— ‘‘(ii) CONSIDERATION.—In selecting meas- the management of care by an applicable ‘‘(A) DRAFT MEASURE DEVELOPMENT PLAN.— ures for development under this subsection, provider (as defined in subparagraph (B)) for Not later than January 1, 2015, the Secretary the Secretary shall consider— individuals with chronic care needs the Sec- shall develop, and post on the Internet ‘‘(I) whether such measures would be elec- retary shall— website of the Centers for Medicare & Med- tronically specified; and ‘‘(i) establish one or more HCPCS codes for icaid Services, a draft plan for the develop- ‘‘(II) clinical practice guidelines to the ex- chronic care management services for such ment of quality measures for application tent that such guidelines exist. individuals; and under the applicable provisions (as defined in ‘‘(3) ANNUAL REPORT BY THE SECRETARY.— ‘‘(ii) subject to subparagraph (D), make paragraph (5)). Under such plan the Sec- ‘‘(A) IN GENERAL.—Not later than May 1, payment (as the Secretary determines to be retary shall— 2016, and annually thereafter, the Secretary appropriate) under this section for such man- ‘‘(i) address how measures used by private shall post on the Internet website of the Cen- agement services furnished on or after Janu- payers and integrated delivery systems could ters for Medicare & Medicaid Services a re- ary 1, 2015, by an applicable provider. be incorporated under title XVIII; port on the progress made in developing ‘‘(B) APPLICABLE PROVIDER DEFINED.—For ‘‘(ii) describe how coordination, to the ex- quality measures for application under the purposes of this paragraph, the term ‘appli- tent possible, will occur across organizations applicable provisions. cable provider’ means a physician (as defined developing such measures; and ‘‘(B) REQUIREMENTS.—Each report sub- in section 1861(r)(1)), physician assistant or ‘‘(iii) take into account how clinical best mitted pursuant to subparagraph (A) shall nurse practitioner (as defined in section practices and clinical practice guidelines include the following: 1861(aa)(5)(A)), or clinical nurse specialist (as should be used in the development of quality ‘‘(i) A description of the Secretary’s efforts defined in section 1861(aa)(5)(B)) who fur- measures. to implement this paragraph. nishes services as part of a patient-centered

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00014 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2451 medical home or a comparable specialty made under the fee schedule established Supplementary Medical Insurance Trust practice that— under subsection (b). Such information may Fund under section 1841, of $2,000,000 to the ‘‘(i) is recognized as such a medical home be collected or obtained from any eligible Centers for Medicare & Medicaid Services or comparable specialty practice by an orga- professional or any other source. Program Management Account for each fis- nization that is recognized by the Secretary ‘‘(ii) USE OF INFORMATION.—Notwith- cal year beginning with fiscal year 2014. for purposes of such recognition as such a standing any other provision of law, subject Amounts transferred under the preceding medical home or practice; or to clause (v), the Secretary may (as the Sec- sentence for a fiscal year shall be available ‘‘(ii) meets such other comparable quali- retary determines appropriate) use informa- until expended.’’. fications as the Secretary determines to be tion collected or obtained pursuant to clause (2) LIMITATION ON REVIEW.—Section appropriate. (i) in the determination of relative values for 1848(i)(1) of the Social Security Act (42 U.S.C. ‘‘(C) BUDGET NEUTRALITY.—The budget neu- services under this section. 1395w–4(i)(1)) is amended— trality provision under subsection ‘‘(iii) TYPES OF INFORMATION.—The types of (A) in subparagraph (D), by striking ‘‘and’’ (c)(2)(B)(ii)(II) shall apply in establishing the information described in clauses (i) and (ii) at the end; payment under subparagraph (A)(ii). may, at the Secretary’s discretion, include (B) in subparagraph (E), by striking the pe- ‘‘(D) POLICIES RELATING TO PAYMENT.—In any or all of the following: riod at the end and inserting ‘‘, and’’; and carrying out this paragraph, with respect to ‘‘(I) Time involved in furnishing services. (C) by adding at the end the following new chronic care management services, the Sec- ‘‘(II) Amounts and types of practice ex- subparagraph: retary shall— pense inputs involved with furnishing serv- ‘‘(F) the collection and use of information ‘‘(i) make payment to only one applicable ices. in the determination of relative values under provider for such services furnished to an in- ‘‘(III) Prices (net of any discounts) for subsection (c)(2)(M).’’. dividual during a period; practice expense inputs, which may include (b) AUTHORITY FOR ALTERNATIVE AP- ‘‘(ii) not make payment under subpara- paid invoice prices or other documentation PROACHES TO ESTABLISHING PRACTICE EX- graph (A) if such payment would be duplica- or records. PENSE RELATIVE VALUES.—Section 1848(c)(2) tive of payment that is otherwise made ‘‘(IV) Overhead and accounting informa- of the Social Security Act (42 U.S.C. 1395w– under this title for such services (such as in tion for practices of physicians and other 4(c)(2)), as amended by subsection (a), is the case of hospice care or home health serv- suppliers. amended by adding at the end the following ices); and ‘‘(V) Any other element that would im- new subparagraph: ‘‘(iii) not require that an annual wellness prove the valuation of services under this ‘‘(N) AUTHORITY FOR ALTERNATIVE AP- visit (as defined in section 1861(hhh)) or an section. PROACHES TO ESTABLISHING PRACTICE EXPENSE initial preventive physical examination (as ‘‘(iv) INFORMATION COLLECTION MECHA- RELATIVE VALUES.—The Secretary may es- defined in section 1861(ww)) be furnished as a NISMS.—Information may be collected or ob- tablish or adjust practice expense relative condition of payment for such management tained pursuant to this subparagraph from values under this subsection using cost, services.’’. any or all of the following: charge, or other data from suppliers or pro- (b) EDUCATION AND OUTREACH.— ‘‘(I) Surveys of physicians, other suppliers, viders of services, including information col- (1) CAMPAIGN.— providers of services, manufacturers, and lected or obtained under subparagraph (M).’’. (A) IN GENERAL.—The Secretary of Health vendors. and Human Services (in this subsection re- ‘‘(II) Surgical logs, billing systems, or (c) REVISED AND EXPANDED IDENTIFICATION ferred to as the ‘‘Secretary’’) shall conduct other practice or facility records. OF POTENTIALLY MISVALUED CODES.—Section an education and outreach campaign to in- ‘‘(III) Electronic health records. 1848(c)(2)(K)(ii) of the Social Security Act (42 form professionals who furnish items and ‘‘(IV) Any other mechanism determined ap- U.S.C. 1395w–4(c)(2)(K)(ii)) is amended to read services under part B of title XVIII of the propriate by the Secretary. as follows: Social Security Act and individuals enrolled ‘‘(v) TRANSPARENCY OF USE OF INFORMA- ‘‘(ii) IDENTIFICATION OF POTENTIALLY under such part of the benefits of chronic TION.— MISVALUED CODES.—For purposes of identi- care management services described in sec- ‘‘(I) IN GENERAL.—Subject to subclauses (II) fying potentially misvalued codes pursuant tion 1848(b)(8) of the Social Security Act, as and (III), if the Secretary uses information to clause (i)(I), the Secretary shall examine added by subsection (a), and encourage such collected or obtained under this subpara- codes (and families of codes as appropriate) individuals with chronic care needs to re- graph in the determination of relative values based on any or all of the following criteria: ceive such services. under this subsection, the Secretary shall ‘‘(I) Codes that have experienced the fast- (B) REQUIREMENTS.—Such campaign shall— disclose the information source and discuss est growth. (i) be directed by the Office of Rural Health the use of such information in such deter- ‘‘(II) Codes that have experienced substan- Policy of the Department of Health and mination of relative values through notice tial changes in practice expenses. Human Services and the Office of Minority and comment rulemaking. ‘‘(III) Codes that describe new technologies Health of the Centers for Medicare & Med- ‘‘(II) THRESHOLDS FOR USE.—The Secretary or services within an appropriate time period icaid Services; and may establish thresholds in order to use such (such as 3 years) after the relative values are (ii) focus on encouraging participation by information, including the exclusion of in- initially established for such codes. underserved rural populations and racial and formation collected or obtained from eligible ‘‘(IV) Codes which are multiple codes that ethnic minority populations. professionals who use very high resources (as are frequently billed in conjunction with fur- (2) REPORT.— determined by the Secretary) in furnishing a nishing a single service. (A) IN GENERAL.—Not later than December service. ‘‘(V) Codes with low relative values, par- 31, 2017, the Secretary shall submit to Con- ‘‘(III) DISCLOSURE OF INFORMATION.—The ticularly those that are often billed multiple gress a report on the use of chronic care Secretary shall make aggregate information times for a single treatment. management services described in such sec- available under this subparagraph but shall ‘‘(VI) Codes that have not been subject to tion 1848(b)(8) by individuals living in rural not disclose information in a form or manner review since implementation of the fee areas and by racial and ethnic minority pop- that identifies an eligible professional or a schedule. ulations. Such report shall— group practice, or information collected or ‘‘(VII) Codes that account for the majority (i) identify barriers to receiving chronic obtained pursuant to a nondisclosure agree- of spending under the physician fee schedule. care management services; and ment. ‘‘(VIII) Codes for services that have experi- (ii) make recommendations for increasing ‘‘(vi) INCENTIVE TO PARTICIPATE.—The Sec- enced a substantial change in the hospital the appropriate use of chronic care manage- retary may provide for such payments under length of stay or procedure time. ment services. this part to an eligible professional that sub- ‘‘(IX) Codes for which there may be a SEC. 5. ENSURING ACCURATE VALUATION OF mits such solicited information under this change in the typical site of service since the SERVICES UNDER THE PHYSICIAN subparagraph as the Secretary determines code was last valued. FEE SCHEDULE. appropriate in order to compensate such eli- ‘‘(X) Codes for which there is a significant (a) AUTHORITY TO COLLECT AND USE INFOR- gible professional for such submission. Such difference in payment for the same service MATION ON PHYSICIANS’ SERVICES IN THE DE- payments shall be provided in a form and between different sites of service. TERMINATION OF RELATIVE VALUES.— manner specified by the Secretary. ‘‘(XI) Codes for which there may be anoma- (1) IN GENERAL.—Section 1848(c)(2) of the ‘‘(vii) ADMINISTRATION.—Chapter 35 of title lies in relative values within a family of Social Security Act (42 U.S.C. 1395w–4(c)(2)) 44, United States Code, shall not apply to in- codes. is amended by adding at the end the fol- formation collected or obtained under this ‘‘(XII) Codes for services where there may lowing new subparagraph: subparagraph. be efficiencies when a service is furnished at ‘‘(M) AUTHORITY TO COLLECT AND USE INFOR- ‘‘(viii) DEFINITION OF ELIGIBLE PROFES- the same time as other services. MATION ON PHYSICIANS’ SERVICES IN THE DE- SIONAL.—In this subparagraph, the term ‘eli- ‘‘(XIII) Codes with high intra-service work TERMINATION OF RELATIVE VALUES.— gible professional’ has the meaning given per unit of time. ‘‘(i) COLLECTION OF INFORMATION.—Notwith- such term in subsection (k)(3)(B). ‘‘(XIV) Codes with high practice expense standing any other provision of law, the Sec- ‘‘(ix) FUNDING.—For purposes of carrying relative value units. retary may collect or obtain information on out this subparagraph, in addition to funds ‘‘(XV) Codes with high cost supplies. the resources directly or indirectly related otherwise appropriated, the Secretary shall ‘‘(XVI) Codes as determined appropriate by to furnishing services for which payment is provide for the transfer, from the Federal the Secretary.’’.

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00015 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2452 CONGRESSIONAL RECORD — HOUSE March 14, 2014

(d) TARGET FOR RELATIVE VALUE ADJUST- (2) CONFORMING AMENDMENTS.—Section graphic index values computed for the fee MENTS FOR MISVALUED SERVICES.— 1848(c)(2) of the Social Security Act (42 schedule area under subparagraph (A) for the (1) IN GENERAL.—Section 1848(c)(2) of the U.S.C. 1395w–4(c)(2)) is amended— year (determined without regard to this sub- Social Security Act (42 U.S.C. 1395w–4(c)(2)), (A) in subparagraph (B)(ii)(I), by striking paragraph). as amended by subsections (a) and (b), is ‘‘subclause (II)’’ and inserting ‘‘subclause (II) ‘‘(ii) OLD WEIGHTING FACTOR.—The old amended by adding at the end the following and paragraph (7)’’; and weighting factor described in this clause— new subparagraph: (B) in subparagraph (K)(iii)(VI)— ‘‘(I) for 2017, is 5⁄6; and ‘‘(O) TARGET FOR RELATIVE VALUE ADJUST- (i) by striking ‘‘provisions of subparagraph ‘‘(II) for each succeeding year, is the old MENTS FOR MISVALUED SERVICES.—With re- (B)(ii)(II)’’ and inserting ‘‘provisions of sub- weighting factor described in this clause for spect to fee schedules established for each of paragraph (B)(ii)(II) and paragraph (7)’’; and the previous year minus 1⁄6. 2015 through 2018, the following shall apply: (ii) by striking ‘‘under subparagraph ‘‘(iii) MSA-BASED WEIGHTING FACTOR.—The ‘‘(i) DETERMINATION OF NET REDUCTION IN (B)(ii)(II)’’ and inserting ‘‘under subpara- MSA-based weighting factor described in EXPENDITURES.—For each year, the Secretary graph (B)(ii)(I)’’. this clause for a year is 1 minus the old shall determine the estimated net reduction (f) AUTHORITY TO SMOOTH RELATIVE VAL- weighting factor under clause (ii) for that in expenditures under the fee schedule under UES WITHIN GROUPS OF SERVICES.—Section year. this section with respect to the year as a re- 1848(c)(2)(C) of the Social Security Act (42 ‘‘(C) HOLD HARMLESS.—For services fur- sult of adjustments to the relative values es- U.S.C. 1395w–4(c)(2)(C)) is amended— nished in a transition area in California dur- tablished under this paragraph for misvalued (1) in each of clauses (i) and (iii), by strik- ing a year beginning with 2017, the geo- codes. ing ‘‘the service’’ and inserting ‘‘the service graphic index values to be applied under this ‘‘(ii) BUDGET NEUTRAL REDISTRIBUTION OF or group of services’’ each place it appears; subsection for such year shall not be less FUNDS IF TARGET MET AND COUNTING OVER- and than the corresponding geographic index val- AGES TOWARDS THE TARGET FOR THE SUC- (2) in the first sentence of clause (ii), by in- ues that would have applied in such transi- CEEDING YEAR.—If the estimated net reduc- serting ‘‘or group of services’’ before the pe- tion area (as estimated by the Secretary) if tion in expenditures determined under clause riod. this paragraph did not apply. (i) for the year is equal to or greater than (g) GAO STUDY AND REPORT ON RELATIVE ‘‘(D) TRANSITION AREA DEFINED.—In this the target for the year— VALUE SCALE UPDATE COMMITTEE.— paragraph, the term ‘transition area’ means ‘‘(I) reduced expenditures attributable to (1) STUDY.—The Comptroller General of the each of the following fee schedule areas for such adjustments shall be redistributed for United States (in this subsection referred to 2013: the year in a budget neutral manner in ac- as the ‘‘Comptroller General’’) shall conduct ‘‘(i) The rest-of-State payment locality. cordance with subparagraph (B)(ii)(II); and a study of the processes used by the Relative ‘‘(ii) Payment locality 3. Value Scale Update Committee (RUC) to pro- ‘‘(II) the amount by which such reduced ex- ‘‘(E) REFERENCES TO FEE SCHEDULE vide recommendations to the Secretary of penditures exceeds the target for the year AREAS.—Effective for services furnished on shall be treated as a reduction in expendi- Health and Human Services regarding rel- or after January 1, 2017, for California, any tures described in clause (i) for the suc- ative values for specific services under the reference in this section to a fee schedule ceeding year, for purposes of determining Medicare physician fee schedule under sec- area shall be deemed a reference to a fee whether the target has or has not been met tion 1848 of the Social Security Act (42 schedule area established in accordance with under this subparagraph with respect to that U.S.C. 1395w–4). this paragraph.’’. (2) REPORT.—Not later than 1 year after year. (2) CONFORMING AMENDMENT TO DEFINITION the date of the enactment of this Act, the ‘‘(iii) EXEMPTION FROM BUDGET NEUTRALITY OF FEE SCHEDULE AREA.—Section 1848(j)(2) of IF TARGET NOT MET.—If the estimated net re- Comptroller General shall submit to Con- the Social Security Act (42 U.S.C. 1395w– duction in expenditures determined under gress a report containing the results of the 4(j)(2)) is amended by striking ‘‘The term’’ clause (i) for the year is less than the target study conducted under paragraph (1). and inserting ‘‘Except as provided in sub- (h) ADJUSTMENT TO MEDICARE PAYMENT LO- for the year, reduced expenditures in an section (e)(6)(D), the term’’. CALITIES.— amount equal to the target recapture (i) DISCLOSURE OF DATA USED TO ESTABLISH (1) IN GENERAL.—Section 1848(e) of the So- amount shall not be taken into account in MULTIPLE PROCEDURE PAYMENT REDUCTION cial Security Act (42 U.S.C. 1395w–4(e)) is applying subparagraph (B)(ii)(II) with re- POLICY.—The Secretary of Health and spect to fee schedules beginning with 2015. amended by adding at the end the following Human Services shall make publicly avail- ‘‘(iv) TARGET RECAPTURE AMOUNT.—For new paragraph: able the information used to establish the purposes of clause (iii), the target recapture ‘‘(6) USE OF MSAS AS FEE SCHEDULE AREAS IN multiple procedure payment reduction pol- amount is, with respect to a year, an amount CALIFORNIA.— icy to the professional component of imaging equal to the difference between— ‘‘(A) IN GENERAL.—Subject to the suc- services in the final rule published in the ‘‘(I) the target for the year; and ceeding provisions of this paragraph and not- Federal Register, v. 77, n. 222, November 16, ‘‘(II) the estimated net reduction in ex- withstanding the previous provisions of this 2012, pages 68891–69380 under the physician penditures determined under clause (i) for subsection, for services furnished on or after fee schedule under section 1848 of the Social the year. January 1, 2017, the fee schedule areas used Security Act (42 U.S.C. 1395w–4). ‘‘(v) TARGET.—For purposes of this sub- for payment under this section applicable to SEC. 6. PROMOTING EVIDENCE-BASED CARE. paragraph, with respect to a year, the target California shall be the following: (a) IN GENERAL.—Section 1834 of the Social is calculated as 0.5 percent of the estimated ‘‘(i) Each Metropolitan Statistical Area Security Act (42 U.S.C. 1395m) is amended by amount of expenditures under the fee sched- (each in this paragraph referred to as an adding at the end the following new sub- ule under this section for the year.’’. ‘MSA’), as defined by the Director of the Of- section: (2) CONFORMING AMENDMENT.—Section fice of Management and Budget as of Decem- ‘‘(p) RECOGNIZING APPROPRIATE USE CRI- 1848(c)(2)(B)(v) of the Social Security Act (42 ber 31 of the previous year, shall be a fee TERIA FOR CERTAIN IMAGING SERVICES.— U.S.C. 1395w–4(c)(2)(B)(v)) is amended by add- schedule area. ‘‘(1) PROGRAM ESTABLISHED.— ing at the end the following new subclause: ‘‘(ii) All areas not included in an MSA ‘‘(A) IN GENERAL.—The Secretary shall es- ‘‘(VIII) REDUCTIONS FOR MISVALUED SERV- shall be treated as a single rest-of-State fee tablish a program to promote the use of ap- ICES IF TARGET NOT MET.—Effective for fee schedule area. propriate use criteria (as defined in subpara- schedules beginning with 2015, reduced ex- ‘‘(B) TRANSITION FOR MSAS PREVIOUSLY IN graph (B)) for applicable imaging services (as penditures attributable to the application of REST-OF-STATE PAYMENT LOCALITY OR IN LO- defined in subparagraph (C)) furnished in an the target recapture amount described in CALITY 3.— applicable setting (as defined in subpara- subparagraph (O)(iii).’’. ‘‘(i) IN GENERAL.—For services furnished in graph (D)) by ordering professionals and fur- (e) PHASE-INOFSIGNIFICANT RELATIVE California during a year beginning with 2017 nishing professionals (as defined in subpara- VALUE UNIT (RVU) REDUCTIONS.— and ending with 2021 in an MSA in a transi- graphs (E) and (F), respectively). (1) IN GENERAL.—Section 1848(c) of the So- tion area (as defined in subparagraph (D)), ‘‘(B) APPROPRIATE USE CRITERIA DEFINED.— cial Security Act (42 U.S.C. 1395w–4(c)) is subject to subparagraph (C), the geographic In this subsection, the term ‘appropriate use amended by adding at the end the following index values to be applied under this sub- criteria’ means criteria, only developed or new paragraph: section for such year shall be equal to the endorsed by national professional medical ‘‘(7) PHASE-IN OF SIGNIFICANT RELATIVE sum of the following: specialty societies or other provider-led enti- VALUE UNIT (RVU) REDUCTIONS.—Effective for ‘‘(I) CURRENT LAW COMPONENT.—The old ties, to assist ordering professionals and fur- fee schedules established beginning with weighting factor (described in clause (ii)) for nishing professionals in making the most ap- 2015, if the total relative value units for a such year multiplied by the geographic index propriate treatment decision for a specific service for a year would otherwise be de- values under this subsection for the fee clinical condition. To the extent feasible, creased by an estimated amount equal to or schedule area that included such MSA that such criteria shall be evidence-based. greater than 20 percent as compared to the would have applied in such area (as esti- ‘‘(C) APPLICABLE IMAGING SERVICE DE- total relative value units for the previous mated by the Secretary) if this paragraph FINED.—In this subsection, the term ‘applica- year, the applicable adjustments in work, did not apply. ble imaging service’ means an advanced di- practice expense, and malpractice relative ‘‘(II) MSA-BASED COMPONENT.—The MSA- agnostic imaging service (as defined in sub- value units shall be phased-in over a 2-year based weighting factor (described in clause section (e)(1)(B)) for which the Secretary de- period.’’. (iii)) for such year multiplied by the geo- termines—

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00016 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2453 ‘‘(i) one or more applicable appropriate use ‘‘(II) Use of private sector clinical decision consulted by the ordering professional for criteria specified under paragraph (2) apply; support mechanisms that are independent the service. ‘‘(ii) there are one or more qualified clin- from certified EHR technology, which may ‘‘(ii) Information regarding— ical decision support mechanisms listed include use of clinical decision support ‘‘(I) whether the service ordered would ad- under paragraph (3)(C); and mechanisms available from medical spe- here to the applicable appropriate use cri- ‘‘(iii) one or more of such mechanisms is cialty organizations. teria specified under paragraph (2); available free of charge. ‘‘(III) Use of a clinical decision support ‘‘(II) whether the service ordered would not ‘‘(D) APPLICABLE SETTING DEFINED.—In this mechanism established by the Secretary. adhere to such criteria; or subsection, the term ‘applicable setting’ ‘‘(B) QUALIFIED CLINICAL DECISION SUPPORT ‘‘(III) whether such criteria was not appli- means a physician’s office, a hospital out- MECHANISMS.— cable to the service ordered. patient department (including an emergency ‘‘(i) IN GENERAL.—For purposes of this sub- ‘‘(iii) The national provider identifier of department), an ambulatory surgical center, section, a qualified clinical decision support the ordering professional (if different from and any other provider-led outpatient set- mechanism is a mechanism that the Sec- the furnishing professional). ting determined appropriate by the Sec- retary determines meets the requirements ‘‘(C) EXCEPTIONS.—The provisions of sub- retary. described in clause (ii). paragraphs (A) and (B) and paragraph (6)(A) shall not apply to the following: ‘‘(E) ORDERING PROFESSIONAL DEFINED.—In ‘‘(ii) REQUIREMENTS.—The requirements de- this subsection, the term ‘ordering profes- scribed in this clause are the following: ‘‘(i) EMERGENCY SERVICES.—An applicable sional’ means a physician (as defined in sec- ‘‘(I) The mechanism makes available to the imaging service ordered for an individual with an emergency medical condition (as de- tion 1861(r)) or a practitioner described in ordering professional applicable appropriate fined in section 1867(e)(1)). section 1842(b)(18)(C) who orders an applica- use criteria specified under paragraph (2) and ‘‘(ii) INPATIENT SERVICES.—An applicable ble imaging service for an individual. the supporting documentation for the appli- imaging service ordered for an inpatient and ‘‘(F) FURNISHING PROFESSIONAL DEFINED.— cable imaging service ordered. for which payment is made under part A. In this subsection, the term ‘furnishing pro- ‘‘(II) In the case where there are more than ‘‘(iii) ALTERNATIVE PAYMENT MODELS.—An fessional’ means a physician (as defined in one applicable appropriate use criteria speci- applicable imaging service ordered by an or- fied under such paragraph for an applicable section 1861(r)) or a practitioner described in dering professional with respect to an indi- section 1842(b)(18)(C) who furnishes an appli- imaging service, the mechanism indicates vidual attributed to an alternative payment cable imaging service for an individual. the criteria that it uses for the service. model (as defined in section 1833(z)(3)(C)). ‘‘(2) ESTABLISHMENT OF APPLICABLE APPRO- ‘‘(III) The mechanism determines the ex- ‘‘(iv) SIGNIFICANT HARDSHIP.—An applicable PRIATE USE CRITERIA.— tent to which an applicable imaging service imaging service ordered by an ordering pro- ‘‘(A) IN GENERAL.—Not later than Novem- ordered is consistent with the applicable ap- fessional who the Secretary may, on a case- ber 15, 2015, the Secretary shall through rule- propriate use criteria so specified. by-case basis, exempt from the application of making, and in consultation with physicians, ‘‘(IV) The mechanism generates and pro- such provisions if the Secretary determines, practitioners, and other stakeholders, speci- vides to the ordering professional a certifi- subject to annual renewal, that consultation fy applicable appropriate use criteria for ap- cation or documentation that documents with applicable appropriate use criteria plicable imaging services only from among that the qualified clinical decision support would result in a significant hardship, such appropriate use criteria developed or en- mechanism was consulted by the ordering as in the case of a professional who practices dorsed by national professional medical spe- professional. in a rural area without sufficient Internet cialty societies or other provider-led enti- ‘‘(V) The mechanism is updated on a time- access. ties. ly basis to reflect revisions to the specifica- ‘‘(D) APPLICABLE PAYMENT SYSTEM DE- ‘‘(B) CONSIDERATIONS.—In specifying appli- tion of applicable appropriate use criteria FINED.—In this subsection, the term ‘applica- cable appropriate use criteria under subpara- under such paragraph. ble payment system’ means the following: graph (A), the Secretary shall take into ac- ‘‘(VI) The mechanism meets privacy and ‘‘(i) The physician fee schedule established count whether the criteria— security standards under applicable provi- under section 1848(b). ‘‘(i) have stakeholder consensus; sions of law. ‘‘(ii) The prospective payment system for ‘‘(ii) are scientifically valid and evidence ‘‘(VII) The mechanism performs such other hospital outpatient department services based; and functions as specified by the Secretary, under section 1833(t). ‘‘(iii) are based on studies that are pub- which may include a requirement to provide ‘‘(iii) The ambulatory surgical center pay- lished and reviewable by stakeholders. aggregate feedback to the ordering profes- ment systems under section 1833(i). ‘‘(C) REVISIONS.—The Secretary shall re- sional. ‘‘(5) IDENTIFICATION OF OUTLIER ORDERING view, on an annual basis, the specified appli- ‘‘(C) LIST OF MECHANISMS FOR CONSULTATION PROFESSIONALS.— cable appropriate use criteria to determine if WITH APPLICABLE APPROPRIATE USE CRI- ‘‘(A) IN GENERAL.—With respect to applica- there is a need to update or revise (as appro- TERIA.— ble imaging services furnished beginning priate) such specification of applicable ap- ‘‘(i) INITIAL LIST.—Not later than April 1, with 2017, the Secretary shall determine, on propriate use criteria and make such updates 2016, the Secretary shall publish a list of an annual basis, no more than five percent of or revisions through rulemaking. mechanisms specified under this paragraph. the total number of ordering professionals ‘‘(D) TREATMENT OF MULTIPLE APPLICABLE ‘‘(ii) PERIODIC UPDATING OF LIST.—The Sec- who are outlier ordering professionals. APPROPRIATE USE CRITERIA.—In the case retary shall identify on an annual basis the ‘‘(B) OUTLIER ORDERING PROFESSIONALS.— where the Secretary determines that more list of qualified clinical decision support The determination of an outlier ordering than one appropriate use criteria applies mechanisms specified under this paragraph. professional shall— with respect to an applicable imaging serv- ‘‘(4) CONSULTATION WITH APPLICABLE APPRO- ‘‘(i) be based on low adherence to applica- ice, the Secretary shall permit one or more PRIATE USE CRITERIA.— ble appropriate use criteria specified under applicable appropriate use criteria under ‘‘(A) CONSULTATION BY ORDERING PROFES- paragraph (2), which may be based on com- this paragraph for the service. SIONAL.—Beginning with January 1, 2017, sub- parison to other ordering professionals; and ‘‘(3) MECHANISMS FOR CONSULTATION WITH ject to subparagraph (C), with respect to an ‘‘(ii) include data for ordering professionals APPLICABLE APPROPRIATE USE CRITERIA.— applicable imaging service ordered by an or- for whom prior authorization under para- ‘‘(A) IDENTIFICATION OF MECHANISMS TO CON- dering professional that would be furnished graph (6)(A) applies. SULT WITH APPLICABLE APPROPRIATE USE CRI- in an applicable setting and paid for under ‘‘(C) USE OF TWO YEARS OF DATA.—The Sec- TERIA.— an applicable payment system (as defined in retary shall use two years of data to identify ‘‘(i) IN GENERAL.—The Secretary shall subparagraph (D)), an ordering professional outlier ordering professionals under this specify qualified clinical decision support shall— paragraph. mechanisms that could be used by ordering ‘‘(i) consult with a qualified decision sup- ‘‘(D) PROCESS.—The Secretary shall estab- professionals to consult with applicable ap- port mechanism listed under paragraph lish a process for determining when an propriate use criteria for applicable imaging (3)(C); and outlier ordering professional is no longer an services. ‘‘(ii) provide to the furnishing professional outlier ordering professional. ‘‘(ii) CONSULTATION.—The Secretary shall the information described in clauses (i) ‘‘(E) CONSULTATION WITH STAKEHOLDERS.— consult with physicians, practitioners, through (iii) of subparagraph (B). The Secretary shall consult with physicians, health care technology experts, and other ‘‘(B) REPORTING BY FURNISHING PROFES- practitioners and other stakeholders in de- stakeholders in specifying mechanisms SIONAL.—Beginning with January 1, 2017, sub- veloping methods to identify outlier order- under this paragraph. ject to subparagraph (C), with respect to an ing professionals under this paragraph. ‘‘(iii) INCLUSION OF CERTAIN MECHANISMS.— applicable imaging service furnished in an ‘‘(6) PRIOR AUTHORIZATION FOR ORDERING Mechanisms specified under this paragraph applicable setting and paid for under an ap- PROFESSIONALS WHO ARE OUTLIERS.— may include any or all of the following that plicable payment system (as defined in sub- ‘‘(A) IN GENERAL.—Beginning January 1, meet the requirements described in subpara- paragraph (D)), payment for such service 2020, subject to paragraph (4)(C), with respect graph (B)(ii): may only be made if the claim for the serv- to services furnished during a year, the Sec- ‘‘(I) Use of clinical decision support mod- ice includes the following: retary shall, for a period determined appro- ules in certified EHR technology (as defined ‘‘(i) Information about which qualified priate by the Secretary, apply prior author- in section 1848(o)(4)). clinical decision support mechanism was ization for applicable imaging services that

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00017 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2454 CONGRESSIONAL RECORD — HOUSE March 14, 2014

are ordered by an outlier ordering profes- (B) with respect to other eligible profes- (B) PURPOSES DESCRIBED.—The purposes de- sional identified under paragraph (5). sionals, by not later than July 1, 2016. scribed in this subparagraph are assisting ‘‘(B) APPROPRIATE USE CRITERIA IN PRIOR (2) ANNUAL UPDATING.—The information providers of services and suppliers in devel- AUTHORIZATION.—In applying prior authoriza- made available under this section shall be oping and participating in quality and pa- tion under subparagraph (A), the Secretary updated on Physician Compare not less fre- tient care improvement activities, including shall utilize only the applicable appropriate quently than on an annual basis. developing new models of care. use criteria specified under this subsection. (f) OPPORTUNITY TO REVIEW AND SUBMIT (C) MEDICARE CLAIMS DATA MUST BE PRO- ‘‘(C) FUNDING.—For purposes of carrying CORRECTIONS.—The Secretary shall provide VIDED AT NO COST.—A qualified entity may out this paragraph, the Secretary shall pro- for an opportunity for an eligible profes- not charge a fee for providing the data under vide for the transfer, from the Federal Sup- sional to review, and submit corrections for, subparagraph (A)(ii). plementary Medical Insurance Trust Fund the information to be made public with re- (3) PROTECTION OF INFORMATION.— under section 1841, of $5,000,000 to the Centers spect to the eligible professional under this (A) IN GENERAL.—Except as provided in for Medicare & Medicaid Services Program section prior to such information being made subparagraph (B), an analysis or data that is Management Account for each of fiscal years public. provided or sold under paragraph (1) or (2) 2019 through 2021. Amounts transferred under (g) DEFINITIONS.—In this section: shall not contain information that individ- the preceding sentence shall remain avail- (1) ELIGIBLE PROFESSIONAL; PHYSICIAN; SEC- ually identifies a patient. able until expended. RETARY.—The terms ‘‘eligible professional’’, (B) INFORMATION ON PATIENTS OF THE PRO- ‘‘(7) CONSTRUCTION.—Nothing in this sub- ‘‘physician’’, and ‘‘Secretary’’ have the VIDER OF SERVICES OR SUPPLIER.—To the ex- section shall be construed as granting the meaning given such terms in section 10331(i) tent consistent with applicable information, Secretary the authority to develop or ini- of Public Law 111–148. privacy, security, and disclosure laws, an tiate the development of clinical practice (2) PHYSICIAN COMPARE.—The term ‘‘Physi- analysis or data that is provided or sold to a guidelines or appropriate use criteria.’’. cian Compare’’ means the Physician Com- provider of services or supplier under para- (b) CONFORMING AMENDMENT.—Section pare Internet website of the Centers for graph (1) or (2) may contain information that 1833(t)(16) of the Social Security Act (42 Medicare & Medicaid Services (or a successor individually identifies a patient of such pro- U.S.C. 1395l(t)(16)) is amended by adding at website). vider or supplier, including with respect to the end the following new subparagraph: SEC. 8. EXPANDING AVAILABILITY OF MEDICARE items and services furnished to the patient ‘‘(E) APPLICATION OF APPROPRIATE USE CRI- DATA. by other providers of services or suppliers. TERIA FOR CERTAIN IMAGING SERVICES.—For (a) EXPANDING USES OF MEDICARE DATA BY (C) PROHIBITION ON USING ANALYSES OR provisions relating to the application of ap- QUALIFIED ENTITIES.— DATA FOR MARKETING PURPOSES.—An author- propriate use criteria for certain imaging (1) ADDITIONAL ANALYSES.— ized user shall not use an analysis or data services, see section 1834(p).’’. (A) IN GENERAL.—Subject to subparagraph provided or sold under paragraph (1) or (2) for (c) REPORT ON EXPERIENCE OF IMAGING AP- (B), to the extent consistent with applicable marketing purposes. PROPRIATE USE CRITERIA PROGRAM.—Not information, privacy, security, and disclo- (4) DATA USE AGREEMENT.—A qualified enti- later than 18 months after the date of the en- sure laws (including paragraph (3)), notwith- ty and an authorized user described in actment of this Act, the Comptroller General standing paragraph (4)(B) of section 1874(e) of clauses (i), (ii), and (v) of paragraph (9)(A) of the United States shall submit to Con- the Social Security Act (42 U.S.C. 1395kk(e)) shall enter into an agreement regarding the gress a report that includes a description of and the second sentence of paragraph (4)(D) use of any data that the qualified entity is the extent to which appropriate use criteria of such section, beginning July 1, 2015, a providing or selling to the authorized user could be used for other services under part B qualified entity may use the combined data under paragraph (2). Such agreement shall of title XVIII of the Social Security Act (42 described in paragraph (4)(B)(iii) of such sec- describe the requirements for privacy and se- U.S.C. 1395j et seq.), such as radiation ther- tion received by such entity under such sec- curity of the data and, as determined appro- apy and clinical diagnostic laboratory serv- tion, and information derived from the eval- priate by the Secretary, any prohibitions on ices. uation described in such paragraph (4)(D), to using such data to link to other individually SEC. 7. EMPOWERING BENEFICIARY CHOICES conduct additional non-public analyses (as identifiable sources of information. If the au- THROUGH ACCESS TO INFORMATION ON PHYSICIANS’ SERVICES. determined appropriate by the Secretary) thorized user is not a covered entity under (a) IN GENERAL.—The Secretary shall make and provide or sell such analyses to author- the rules promulgated pursuant to the publicly available on Physician Compare the ized users for non-public use (including for Health Insurance Portability and Account- information described in subsection (b) with the purposes of assisting providers of serv- ability Act of 1996, the agreement shall iden- respect to eligible professionals. ices and suppliers to develop and participate tify the relevant regulations, as determined (b) INFORMATION DESCRIBED.—The following in quality and patient care improvement ac- by the Secretary, that the user shall comply information, with respect to an eligible pro- tivities, including developing new models of with as if it were acting in the capacity of fessional, is described in this subsection: care). such a covered entity. (1) Information on the number of services (B) LIMITATIONS WITH RESPECT TO ANAL- (5) NO REDISCLOSURE OF ANALYSES OR furnished by the eligible professional under YSES.— DATA.— part B of title XVIII of the Social Security (i) EMPLOYERS.—Any analyses provided or (A) IN GENERAL.—Except as provided in Act (42 U.S.C. 1395j et seq.), which may in- sold under subparagraph (A) to an employer subparagraph (B), an authorized user that is clude information on the most frequent serv- described in paragraph (9)(A)(iii) may only provided or sold an analysis or data under ices furnished or groupings of services. be used by such employer for purposes of pro- paragraph (1) or (2) shall not redisclose or (2) Information on submitted charges and viding health insurance to employees and re- make public such analysis or data or any payments for services under such part. tirees of the employer. analysis using such data. (3) A unique identifier for the eligible pro- (ii) HEALTH INSURANCE ISSUERS.—A quali- (B) PERMITTED REDISCLOSURE.—A provider fessional that is available to the public, such fied entity may not provide or sell an anal- of services or supplier that is provided or as a national provider identifier. ysis to a health insurance issuer described in sold an analysis or data under paragraph (1) (c) SEARCHABILITY.—The information made paragraph (9)(A)(iv) unless the issuer is pro- or (2) may, as determined by the Secretary, available under this section shall be search- viding the qualified entity with data under redisclose such analysis or data for the pur- able by at least the following: section 1874(e)(4)(B)(iii) of the Social Secu- poses of performance improvement and care (1) The specialty or type of the eligible rity Act (42 U.S.C. 1395kk(e)(4)(B)(iii)). coordination activities but shall not make professional. (2) ACCESS TO CERTAIN DATA.— public such analysis or data or any analysis (2) Characteristics of the services fur- (A) ACCESS.—To the extent consistent with using such data. nished, such as volume or groupings of serv- applicable information, privacy, security, (6) OPPORTUNITY FOR PROVIDERS OF SERV- ices. and disclosure laws (including paragraph (3)), ICES AND SUPPLIERS TO REVIEW.—Prior to a (3) The location of the eligible profes- notwithstanding paragraph (4)(B) of section qualified entity providing or selling an anal- sional. 1874(e) of the Social Security Act (42 U.S.C. ysis to an authorized user under paragraph (d) DISCLOSURE.—The information made 1395kk(e)) and the second sentence of para- (1), to the extent that such analysis would available under this section shall indicate, graph (4)(D) of such section, beginning July individually identify a provider of services or where appropriate, that publicized informa- 1, 2015, a qualified entity may— supplier who is not being provided or sold tion may not be representative of the eligi- (i) provide or sell the combined data de- such analysis, such qualified entity shall ble professional’s entire patient population, scribed in paragraph (4)(B)(iii) of such sec- provide such provider or supplier with the the variety of services furnished by the eligi- tion to authorized users described in clauses opportunity to appeal and correct errors in ble professional, or the health conditions of (i), (ii), and (v) of paragraph (9)(A) for non- the manner described in section individuals treated. public use, including for the purposes de- 1874(e)(4)(C)(ii) of the Social Security Act (42 (e) IMPLEMENTATION.— scribed in subparagraph (B); or U.S.C. 1395kk(e)(4)(C)(ii)). (1) INITIAL IMPLEMENTATION.—Physician (ii) subject to subparagraph (C), provide (7) ASSESSMENT FOR A BREACH.— Compare shall include the information de- Medicare claims data to authorized users de- (A) IN GENERAL.—In the case of a breach of scribed in subsection (b)— scribed in clauses (i), (ii), and (v), of para- a data use agreement under this section or (A) with respect to physicians, by not later graph (9)(A) for non-public use, including for section 1874(e) of the Social Security Act (42 than July 1, 2015; and the purposes described in subparagraph (B). U.S.C. 1395kk(e)), the Secretary shall impose

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00018 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2455 an assessment on the qualified entity both in 1848(m)(3)(E) of the Social Security Act (42 sician or practitioner under subparagraph the case of— U.S.C. 1395w–4(m)(3)(E)), provide the data de- (B), the 2-year period beginning on the date (i) an agreement between the Secretary scribed in subparagraph (B) (in a form and the affidavit is signed and includes each sub- and a qualified entity; and manner determined to be appropriate) to sequent 2-year period unless the physician or (ii) an agreement between a qualified enti- such qualified clinical data registry for pur- practitioner involved provides notice to the ty and an authorized user. poses of linking such data with clinical out- Secretary (in a form and manner specified by (B) ASSESSMENT.—The assessment under comes data and performing risk-adjusted, the Secretary), not later than 30 days before subparagraph (A) shall be an amount up to scientifically valid analyses and research to the end of the previous 2-year period, that $100 for each individual entitled to, or en- support quality improvement or patient safe- the physician or practitioner does not want rolled for, benefits under part A of title ty, provided that any public reporting of to extend the application of the affidavit for XVIII of the Social Security Act or enrolled such analyses or research that identifies a such subsequent 2-year period.’’. for benefits under part B of such title— provider of services or supplier shall only be (B) EFFECTIVE DATE.—The amendments (i) in the case of an agreement described in conducted with the opportunity of such pro- made by subparagraph (A) shall apply to affi- subparagraph (A)(i), for whom the Secretary vider or supplier to appeal and correct errors davits entered into on or after the date that provided data on to the qualified entity in the manner described in subsection (a)(6). is 60 days after the date of the enactment of under paragraph (2); and (B) DATA DESCRIBED.—The data described this Act. (ii) in the case of an agreement described in this subparagraph is— (2) PUBLIC AVAILABILITY OF INFORMATION ON in subparagraph (A)(ii), for whom the quali- (i) claims data under the Medicare pro- OPT-OUT PHYSICIANS AND PRACTITIONERS.— fied entity provided data on to the author- gram under title XVIII of the Social Secu- Section 1802(b) of the Social Security Act (42 ized user under paragraph (2). rity Act; and U.S.C. 1395a(b)) is amended— (C) DEPOSIT OF AMOUNTS COLLECTED.—Any (ii) if the Secretary determines appro- (A) in paragraph (5), by adding at the end amounts collected pursuant to this para- priate, claims data under the Medicaid pro- the following new subparagraph: graph shall be deposited in Federal Supple- gram under title XIX of such Act and the ‘‘(D) OPT-OUT PHYSICIAN OR PRACTITIONER.— mentary Medical Insurance Trust Fund State Children’s Health Insurance Program The term ‘opt-out physician or practitioner’ under section 1841 of the Social Security Act under title XXI of such Act. means a physician or practitioner who has in (42 U.S.C. 1395t). (2) FEE.—Data described in paragraph effect an affidavit under paragraph (3)(B).’’; (8) ANNUAL REPORTS.—Any qualified entity (1)(B) shall be provided to a qualified clinical (B) by redesignating paragraph (5) as para- that provides or sells an analysis or data data registry under paragraph (1) at a fee graph (6); and under paragraph (1) or (2) shall annually sub- equal to the cost of providing such data. Any (C) by inserting after paragraph (4) the fol- mit to the Secretary a report that includes— fee collected pursuant to the preceding sen- lowing new paragraph: (A) a summary of the analyses provided or tence shall be deposited in the Centers for ‘‘(5) POSTING OF INFORMATION ON OPT-OUT sold, including the number of such analyses, Medicare & Medicaid Services Program Man- PHYSICIANS AND PRACTITIONERS.— the number of purchasers of such analyses, agement Account. ‘‘(A) IN GENERAL.—Beginning not later and the total amount of fees received for (c) EXPANSION OF DATA AVAILABLE TO than February 1, 2015, the Secretary shall such analyses; QUALIFIED ENTITIES.—Section 1874(e) of the make publicly available through an appro- (B) a description of the topics and purposes Social Security Act (42 U.S.C. 1395kk(e)) is priate publicly accessible website of the De- of such analyses; amended— partment of Health and Human Services in- (C) information on the entities who re- (1) in the subsection heading, by striking formation on the number and characteristics ceived the data under paragraph (2), the uses ‘‘MEDICARE’’; and of opt-out physicians and practitioners and of the data, and the total amount of fees re- (2) in paragraph (3)— shall update such information on such ceived for providing, selling, or sharing the (A) by inserting after the first sentence the website not less often than annually. data; and following new sentence: ‘‘Beginning July 1, ‘‘(B) INFORMATION TO BE INCLUDED.—The in- (D) other information determined appro- 2015, if the Secretary determines appro- formation to be made available under sub- priate by the Secretary. priate, the data described in this paragraph paragraph (A) shall include at least the fol- (9) DEFINITIONS.—In this subsection and may also include standardized extracts (as lowing with respect to opt-out physicians subsection (b): determined by the Secretary) of claims data and practitioners: (A) AUTHORIZED USER.—The term ‘‘author- under titles XIX and XXI for assistance pro- ‘‘(i) Their number. ized user’’ means the following: vided under such titles for one or more speci- ‘‘(ii) Their physician or professional spe- (i) A provider of services. fied geographic areas and time periods re- cialty or other designation. (ii) A supplier. quested by a qualified entity.’’; and ‘‘(iii) Their geographic distribution. (iii) An employer (as defined in section 3(5) (B) in the last sentence, by inserting ‘‘or ‘‘(iv) The timing of their becoming opt-out of the Employee Retirement Insurance Secu- under titles XIX or XXI’’ before the period at physicians and practitioners, relative to rity Act of 1974). the end. when they first entered practice and with re- (iv) A health insurance issuer (as defined in (d) REVISION OF PLACEMENT OF FEES.—Sec- spect to applicable 2-year periods. section 2791 of the Public Health Service tion 1874(e)(4)(A) of the Social Security Act ‘‘(v) The proportion of such physicians and Act). (42 U.S.C. 1395kk(e)(4)(A)) is amended, in the practitioners who billed for emergency or ur- second sentence— (v) A medical society or hospital associa- gent care services.’’. tion. (1) by inserting ‘‘, for periods prior to July (b) GAINSHARING STUDY AND REPORT.—Not (vi) Any entity not described in clauses (i) 1, 2015,’’ after ‘‘deposited’’; and later than 6 months after the date of the en- through (v) that is approved by the Sec- (2) by inserting the following before the pe- actment of this Act, the Secretary of Health retary (other than an employer or health in- riod at the end: ‘‘, and, beginning July 1, and Human Services, in consultation with surance issuer not described in clauses (iii) 2015, into the Centers for Medicare & Med- the Inspector General of the Department of and (iv), respectively, as determined by the icaid Services Program Management Ac- Health and Human Services, shall submit to Secretary). count’’. Congress a report with legislative rec- (B) PROVIDER OF SERVICES.—The term ‘‘pro- SEC. 9. REDUCING ADMINISTRATIVE BURDEN ommendations to amend existing fraud and vider of services’’ has the meaning given AND OTHER PROVISIONS. abuse laws, through exceptions, safe harbors, such term in section 1861(u) of the Social Se- (a) MEDICARE PHYSICIAN AND PRACTITIONER or other narrowly targeted provisions, to curity Act (42 U.S.C. 1395x(u)). OPT-OUT TO PRIVATE CONTRACT.— permit gainsharing or similar arrangements (C) QUALIFIED ENTITY.—The term ‘‘quali- (1) INDEFINITE, CONTINUING AUTOMATIC EX- between physicians and hospitals that im- fied entity’’ has the meaning given such TENSION OF OPT OUT ELECTION.— prove care while reducing waste and increas- term in section 1874(e)(2) of the Social Secu- (A) IN GENERAL.—Section 1802(b)(3) of the ing efficiency. The report shall— rity Act (42 U.S.C. 1395kk(e)). Social Security Act (42 U.S.C. 1395a(b)(3)) is (1) consider whether such provisions should (D) SECRETARY.—The term ‘‘Secretary’’ amended— apply to ownership interests, compensation means the Secretary of Health and Human (i) in subparagraph (B)(ii), by striking arrangements, or other relationships; Services. ‘‘during the 2-year period beginning on the (2) describe how the recommendations ad- (E) SUPPLIER.—The term ‘‘supplier’’ has date the affidavit is signed’’ and inserting dress accountability, transparency, and qual- the meaning given such term in section ‘‘during the applicable 2-year period (as de- ity, including how best to limit inducements 1861(d) of the Social Security Act (42 U.S.C. fined in subparagraph (D))’’; to stint on care, discharge patients pre- 1395x(d)). (ii) in subparagraph (C), by striking ‘‘dur- maturely, or otherwise reduce or limit medi- (b) ACCESS TO MEDICARE DATA BY QUALI- ing the 2-year period described in subpara- cally necessary care; and FIED CLINICAL DATA REGISTRIES TO FACILI- graph (B)(ii)’’ and inserting ‘‘during the ap- (3) consider whether a portion of any sav- TATE QUALITY IMPROVEMENT.— plicable 2-year period’’; and ings generated by such arrangements should (1) ACCESS.— (iii) by adding at the end the following new accrue to the Medicare program under title (A) IN GENERAL.—To the extent consistent subparagraph: XVIII of the Social Security Act. with applicable information, privacy, secu- ‘‘(D) APPLICABLE 2-YEAR PERIODS FOR EF- (c) PROMOTING INTEROPERABILITY OF ELEC- rity, and disclosure laws, beginning July 1, FECTIVENESS OF AFFIDAVITS.—In this sub- TRONIC HEALTH RECORD SYSTEMS.— 2015, the Secretary shall, at the request of a section, the term ‘applicable 2-year period’ (1) RECOMMENDATIONS FOR ACHIEVING WIDE- qualified clinical data registry under section means, with respect to an affidavit of a phy- SPREAD EHR INTEROPERABILITY.—

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00019 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2456 CONGRESSIONAL RECORD — HOUSE March 14, 2014

(A) OBJECTIVE.—As a consequence of a sig- nology products to enable such users to di- tion 1848 of the Social Security Act (42 nificant Federal investment in the imple- rectly compare the functionality and other U.S.C. 1395w–4) in order to accurately reflect mentation of health information technology features of such products. Such information the resources involved in furnishing such through the Medicare and Medicaid EHR in- may be made available through contracts services. centive programs, Congress declares it a na- with physician, hospital, or other organiza- (B) DEFINITIONS.—For purposes of this tional objective to achieve widespread ex- tions that maintain such comparative infor- paragraph: change of health information through inter- mation. (i) REMOTE PATIENT MONITORING SERVICES.— operable certified EHR technology nation- (B) REPORT.—Not later than 1 year after The term ‘‘remote patient monitoring serv- wide by December 31, 2017. the date of the enactment of this Act, the ices’’ means services furnished through re- (B) DEFINITIONS.—In this paragraph: Secretary shall submit to Congress a report mote patient monitoring technology. (i) WIDESPREAD INTEROPERABILITY.—The on the website. The report shall include in- (ii) REMOTE PATIENT MONITORING TECH- term ‘‘widespread interoperability’’ means formation on the benefits of, and resources NOLOGY.—The term ‘‘remote patient moni- interoperability between certified EHR tech- needed to develop and maintain, such a toring technology’’ means a coordinated sys- nology systems employed by meaningful website. tem that uses one or more home-based or EHR users under the Medicare and Medicaid (4) DEFINITIONS.—In this subsection: mobile monitoring devices that automati- EHR incentive programs and other clinicians (A) The term ‘‘certified EHR technology’’ cally transmit vital sign data or information and health care providers on a nationwide has the meaning given such term in section on activities of daily living and may include basis. 1848(o)(4) of the Social Security Act (42 responses to assessment questions collected (ii) INTEROPERABILITY.—The term ‘‘inter- U.S.C. 1395w–4(o)(4)). on the devices wirelessly or through a tele- operability’’ means the ability of two or (B) The term ‘‘meaningful EHR user’’ has communications connection to a server that more health information systems or compo- the meaning given such term under the complies with the Federal regulations (con- nents to exchange clinical and other infor- Medicare EHR incentive programs. cerning the privacy of individually identifi- mation and to use the information that has (C) The term ‘‘Medicare and Medicaid EHR able health information) promulgated under been exchanged using common standards as incentive programs’’ means— section 264(c) of the Health Insurance Port- to provide access to longitudinal informa- (i) in the case of the Medicare program ability and Accountability Act of 1996, as tion for health care providers in order to fa- under title XVIII of the Social Security Act, part of an established plan of care for that cilitate coordinated care and improved pa- the incentive programs under section patient that includes the review and inter- tient outcomes. 1814(l)(3), section 1848(o), subsections (l) and pretation of that data by a health care pro- (C) ESTABLISHMENT OF METRICS.—Not later (m) of section 1853, and section 1886(n) of the fessional. than July 1, 2015, and in consultation with Social Security Act (42 U.S.C. 1395f(l)(3), (3) REPORTS.—Not later than 24 months stakeholders, the Secretary shall establish 1395w–4(o), 1395w–23, 1395ww(n)); and after the date of the enactment of this Act, metrics to be used to determine if and to the (ii) in the case of the Medicaid program the Comptroller General shall submit to extent that the objective described in sub- under title XIX of such Act, the incentive Congress— paragraph (A) has been achieved. program under subsections (a)(3)(F) and (t) (A) a report containing the results of the (D) RECOMMENDATIONS IF OBJECTIVE NOT of section 1903 of such Act (42 U.S.C. 1396b). study conducted under paragraph (1); and ACHIEVED.—If the Secretary of Health and (D) The term ‘‘Secretary’’ means the Sec- (B) a report containing the results of the Human Services determines that the objec- retary of Health and Human Services. study conducted under paragraph (2). tive described in subparagraph (A) has not (d) GAO STUDIES AND REPORTS ON THE USE been achieved by December 31, 2017, then the OF TELEHEALTH UNDER FEDERAL PROGRAMS A report required under this paragraph shall Secretary shall submit to Congress a report, AND ON REMOTE PATIENT MONITORING SERV- be submitted together with recommenda- by not later than December 31, 2018, that ICES.— tions for such legislation and administrative identifies barriers to such objective and rec- (1) STUDY ON TELEHEALTH SERVICES.—The action as the Comptroller General deter- ommends actions that the Federal Govern- Comptroller General of the United States mines appropriate. The Comptroller General ment can take to achieve such objective. shall conduct a study on the following: may submit one report containing the re- Such recommended actions may include rec- (A) How the definition of telehealth across sults described in subparagraphs (A) and (B) ommendations— various Federal programs and Federal efforts and the recommendations described in the (i) to adjust payments for not being mean- can inform the use of telehealth in the Medi- previous sentence. ingful EHR users under the Medicare EHR care program under title XVIII of the Social (e) RULE OF CONSTRUCTION REGARDING incentive programs; and Security Act (42 U.S.C. 1395 et seq.). HEALTHCARE PROVIDER STANDARDS OF (ii) for criteria for decertifying certified (B) Issues that can facilitate or inhibit the CARE.— EHR technology products. use of telehealth under the Medicare pro- (1) MAINTENANCE OF STATE STANDARDS.— (2) PREVENTING BLOCKING THE SHARING OF gram under such title, including oversight The development, recognition, or implemen- INFORMATION.— and professional licensure, changing tech- tation of any guideline or other standard (A) FOR MEANINGFUL EHR PROFESSIONALS.— nology, privacy and security, infrastructure under any Federal health care provision Section 1848(o)(2)(A)(ii) of the Social Secu- requirements, and varying needs across shall not be construed— rity Act (42 U.S.C. 1395w–4(o)(2)(A)(ii)) is urban and rural areas. (A) to establish the standard of care or amended by inserting before the period at (C) Potential implications of greater use of duty of care owed by a health care provider the end the following: ‘‘, and the professional telehealth with respect to payment and de- to a patient in any medical malpractice or demonstrates (through a process specified by livery system transformations under the medical product liability action or claim; or the Secretary, such as the use of an attesta- Medicare program under such title XVIII and (B) to preempt any standard of care or tion) that the professional has not know- the Medicaid program under title XIX of duty of care, owed by a health care provider ingly and willfully taken any action to limit such Act (42 U.S.C. 1396 et seq.). to a patient, duly established under State or or restrict the compatibility or interoper- (D) How the Centers for Medicare & Med- common law. ability of the certified EHR technology’’. icaid Services conducts oversight of pay- (2) DEFINITIONS.—For purposes of this sub- (B) FOR MEANINGFUL EHR HOSPITALS.—Sec- ments made under the Medicare program section: tion 1886(n)(3)(A)(ii) of the Social Security under such title XVIII to providers for tele- (A) FEDERAL HEALTH CARE PROVISION.—The Act (42 U.S.C. 1395ww(n)(3)(A)(ii)) is amended health services. term ‘‘Federal health care provision’’ means by inserting before the period at the end the (2) STUDY ON REMOTE PATIENT MONITORING any provision of the Patient Protection and following: ‘‘, and the hospital demonstrates SERVICES.— (Public Law 111–148), (through a process specified by the Sec- (A) IN GENERAL.—The Comptroller General title I or subtitle B of title II of the Health retary, such as the use of an attestation) of the United States shall conduct a study— Care and Education Reconciliation Act of that the hospital has not knowingly and (i) of the dissemination of remote patient 2010 (Public Law 111–152), or title XVIII or willfully taken any action to limit or re- monitoring technology in the private health XIX of the Social Security Act. strict the compatibility or interoperability insurance market; (B) HEALTH CARE PROVIDER.—The term of the certified EHR technology’’. (ii) of the financial incentives in the pri- ‘‘health care provider’’ means any individual (C) EFFECTIVE DATE.—The amendments vate health insurance market relating to or entity— made by this subsection shall apply to mean- adoption of such technology; (i) licensed, registered, or certified under ingful EHR users as of the date that is one (iii) of the barriers to adoption of such Federal or State laws or regulations to pro- year after the date of the enactment of this services under the Medicare program under vide health care services; or Act. title XVIII of the Social Security Act; (ii) required to be so licensed, registered, (3) STUDY AND REPORT ON THE FEASIBILITY (iv) that evaluates the patients, condi- or certified but that is exempted by other OF ESTABLISHING A WEBSITE TO COMPARE CER- tions, and clinical circumstances that could statute or regulation. TIFIED EHR TECHNOLOGY PRODUCTS.— most benefit from remote patient moni- (C) MEDICAL MALPRACTICE OR MEDICAL (A) STUDY.—The Secretary shall conduct a toring services; and PRODUCT LIABILITY ACTION OR CLAIM.—The study to examine the feasibility of estab- (v) that evaluates the challenges related to term ‘‘medical malpractice or medical prod- lishing mechanisms that includes aggregated establishing appropriate valuation for re- uct liability action or claim’’ means a med- results of surveys of meaningful EHR users mote patient monitoring services under the ical malpractice action or claim (as defined on the functionality of certified EHR tech- Medicare physician fee schedule under sec- in section 431(7) of the Health Care Quality

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00020 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2457 Improvement Act of 1986 (42 U.S.C. 11151(7))) There was no objection. physicians to focus on providing qual- and includes a liability action or claim relat- Mr. PITTS. Mr. Speaker, I yield my- ity care instead of a high quantity of ing to a health care provider’s prescription self such time as I may consume. care. or provision of a drug, device, or biological Mr. Speaker, the sustainable growth Finally, while it has always been ex- product (as such terms are defined in section tremely expensive to permanently re- 201 of the Federal Food, Drug, and Cosmetic rate, or SGR, is the formula through Act or section 351 of the Public Health Serv- which Medicare reimburses physicians. peal and replace the SGR, it is now es- ice Act). Since 2003, Congress has voted 17 times timated to cost less than $140 billion. (D) STATE.—The term ‘‘State’’ includes the for temporary patches, or ‘‘doc fixes,’’ This is less than half the cost of what District of Columbia, Puerto Rico, and any to avert ever larger cuts to providers. it would have been a few years ago. other commonwealth, possession, or terri- The uncertainty of the SGR threat- While the costs remain significant, I tory of the United States. ens doctors’ ability to continue prac- believe that it is imperative we perma- (3) PRESERVATION OF STATE LAW.—No provi- ticing medicine and accepting Medi- nently fix physician payment now. sion of the Patient Protection and Afford- care patients and endangers seniors’ That is why I am so furious Repub- able Care Act (Public Law 111–148), title I or access to care. licans are wasting valuable time by subtitle B of title II of the Health Care and pairing this much-needed legislation Education Reconciliation Act of 2010 (Public Absent congressional action, pro- Law 111–152), or title XVIII or XIX of the So- viders face a 24 percent cut on April 1, with yet another ridiculous Affordable cial Security Act shall be construed to pre- 2014. To stave off this cut, we can ei- Care Act repeal vote. After more than empt any State or common law governing ther pass another ‘‘patch’’ and kick the 50 repeal votes, I think it is clear to ev- medical professional or medical product li- can down the road again, or we can re- eryone where both Democrats and Re- ability actions or claims. peal this flawed formula for good. publicans stand on the Affordable Care SEC. 10. DELAY IN IMPLEMENTATION OF PEN- Today’s bill, H.R. 4015, firmly repeals Act. We don’t need another repeal vote. ALTY FOR FAILURE TO COMPLY The current SGR patch expires in 17 WITH INDIVIDUAL HEALTH INSUR- the SGR and replaces it with payment ANCE MANDATE. reform policy that has been agreed days. We should be focused on finding (a) IN GENERAL.—Section 5000A(c) of the In- upon by the bipartisan leaders of the bipartisan pay-fors to permanently fix ternal Revenue Code of 1986 is amended by Energy and Commerce, the Ways and the SGR instead of having Republicans adding at the end the following new para- Means, and Senate Finance Commit- push through yet another bill that will graph: surely die in the Senate. ‘‘(5) DELAY IN IMPLEMENTATION OF PEN- tees. As chairman of the Energy and Com- Mr. PITTS. Mr. Speaker, at this ALTY.—Notwithstanding any other provision time, I yield 2 minutes to the gen- of this subsection, the monthly penalty merce Health Subcommittee, I have tleman from Georgia (Mr. GINGREY), amount with respect to any taxpayer for any been working for the past 3 years on month beginning before January 1, 2019, legislation to permanently repeal the one of the cochairs of the Doctors Cau- cus, who has contributed a great deal shall be zero.’’. SGR, and I am very pleased that on (b) DELAY OF CERTAIN PHASE INS AND IN- to accomplish this bipartisan agree- February 6, 2014, we reached a bipar- DEXING.‘ ment. (1) PHASE IN OF PERCENTAGE OF INCOME LIM- tisan, bicameral agreement, embodied Mr. GINGREY of Georgia. Mr. Speak- ITATION.—Section 5000A(c)(2)(B) of such Code in today’s legislation. er, today we vote to repeal the sustain- is amended— Unfortunately, since then, Senate (A) by striking ‘‘2014’’ in clause (i) and in- able growth rate, a formula that was Majority Leader REID has refused to flawed from its 1997 beginning, and it serting ‘‘2019’’, and negotiate with us on how to pay for (B) by striking ‘‘2015’’ in clauses (ii) and has run its ugly course. (iii) and inserting ‘‘2020’’. this package. So we have brought for- As cochairman of the House GOP (2) PHASE IN OF APPLICABLE DOLLAR ward H.R. 4015, which is fully paid for Doctors Caucus, I would like to thank AMOUNT.—Section 5000A(c)(3)(B) of such Code by delaying implementation of the in- the Energy and Commerce Committee, is amended— dividual mandate—a policy supported especially Chairman UPTON, Ranking (A) by striking ‘‘2014’’ and inserting ‘‘2019’’, by both Republicans and Democrats. Member WAXMAN, Health Sub- and The bill enjoys more than 100 cospon- (B) by striking ‘‘2015’’ (before amendment committee Chairman PITTS and Rank- by subparagraph (A)) and inserting ‘‘2020’’. sors and the support of over 700 na- ing Member PALLONE, and especially a (3) INDEXING OF APPLICABLE DOLLAR tional and State provider and stake- member of the Doctors Caucus, Vice AMOUNT.—Section 5000A(c)(3)(D) of such Code holder groups. So I urge all of my col- Chair Dr. MICHAEL BURGESS, and, of is amended— leagues to vote for H.R. 4015 to ensure course, the Ways and Means Com- (A) by striking ‘‘2016’’ in the matter pre- that our seniors have access to the doc- ceding clause (i) and inserting ‘‘2021’’, and mittee and the Senate Finance Com- (B) by striking ‘‘2015’’ in clause (ii) and in- tors they know and trust. mittee and their staffs for their tireless serting ‘‘2020’’. I reserve the balance of my time. work to produce a policy which will (4) INDEXING OF EXEMPTION BASED ON HOUSE- Mr. WAXMAN. Mr. Speaker, to start help to ensure that seniors continue to HOLD INCOME.—Secton 5000A(e)(1)(D) of such the debate on our side, I yield 2 min- have access to quality providers. Code is amended— utes to the gentleman from New York Included in this legislation is my bill, (A) by striking ‘‘2014’’ (before amendment (Mr. ENGEL). and it is called the Standard of Care by subparagraph (B)) and inserting ‘‘2019’’, Mr. ENGEL. I thank my friend from and Protection Act. It provides much-need- (B) by striking ‘‘2013’’ and inserting ‘‘2018’’. California for yielding to me. ed clarity to the practice of medicine (c) EFFECTIVE DATE.—The amendments Mr. Speaker, I rise in strong opposi- by confirming that Federal quality in- made by this section shall apply to months tion, not to the policy before us, but to centives are no substitute in a medical beginning after December 31, 2013. the poison pill pay-for attached to this malpractice case for the standards of The SPEAKER pro tempore. The gen- much-needed SGR repeal-and-replace care developed by specialty societies tleman from Pennsylvania (Mr. PITTS), legislation. and determined and practiced by physi- the gentleman from California (Mr. I support the bipartisan, bicameral cians. This is an extremely important WAXMAN), the gentleman from Michi- agreement contained in H.R. 4015 for determination that will provide fair- gan (Mr. CAMP), and the gentleman numerous reasons. There is almost uni- ness to both patient plaintiffs and doc- from Michigan (Mr. LEVIN) each will versal agreement that the sustainable tors. control 15 minutes. growth rate is a flawed formula and, With the vote today, we take an im- The Chair recognizes the gentleman therefore, Congress has been left to portant step toward replacing the from Pennsylvania. temporarily patch physician reim- flawed formula, while at the same time GENERAL LEAVE bursement for far too long. protecting Americans by delaying the Mr. PITTS. Mr. Speaker, I ask unani- This bill permanently repeals the individual mandate of ObamaCare by 5 mous consent that all Members may SGR and provides physicians with a years. While the current administra- have 5 legislative days to revise and ex- small increase in pay for the first 5 tion continues to add delays when it is tend their remarks and to include ex- years. I want to see our physician politically expedient, this policy gives traneous materials on H.R. 4015. workforce fairly compensated for pro- certainty to individuals that they The SPEAKER pro tempore. Is there viding high-quality care to our con- won’t be taxed or fined, Mr. Speaker, objection to the request of the gen- stituents. The SGR fails to adequately for not complying with a law that they tleman from Pennsylvania? do this. This legislation incentivizes can’t afford.

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00021 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.001 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2458 CONGRESSIONAL RECORD — HOUSE March 14, 2014 This may not be the final version of from Florida (Mr. BILIRAKIS), a valu- I urge the majority to pull this bill, the bill, but it is time for the Senate to able member of the Health Sub- go back to the negotiating table with pass their own version and appoint con- committee. all of us, and help us fix Medicare pro- ferees. SGR repeal is too important for Mr. BILIRAKIS. Thank you, Mr. vider payments once and for all. both seniors and their doctors, and we Chairman. Mr. PITTS. Mr. Speaker, I am have come too far for this policy to not Mr. Speaker, I rise today supporting pleased to yield 1 minute to the gen- reach the President’s desk this year. repealing the SGR formula. The SGR tleman from Nevada (Mr. HECK), an- The SPEAKER pro tempore. The cuts would reduce doctors’ compensa- other member of the Doctors Caucus. time of the gentleman has expired. tion for treating Medicare patients by Mr. HECK of Nevada. Mr. Speaker, I Mr. PITTS. Mr. Speaker, I yield the 24 percent. H.R. 4015 repeals and re- rise in support of H.R. 4015. I have al- gentleman an additional 15 seconds. places SGR with a merit-based incen- ways stated that the number one Mr. GINGREY of Georgia. Let me tive payment system—MIPS—that threat to Medicare and seniors’ access just say again, we have come too far pays doctors based on quality, not vol- to health care is the flawed SGR for- for this policy to not reach the Presi- ume. mula. At no time prior have we been so dent’s desk, and I mean this year. The Paying doctors based on quality close in a bipartisan, bicameral way to Senate Majority Leader needs to come incentivizes physicians to be as effi- ensuring that our seniors have access to the table. Let’s find a suitable path cient and effective as possible in keep- to the health care providers of their forward, and let’s repeal this ing their patients healthy. MIPS is choosing, and now when we are so close unsustainable physician payment pol- fully paid for by a delay of is not the time to derail the progress icy. ObamaCare’s individual mandate—a made by using controversial pay-fors. Mr. WAXMAN. Mr. Speaker, at this tax on Americans to force them to pur- I will vote in favor of H.R. 4015 today time, I am pleased to yield 2 minutes chase more expensive health care that because of the policy changes it rep- to the gentlewoman from the State of doesn’t meet their needs. resents. I ask my friends on the other This bill will provide doctors who Colorado (Ms. DEGETTE). side of the aisle to vote ‘‘aye’’ so we Ms. DEGETTE. Mr. Speaker, every treat Medicare patients with certainty, can send this bill to the Senate, and I year, sometimes more than once a incentivize and reward doctors to keep call on the Senate to pass legislation year, since 2003 Congress has had to seniors healthy with better care, and that includes the agreed-to policy pro- step in to prevent a cut in physician provide individuals relief under visions with the pay-for of their choos- payments. With input from a wide vari- ObamaCare. ing. Then, let’s go to conference and fix Support our seniors, our doctors, and ety of stakeholders, we have tried to the SGR once and for all. fairness for individuals under work together for many, many years Providing stability and predict- ObamaCare. I urge my colleagues to on a solution to the flawed system to ability to our health care providers support H.R. 4015. the sustainable growth rate formula. will result in stability and predict- Mr. WAXMAN. Mr. Speaker, at this Until this year, we were out of luck, ability for our seniors. Passing SGR re- time, I yield 2 minutes to the gentle- and the price tag for fixing the formula form is the fiscally responsible thing to woman from California (Mrs. CAPPS), was ever increasing. do. The longer we delay, the more it my good friend. The underlying legislation that we Mrs. CAPPS. I thank my colleague will cost. consider today was 11 years in the for yielding. Let’s give seniors the peace of mind making. I am very proud to cosponsor Mr. Speaker, I have long been a sup- they deserve, so that they will be able this bill because it is a compromise so- porter of a permanent fix to the sus- to see the Medicare provider of their lution for the formula we agreed on. tainable growth rate, or SGR. The choice. Let’s pass H.R. 4015. But sadly—sadly—the majority has flawed SGR harms providers and con- Mr. WAXMAN. Mr. Speaker, I yield 2 prescribed a bitter pill to swallow for sumers alike and keeps us from true in- minutes to the gentleman from New passage of this important bill for pa- novation in the health care sector, but Jersey (Mr. PALLONE), who is ranking tients and doctors. Instead of coming for too long, the conversation has member of the Health Subcommittee. to the negotiating table to discuss mu- ended with everyone recognizing a Mr. PALLONE. Mr. Speaker, I thank tually acceptable ways to pay for this problem but no one willing to find a Mr. WAXMAN. Mr. Speaker, today the Republican bill, the majority has decided to pay middle ground to fix it. for it by delaying important provisions leadership once again chooses politics of the Affordable Care Act. b 0930 over substance and what is good for the Everybody knows that this provision Instead, we lumber from patch to American people. The current SGR is a nonstarter. It is a nonstarter in the patch, kicking the can down the road patch will expire on March 31, at which other body and in my Caucus right with piecemeal delays or fixes here in point Medicare’s payment to physi- here in the House. Because of this Congress, such as we are doing today. cians will be cut by almost 24 percent. shortsighted tactic, the Republicans These disagreements let the issue lin- It is critical that we take meaningful have almost guaranteed that we are ger, causing more instability in our action to fix the SGR before the end of going to need yet another short-term communities while the cost of a fix the month. SGR patch before the current one ex- continues to rise. That is why I have We all know that the SGR formula is pires on March 31. been so proud to be part of crafting the flawed. After 10 years of patching these This is bad for the doctors of Amer- bipartisan, bicameral SGR fix policy. cuts, after wasting $150 billion, enough ica. This is bad for the patients of This policy provides a positive pay- is enough. It is why we began last year America. Let’s get real. Let’s fix this ment update to our providers, pushes seriously looking at this issue, and we problem for good. And you know, Mr. us toward a system rewarding quality came up with a bipartisan, bicameral GINGREY just recognized that this bill and fixing the GPCI, ensuring that cen- solution. In fact, if was quite the lesson is not going anywhere. So let’s sit tral coast providers and others will fi- in legislating. Particularly, we ended down. Let’s do what we did with the nally gain accurate Medicare reim- up arriving at a consensus bill on the SGR itself, and let’s figure out how to bursement. SGR. pay for it. But today, this bipartisan process is So I ask the Republican leadership: Mr. PITTS. Mr. Speaker, may I in- being derailed once again. By tying a For what reason have you poisoned quire about how much time remains on delay of the individual mandate to this this process with an unacceptable pay- each side? policy, the House majority has for? The SPEAKER pro tempore. The gen- poisoned such a bipartisan process. Ac- This bill will pass today and go no- tleman from Pennsylvania has 101⁄4 cess to health care for more than 50 where. It will not be taken up by the minutes remaining. The gentleman million seniors and persons with dis- Senate or signed by the President. You from California has 11 minutes remain- abilities is a serious matter. These par- have singlehandedly, in my belief, ing. tisan games could very well end our stomped on months and months of hard Mr. PITTS. Mr. Speaker, at this Nation’s best shot at amending a bad work and effort by my colleagues on time, I yield 1 minute to the gentleman policy. both sides of the aisle and our staffs.

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00022 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.005 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2459

Late nights, weekends, hard com- Verification of eligibility for ex- BOEHNER, who charged the Energy and Com- promises. We all saw the greater good change subsidies; delayed. merce Committee to find a workable solution in finally getting a permanent policy Reinsurance fee for some unions; de- to get rid of SGR. This has been a long jour- replacement for the SGR. But instead layed. ney with many important players on both sides of working with our leadership, the Re- Nondiscrimination requirement for of the aisle, and in both chambers. I do want publicans have turned this into their employer coverage; delayed. to commend Health Subcommittee Chairman 51st vote to repeal or undermine the Subsidies only through the exchange; JOE PITTS for helping lead the effort and the ACA, and you are going to leave 13 mil- delayed. bill’s sponsor Dr. MICHAEL BURGESS, for his lion Americans uninsured if you were Shop employee choice delay; delayed tireless commitment from day one. We also ever to succeed in repealing the ACA. Shop online purchasing; delayed. would not be here without the efforts and sup- This is just a poison pill. The pay-for Numerous HealthCare.gov technical; port of the GOP Doctors Caucus—a group is a poison pill for something that we delayed. who understands all too well the threat that agreed on in terms of the substance of This was never ready for prime time. SGR has posed. And of course I appreciate fixing the SGR. You could have picked We have said that from the start. If the our partnership with my good friend DAVE other ways of paying for this. I think administration has decided to delay all CAMP and the Ways and Means Committee. we are close to a consensus on the pay- these things, almost two dozen, why While this is a significant milestone, the cost for. Instead, you put in this poison pill. not delay this, too? And why not use of SGR repeal is not insignificant. We have You are wasting valuable time where the savings then not only to help the strived over the past few months to find com- you will basically do nothing. physicians, we have to think about the mon ground with the Senate to identify a way We only have 2 weeks left. Let’s de- seniors. to pay for this agreement that both chambers feat this bill today, sit down over the The SPEAKER pro tempore. The can support. Time is not on our side as the next 2 weeks and come up with a pay- time of the gentleman has expired. current patch is set to expire at the end of this for that makes sense, not a pay-for Mr. PITTS. I yield an additional 30 month. So today the House has chosen to act that simply repeals the Affordable Care seconds to the gentleman. rather than stand idly by and is prepared to Act, which is working well. More and Mr. UPTON. This isn’t just to help send a bill to the Senate with a bipartisan more people are signing up. I had an our physicians, it is to help the most payfor: relief for individual Americans from the enrollment event this weekend in my vulnerable, our seniors, because if we mandate that they purchase government-ap- district. People are signing up. Don’t don’t reimburse our docs, the ‘‘closed’’ proved insurance. destroy the process. We have a good sign is going to come up where they go The White House has already seen fit to SGR fix. for services. They are going to be de- delay many parts of the president’s health Mr. PITTS. Mr. Speaker, I am very nied the coverage that they have paid care law, including the employer mandate. pleased to yield 2 minutes to the gen- taxes for, that they expect to have, and And it has also quietly delayed the individual tleman from Michigan (Mr. UPTON), the yet another broken promise will be mandate for the millions of Americans whose distinguished chairman of the Energy there. health care plans the law cancelled. If Senate and Commerce Committee, one of the If the administration can delay these Democratic colleagues don’t want to afford in- chief architects of this bill. things, why don’t we delay this? Why dividuals the same rights as special interests Mr. UPTON. Mr. Speaker, first I don’t we use the savings then to pay with a direct line to the president, then I would want to commend Republicans and for a program that works, and I would ask them to simply pass their own fully offset Democrats for getting the policy right. suggest that we vote for this. Let’s SGR package and let’s go to conference to This is a tough nut to crack. It was 51– work with the Senate to get it done. iron out our differences. But make no mistake, 0 in our committee, led by JOE PITTS, Mr. Speaker, we are here today to vote for SGR must be paid for. Dr. BURGESS, the Doc Caucus, Mr. WAX- a bill that would provide certainty and peace of We have never come this far in finding a MAN, Mr. DINGELL, and Mr. PALLONE. mind to our nation’s seniors and fairness for permanent solution. But there is still much We worked long and hard to get the all Americans under the president’s health work to be done after today’s vote, and I call policy right, and we worked with the care law. Repeal of the system of physician on my Chairman RON WYDEN to pick up the other committees to do it as well. cuts under Medicare, or SGR, has been a torch and work with Majority Leader HARRY The difficulty we always knew was problem that has plagued seniors, doctors, REID to put politics aside, stand up for our going to be on the pay-for. I would sug- and Congress for well over a decade. These seniors and doctors, and let’s solve SGR this gest this: we want to work with the cuts have threatened access to our seniors’ year. Senate; we want to get this thing done; health care and the Medicare promise that our I urge all my colleagues to support H.R. pay-for is the toughest part, but let’s country has made to every American—both 4015 and the millions of seniors who are go to conference. Let’s work with the those in the program today and those who watching us here today. Senate to get a pay-for that can work. count on it as part of their future retirement. Mr. WAXMAN. Mr. Speaker, I want Now, we know that there is a dead- Our purpose here today is Medicare reform to point out that none of the delays line coming up at the end of this so that we can keep the promise made to all that Mr. UPTON indicated on that chart month. As we look to try and find a seniors, current and future. The Medicare pro- would result in 13 million people losing pay-for, let me go through some of the gram is going insolvent, and Congress will insurance coverage and raise premiums other delays that this administration need to act if we are to prevent bankruptcy. 10–20 percent. This is not a delay that has already done: Today is one step toward keeping the Medi- we can agree to. It hurts the Affordable Individual mandate delay, Americans care promise. Many of us did roundtables with Care Act, and it is a betrayal of our with canceled coverage due to our doctors back home, I did so in Michigan, working together on a bipartisan basis ObamaCare; delayed. and we visited with countless seniors. We to resolve this problem. We worked to- Individual mandate, deadline for pur- heard their concerns loud and clear and have gether on the policy, but we were never chasing coverage; delayed. acted. brought in to work together on funding Individual mandates for non-ACA H.R. 4015, the SGR Repeal and Medicare that policy. compliant plans; delayed by the admin- Provider Payment Modernization Act, is the At this time I yield 2 minutes to the istration. product of years of bipartisan efforts to re- gentleman from Texas (Mr. GENE Annual limit requirement; delayed. move the threat of SGR. The legislation would GREEN). MLR requirement; delayed. once and for all repeal the broken SGR and Mr. GENE GREEN of Texas. Mr. MA cuts through demo bonus money; replace it with a system that promotes the Speaker, I rise to express strong objec- delayed. highest quality of care for seniors, eases the tion to the decision to use the Afford- Employer reporting; delayed. burden on physicians who are struggling able Care Act’s individual responsi- Employer mandate; delayed. under an increasing number of government bility requirement to pay for the SGR Subsidies only in State-run ex- programs that take time away from patients, reform. changes; delayed. and promotes new forms of health care deliv- This bill hijacks a thoughtful solu- High-risk pool closure; delayed. ery and innovation with an eye on the future. tion to a problem that has been harm- Out-of-pocket waiver for group We stand here today on the House floor in ing Medicare beneficiaries, providers, health plans; delayed. no small part because of our speaker, JOHN and our budget for years and turns it

VerDate Mar 15 2010 23:31 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00023 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.007 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2460 CONGRESSIONAL RECORD — HOUSE March 14, 2014 into a political stunt. This decision is a Mr. Speaker, I yield 1 minute to the tainty so they can best serve their pa- poison pill and nothing more than gentleman from Indiana (Mr. BUCSHON), tients. If a permanent solution to the more partisan politics. another member of the Doctors Caucus. SGR is not reached soon, doctors will Congress has overridden the SGR- Mr. BUCSHON. Mr. Speaker, I rise be forced to make tough decisions mandated cuts to Medicare physician today in support of this legislation. As about which patients they will see and payments each year since 2003. Year a practicing physician for over 15 those which they can no longer afford after year, these temporary patches years, the majority of my patients to see. have been costly and disruptive. Re- were Medicare patients. I know first- Mr. PITTS. May I inquire of the time forming the system is long overdue. hand how flawed the SGR is. By not re- remaining. Temporary fixes to SGR are a losing pealing this flawed system, to remain The SPEAKER pro tempore. The gen- situation. The money still has to be in business, many doctors across Amer- tleman from Pennsylvania has 43⁄4 min- spent, but only to just maintain the ica will be forced to limit the number utes remaining. The gentleman from broken status quo. of Medicare patients that they see, and California has 31⁄2 minutes remaining. The bipartisan, bicameral SGR bill is many may refuse to see Medicare pa- Mr. PITTS. Mr. Speaker, at this time the closest we have come to fixing this tients all together. I am pleased to yield 1 minute to the problem once and for all, and this deci- Failing to act or voting ‘‘no’’ on this gentleman from Tennessee (Mr. ROE), sion gets us further from that goal. Re- legislation will limit seniors’ access to another cochair of the Doctors Caucus. pealing the ACA is a game we have their doctors. This will be especially Mr. ROE of Tennessee. Mr. Speaker, played now 51 times. Holding SGR re- dangerous in rural areas where there this physician rises in strong support form hostage to destroy the ACA and are already physician shortages. It is of H.R. 4015, the SGR repeal. This bi- deny millions of Americans access to time we finally solve this problem and cameral, bipartisan compromise will managed care is disgraceful. Our sen- ensure that Medicare patients have ac- preserve seniors’ access to needed med- iors, our doctors, including the AMA, cess to their chosen doctors. ical care and give physicians certainty the Texas Medical Association, the I urge my colleagues to stand up for about how Medicare will pay them for California Medical Association, and the all of the seniors in America and sup- their services. American people deserve better. port this legislation. b 0945 Mr. WAXMAN. Mr. Speaker, I yield 2 In order for our health care system This bill also lays the groundwork minutes to the gentleman from North to work, Americans must have insur- for a gradual transition to a reimburse- Carolina (Mr. BUTTERFIELD). ance. Delaying or repealing the re- ment system that rewards value in- quirement that individuals obtain cov- Mr. BUTTERFIELD. Mr. Speaker, I rise in strong opposition to this bill. stead of volume. erage would drive up premiums and The House, by passing H.R. 4015, will This began as a bipartisan effort, but, leave millions uninsured. Again, this is take a big step toward the permanent predictably, this has devolved into purely a partisan pay-for which proves repeal of a flawed payment formula nothing but another attempt by House that there is not a sincere effort to fi- that has hampered physicians since Republicans to dismantle the Afford- nally enact SGR reform but rather just 1997, but we can’t allow the process to able Care Act. Here we go again. Over another political game. stop here. Mr. PITTS. Mr. Speaker, I submit for 4.2 million people have signed up for af- I encourage our Senate colleagues to the RECORD a letter from the Texas fordable insurance so far, and the num- pass a bill as soon as possible, so that Medical Association in support of this bers are growing. we can move into conference and find a We all support a permanent repeal of legislation. mechanism to repeal this bill. the sustainable growth rate because TEXAS MEDICAL ASSOCIATION, I would like to thank the members Austin, TX, March 13, 2014. the SGR in current law is anything but and staff of the committees for their Hon. MICHAEL C. BURGESS, MD, sustainable. We are demanding more tireless efforts on this bill, particularly out of our doctors and health care pro- House of Representatives, Washington, DC. my friend Dr. MIKE BURGESS, who has DEAR REPRESENTATIVE BURGESS: On behalf fessionals. We are asking that they op- long championed this reform. of the 47,000–plus physician and medical stu- erate with maximum efficiency to play I encourage my colleagues to support dent members of the Texas Medical Associa- their part in reining in health care tion, I am writing to reiterate our strong H.R. 4015. Mr. Speaker, the American spending, and they deserve the same Medical Association represents less support for the work you have done to effec- from Congress. tuate the repeal of Medicare’s Sustainable than 20 percent of the physicians in Growth Rate (SGR) formula. In conjunction Unfortunately, my Republican col- this country. with your Texas colleague, Kevin Brady, you leagues don’t share that view. That is Mr. WAXMAN. Mr. Speaker, I con- have gotten closer to solving this chal- why they have offered a pay-for that tinue to reserve the balance of my lenging issue than ever before. And you have they know will be completely unac- time. done so with the support of every member of ceptable to most Democrats and cer- Mr. PITTS. Mr. Speaker, at this the Texas delegation, both Democratic and tainly stands no chance of passage in time, I am pleased to yield 1 minute to Republican, on the Energy & Commerce and the Senate. The President has even the gentlelady from North Carolina Ways & Means Committees. said he would veto this bill, and right- Perhaps more than anyone in Congress, (Mrs. ELLMERS), who is another impor- you understand the frustration and anxiety fully so. tant member of the Health Sub- that the ongoing SGR uncertainty creates The American Medical Association, committee. for practicing physicians. You have worked which represents most of the doctors Mrs. ELLMERS. Mr. Speaker, I rise tirelessly to craft a piece of legislation that throughout the country, and I am dis- today in support of H.R. 4015, the SGR not only repeals the SGR immediately, but appointed that the Texas Medical Asso- repeal. also guarantees positive updates for physi- ciation is at variance with their na- This has been a long time coming, cians for five years, removes potential tional association, but the AMA and and I am very excited to be part of it. causes of liability against physicians, and the AARP and a dozen other organiza- I want to see this legislation move for- eliminates some unnecessary bureaucratic red tape that prevents physicians from con- tions representing health care pro- ward. centrating on patient care. viders and hospitals and seniors have I want to agree and disagree with my We especially appreciate your ongoing con- decried Republican partisan tactics. esteemed colleagues across the aisle. sultation and dialogue with TMA and Texas They don’t like this. This does boil down to patient care. physicians throughout this process. We have 5 legislative days before the This will negatively affect our seniors As you know well, the SGR Repeal and last SGR extension runs out on March if we do not solve this problem for Medicare Provider Payment Modernization 31. Five days. Should Republicans not Medicare reimbursement. It is patient Act of 2014 has made it this far because of a come to their senses in time, I want access that is the core of this issue. bipartisan, bicameral agreement on the need doctors to know that a nearly 30 per- However, when we speak about asso- to replace the SGR. We are committed to helping you finish the task. cent cut to their reimbursement should ciations, such as the AMA—or the Sincerely, be laid squarely at the feet of my Re- American Medical Association—we are STEPHEN L. BROTHERTON, MD, publican friends here in the House. talking about a group who only rep- President. Doctors need predictability and cer- resents about 11 percent of physicians

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00024 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.009 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2461 across this country, and that number Mr. BURGESS. Mr. Speaker, I want partisan fashion. It is ready to go. We decreases every year. to thank my friend from Pennsylvania call upon our colleagues in the other There is a reason for that. They are for yielding me the time, the chairman body. Use whatever Senate procedures not representing doctors in this coun- of the subcommittee, for making this you need to, but get this done because try, and their voice is not as strong as possible to bring this bill to the floor the clock is ticking. The clock is tick- it once was and should be. today. ing towards March 31. With that, Mr. Speaker, I thank you I want to thank Chairman UPTON of We all know what happens to the Na- for this time, and I thank my col- the full committee and Ranking Mem- tion’s seniors on that date. We all leagues for this important message ber WAXMAN of the full committee for know what happens to their doctors. today. I hope all Members support the also making this possible. It has been a Let us get this done. SGR reform. lot of hard work getting us to this Mr. PITTS. I yield back the balance Mr. WAXMAN. Mr. Speaker, I yield point. of my time. myself 2 minutes. Chairman UPTON talked about Mr. CAMP. Mr. Speaker, I yield my- This should be a moment of biparti- delays. I would just point out that self such time as I may consume. sanship where we finally fix this sus- there has been yet another delay, the I rise today, Mr. Speaker, to strongly tainable growth rate in Medicare phy- delay of the closure of the risk pools support H.R. 4015, the SGR Repeal and sician reimbursement. None of us think because—let’s be honest—the Afford- Provider Payment Modernization Act, it is supportable. Doctors are always able Care Act is not ready to take on as amended. facing the peril of a deep cut if we those people who have preexisting con- The Ways and Means Committee and don’t patch it up or fix it permanently. ditions, so they felt it necessary to Energy and Commerce Committee and It is time to fix it permanently. keep the risk pools open for an addi- Senate Finance Committee have We worked together on a bipartisan tional length of time. worked in a bipartisan manner to de- basis on our committee and came up I want to talk to my friends on the velop a permanent physician payment with a policy to replace the SGR. The Democratic side of the aisle. I particu- fix repeal. Ways and Means Committee and the larly want to talk to those who have Years of hearings, discussion drafts, Senate Finance Committee followed only been here one or two terms. The and ongoing dialogues with stake- us, and they did their approach, and we last time we had a bill like this on the holders have resulted in H.R. 4015, a bi- all worked out one uniform approach floor of the House, Democrats were in partisan, bicameral agreement on SGR with the idea that we are finally going charge. replacement policy. to end this nonsense of threatening the Mr. DINGELL was chairman of our En- This bill has over 100 cosponsors, has doctors that take care of Medicare pa- ergy and Commerce Committee. He the support of 18 Members of the House tients. brought a bill to the floor, H.R. 3961, Doctors Caucus, and 600 national and This is an issue of patient access to which was an SGR repeal bill. State organizations representing physi- This bill had already been rejected by medical care that has been promised cians and other professionals. the Senate, so it really had no chance under Medicare; yet the Republicans There is a reason for all of this sup- of going anywhere. This bill was not are now insisting we pay for the perma- port. H.R. 4015 has a lot to like. It re- paid for. The policy was awful and nent fix. Well, this has come up many, peals the outdated SGR formula and would have given us two SGRs, instead many times. Sometimes, we paid for it, gives seniors the certainty that they of one; but nevertheless, that bill came but sometimes, we didn’t pay for it; will have access to their doctors. but we always made sure that there to the floor. It only garnered one Republican vote. It incentivizes better care and better was a fix on a bipartisan basis. results for seniors that rely on the Instead, today, the Republicans, I was that vote. I was that vote because I thought it was important that the Medicare program, and it breaks the without talking to us—they wanted to cycle of uncertainty for doctors and talk to us about the policy, but with- Nation’s doctors heard that we were willing to work together across party their patients, providing permanent re- out talking to us—are trying to pay for lief and improving how Medicare pays this by hurting the Affordable Care lines, if need be, to solve this problem for them. I wanted to preserve the doctors. Act. We must not let this opportunity What they are doing is putting a par- process going forward. pass by. Time is short. If we do not act, tisan poison pill offset, an offset that Ladies and gentlemen, the bill you in just 2 weeks, doctors will see a 24 would cause 13 million people to lose have on the floor today, H.R. 4015, is percent cut in their Medicare reim- insurance coverage and would raise not the destination. It is the key that bursement, jeopardizing seniors’ access premiums by 10 to 20 percent for every- gets you through the door to get to to care. body else in the exchange. They have that destination. 1 We must safeguard taxpayer dollars. to know this is not acceptable; we For 4 ⁄2 weeks, since February 6, the That is why we pay for permanent re- can’t support it. policy has been out there for all to see. They are now coming here to the We have awaited anyone from the Sen- peal by delaying the health care law’s floor saying that there is some attempt ate side who wanted to talk to us about individual mandate for 5 years. Ameri- by the Democrats to undermine our negotiating bipartisan pay-fors—radio cans across the country are facing policy agreement. Well, let’s stop silence. higher costs, losing the coverage they blaming each other. Let’s get to work Look, I don’t know what rule XIV is have and like, and are seeing smaller and resolve this problem and vote down over in the Senate, but it is apparently paychecks as a result of ObamaCare. Last week, the administration an- this bill. pretty important. The majority leader I reserve the balance of my time. in the other body has brought this bill nounced that it would continue to ex- Mr. PITTS. Mr. Speaker, may I in- up under rule XIV; but they were doing pand certain exemptions from the indi- quire of the minority how many speak- nothing before. vidual mandate for 2 years. This pro- ers they have left? For 4 weeks, this policy languished posal would extend that further—would Mr. WAXMAN. I have one more without them picking it up. Now that extend further what the administration speaker. the House is moving—now that the is already doing and give all Americans Mr. PITTS. We have one more speak- House is moving a bill and will likely relief from the mandates and penalties er. I reserve the balance of my time. pass the bill today with a decent pay- of ObamaCare. It is only fair. Mr. WAXMAN. You have one more for that is, in fact, bipartisan because I urge all members to support H.R. speaker? I yield back the balance of my 27 Democrats voted for this very pay- 4105. I reserve the balance of my time. time. for last week on the floor of this Mr. Speaker, I ask unanimous con- Mr. PITTS. At this time then, Mr. House—in fact, it was unanimous if we sent that the gentleman from Texas Speaker, I yield the balance of my time were exempting firefighters or veterans (Mr. BRADY) control the remainder of to the gentleman from Texas, Dr. BUR- from the individual mandate in the Af- the time. GESS, the prime sponsor of this legisla- fordable Care Act. The SPEAKER pro tempore. Is there tion, who has worked tirelessly to This is a bipartisan pay-for. It has objection to the request of the gen- achieve this day. passed the floor of this House in a bi- tleman from Texas?

VerDate Mar 15 2010 00:02 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00025 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.014 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2462 CONGRESSIONAL RECORD — HOUSE March 14, 2014 There was no objection. centered approach that provides sta- that, one day before this year ends, the Mr. LEVIN. Mr. Speaker, I yield my- bility to our doctors, rewards them for Republicans will come to their senses self such time as I may consume. high-quality care, begins to streamline and will try to gain the respectability What is going on here? The Repub- the red tape our physicians face, and and the credibility that they once en- licans are bringing up a totally par- encourages better coordination and joyed. tisan bill to thwart a bipartisan bill. prevention. Over time, it transitions to I am a die-hard Democrat, but I don’t They are tossing aside common ground a model that rewards value over vol- want this country just to have one for barren ground, another Affordable ume by using the real-life approaches party. We do need two responsible par- Care repeal vote. They are throwing that doctors use, not what Washington ties in order to guide this Nation out a historic bipartisan breakthrough wants. through its democratic process. to permanently end and replace the H.R. 4015 is a solid foundation from Mr. BRADY of Texas. Mr. Speaker, I broken Medicare physician payment which to build an even better Medicare am pleased to yield 3 minutes to the formula, once again turning to totally system, and it has overwhelming sup- gentleman from Louisiana (Mr. BOU- partisan politics. port from physicians. This is a major STANY), a physician and a key member The breakthrough achieved by our step forward, but we need to finish the of the Ways and Means Committee. I committees would permanently replace job. We need to work together—Repub- cannot describe how much of an impor- the deeply flawed SGR formula with a licans and Democrats, the House and tant role he has played in finding this system designed to build on delivery the Senate—to figure out how to make new solution to how we reimburse doc- system reform, reforms that move this policy a reality in a way that tors under Medicare. Medicare physician payments toward a doesn’t increase the deficit. Mr. BOUSTANY. I applaud Chairman more accountable value-driven system. There may be disagreements over BRADY’s leadership on this issue. He The underlying policy agreement is how to pay for this reform. That is un- has been instrumental in getting us to broadly supported by both provider derstandable as it is difficult, and to- this point. communities and beneficiaries; but to- day’s bill is not the last word. Let’s Mr. Speaker, I rise in support of this day’s exercise is opposed by groups rep- continue to advance this long overdue bill after 3 long years of working on resenting seniors, doctors, health solution and commit to finding a bipar- the policy to actually get to a bipar- plans, and others because it guts the tisan solution between the House and tisan, bicameral agreement on policy Affordable Care Act through a 5-year the Senate. The clock is ticking, so and divided government. It has not delay to the individual mandate. let’s act together today. been easy, but we have managed to get What would the result be? According Mr. Speaker, I reserve the balance of an agreement on a policy to repeal to CBO and the Joint Task Committee, my time. automatic annual cuts to physicians. A the Republican bill would increase the Mr. LEVIN. Mr. Speaker, it is now 24 percent cut in just a matter of weeks number of uninsured Americans by 13 my pleasure to yield 2 minutes to the is facing doctors under this flawed for- million. What is more, the bill would gentleman from New York (Mr. RAN- mula. raise individual market health insur- GEL). Now, Congress first promised to re- ance premiums by 10 to 20 percent for (Mr. RANGEL asked and was given peal this formula more than a decade those who remain insured. permission to revise and extend his re- ago. Democrats repeated the promise Last week, we saw the 50th vote. This marks.) when we were debating ObamaCare. is now the 51st vote to undermine the Mr. RANGEL. Thank you, Chairman They failed to put it in there. They Affordable Care Act. So much for good LEVIN. failed to address it in ObamaCare. The faith and so much for good will. Mr. Speaker, this bill has nothing to passage of this important bipartisan Instead of working to find common do with paying the doctors who work legislation would finally honor that ground to finish the job on a bipartisan every day in giving medical care to promise, that of protecting seniors’ ac- solution vital to fixing a problem in Medicare patients. It has to do with de- cess to doctors. A doctor-patient rela- our health care system, House Repub- stroying the Affordable Care Act for tionship is built on trust and high licans are taking once again a cynical the 51st time. quality. It ensures quality measures step in a very familiar direction, con- I am certain that those who are lis- going forward, and it creates certainty cerned only about the November elec- tening to the debate and who know for physicians and seniors. tion. what is going on believe it is ridiculous I want to point out something be- I urge my colleagues to vote ‘‘no,’’ to try to defeat a bill that has been cause our friends have not given the and I reserve the balance of my time. signed into law, because they know full story here. Mr. BRADY of Texas. Mr. Speaker, I that the Senate is not going to pass it, We have agreed on the policy, but we yield myself such time as I may con- and they know—the Republicans, that have a problem in coming up with the sume. is—that the President would veto it. pay-fors. It is a tough conversation, Enough really is enough. The unfair So why do they do it? but the talks have broken down in a di- way Medicare pays our local doctors to They do it because there is a small vided government. Senate leadership treat our seniors has gone on for far group of people in the Republican has refused to negotiate in good faith too long. Party that doesn’t mind politically It is making it harder for seniors to and to discuss responsible ways to pay dying. I don’t mind their taking down see a doctor they know and who knows for the bill’s $138 billion price tag. We the party if that is their intent, but them. It is chasing local doctors out of are going to pass this bill to get those they are taking down the Democrats Medicare and out of private practice, discussions started. Republicans pro- and the reputations of the House of and it is encouraging too much waste posed savings from the delay of Representatives as well. Somewhere and too many unnecessary procedures ObamaCare’s very unpopular individual along the line, the Speaker has to do within Medicare. mandate. As chairman of the Health Sub- again what he has done before, and Now, I don’t think it is acceptable to committee of Ways and Means, my top that is to say, ‘‘Enough of this. We are do nothing, and I don’t think it is ac- priority has been to find a permanent, not going to allow the wings of the ceptable for the Senate Majority Lead- reliable 21st century solution that both Congress to be broken on one side just er and others in the Senate to just put political parties and physicians can because some people want their way.’’ their heads in the sand on this. I hope So I assume that nobody in these dis- embrace. that the Senate will pass a version of tricts has insurance problems. I assume H.R. 4015, giving us time to get to- b 1000 that everyone is insured and is working gether to hash out the differences. We H.R. 4015 repeals the current flawed in these districts in which they are try- are so close. We are on the goal line in formula for reimbursing our doctors, ing to destroy the Affordable Care Act this work that has been undone for and it ends the yearly threat of mas- and that they don’t have any pre- years. It is time to get it done. sive cuts. conditions that restrict them from get- The President’s own budget lists bi- In working with America’s physi- ting health care. They all are working partisan Medicare reforms that the cians, it establishes a more patient- and they all are happy. I just hope President put on the table that could

VerDate Mar 15 2010 00:02 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00026 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.015 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2463 easily raise the bulk of savings needed campaign. We see wild claims about your head on a pillow tonight, knowing to repeal the SGR, and we could do this people who live in inner cities in that that your doctor is going to be there without shifting more costs to our Na- they are somehow worthless and that for you, that I will be beside you, that tion’s credit card and without resort- they don’t want to take care of their I will be by your bed, saying the ro- ing to budget gimmicks or by imposing families and feed them, and we hear sary; and when you have finally gone, I massive new cuts on hospitals and things of the Speaker’s of- can’t wait until the next time we are other providers. We have a clear path. fice that clearly aren’t true about the able to meet each other again in Heav- We can get this done in a bipartisan ACA. en’’? Why would we make their last way. Let’s suppose that actually hap- days so difficult? Why would we make Mr. Speaker, as a heart surgeon who pened. What would happen if we re- it so uncertain? has cared for thousands of seniors pealed and destroyed the ACA today? So we talk about an SGR, but where under the Medicare program, I urge my We would get rid of 13 million people I come from, it is not bad, and it is not House and Senate colleagues to pass on the rolls by 2018. We would take a doc fix—it is a senior fix. this bill. Let’s get down to the negotia- away health insurance. Health insur- When can we possibly put politics be- tions of how we are going to pay for it ance premiums would rise 10 to 20 per- hind us and start to look at what is in good faith, and let’s finalize an cent by 2018. Millions of Americans best for the people we represent? agreement on how to fix this long- would not be able to afford the health I am a Representative of Pennsylva- standing problem, which has been a care they need. nia’s Third District—so privileged and thorn not only in the sides of doctors This is a failure of leadership. They so proud to be able to do it, not boast- but which has been a real problem for would rather run a propaganda cam- ful proud, but thankful proud that I Medicare access, a real problem for paign to hold onto the House. We can actually go and do something for seniors seeking access to a high-qual- watched in Florida just in the last the people who raised me, who taught ity doctor-patient relationship. week when $13 million, I guess, was me, who coached me, and who have Mr. Speaker, I have had enough. It is spent on that campaign to tar the Af- walked me through the most difficult time to get this done. Pass this bill. fordable Care Act. That is what this is parts of my life and that I can look Mr. LEVIN. Mr. Speaker, I yield my- all about. No one should be the least back at their lives and say, ‘‘But you self 15 seconds. bit confused. That is not what America I say to my colleague that what you sacrificed so much that I could be wants. America wants health security. are doing, essentially, is undercutting here.’’ Vote ‘‘no’’ on this bill. Can we not just come together and do bipartisanship with pure partisan poli- Mr. BRADY of Texas. Mr. Speaker, I tics. Pointing to the Senate is pure something that really is a big thank- am really pleased to yield 3 minutes to you and a kiss on the forehead as they mythology. the gentleman from Pennsylvania (Mr. I now yield 3 minutes to the gen- lay there, wondering, ‘‘Where are those KELLY), a gentleman who is one of the tleman from Washington (Mr. folks that we did so much for?’’ newest members of the Ways and MCDERMOTT), the on My goodness. My friends on the other the Health Subcommittee. Means Committee. He is a business- side, this is not about politics—this is (Mr. MCDERMOTT asked and was man, but he is a real fighter for Penn- about people. We are in the people’s given permission to revise and extend sylvania’s seniors and doctors. House, and these are things that we his remarks.) Mr. KELLY of Pennsylvania. I thank must do. Mr. MCDERMOTT. Mr. Speaker, this the gentleman. Mr. Chairman, I thank you so much 51st attempt to repeal the ACA by Mr. Speaker, there are very few for doing this and for bringing peace of stopping the individual mandate is part times in my life in which I have really mind to the people we represent, but I of the long-term propaganda campaign had the privilege of representing people can’t tell you how disappointing it is done by the Republicans to destroy the who are so dear to me. I just think, if today to hear this turn into some kind health care plan that the President put you were to look at our generation, we of political debate that has nothing to together. would all have to agree that we grew do with the fate of those seniors and of They know that we agree on the pol- up in the greatest towns, at the great- those people whom we love so much icy—everybody here agrees on the pol- est times, with the greatest parents, and who have done so much for us. icy—but they put a poison pill in it. preachers, teachers, and coaches, Mr. LEVIN. Mr. Speaker, I yield my- They knew that this amendment of grandmas and grandpas, and aunts and self 15 seconds. how to pay for it—that is, by delaying uncles. I say to the gentleman from Pennsyl- the mandate—would kill any Demo- This is the people’s House. This is vania that the problem is your bill is cratic support in the House. They have not a Republican House or a Democrat nothing but a political bill. It is noth- no intention of passing this bill. This House. This is the people’s House. What ing except about the November elec- bill is directed at the propaganda cam- are we talking about today? tion—nothing but. paign to the people at Koch Brothers My goodness. This is so disappointing I now yield 2 minutes to the gen- and at so that anybody who that we are so worried about the next tleman from Oregon (Mr. BLU- is watching this will get the idea that election that we can’t see the direction MENAUER), an active, distinguished somehow it is a bad bill. that we are going in—to be able to member of our committee. The fact is that people are benefiting offer peace of mind to those folks who 1015 every single day. The AARP and the have made the greatest sacrifices, who b American Medical Association have de- have made the greatest contributions, Mr. BLUMENAUER. Thank you, Mr. nounced this bill because they want and who have done the best that they LEVIN. the SGR—the doctors’ payment re- could to make sure that the next gen- I was somewhat embarrassed by the form—to go through, and they know eration had the same opportunities remarks of my friend, who is from But- that the Republicans have designed they had. ler, Pennsylvania, the hometown of my this to fail. This is not a doc fix. This is a senior wife, because it is the Republicans who A mandate that has been supported fix. have decided to make this bill about even by the Tea Party—before the Tea As my mother lay dying and my sis- the next election. Party said ‘‘we have got to be against ter and my father, they were sur- There is no reason the House Repub- it’’—is what is at issue here. Doctors rounded by a loving family, and they licans put the medical community and health insurance companies will were also surrounded by caring doc- through this charade again and again, not be able to operate if you don’t have tors. Why would we make this about an year after year, except to use the SGR an individual mandate. The Repub- election? Why would we not look in- as a tool for power, partisan advantage, licans said this. The Heritage Institute ward to whom it is we are trying to and fundraising. said it. Everybody said it, but they protect? Why can we not protect the This political tool disrupts the lives want to kill it. most vulnerable in our society right of millions of medical providers and This is an alternative universe that now, especially in their end days and in tens of millions of their patients who we are creating with this propaganda their end times and say, ‘‘You can lay rely upon them.

VerDate Mar 15 2010 00:02 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00027 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.016 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2464 CONGRESSIONAL RECORD — HOUSE March 14, 2014 We had, in fact, been making remark- here feel we should continue the status ful bipartisan policymaking and able progress in both the Commerce quo of Washington, D.C., and not pay thrown it away in order to score some Committee and the Ways and Means for our policy decisions that we decide really poor and cheap political points. Committee on a bipartisan solution. here in Washington. All you are trying to do is undermine Instead, the Republicans have hijacked We have put forth a proposed solu- affordable care. this bipartisan solution and made it so tion on this side of the aisle to say, What are you going to do with the 13 bad that even the American Medical Look, let’s take what you are doing to million people who can’t get affordable Association rejects it. the employer mandate under the Af- care if we delay the personal mandate? What then should we do? First, we fordable Care Act by extending a delay You have never come up with an an- should reject this bill overwhelmingly. for the employer mandate that they swer. You have never had an answer to It certainly will never be enacted into have already done for the White House what are you going to do about health law. to the individuals who are subject to care. All you can do is criticize and What should we do then? I would the Affordable Care Act. criticize. argue that we ought to just reset the Doesn’t that make sense? Isn’t that The SPEAKER pro tempore. The baseline. the fair thing to do? Isn’t that the time of the gentleman has expired. Remember the alternative minimum right thing to do? Mr. LEVIN. I yield the gentleman an tax? We finally decided it would never If you are going to delay it for Big additional 30 seconds. be imposed. Adjusted the budget to re- Business, why don’t you delay it for Mr. PASCRELL. Delaying the indi- flect the fact that it will never happen. moms and pops and sons and daughters vidual mandate will result in 13 million And if you won’t do that, at least give across America and use that money in fewer Americans getting health insur- the medical community procedural savings to pay for a permanent solu- ance through the ACA and higher pre- fairness. tion here in Washington, D.C., when it miums for those with health insurance. KEVIN BRADY said, Let’s work in a bi- comes to paying for our doctors as they You want it to fail. You don’t want it partisan approach. He admits that this care for our elderly and our seniors? to succeed. You forgot what you did isn’t going to be the last word. Well, That is a commonsense proposal, and back 9 years ago when we passed the let’s try procedural fairness. Allow the yet we play political theater on this premium D. We went back to our dis- bipartisan proposal on the floor under important issue. We can’t do that. Our tricts and made it work, even though an open rule for a full debate and hardworking taxpayers back home, Mr. we voted against it. That is the Amer- amendment. Speaker, deserve better. ican way. Now there is a novel thought. Let the I came here to Washington, D.C., to Learn the American way. It works. legislative process work and let the do something: to change the status Don’t go on recess. House work its will. Then this shame- quo. We have an opportunity to take Mr. BRADY of Texas. Mr. Speaker, I ful charade will end. an issue that has been pending ad nau- reserve the balance of my time. Mr. BRADY of Texas. Mr. Speaker, seam since 2003 and get it taken care of The SPEAKER pro tempore. The may I inquire how much time is re- permanently and give that certainty, Chair would ask Members to address maining? that ability for our providers, for our their remarks to the Chair and not to The SPEAKER pro tempore. Each seniors, to know what they are going others in the second person. side has 5 minutes remaining. to get paid and to make sure that our Mr. LEVIN. Mr. Speaker, I yield 1 Mr. BRADY of Texas. Mr. Speaker, I seniors have the comfort of knowing minute to the gentleman from Min- yield 3 minutes to the gentleman from that their doctors are going to have nesota (Mr. NOLAN). New York (Mr. REED), one of our key their doors open to take care of them (Mr. NOLAN asked and was given members of the Ways and Means Com- when they need them the most. That is permission to revise and extend his re- mittee, who has brought the concerns what we should be focusing on, Mr. marks.) of New York doctors to our attention. Speaker. Mr. NOLAN. Mr. Speaker, I rise in Mr. REED. I thank Chairman BRADY I encourage my colleagues to support support of my colleague DAN KILDEE’s for yielding the time. this legislation and get this permanent efforts to reinstate the health care tax Mr. Speaker, I rise today to talk solution in place. credit. Unfortunately, it was rejected about the very important issue that Mr. LEVIN. I yield 11⁄2 minutes to the by the House Republicans under yet this bill is here to address. We have at gentleman from New Jersey (Mr. PAS- another closed rule. the end of the month a cliff where our CRELL), a member of our committee. Having served in this Congress at an providers under Medicare are going to Mr. PASCRELL. Mr. Speaker, to earlier time in my life, I am astonished be looking at a 24 percent cut in their quote a very famous President: how undemocratic this institution has reimbursements for caring for our sen- There they go again. become. Back in the day, if you had an iors. This is an alternative universe, amendment, you got an opportunity to What are we doing today? The other through the Speaker, that you are try- offer it. You had an opportunity to de- side is engaging in political theater ing to create. bate it until all the debate was ex- rather than deal with the issue at For years, we have been talking hausted and then you had an oppor- hand. about how to reform SGR and how to tunity to vote on it. What a tragedy We have an opportunity, Mr. Speak- pay for our Medicare providers. I, along that the people’s House seems to hard- er, to fix a problem out of Washington, with my Democratic colleagues—and ly be a democratic institution any D.C., that has repeatedly been coming some Republicans—supported past ef- longer. up since 2003—and do it on a long-term, forts to repeal and replace SGR once When this program that I am talking permanent basis. We have spent $150 and for all, but we have never been able about here, the health care tax credit, billion in minor patches to the doc fix to get it done. expired in January, thousands of re- over that period of time. That changed late last year. The En- tired workers on the Iron Range in my Today, we have an opportunity— ergy and Commerce Committee passed district of Minnesota saw their pen- through the bipartisan work on the unanimously a bill to repeal and re- sions cut in half. These are former em- policy that will resolve this issue once place SGR. Building on that proposal, ployees of companies like LTV and Na- and for all—to do it at a cost of $138 Republicans and Democrats on the tional Steel—giants in American man- billion. That would take care of this Senate Finance Committee and in the ufacturing. Some of these hardworking threat to our seniors and to the doctors Ways and Means Committee here, men and women are responsible for that are providing for them on a per- which I sit on, came together and pulling America out of the Great De- manent basis. That is the right thing passed the bill that repeals SGR and pression, helping us win World War II, to do. replaces it with a payment system that supplying the world with superior prod- So what is the argument over? Well, rewards providers for delivering qual- ucts made in America. how we are going to pay for it? ity care to our seniors. Mr. Speaker, let us have a vote. Let’s My friends in the other Chamber on What you have done, through the start opening up the rules in this the other side of this esteemed building Speaker, is to take months of thought- Chamber.

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00028 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.020 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2465 Mr. BRADY of Texas. Mr. Speaker, I Act, being a woman is no longer a pre- Shield, the California Medical Associa- continue to reserve the balance of my existing medical condition. The Repub- tion, from AFSCME, and also from the time. lican actions here today would reverse Alliance for Retired Americans. These Mr. LEVIN. It is now my pleasure to that and take us back to a time where are just a few of the examples of letters yield 1 minute to the gentlelady from women paid more for policies simply and communications from opponents. California (Ms. PELOSI), our very dis- because they were women. You know, you can just boil this tinguished leader. It would, again, reject, eliminate the down to a few words. The Republicans Ms. PELOSI. Mr. Speaker, I thank very important provision of the Afford- are so intent on manipulating every- the gentleman for yielding, and I thank able Care Act about not being denied thing so that they think they can him for his relentless and persistent coverage because you have a pre- strengthen themselves for November leadership in helping America’s sen- existing medical condition. Tens of that they put a poison pill into a bipar- iors, today manifested in his support millions of families—probably a hun- tisan product, a product that we for the SGR and his opposition to this dred million people—are affected by worked months to perfect. ill-designed approach by the Repub- not being denied coverage because of a So there is no shame. March is irrele- licans. preexisting medical condition. That is vant; November seems to be every- Mr. Speaker, today, House Repub- how many people it would affect. thing. licans are proving that their obsession This bill cannot become law. This is b 1030 with tearing down the Affordable Care an effort simply of a political nature. I very much urge you, at this last Act is blurring their vision and that it It would eliminate the requirement minute, rethink what you are doing. It has no boundaries. of the Affordable Care Act that there is so transparent. It is so transparent. For their 51st vote to repeal or un- be no cap, either annual or lifetime limit, on the health insurance that you Mr. Speaker, I yield back the balance dermine the Affordable Care Act, Re- of my time. publicans are turning their partisan- would receive. For these and other rea- ship against the health and security of sons, this is a really bad idea. MARCH 11, 2014. We may only hope that, after this Hon. , our Nation’s seniors. Speaker, House of Representatives, The House Republican leadership’s 51st vote, Republicans’ fever will Washington, DC. political games are threatening to de- break, and they will return to work Hon. NANCY PELOSI, rail months of bipartisan, bicameral— with Democrats to pass bipartisan, bi- House Democratic Leader, House of Representa- House and Senate—progress on a per- cameral legislation as a permanent doc tives manent Medicare doc fix, threatening fix that seniors need before the end of Washington, DC. our seniors’ ability to see their doctors the month. DEAR SPEAKER BOEHNER AND LEADER We are going out today, again, with PELOSI: On behalf of America’s Health Insur- and get the health care they need. ance Plans (AHIP) and the Blue Cross Blue Earlier this week, the AARP, the Na- work undone; 10 days before we come Shield Association (BCBSA), we are writing tional Committee to Preserve Social back the 24th of March. The SGR ex- to express our strong opposition to repealing Security and Medicare, the National pires at the end of March. or delaying the Affordable Care Act’s (ACA) Council on Aging, and other key sen- We shouldn’t be wasting time on this individual mandate as part of the Medicare iors’ advocacy groups wrote to congres- foolishness and recklessness. We should physician payment reform bill. sional leadership to make it clear that be finding a solution. That is what the Our members believe it is critically impor- American people sent us here to do. tant to modernize the Medicare physician the Republicans’ actions would ‘‘inject payment system to promote improvements partisan politics into bipartisan legis- The Republican fixation with de- in quality, value, and patient outcomes. lation,’’ and that this ‘‘undermines the stroying the health security of millions However, we have deep concerns about pack- months of hard work done by commit- of Americans through their efforts to aging the Medicare physician payment bill tees, their staffs, and concerned stake- destroy the Affordable Care Act im- with legislation that would sever the link be- holders.’’ peril the permanent ‘‘doc fix,’’ and that tween the ACA’s individual mandate and its The Republicans’ approach has been must stop. market reforms. The experience of states rejected not only by the senior advo- Congress is wasting time again, as I that attempted this in the 1990s dem- onstrates that removing this important link- cacy groups but by providers, doctors, said, on these endless, wasteful votes. age will result in more uninsured Americans, insurers, and seniors. Yet they persist Time should be spent renewing emer- higher costs, and reduced choices for individ- with their reckless partisan antics gency unemployment insurance, rais- uals and families. To avoid these outcomes, even as time quickly runs down to ad- ing the minimum wage, rebuilding we are asking Congress to reject efforts to dress the sustainable growth rate for- America by investing in education and repeal or delay the individual mandate in the mula before the end of the month. building our infrastructure, creating debate on Medicare physician payment re- Twice this week, Republicans jobs. form. Thank you for considering our views on blocked the House from considering a The American people deserve better these important issues. fully paid-for measure that includes than this. They deserve a Congress that Sincerely, the reforms to the SGR supported by works to strengthen the middle class, KAREN IGNAGNI, both Democrats and Republicans in the tackle the opportunity gap, create President and CEO, House and in the Senate and on the jobs, and build an economy that works America’s Health Insurance Plans. committees. for everyone. SCOTT P. SEROTA, Why have Republicans chosen to pro- I urge my colleagues to vote against President and CEO, ceed in this manner after months of bi- this bill, and I hope that when we re- BlueCross BlueShield Association. partisan progress? Why didn’t Repub- turn after the recess week, yet another AFSCME, lican leadership work with Democrats recess week, Republicans will be ready Washington, DC, March 11, 2014. to find acceptable offsets? We need to to get serious and be ready to get back DEAR REPRESENTATIVES: On behalf of the get this done—and Republicans know to work for a permanent doc fix so that 1.6 million workers and retiree members of that their badly partisan effort is a our seniors will be served. the American Federation of State, County nonstarter. The SPEAKER pro tempore. The gen- and Municipal Employees (AFSCME), I write with regret to oppose legislation which re- If passed, it would spike health insur- tleman from Texas (Mr. BRADY) has 2 forms physician payments under Medicare ance premiums by 10 to 20 percent, ac- minutes, and the gentleman from (H.R. 4015). AFSCME strongly supports re- cording to the Congressional Budget Michigan (Mr. LEVIN) has 1 minute re- pealing and replacing the flawed Medicare Office. It would cause 13 million fewer maining. payments system for physicians. However, Americans to be insured, says the Con- Mr. BRADY of Texas. Mr. Speaker, I we oppose this bill because it pays for the gressional Budget Office. am prepared to close. needed reforms by robbing seniors and mil- What does this mean to families? If Mr. LEVIN. Mr. Speaker, I yield my- lions of families of the peace of mind that you have a child in your family be- self the balance of my time. comes from having affordable health care in- surance. tween the ages of 18 and 26, they would I will place into the RECORD the fol- For decades, Congress has had an annual no longer be able to be on their par- lowing letters from American Health ritual of blocking a scheduled cut to physi- ents’ policy. Under the Affordable Care Insurance Plans, Blue Cross Blue cians’ Medicare reimbursement payments as

VerDate Mar 15 2010 00:02 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00029 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.019 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2466 CONGRESSIONAL RECORD — HOUSE March 14, 2014 required under the Sustainable Growth Rate. Congress’ failure to address this issue has big step forward. We have got some Each time Congress has approved a short- harmed access to care for all patients in work to do. I know we can do it. term relief for the scheduled cut to physi- California. It has forced California physi- I went to see my doctor the other cians’ Medicare payments, it has increased cians out of Medicare and some out of prac- beneficiaries’ Part B premiums. Congress tice. Medicare rates lag 25% behind the costs week. He is 66 years old, looks like he should reform Medicare payments for doc- to provide care. It has stifled innovation and is 46; kind of makes me mad. But he tors, but it should hold seniors harmless and left small practices without the resources to has got a successful practice, a very not undermine the Affordable Care Act invest in quality and electronic health good doctor. (ACA) in the process. records. The cost of a decade of short-term The bill delays the individual mandate in He told me he would like to keep patches total $153 billion—more than the practicing for another 5 or 6 years, and the ACA. This will hurt families trying to cost to adopt this legislation. Even the Wall get affordable health coverage through the Street Journal has called the SGR budgeting he said: But KEVIN, I am not going to. health care exchanges in their states. H.R. a ‘‘sham’’ and called upon Congress to ‘‘sim- This will probably be my last year. 4015 threatens important consumer protec- ply pass the bill as is and forgo the pretense Medicare has just made it too hard for tions. The ACA prohibits denying coverage of fake-paying for it.’’ him to stay this practice. due to a pre-existing condition, charging in- We strongly urge Congress to build on the As I left the examining room, I dividuals more for coverage based on health bipartisan, bicameral process for finalizing status and dropping coverage if an individual looked at his assistant who has been this important legislation. We urge a nego- with him 30-some years, all his profes- becomes ill. Without a required duty that tiation on bipartisan funding sources before the uninsured must get coverage, these con- March 31. sional staff, a full waiting room, and I sumer protections become harder to sustain. Sincerely, thought, what are we doing chasing a Medicare is a huge success story because it RICHARD E. THORP, MD, doctor like this out of practice early? shares the cost from unexpected illness and President. Who is going to replace him? Who is injury among a large group of healthy and less healthy seniors. Like Medicare, the ACA going to take care of these people? ALLIANCE FOR RETIRED depends on a good balance of young and He is not alone. In Texas, less than AMERICANS, healthy individuals along with older and half of Texas family physicians take sicker individuals. The required duty to ob- Washington, DC, March 13, 2014. DEAR REPRESENTATIVE: On behalf of the new Medicare patients. Many of them tain coverage will drive more of the unin- four million members of the Alliance for Re- are rethinking their relationship with sured (including the young and healthy) to Medicare. Others are closing their pri- seek information about the ACA. When they tired Americans, I am writing to oppose the do, they will discover that good quality, af- passage of H.R. 4015, the SGR Repeal and vate practices. So more and more sen- fordable coverage is available to them at Medicare Provider Payment Modernization iors are chasing fewer and fewer doc- last. The so-called savings from delaying the Act. While the February 2014 agreement tors, and that is the dilemma we face individual mandate creates an imbalance in reached by the House and Senate to fix the today. the population covered. This leads to higher sustainable growth rate formula in Medi- care’s physician reimbursement was bi- Maybe I am an optimist, but I think costs for everybody in the exchange. we are 90 percent of the way toward By the end of February, four million indi- cameral and bipartisan, this legislation is viduals had obtained private insurance cov- not. solving this solution. We have broad erage through the federal and state ex- This legislation turns its back on a good support for this policy and this bill. changes. Every day, more families are gain- faith agreement by including an irrespon- We have a duty to make sure our sen- ing the peace of mind that comes with com- sible pay-for. Under this egregious proposal, iors have access to their doctors, and prehensive and affordable health coverage. doctors would be paid on the backs of unin- sured Americans. This is simply unaccept- Democrats and Republicans have been We urge you to oppose H.R. 4015 so that more putting in a lot of work to solve this families can realize that peace of mind. able. To add insult to injury, the legislation Sincerely, permanently fixes SGR and provides a 0.5 problem. Yeah, we have some work to CHARLES M. LOVELESS, percent update for doctors, but does not per- do. Director of Government Affairs. manently extend the Qualified Individual Now is the time to permanently fix (QI) program, an extender that always ac- the way we reimburse our doctors. As CALIFORNIA MEDICAL companies the SGR patch. we move forward, let’s work in a bipar- The QI program pays the monthly Medi- ASSOCIATION, tisan way, across the Chambers, across Washington, DC, March 10, 2014. care Part B premiums for seniors and indi- Re H.R. 4015 ‘‘The SGR Repeal and Medicare viduals with disabilities who have incomes of the parties to get it done. I am abso- Modernization Act of 2014’’ 120% to 135% of the Federal Poverty Level lutely confident we can do that. (FPL)—about $13,700 to $15,300 for an indi- Hon. JOHN BOEHNER, Mr. Speaker, I yield back the balance Speaker, House of Representatives, vidual—and assets no higher than $7,080 for of my time. Washington, DC. an individual. It is disturbing to us that the authors of this proposal found money to pro- Mr. HOLT. Mr. Speaker, I rise in opposition Hon. NANCY PELOSI, vide an update for physicians, who on aver- to H.R. 4015, a transparently phony attempt to Minority Leader, House of Representatives, fix the flawed Medicare payment system. Washington, DC. age make upwards of $200,000 per year, but not for low-income Medicare beneficiaries. For 17 years, we have neglected to address CMA POSITION: SUPPORT THE POLICY; OPPOSE The Alliance for Retired Americans is sup- the erring formula by which we compensate THE OFFSET AS A NON-VIABLE, BICAMERAL portive of fixing Medicare’s physician pay- OPTION Medicare physicians. By repealing and replac- ment formula and stands ready to work with ing the inadequate Sustainable Growth Rate, DEAR SPEAKER BOEHNER AND LEADER Congress to come up with an acceptable off- PELOSI: On behalf of the California Medical set. Financing options could include using we have the power to improve Medicare for Association, I want to express our strong the Overseas Contingency Operations (OCO) our seniors and more fairly reimburse their support for the hard-fought and long-awaited funds or the Medicare Drug Discount Act, health care providers. Medicare SGR reform POLICY in the bipar- which would save the government $141 bil- Today’s vote should be about redesigning tisan and bicameral legislation, H.R. 4015 lion over ten years. These options would the Medicare payment structure so that we re- ‘‘The SGR Repeal and Medicare Moderniza- cover the permanent fix without shifting tion Act of 2014.’’ We applaud the work and ward physicians for the quality of health care costs on to Medicare beneficiaries. provided, not the quantity of procedures per- the perseverance of the House and Senate However, as it currently stands, we cannot Committees to achieve a bipartisan agree- support this legislation that slams uninsured formed. We should be considering how to ment to repeal the flawed Medicare SGR and Americans. We urge you to oppose H.R. 4015. transform our health care system to one that institute a reasonable new payment system. Sincerely, encourages value driven care and incentivizes Congress has not made this much progress in RICHARD J. FIESTA, the coordination of critical services to meet the a decade. Executive Director. While we share the frustration that there needs of our aging population. is not a clear legislative path for bipartisan Mr. BRADY of Texas. Mr. Speaker, I But today’s vote is not a sincere effort to im- funding offsets, we are extremely dis- yield myself the balance of my time. prove the delivery of care for the nearly 50 appointed with the recent decision to pursue First, I want to commend and thank million seniors and people with disabilities who a partisan funding source—the repeal of the our Democrat colleagues on the Ways rely on Medicare. In fact, today’s vote is yet ACA’s individual mandate. Regardless of our and Means Committee and the staff for another attempt to destabilize the private position on the ACA, this is not an accept- able, viable funding option in the U.S. Sen- working so hard, along with Energy health insurance market and subvert the Af- ate. And therefore, it could result in another and Commerce and the Finance Com- fordable Care Act. The Republicans have pre- 9-month patch which is simply unacceptable mittee in the Senate, to find a good, sented a false choice between jeopardizing to California physicians. solid solution. I think we have made a access to care for our seniors, or dangerously

VerDate Mar 15 2010 01:00 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00030 Fmt 4634 Sfmt 9920 E:\CR\FM\A14MR7.005 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2467 increasing the cost of health care for all Amer- Ms. SCHWARTZ. Mr. Speaker, I rise today amendment to undermine the individual man- icans by delaying the Affordable Care Act’s in- in opposition of H.R. 4015, legislation Repub- date of the Affordable Care Act. dividual responsibility provision. Make no mis- licans have introduced to gut the Affordable While there are positive provisions in H.R. take: shifting access to affordable health insur- Care Act to pay for a bipartisan, bicameral 4015, the SGR Repeal and Medicare Provider ance farther and farther out of reach for mil- agreement to repeal Medicare’s broken Sus- Payment Modernization Act of 2014, an lions of Americans is not an ‘‘offset’’— it is a tainable Growth Rate (SGR) formula. amendment added by Chairman DAVE CAMP scandal. For months, we have worked in a bipartisan, would delay the Affordable Care Act’s indi- While I support the underlying attempt to re- good-faith effort to develop a permanent solu- vidual mandate by five years. place the Sustainable Growth Rate, I cannot in tion for Medicare’s physician payment system Commonly referred to as the ‘‘doc fix,’’ SGR good conscience vote for this bill because this that has threatened seniors’ access to care for Repeal has been on the table since the begin- ‘‘fix’’ creates far more problems than it solves. more than a decade. In February 2013, I intro- ning of this Congress and desperately requires Mr. HONDA. Mr. Speaker, I rise today in op- duced the bipartisan Medicare Physician Pay- action. This legislation would repeal the cuts position to the version of H.R. 4015 that Re- ment Innovation Act (H.R. 574) with Rep. JOE to physician Medicare payments and allow for publican leadership has brought to the floor of HECK (R–NV) to repeal the SGR and set out small increases over 10 years. The second the House. a clear path toward comprehensive reforms of part of this legislation would make MEDPAC The Balanced Budget Act of 1997 created Medicare payment and delivery systems. Last and GAO report more to Congress, including SGR in an attempt to control spending in the month, three committees, including Ways and new payment rules that became final this year. Medicare program, and it was adopted for Means, on which I serve, announced a bipar- There would also be additional protections against Medicare fraud. TRICARE as well. For years, this methodology tisan, bicameral agreement that incorporates However, if this legislation passes with the has consistently produced unrealistic expendi- the overarching framework of my legislation ture targets. These targets trigger untenable Camp Amendment, the 5-year delay of the in- and includes several specific provisions. dividual mandate provision will increase the reductions in payment rates to doctors pro- Finding common ground on a responsible viding services to Medicare patients. number of uninsured Americans by 13 million way to pay for a permanent SGR fix was in 2018. A CBO analysis said that premiums As a result, Congress has buried the true never going to be easy, but that does not cost of this policy through annual Congres- would likely increase 10–20 percent in the in- mean it should be used to score political dividual marketplace during the years without sional overrides of these scheduled cuts. Each points. Seniors must have access to their doc- of these short-term ‘‘fixes’’ has achieved the a mandate penalty. tors and time is running out. I strongly urge important goal of averting an immediate crisis I urge my colleagues to heed my warning Republicans to join Democrats to act on this in access to physicians for Medicare bene- about this new effort to undermine the Afford- significant bipartisan opportunity to enact a ficiaries, but has exacerbated a longer-term able Care Act. permanent solution that provides more secu- crisis in Medicare financing. Ms. JACKSON LEE. Mr. Speaker, I rise to Continued short term patches create insta- rity and certainty for seniors and their doctors. speak in strong opposition to H.R. 4015, the Mr. COURTNEY. Mr. Speaker, I regret that bility in the health care system and the econ- SGR Repeal and Medicare Provider Payment I cannot be present for today’s session, as I omy as a whole. Doctors have been ham- Modernization Act of 2014 because of the am joining Admiral Mike Connor, Commander strung by yearly doubt about what reimburse- passage of the Rule to this bill. of our nation’s submarine forces, on a visit to ment rates will be, and patients have had to I am not alone in opposing this irresponsible pay the eventual price in uneven, substandard an in-service class submarine to see measure. I am joined by AARP, Alliance for quality of care. firsthand the skill of our submariners and the Retired Americans, American Academy of The SGR needs to be repealed and the vital role they play in our nation’s defense. It Family Physicians, American Geriatrics Soci- Medicare payment system needs to be re- will also give me a chance to review and dis- ety, American Osteopathic Association, Center formed now. To accomplish this, I signed on cuss the Navy’s FY 15 request for Virginia for Medicare Advocacy, Inc., Families USA, as a co-sponsor of the original version of the class submarine construction and the Ohio Medicare Rights Center, National Committee bipartisan bill H.R. 4015, the SGR Repeal and Class Replacement Program, critical issues for to Preserve Social Security and Medicare, Na- Medicare Provider Payment Modernization Act the Second District of Connecticut. Had I been tional Association of Area Agencies on Aging, of 2014. present, however, I would have voted ‘‘no’’ on and the National Council on Aging. H.R. 4015 proposes five years of 0.5% pay- the SGR Repeal and Medicare Provider Pay- I strongly support providing adequate com- ment increases for the Medicare physician fee ment Modernization Act (H.R. 4015). pensation to our physicians who serve Medi- care patients. Medicare patients in very state schedule before freezing payments at that For too long, the sustainable growth rate make up 10 percent or more of those who level for five additional years. It also supports (SGR) formula has created a weight of uncer- tainty not only for Medicare beneficiaries and have health insurance. alternative payment models, and creates a Medicare patients and the medical pay- new Merit-Based Incentive Payment System veterans, but more broadly throughout our health care system. For the past decade, ments made to their physicians and medical (MIPS) for those who stay on the fee-for-serv- service providers is critical to our nation’s ice payment model. health care providers from around the country have had to leave their practices to travel to health care economy. Despite months of bipartisan work to forge It is important for our seniors to know that Washington and ask for relief from SGR’s this compromise, House Republicans amend- Medicare will be there when they need it. But automatic rescission. This is not right. It is ed the bill to delay the individual mandate re- it is equally important that there are physicians counterproductive and wasteful. And, a perma- quirement in the Affordable Care Act. This un- who are willing to attend to them without going nent fix—which I strongly support and have conscionable political stunt to undermine the broke. Affordable Care Act puts our Medicare health worked on a bipartisan basis to achieve—is That is why we have a Sustainable Growth system in jeopardy at a critical time, with pay- long overdue. Rate or ‘‘SGR.’’ Medicare reimbursement en- ment rates set to drop dramatically on April 1, Committee efforts in the House and Senate ables rural physicians and hospitals to remain 2014. to repeal the SGR formula permanently have open for business. I am committed to reforming our Medicare been a bipartisan, bicameral bright spot in the As with any business, medical clinics and system and repealing the SGR, but the bill 113th Congress. Unfortunately, the injection of physician offices have payrolls to meet, bills to House Republican leadership brought to the a partisan fiscal offset into H.R. 4015 has pay, and expenses to meet as they become House floor fails to strengthen Medicare, or decimated previous, widespread endorse- due. If revenues are not sufficient to cover help Americans get access to affordable ments of the proposal, now generating opposi- costs, the business will not long survive. health care. I cannot support the flawed tion from the American Medical Association Thus, it is critical that we not disrupt timely amended version of the bill. (AMA) and the American Association of Re- and adequate payment to Medicare providers, Medicare has guaranteed essential health tired People (AARP). The White House has but that is exactly what will happen at the end protections to seniors and certain disabled also announced that if President Obama were of this month if the SGR is not approved by persons for nearly four decades. I believe presented with this measure, he would veto it. the House and the Senate and signed into law Medicare is more than just a program, it is a As amended, I too cannot support H.R. 4015 by President Obama. covenant that exists between the government and had I been present for the vote on the The problem with H.R. 4015 is what hap- and the American people. legislation, I would have voted ‘‘no.’’ pened when the Rule for this bill passed the I support fixing and reforming this system Ms. EDDIE BERNICE JOHNSON of Texas. House. permanently, but H.R. 4015 as amended is Mr. Speaker, I rise in support of legislation to The rule for H.R. 4015 added language that not the way to do that, and so I urge my col- repeal the Sustainable Growth Rate and up- would delay the Affordable Care Act’s imple- leagues to oppose this bill. date Medicare’s payment system without the mentation of the individual mandate.

VerDate Mar 15 2010 00:32 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00031 Fmt 4634 Sfmt 9920 E:\CR\FM\A14MR7.004 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2468 CONGRESSIONAL RECORD — HOUSE March 14, 2014 I oppose the bill for two reasons: We know that for every person who gets a MOTION TO RECOMMIT It corrupts what was a strongly supported bi- job—three others are still searching for em- Mr. LOEBSACK. Mr. Speaker, I have partisan bill to sustain physician reimburse- ployment. a motion to recommit at the desk. ment rates for medical services approved This is another attempt to undermine the Af- The SPEAKER pro tempore. Is the under Medicare, and fordable Care Act. Instead of trying to repeal gentleman opposed to the bill? It is another attempt by the Republicans to the Affordable Care Act, House Republicans Mr. LOEBSACK. I am opposed in its mislead the public regarding the Affordable are now seeking ways to impede or frustrate current form. Care Act. its implementation. Mr. PITTS. Mr. Speaker, I reserve a After shutting down the federal government I know that many predicted that the Afford- point of order against the motion to re- last year in an attempt to end the Affordable able Care Act would cause havoc on the na- commit. tion’s health care system. But it is not the ACA Care Act, they have resorted to their latest The SPEAKER pro tempore. A point that is causing havoc—it is the 50 desperate gimmick of attaching to a critically needed of order is reserved. but futile attempts by the Tea Party to scuttle piece of legislation to make sure our nation’s The Clerk will report the motion to a law that has been passed by Congress, seniors continue to have access to physicians recommit. signed by the President, upheld by the Su- and hospitals an attempt to harm Obamacare. preme Court. I ask my colleagues to support Medicare pa- The Clerk read as follows: The most threatening actions to our nation’s tients and their physicians by rejecting the bill. Mr. Loebsack moves to recommit the bill healthcare system by Tea Party Republicans Mr. DEFAZIO. Mr. Speaker, today I will vote H.R. 4015 to the Committee on Ways and are their attacks on Medicare. against H.R. 4015 despite being a cosponsor Means with instructions to report the same In 2014, according to the Kaiser Foundation of the original bill. It should not have been that back to the House forthwith with the fol- lowing amendment: 16 percent of the nation’s people have med- way. H.R. 4015 as originally drafted repealed At the end of the bill, add the following: ical insurance under Medicare: the misguided SGR formula and laid out a Texas has 12 percent of its residents in- reasonable path toward reimbursing doctors SEC. ll. PROHIBITION ON MEDICARE CUTS OR based on the quality of care that they provide. VOUCHERS. sured under Medicare; Nothing in this Act shall reduce benefits Arkansas, Florida and Vermont have 19 per- The bill had 118 bipartisan cosponsors. I heard from medical professionals all over Or- under the Medicare program under title cent of their residents insured under Medicare; XVIII of the Social Security Act, eliminate West Virginia and Maine have 21 percent of egon who were hopeful that Congress would guaranteed health insurance benefits avail- their residents insured under Medicare; and actually be able to pass H.R. 4015 and finally able to seniors or individuals with disabil- Kentucky, Mississippi, Missouri, Ohio, Okla- do away with short term SGR fixes. ities under such program, or establish a homa, Oregon, South Dakota, Tennessee, Unfortunately Republican House leadership Medicare voucher plan that provides limited Wisconsin, Ohio, Oklahoma, and Oregon have squandered this opportunity. Instead of finding payments to Medicare beneficiaries in order 18 percent of their residents insured under a bipartisan way to pay for H.R. 4015, House to purchase health care in the private sector. Medicare. Republican leadership inserted an ideological The SPEAKER pro tempore. Pursu- Every state has more than 10 percent of pay-for that would leave 13 million people un- ant to the rule, the gentleman from their residents insured by Medicare. insured according to the Congressional Budg- Iowa is recognized for 5 minutes in sup- The uncertainly created by the majority re- et Office. Because of this partisan gimmick, port of his motion. garding Medicare reimbursement over the last the Senate will never take up H.R. 4015. That Mr. LOEBSACK. Mr. Speaker, this is several years has forced physicians to re- leaves our nation’s medical professionals ex- the final amendment to the bill, which actly where they were before the vote—facing evaluate continuing their medical practice and will not kill the bill or send it back to an approximately 27% cut in Medicare and frustrated hospitals working to make budget the committee. If adopted, the bill will TRICARE reimbursements if Congress doesn’t projections over several years into the future— immediately proceed to final passage, fix the SGR before March 31st. this is critical to business decision making. as amended. Because of uncertainty created by Medicare In 1997 I voted against creating the faulty SGR formula. I opposed the 1997 law be- I regularly meet with seniors across physician reimbursement—physicians and Iowa, and far too often I hear that hospitals have been forced to close their of- cause it balanced the budget on the backs of seniors and health care providers by substan- many of them are struggling to make fices, reduce services, or merge. ends meet, just as I am sure that many When patients find they cannot keep their tially cutting Medicare. By delaying these cuts instead of permanently fixing the SGR for- of my colleagues hear from their sen- physician or that their options for health care iors as well. They tell me how much are being affected—it is not because of the Af- mula, the potential cuts have grown every year. they rely on Medicare in order to stay fordable Care Act. healthy and just to afford their daily Our nation has taken a momentous step in Rather than cutting medical coverage for 13 million Americans, Congress should pay for necessities. creating a mindset that good health is a per- H.R. 4015 by allowing Medicare to negotiate Mr. Speaker, our seniors did not get sonal responsibility with the enactment of the prescription drug prices. Every single other de- us into this fiscal mess that we are in Affordable Care Act. The health care law did veloped country in the world permits their gov- today, and I think we have to keep not automatically enroll all citizens into the ernment to negotiate drug prices for all of their that in mind. It is unfair to punish program; it was specifically designed to be an citizens. In the U.S. private insurance compa- them for Washington’s irresponsible opt-in process. nies negotiate prices, and the Veterans Ad- There are tens of thousands of visitors each behavior. That is why we have got to ministration negotiates prices, but the federal protect Medicare for seniors who have day to the website and despite problems with government is prevented from negotiating drug the initial rollout of the online health insurance worked a lifetime to pay into it. prices for Medicare. This means that drug This also is an issue I will say that is registration process, millions have enrolled companies are free to charge Medicare recipi- and experience the peace of mind that comes personal to me. I grew up in a family ents higher prices than anyone else in the that struggled to make ends meet. I from having affordable, high quality health in- world. Allowing the federal government to ne- surance that is there when you need it. often talked about how I grew up in gotiate drug prices for Medicare would fully poverty. My mom was a single parent So it is puzzling that with less than 70 legis- pay for the SGR fix. The House could have lative days remaining in the Second Session who struggled with mental illness, and ensured proper reimbursements for doctors literally, in the fourth grade, we landed of the 113th Congress, we are still seeing at- and reduced drug prices for seniors in one bill tempts to end the Affordable Care Act. at the doorstep of my maternal grand- today. Instead we voted on a bill that is going mother. It is very troubling that a bill critical to the nowhere. provision of payments to physicians that treat The SPEAKER pro tempore. All time My grandmother often relied on So- Medicare patients is not safe from the partisan for debate has expired. cial Security survivor benefits to care political games of the House of Republicans. Pursuant to House Resolution 515, for me and my siblings. Without the The House should be considering legislation the previous question is ordered on the promise of health care through Medi- to address the most pressing needs of the bill, as amended. care, she would not have been able to American people. Today, we should be debat- The question is on the engrossment afford to put food on the table. ing legislation to extend emergency unemploy- and third reading of the bill. No senior—and I think all of us in ment insurance benefits. The House should be The bill was ordered to be engrossed this body can agree—no senior should debating a jobs creation bill to put Americans and read a third time, and was read the have to choose between paying their who are seeking employment back to work. third time. bills or paying for their medication.

VerDate Mar 15 2010 00:32 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00032 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.014 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2469 Mr. Speaker, replacing Medicare with care, or will you vote to let it go bank- McDermott Pingree (ME) Sinema a voucher system would end the guar- rupt? McGovern Pocan Sires McIntyre Polis Slaughter antee of health care and financial secu- What kind of country are we living in McNerney Price (NC) Speier rity for our seniors as well. Vouchers when our own government has reduced Meeks Quigley Swalwell (CA) would force seniors to pay more and the American Dream to a choice be- Meng Rahall Takano Michaud Rangel more of their health care costs out of tween health care and groceries? Thompson (CA) Miller, George Richmond Thompson (MS) pocket. This motion to recommit embraces Moore Roybal-Allard Tierney Moran Ruiz In these tough economic times, we the tired gimmicks of yesterday that Titus Murphy (FL) Ruppersberger need to find ways to be more efficient Tonko the public has grown to distrust. You Nadler Ryan (OH) while maintaining quality care. have a clear choice. You either vote Napolitano Sa´ nchez, Linda Tsongas I know that seniors don’t want a ‘‘no’’ and stand up for what is right, to Neal T. Van Hollen Vargas voucher that forces them to buy insur- give our seniors the peace of mind they Negrete McLeod Sanchez, Loretta Nolan Sarbanes Veasey ance that may not meet their needs be- deserve, or you can vote ‘‘yes’’ on this O’Rourke Schakowsky Vela cause they tell me that every single motion to recommit and demonstrate Owens Schiff Vela´ zquez time I meet with them. They do not to the American public that political Pallone Schneider Visclosky want their health care to be subject to Pascrell Schrader Walz games are more important to you than Pastor (AZ) Schwartz Wasserman the whims of insurance companies their health and welfare. Payne Scott (VA) Schultz looking to make a profit when they, I, for one, will be voting with seniors Pelosi Scott, David Waters those seniors, get sick. Perlmutter Serrano Waxman this morning, and I would encourage Peters (CA) Sewell (AL) They don’t want higher costs, and all of my colleagues to do the same. Welch Peters (MI) Shea-Porter Yarmuth they certainly don’t want reduced ben- Vote ‘‘no’’ on the motion to recom- Peterson Sherman efits. They want to keep Medicare the mit. NAYS—226 way it is, a guaranteed benefit they Mr. Speaker, I yield back the balance can count on when they need it. They of my time. Aderholt Goodlatte Mullin Amash Gowdy Mulvaney paid into it, and they deserve it. The SPEAKER pro tempore. Without Mr. Speaker, I ask my colleagues on Bachus Granger Murphy (PA) objection, the previous question is or- Barletta Graves (GA) Neugebauer both sides of the aisle to support this dered on the motion to recommit. Barr Graves (MO) Noem Barton Griffin (AR) Nugent final amendment to the bill. There was no objection. I yield back the balance of my time. Benishek Griffith (VA) Nunes The SPEAKER pro tempore. The Bentivolio Grimm Nunnelee Mr. PITTS. Mr. Speaker, I withdraw question is on the motion to recommit. Bilirakis Guthrie Olson my point of order and claim the time Bishop (UT) Hall Palazzo in opposition to the motion. The question was taken; and the Black Hanna Paulsen The SPEAKER pro tempore. The res- Speaker pro tempore announced that Blackburn Harper Pearce the noes appeared to have it. Boustany Harris Perry ervation is withdrawn. Brady (TX) Hartzler Petri The gentleman from Pennsylvania is Mr. LOEBSACK. Mr. Speaker, on Bridenstine Hastings (WA) Pittenger recognized for 5 minutes. that I demand the yeas and nays. Brooks (AL) Heck (NV) Pitts Mr. PITTS. Mr. Speaker, to begin The yeas and nays were ordered. Brooks (IN) Hensarling Poe (TX) Broun (GA) Herrera Beutler Pompeo with, I would just like to acknowledge The SPEAKER pro tempore. Pursu- Buchanan Holding Posey all the good work on both sides of the ant to clause 9 of rule XX, the Chair Bucshon Hudson Price (GA) aisle in reaching the bipartisan policy will reduce to 5 minutes the minimum Burgess Huelskamp Reed time for any electronic vote on the Byrne Huizenga (MI) Reichert agreement in the SGR, and especially Calvert Hultgren Renacci want to thank our staff, Clay Alspach question of passage of the bill. Camp Hunter Ribble and Robert Horne and Chris Pope, and The vote was taken by electronic de- Campbell Hurt Rice (SC) everyone on both sides of the aisle and vice, and there were—yeas 191, nays Cantor Issa Rigell Capito Jenkins Roby their staff, for all the good work. 226, not voting 14, as follows: Carter Johnson (OH) Roe (TN) Mr. Speaker, this bill before us pre- [Roll No. 134] Cassidy Johnson, Sam Rogers (AL) sents each and every Member of this Chabot Jolly Rogers (KY) YEAS—191 Chaffetz Jones Rogers (MI) body a simple choice: Do we patch Barber DeFazio Huffman Coble Jordan Rohrabacher Medicare, or do we fix it? Barrow (GA) DeGette Israel Coffman Joyce Rooney Do we choose to fight for the Medi- Beatty Delaney Jackson Lee Cole Kelly (PA) Ros-Lehtinen care promise that this country has Becerra DeLauro Jeffries Collins (GA) King (IA) Roskam Bera (CA) DelBene Johnson (GA) Collins (NY) King (NY) Ross made to every American, or do we vote Bishop (GA) Deutch Johnson, E. B. Conaway Kingston Rothfus against it? Bishop (NY) Doggett Kaptur Cook Kinzinger (IL) Royce My friends, I am voting today to Blumenauer Doyle Keating Cotton Kline Runyan keep the Medicare promise to Ameri- Bonamici Duckworth Kelly (IL) Cramer Labrador Ryan (WI) Brady (PA) Edwards Kennedy Crawford LaMalfa Salmon cans. We must not let another oppor- Braley (IA) Ellison Kildee Crenshaw Lamborn Sanford tunity to save Medicare for our seniors Brown (FL) Engel Kilmer Daines Lance Scalise fall by the wayside. Brownley (CA) Enyart Kind Davis, Rodney Lankford Schock Bustos Eshoo Kirkpatrick Denham Latham Schweikert If Washington is broken, today is an Butterfield Esty Kuster Dent Latta Scott, Austin opportunity to fix it. The bill before us Capps Farr Langevin DeSantis LoBiondo Sensenbrenner is bipartisan, and the pay-for is one Capuano Fattah Larsen (WA) DesJarlais Long Sessions President Obama has used himself Ca´ rdenas Foster Larson (CT) Diaz-Balart Lucas Shimkus Carney Fudge Lee (CA) Duffy Luetkemeyer Shuster many times in the past. Carson (IN) Gabbard Levin Duncan (SC) Lummis Simpson My colleagues, did you scream hypoc- Cartwright Gallego Lewis Duncan (TN) Marchant Smith (MO) risy when President Obama delayed the Castor (FL) Garamendi Lipinski Ellmers Marino Smith (NE) Castro (TX) Garcia Loebsack Farenthold Massie Smith (NJ) mandate for special interests here in Chu Grayson Lofgren Fincher McAllister Smith (TX) D.C.? Then why would you scream hy- Cicilline Green, Al Lowenthal Fitzpatrick McCarthy (CA) Southerland pocrisy now? Clark (MA) Green, Gene Lowey Fleischmann McCaul Stewart The time for political games is over. Clarke (NY) Grijalva Lujan Grisham Fleming McClintock Stivers Clay Gutie´rrez (NM) Flores McHenry Stockman It is time for Members of this body to Cleaver Hahn Luja´ n, Ben Ray Forbes McKeon Stutzman choose. Are you on the side of seniors Clyburn Hanabusa (NM) Fortenberry McKinley Terry in your district that depend on Medi- Cohen Hastings (FL) Lynch Foxx McMorris Thompson (PA) Connolly Heck (WA) Maffei Frelinghuysen Rodgers Thornberry care, or are you against them? Are you Conyers Higgins Maloney, Gardner Meadows Tiberi on the side of younger Americans who Cooper Himes Carolyn Garrett Meehan Tipton keep telling us they are struggling Costa Hinojosa Maloney, Sean Gerlach Messer Turner under an ObamaCare plan that forces Crowley Holt Matheson Gibbs Mica Upton Cuellar Honda Matsui Gibson Miller (FL) Valadao them to choose between groceries and Cummings Horsford McCarthy (NY) Gingrey (GA) Miller (MI) Wagner health care? Are you for saving Medi- Davis (CA) Hoyer McCollum Gohmert Miller, Gary Walberg

VerDate Mar 15 2010 00:32 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00033 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.024 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2470 CONGRESSIONAL RECORD — HOUSE March 14, 2014 Walden Whitfield Woodall Meadows Ribble Smith (TX) NOT VOTING—12 Walorski Williams Yoder Meehan Rice (SC) Southerland Amodei Culberson Gosar Weber (TX) Wilson (SC) Yoho Messer Rigell Stewart Bachmann Davis, Danny Gowdy Webster (FL) Wittman Mica Roby Young (AK) Stivers Bass Dingell Rush Wenstrup Wolf Young (IN) Miller (FL) Roe (TN) Stockman Courtney Franks (AZ) Smith (WA) Westmoreland Womack Miller (MI) Rogers (AL) Stutzman NOT VOTING—14 Miller, Gary Rogers (KY) Terry b 1115 Mullin Rogers (MI) Thompson (PA) Amodei Davis, Danny Rokita Mulvaney Rohrabacher Thornberry So the bill was passed. Bachmann Dingell Rush Murphy (FL) Rokita Tiberi The result of the vote was announced Bass Frankel (FL) Smith (WA) Murphy (PA) Rooney Tipton Courtney Franks (AZ) as above recorded. Wilson (FL) Neugebauer Ros-Lehtinen Turner Culberson Gosar A motion to reconsider was laid on Noem Roskam Upton Nugent Ross the table. b 1107 Valadao Nunes Rothfus Wagner PERSONAL EXPLANATION Mr. MICA changed his vote from Nunnelee Royce Walberg Olson Runyan Mr. FRANKS of Arizona. Mr. Speaker, had ‘‘yea’’ to ‘‘nay.’’ Walden I been present, I would have voted ‘‘yes’’ on Palazzo Ryan (WI) Walorski Ms. LOFGREN and Mr. CICILLINE Paulsen Salmon Weber (TX) rollcall No. 132 on H.R. 3189, I would have changed their vote from ‘‘nay’’ to Pearce Sanford Webster (FL) voted ‘‘yes’’ on rollcall No. 129 on H.R. 3973, Perry Scalise ‘‘yea.’’ Wenstrup Peters (CA) Schneider and I would have voted ‘‘yes’’ on rollcall No. Westmoreland So the motion to recommit was re- Peterson Schock 135 on H.R. 4015. Whitfield jected. Petri Schweikert Williams f Pittenger Scott, Austin The result of the vote was announced Wilson (SC) Pitts Sensenbrenner MESSAGE FROM THE SENATE as above recorded. Wittman Poe (TX) Sessions Stated for: Pompeo Shimkus Wolf A message from the Senate by Ms. Ms. FRANKEL of Florida. Mr. Speaker, on Posey Shuster Womack Curtis, one of its clerks, announced Price (GA) Simpson Woodall that the Senate has passed without rollcall No. 134, the motion to recommit for Yoder H.R. 4015, had I been present, I would have Rahall Sinema amendment bills and a concurrent res- Reed Smith (MO) Yoho voted ‘‘yes.’’ Reichert Smith (NE) Young (AK) olution of the House of the following The SPEAKER pro tempore. The Renacci Smith (NJ) Young (IN) titles: question is on the passage of the bill. H.R. 2650. An act to allow the Fond du Lac The question was taken; and the NAYS—181 Band of Lake Superior Chippewa in the State Speaker pro tempore announced that Beatty Grijalva Neal of Minnesota to lease or transfer certain the ayes appeared to have it. Becerra Gutie´rrez Negrete McLeod land. Bishop (GA) Hahn Nolan Mr. LEVIN. Mr. Speaker, on that I H.R. 4076. An act to address shortages and Bishop (NY) Hanabusa O’Rourke interruptions in the availability of propane demand the yeas and nays. Blumenauer Hastings (FL) Owens and other home heating fuels in the United The yeas and nays were ordered. Bonamici Heck (WA) Pallone Brady (PA) Higgins Pascrell States, and for other purposes. The SPEAKER pro tempore. This is a Braley (IA) Himes Pastor (AZ) H. Con. Res. 93. Concurrent resolution di- 5-minute vote. Brown (FL) Hinojosa Payne recting the Clerk of the House of Representa- The vote was taken by electronic de- Brownley (CA) Holt Pelosi tives to make technical corrections in the vice, and there were—yeas 238, nays Bustos Honda Perlmutter enrollment of H.R. 3370. Butterfield Horsford Peters (MI) 181, not voting 12, as follows: Capps Hoyer Pingree (ME) The message also announced that the [Roll No. 135] Capuano Huffman Pocan Senate has passed bills of the following Ca´ rdenas Israel Polis titles in which the concurrence of the YEAS—238 Carney Jackson Lee Price (NC) Aderholt Davis, Rodney Hudson Carson (IN) Jeffries Quigley House is requested: Amash Denham Huelskamp Cartwright Johnson (GA) Rangel S. 1456. An act to award the Congressional Bachus Dent Huizenga (MI) Castor (FL) Johnson, E. B. Richmond Gold Medal to Shimon Peres. Barber DeSantis Hultgren Castro (TX) Kaptur Roybal-Allard S. 2147. An act to amend Public Law 112–59 Barletta DesJarlais Hunter Chu Keating Ruiz Barr Diaz-Balart Hurt Cicilline Kelly (IL) Ruppersberger to provide for the display of the congres- Barrow (GA) Duffy Issa Clark (MA) Kennedy Ryan (OH) sional gold medal awarded to the Montford Barton Duncan (SC) Jenkins Clarke (NY) Kildee Sa´ nchez, Linda Point Marines, United States Marine Corps, Benishek Duncan (TN) Johnson (OH) Clay Kilmer T. by the Smithsonian Institution and at other Bentivolio Ellmers Johnson, Sam Cleaver Kind Sanchez, Loretta appropriated locations. Bera (CA) Farenthold Jolly Clyburn Kirkpatrick Sarbanes Bilirakis Fincher Jones Cohen Kuster Schakowsky f Bishop (UT) Fitzpatrick Jordan Connolly Langevin Schiff ADJOURNMENT TO TUESDAY, Black Fleischmann Joyce Conyers Larsen (WA) Schrader Blackburn Fleming Kelly (PA) Cooper Larson (CT) Schwartz MARCH 18, 2014 Boustany Flores King (IA) Costa Lee (CA) Scott (VA) Mr. HASTINGS of Washington. Mr. Brady (TX) Forbes King (NY) Crowley Levin Scott, David Bridenstine Fortenberry Kingston Cuellar Lewis Serrano Speaker, I ask unanimous consent that Brooks (AL) Foxx Kinzinger (IL) Cummings Lipinski Sewell (AL) when the House adjourns today, it ad- Brooks (IN) Frelinghuysen Kline Davis (CA) Loebsack Shea-Porter journ to meet at 1 p.m. on Tuesday, Broun (GA) Garcia Labrador DeFazio Lofgren Sherman Buchanan Gardner LaMalfa DeGette Lowenthal Sires March 18, 2014. Bucshon Garrett Lamborn Delaney Lowey Slaughter The SPEAKER pro tempore (Mr. Burgess Gerlach Lance DeLauro Lujan Grisham Speier MCALLISTER). Is there objection to the Byrne Gibbs Lankford DelBene (NM) Swalwell (CA) request of the gentleman from Wash- Calvert Gibson Latham Deutch Luja´ n, Ben Ray Takano Camp Gingrey (GA) Latta Doggett (NM) Thompson (CA) ington? Campbell Gohmert LoBiondo Doyle Lynch Thompson (MS) There was no objection. Cantor Goodlatte Long Duckworth Maffei Tierney Capito Granger Lucas Edwards Maloney, Titus f Carter Graves (GA) Luetkemeyer Ellison Carolyn Tonko CELEBRATING NATIONAL WOMEN’S Cassidy Graves (MO) Lummis Engel Maloney, Sean Tsongas Chabot Griffin (AR) Marchant Enyart Matsui Van Hollen HISTORY MONTH Chaffetz Griffith (VA) Marino Eshoo McCarthy (NY) Vargas (Ms. ROS-LEHTINEN asked and was Coble Grimm Massie Esty McCollum Veasey Coffman Guthrie Matheson Farr McDermott Vela given permission to address the House Cole Hall McAllister Fattah McGovern Vela´ zquez for 1 minute and to revise and extend Collins (GA) Hanna McCarthy (CA) Foster McNerney Visclosky her remarks.) Collins (NY) Harper McCaul Frankel (FL) Meeks Walz Conaway Harris McClintock Fudge Meng Wasserman Ms. ROS-LEHTINEN. Mr. Speaker, Cook Hartzler McHenry Gabbard Michaud Schultz due to National Women’s History Cotton Hastings (WA) McIntyre Gallego Miller, George Waters Month every March, we celebrate the Cramer Heck (NV) McKeon Garamendi Moore Waxman tremendous contributions of women Crawford Hensarling McKinley Grayson Moran Welch Crenshaw Herrera Beutler McMorris Green, Al Nadler Wilson (FL) who have helped make this Nation the Daines Holding Rodgers Green, Gene Napolitano Yarmuth greatest on Earth.

VerDate Mar 15 2010 00:32 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00034 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.009 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2471 But when thinking about our amaz- After graduating from Annapolis, he found traumas many have experienced. Chil- ing female forebearers, what becomes joined the newly established Air Force dren such as four-year-old Adnan, who fled clear is that their primary mission was and later served in Vietnam, where he with his family to Lebanon, suffered facial one of education. Education is the key was a commander with the 555th ‘‘Tri- scarring when his home was bombed and still suffers from emotional distress. ‘‘He cries all in getting girls and boys, women and ple Nickel’’ Fighter Squadron, flying night,’’ his mother is quoted as saying. ‘‘He men to believe in themselves, to have 266 combat missions. For his service, is scared of everything and is afraid when we the confidence and know-how to use he received two Silver Stars for valor, leave him, even for a second.’’ their individual, God-given abilities to five Distinguished Flying Crosses, 15 UNICEF estimates that there are 2 million better their own lives and improve the Air Medals, and a Purple Heart. children like Adnan in need of psychological condition of our communities. Wayne Frye’s legacy also lies in his support or treatment. As we celebrate the wonderful legacy deep-rooted commitment to his com- ‘‘For Syria’s children, the past three years that our American heroines have left munity, and his inspiration to future have been the longest of their lives. Must they endure another year of suffering?’’ said across the United States, let’s not for- generations through his character, UNICEF Executive Director Anthony Lake. get that the mission of education is not faith, and humility. The report warns that the future of 5.5 mil- yet finished. Colonel Wayne T. Frye, thank you lion children inside Syria and living as refu- As a former Florida certified teacher, for your service. A grateful Nation sa- gees in neighbouring countries hangs in the Mr. Speaker, I have witnessed the lutes you. Rest in peace. Rest in peace. balance as violence, the collapse of health transformational impact that edu- f and education services, severe psychological cation can have. Let’s follow the lead distress and the worsening economic impact SYRIA NEEDS UNRESTRICTED of great women that we are honoring on families combine to devastate a genera- HUMANITARIAN ACCESS NOW tion. this month, and let’s continue working The report draws attention to the suffering together to make a quality education a (Mr. MCGOVERN asked and was experienced by children and their families reality for all, both here in our great given permission to address the House who have been trapped in areas under siege Nation and around the world. for 1 minute and to revise and extend for many months. Cut off from aid, living in f his remarks.) rubble and struggling to find food, many Mr. MCGOVERN. Mr. Speaker, I rise Syrian children have been left without pro- EXTEND UNEMPLOYMENT today to call attention to the third an- tection, medical care or psychological sup- INSURANCE niversary of the crisis in Syria which port, and have little or no access to edu- (Mr. LEVIN asked and was given per- will be commemorated on March 15. cation. In the very worst cases children and The United Nations estimates that pregnant women have been deliberately mission to address the House for 1 wounded or killed by snipers. minute.) over 100,000 people have been killed In host countries, 1.2 million Syrian chil- Mr. LEVIN. Mr. Speaker, the bipar- since the violence and unrest began in dren are now refugees living in camps and tisan Senate legislation on unemploy- 2011; 9.3 million people, half of the Syr- overwhelmed host communities, and have ment insurance is a major step forward ian people, need humanitarian assist- limited access to clean water, nutritious for millions of job-seeking Americans. ance. 240,000 of them are living under food or learning opportunities. It has been 76 days since the Federal siege, surviving under the constant The report says that three years on, Syrian unemployment insurance expired for threat of shelling and aerial bombard- children have been forced to grow up faster than any child should. UNICEF estimates 1.3 million job-seeking Americans. Dur- ment. Moreover, they have faced life- that 1 in 10 refugee children is now working ing that time, an additional 700,000 peo- threatening shortages of food, water, and 1 in every 5 Syrian girls in Jordan is ple have seen their lifeline cut off, hin- and medical supplies for more than a forced into early marriage. dering their efforts to get work and year. Children are literally starving to The report calls on the global community hurting our economy. death, while military forces show no to undertake six critical steps: When you add it up, as a result of respect for humanitarian workers. End the cycle of violence in Syria now failure to act, $3 billion has been taken A diplomatic end to the crisis must Grant immediate access to the under- be pursued. At the same time, the hu- reached 1 million children inside Syria out of the economy in January and Create an environment where children are February alone. manitarian crisis must be ameliorated. protected from exploitation and harm Upon passage in the Senate, I urge Humanitarian relief must be allowed to Invest in children’s education Republicans in the House to follow this reach the civilians, and the wounded Help children’s inner healing through psy- bipartisan path to assist the long-term and the sick must receive the medical chological care and support and unemployed who have been without attention that they need. Indiscrimi- Provide support to host communities and Federal assistance since December 28. nate aerial bombardments must cease, governments to mitigate the social and eco- They and their families’ needs are ur- and civilians must be granted safe pas- nomic impact of the conflict on families. sage out of the besieged areas. The Syr- ‘‘This war has to end so that children can gent. It is the responsibility of this, return to their homes to rebuild their lives the people’s House, to act on behalf of ian people need unrestricted humani- in safety with their family and friends. This the people, the millions of long-term tarian aid now. third devastating year for Syrian children unemployed looking for work. UNICEF, must be the last,’’ said Lake. f New York, NY, Mar. 11, 2014. f NUMBER OF CHILDREN SUFFERING MORE THAN HONORING THE LIFE OF COLONEL DOUBLES IN THIRD YEAR OF SYRIA CONFLICT BALANCE OF POWER WAYNE T. FRYE AMONG HARDEST HIT ARE 1 MILLION CHILDREN (Mr. THOMPSON of Pennsylvania (Mr. WENSTRUP asked and was UNDER SIEGE AND IN HARD-TO-REACH AREAS asked and was given permission to ad- given permission to address the House As the conflict in Syria approaches an- dress the House for 1 minute and to re- for 1 minute and to revise and extend other sombre milestone, more than twice as vise and extend his remarks.) his remarks.) many children are now affected compared to Mr. THOMPSON of Pennsylvania. Mr. WENSTRUP. Mr. Speaker, I rise 12 months ago, says a new report by UNICEF Mr. Speaker, the Constitution is very to honor the life of Colonel Wayne T. published today. Particularly hard hit are up clear: the elected Representatives in to a million children who are trapped in Frye of Manchester, Ohio. Colonel Frye areas of Syria that are under siege or that Congress pass the laws and the Presi- was beloved in his community, and is are hard to reach with humanitarian assist- dent enforces those laws. This system remembered not only for his extraor- ance due to continued violence. of checks and balances has served to dinary achievements but also for his Under Siege—the devastating impact on limit abuses of power and hold govern- humble character. children of three years of conflict in Syria ment accountable to the people. In 1948, Wayne Frye joined the focuses on the immense damage caused to From our immigration laws to the United States Marines, and went on to the 5.5 million children now affected by the 2010 health care overhaul, the current attend the Naval Academy in Annap- conflict and calls for an immediate end to White House has selectively enforced the violence and increased support for those olis. While a student, he competed with affected. our laws, and in many cases acted uni- the 1952 Olympic rowing team, known The report includes the accounts of chil- laterally to change or alter them. In as the ‘‘Great Eight,’’ winning a gold dren whose lives have been devastated by the fact, the majority leader’s office re- medal for Team USA. three year old war, and highlights the pro- cently released a report outlining 40

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00035 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.029 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2472 CONGRESSIONAL RECORD — HOUSE March 14, 2014 separate instances where the Obama State of the Union Address. Repub- The program is an absolute necessity administration broke this fundamental licans in the House responded to that for them because it limits their out-of- responsibility. call with the SKILLS Act. This bill pocket expense, protecting them from Yesterday, the House acted on two would streamline 35 ineffective and du- the threat of bankruptcy due to a com- measures to hold the executive branch plicative programs, including 26 identi- plicated and an ongoing medical condi- accountable and restore balance to the fied as being ineffective in a 2011 GAO tion. separation of powers. H.R. 4138, the EN- report. The SKILLS Act empowers job The President’s massive government FORCE Act, which deals with lawsuits creators, promotes accountability, and overhaul of our health care system has against the executive branch for failure gives workers access to the resources raided $300 million from Medicare Ad- to execute the laws, and H.R. 3973, the they need to fill jobs that are available vantage plans and created a health Faithful Execution of the Law Act, now. care tax that has just started this year. which requires the Attorney General to I call on our colleagues in the Senate These payment cuts and the new report to Congress any time a Federal to act on this vital piece of legislation. health insurance tax are already being official implements a policy to refrain America needs a workforce develop- felt with canceled plans, reduced bene- from enforcing Federal law. ment system that works for job seek- fits, and increased co-payments. Mr. Speaker, no matter which party ers, not bureaucrats. There are 33,000 seniors in my coun- ty—Stanislaus County—making under is in the White House, our laws must be f faithfully executed. Americans deserve $20,000 a year, who are going to be hit ANNOUNCEMENT BY THE SPEAKER as much. with almost $100 per month. They have PRO TEMPORE a right to know when this tax is going f The SPEAKER pro tempore. The to hit them, what the expense is going SUPPORTING DEMOCRACY IN Chair announces a correction to an ear- to be. Seniors on limited incomes UKRAINE lier vote tally. On rollcall vote No. 135, should have the right to know, which is (Ms. JACKSON LEE asked and was the ‘‘yeas’’ were 238 and the ‘‘nays’’ why I authored the Seniors’ Right to given permission to address the House were 181. Know Act. for 1 minute and to revise and extend f f her remarks.) b 1130 BIG LAKE Ms. JACKSON LEE. Mr. Speaker, just a couple of weeks ago the eyes of SIGN THE UNEMPLOYMENT (Mr. GALLEGO asked and was given the world were looking at the people of INSURANCE DISCHARGE PETITION permission to address the House for 1 minute and to revise and extend his re- Russia, and all of the world gathered (Mr. HORSFORD asked and was together at the international Olym- marks.) given permission to address the House Mr. GALLEGO. Mr. Speaker, every- pics, athletes of varying backgrounds for 1 minute.) one in Texas knows about the Permian harmoniously competing in a spirit of Mr. HORSFORD. Mr. Speaker, I come Basin’s reputation for oil and gas. cooperation and collaboration. Cer- to the floor to congratulate the two Every UT Longhorn or Texas A&M tainly those of us in the United States Senators from my home State—Senate Aggie knows about the Permanent Uni- watched with great pride our athletes Majority Leader HARRY REID and Sen- versity Fund. represent our Nation and their own ator DEAN HELLER—for putting to- Not everyone knows the critical role special talent. It is unfortunate today gether a bipartisan unemployment in- that Big Lake played in each of these, that President Putin has undermined surance benefit extension. I am thank- so today, my 23 in 1—taking people to and destroyed all of that goodwill. ful on behalf of the 2 million Ameri- the 23rd District in 1 minute—is about I believe it is important that the cans who are depending on UI benefits Big Lake. United States continue to engage with that the Senate is expected to act soon. The first well to hit on university Ukraine, a sovereign nation, and con- But here we go again, Mr. Speaker. lands was the Santa Rita well, which is tinues to encourage Secretary Kerry, The pressure is now on the House. I now enshrined on the UT campus in as the President is doing, for diplo- think it is wrong that one person in the Austin. Just outside of Big Lake was matic resolution. A couple of days from House out of 435 can hold hostage a fi- the site. It was named for the patron now there will be a vote to cede away nancial lifeline for 2 million Ameri- saint of the impossible because no one from Ukraine, a sovereign nation. cans, including 26,000 Nevadans. really expected the well to hit. President Putin has boots on the Every Member of Congress now has a The population went from 100 people ground on soil that is not his, and the choice to make: sign the discharge pe- to over 2,000. Today, those wells have world must stand up in a manner that tition to bring up unemployment insur- produced great, great resources for the collaborates and embraces. No, I am ance in a vote; or don’t and abandon University of Texas and A&M over a not calling for military action by the the Americans who desperately need long period of time. United States, collaboration with our help. There was once a lake in Big Lake; it NATO. But they are people who desire I have signed, and I urge my col- is dry now. It was fed by springs that democracy, and we are a democracy leagues on the other side of the aisle to are no longer there. They are there and we should be there and stand do the same. Moderate House Repub- only when it has had significant rain. alongside of them. licans can do something before they Big Lake is a wonderful place to visit. f leave today. Sign the discharge peti- If you ever have the opportunity, tion. Show your constituents that you COMMEMORATING SKILLS ACT please go. stand with them and bring up a vote to ANNIVERSARY f extend unemployment insurance bene- (Ms. FOXX asked and was given per- fits. WEST VIRGINIA WOMEN mission to address the House for 1 f (Mrs. CAPITO asked and was given minute.) permission to address the House for 1 Ms. FOXX. Mr. Speaker, this Satur- MEDICARE ADVANTAGE minute and to revise and extend her re- day will mark the 1-year anniversary (Mr. DENHAM asked and was given marks.) of House passage of H.R. 803, the permission to address the House for 1 Mrs. CAPITO. Mr. Speaker, women SKILLS Act. This bill, which I spon- minute and to revise and extend his re- have played a significant role in our sored, would bring much-needed reform marks.) Nation’s history and in my home State and reorganization to our broken Fed- Mr. DENHAM. Mr. Speaker, more of West Virginia. I would like to recog- eral workforce development system. than 14 million seniors nationwide de- nize a few who have had wonderful There is bipartisan agreement that pend on Medicare Advantage plans for achievements in art, literature, sports, the current mishmash of Federal work- their health care needs. In two of the government, education, and vol- force programs is not meeting the counties that I represent in Califor- unteerism. needs of America’s job seekers. The nia’s Central Valley, over 60,000 seniors Anna Johnson Gates was the first fe- President called for reforms in his 2012 are enrolled in Medicare Advantage. male elected to the State legislature

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00036 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.030 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2473 from Kanawha County; Elizabeth nity. He lived simply and led by exam- in the southern portion of North Viet- Drewry, the first African American ple, always understanding the impor- nam and the Southeast Asia interdic- elected to the legislature from tance of servant leadership and giving tion area. He remained a combat pilot, McDowell County, West Virginia; Eliz- back. flying 19 combat missions in support abeth Kee, the first woman elected to Les was a native of Laupahoehoe and operations in Vietnam. Congress from Bluefield, West Virginia. graduated from Laupahoehoe High In 1968, Colonel Peterson was as- One West Virginian has given us a School and Hawaii Technical School. signed to the Pentagon as Air Force ac- national holiday—Anna Jarvis, the He worked for the County of Hawaii for tions officer for programs pertaining to founder of Mother’s Day, from Grafton, many years, working his way up to ad- the Strategic Air Command. West Virginia. ministration before he retired. In 1970, he was assigned to the Joint In the sciences, Dr. Harriet Jones Those of us who had the privilege of Chiefs of Staff Operational Directorate. broke down barriers to become the first knowing Les knew we could always Following his assignments in Wash- licensed physician in West Virginia count on him. He was very often the ington, he accepted the post of deputy from Marshall County. first call that people made when they base commander at Dyess Air Force We have two women who reached the needed help with anything. Base, a Strategic Air Command base in very pinnacle of their field. Novelist He was a mentor to so many and a Abilene, Texas. Pearl Buck, from Hillsboro, West Vir- great example for all to follow, as he In 1976, Colonel Peterson retired from ginia, won the Nobel Prize for lit- always taught the next generation to military service and lived most of his erature. In athletics, no one could for- become involved, to be a part of mak- retirement years in Texas. During his get West Virginia’s own Mary Lou ing a positive impact in our commu- 33 years of service to our country, he Retton when she made history by nity, and to undertake the great re- flew B–17s, B–36s, and B–52s and logged achieving her perfect 10s in 1984. sponsibility of being leaders in our fu- over 7,000 flying hours. He was so trusted and experienced, The stories of West Virginian women ture. that he was assigned to America’s nu- and all women must be told. That is Aloha nui, Les, we miss you very clear Air Force in the Strategic Air why I support H.R. 863, the National much. Mahalo for your lifelong com- Command. As a pilot, he was one of the Women’s History Commission Act. mitment to serving Hawaii. Aloha. It is my privilege to talk about so first in our country to fly with atomic many wonderful West Virginia women. f weapons and hydrogen weapons. Colonel Peterson was a highly deco- f GOVERNMENT BUREAUCRACY rated officer. His military honors in- The SPEAKER pro tempore. Under TRIMBLE TECH STUDENTS AT clude the Distinguished Flying Cross, the Speaker’s announced policy of Jan- SXSW FESTIVAL the Meritorious Service Medal, the Air uary 3, 2013, the gentleman from Texas (Mr. VEASEY asked and was given Medal, the Bronze Star, and numerous (Mr. GOHMERT) is recognized for 60 min- other medals and awards that reflected permission to address the House for 1 utes as the designee of the majority his dedication to serving our country minute and to revise and extend his re- leader. in the United States Air Force. marks.) Mr. GOHMERT. Mr. Speaker, at this Mr. VEASEY. Mr. Speaker, I rise A review written by a commanding time, I yield to the gentleman from today to the tragic events that took officer during Colonel Peterson’s mili- Texas (Mr. FLORES), my new friend. place in Austin, Texas, on Thursday at tary career best sums up the way he the annual South by Southwest Fes- REMEMBERING RETIRED UNITED STATES AIR lived his life at home and when on FORCE COLONEL ROBERT DARDEN ‘‘PETE’’ tival. duty. The CO wrote: PETERSON A suspected drunk driver being Peterson requires a lot of his crew. How- Mr. FLORES. Mr. Speaker, I rise chased by the Austin police slammed ever, he gives more than he demands of oth- today to honor retired United States his car into the festival crowd. Two of ers. Air Force Colonel Robert Darden those injured were in high school. Colonel Peterson passed away earlier ‘‘Pete’’ Peterson who passed away on Curtisha Davis—known as ‘‘Tish’’—and this month and was laid to rest on March 2. Deandre Tatum—called ‘‘Dre’’—stu- March 7. Colonel Peterson was a member of dents at Trimble Tech High School in Our thoughts and prayers are with America’s Greatest Generation. He not my hometown of Fort Worth, Texas. the family and friends of Colonel Curtisha is a senior and has broken only served our counsel selflessly dur- ‘‘Pete’’ Peterson. His survivors include bones and other injuries, and Deandre ing World War II, but also during the 7 children, 15 grandchildren, 17 great- is in the intensive-care unit under a Korean war and the Vietnam war. grandchildren, and numerous nieces medically induced coma at the Univer- Colonel Robert Darden Peterson was and nephews. sity Medical Center at Brackenridge. born in Jonesboro, Arkansas, in 1923. He will be forever remembered as a Please continue to pray for the After graduating from high school, patriot, a pilot, a soldier, a husband, a Trimble Tech family. It is a very close- Pete would go on to attend the Univer- father, a grandfather, and as an Amer- knit family at Trimble Tech High sity of Mississippi with a football ican hero. We thank him and his family School, known as the Bulldogs. I ask scholarship. for their outstanding service and sac- for the prayers of everyone. After his first football season at Ole rifice to our country. There was a death involved in this Miss, he enlisted in the United States As I close, I ask everyone to continue particular tragedy, and I ask for pray- Army Air Corps to aid the war effort in praying for our country during these ers for all the families affected, includ- Europe. Colonel Peterson trained as a difficult times and for our military ing these two young people from my B–17 pilot and became an aircraft com- men and women who protect us from hometown, Curtisha and Deandre. mander at age 20. During World War II, external threats and our first respond- he was a member of the 8th Air Force f ers who protect us from internal and completed 28 combat missions. threats right here at home. HONORING THE LIFE OF LES After World War II, Pete briefly re- God bless our military men and BOTELHO turned to civilian life only to be re- women, and God bless the United (Ms. GABBARD asked and was given called to Active Duty in 1947. He would States of America. permission to address the House for 1 serve as assistant chief of directorate Mr. GOHMERT. At this time, Mr. minute.) of combat operations during the Ko- Speaker, I yield to the gentleman from Ms. GABBARD. Mr. Speaker, last rean war and the Vietnam war. New York (Mr. REED), my friend, such week I was deeply saddened to hear the He was responsible for all surveil- time as he may consume. news of the passing of my friend and lance and control of the Strategic Air NO MORE WEEK Hawaii island resident, Les Botelho. I Command winged resources within Mr. REED. Mr. Speaker, I thank the share my heartfelt condolences with Southeast Asia. gentleman from Texas for yielding me his family and his friends. During 1967 and 1968, Colonel Peter- time to address the Chamber today. Les was a committed family man and son served as air operations planner for I rise today to talk about the NO also dedicated to serving his commu- all tactical and support air activities MORE campaign. NO MORE is the first

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00037 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.031 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2474 CONGRESSIONAL RECORD — HOUSE March 14, 2014 unifying symbol meant to express sup- Mr. GOHMERT. Thank you for those ceptional, and it is always a pleasure port for ending sexual assault and do- stirring and important words. to hear about a life well lived, someone mestic violence, similar to the Pink Mr. Speaker, at this time, I yield to who will meet his Maker and who will Ribbon campaign for breast cancer. the gentleman from North Carolina hear the words ‘‘well done, good and Mr. Speaker, next week, March 17–21 (Mr. HOLDING), my friend. faithful servant.’’ is NO MORE week. This symbol will be MACK PIERCE We have some who do a rather sloppy active throughout social media, ad Mr. HOLDING. Mr. Speaker, a small job with the duties they are given. It campaigns, and throughout our coun- but vibrant community called specifically brings to mind, Mr. Speak- try, to highlight for men and women Nahunta, which is hidden off the beat- er, the Daily. It has across the country to come together to en track in eastern North Carolina, got a picture of my friend Justin stand up to end sexual violence by say- sadly said good-bye last year to one of AmashK on the front with the words— ing ‘‘No more.’’ its most beloved residents. Mack in big letters—‘‘Drunken Karaoke with This proliferation is supported by or- Pierce, who lived and breathed Justin Amash.’’ Yet, when you read the ganizations, such as the Avon Founda- Nahunta for 81 years, passed away on story, it is very clear that Justin tion for Women, Mary Kay, National November 3. Amash didn’t have anything to drink. Alliance to End Sexual Violence, Na- Now, up here in Washington, D.C., It was not a drunken karaoke event. As my friend Mr. Amash puts it in a tional Network to End Domestic Vio- the title ‘‘Pork King’’ might not be a letter that many of us have signed: lence, the YWCA, and Department of compliment, but in Nahunta, Mack Justice’s Office on Violence Against Pierce’s company wore the crown The story concerned a fundraiser for Rep- resentative Thomas Massie, which was held Women. proudly. He founded the Nahunta Pork earlier this week. The fundraiser was hosted Mr. Speaker, I come here today to Center in 1975, and grew it into one of by a number of Virginia Young Republicans say no more because of something very the largest pork retail displayers in the at an Irish pub in Clarendon. One of your re- personal to me. Within the last year, Nation. In the eastern portion of my porters who regularly covers House Repub- my family experienced firsthand the congressional district, it is impossible licans attended the event. As you reported, issues of sexual assault. to miss the enormous yellow signs up Representative Amash spoke as a guest at My beautiful niece, 18 years old, was and down the interstate that declare the event. He introduced Representative Massie, and talked briefly to a crowd of raped. We saw that event impact a the Nahunta Pork Center as the ‘‘Pork young people about public policy and prin- young life—our family—in a way that I King,’’ a treasured title in one of the ciples that many Republicans share. cannot express, Mr. Speaker. country’s largest pork-producing After the event officially ended—not part of the event—Representative Amash stuck b 1145 States. Mack had a keen insight for business around to take pictures with fans in the I come here today to say, ‘‘No more.’’ and an unwavering commitment to his crowd as a courtesy to the Young Republican Last night, I had an opportunity to family, his faith, and his community. hosts, and there were some who stayed for speak with my niece. I said: If you had Rather than taking his business to a the usual Tuesday night karaoke. Represent- an opportunity to address the country ative Amash did not participate in any larger city as it grew, Mack chose to karaoke singing or drinking. and to address the Chamber of the U.S. build a successful, stable business that That is even noted in the article. House of Representatives, what would would bring employees and customers you say? How would you answer the That is why it was such a surprise that alike to his hometown of Nahunta. As the National Journal would have as the question ‘‘no more because’’? a result, thanks to Mack, Nahunta is a Essentially, what she said was: ‘‘No headline—front page, top story— household name in eastern North Caro- ‘‘Drunken Karaoke with Justin more because’’ there are no excuses. lina, and it is recognizable to its cus- No one can make an excuse as to why Amash.’’ That is libelist. That is out- tomers up and down the east coast. The rageous, and particularly—I did some sexual assault is acceptable. No one Nahunta Pork Center has remained in should offer an excuse that a woman checking—it turns out that the Na- the same location since it opened, and tional Journal has a contract with the wanted it, that a woman asked for it. it has grown substantially as its cus- House of Representatives to provide ev- Mr. Speaker, we need to change the tomer base has increased. Throughout erybody a copy of the print version for culture in our country as we are afraid his life, Mack focused on providing the $617,000 per year. to talk about this issue. So many best product and outstanding service, With that kind of sleazy title, I think women have been impacted. Men across and his hard work helped put Nahunta it is time to relook at that contract. I the country have not been taught how on the map. Business, though, was sec- mean, we all know the National Jour- to deal with this issue in an open and ond to family and community. nal’s ratings of conservatives. JUSTIN honest fashion. March 17 to 21 is an op- If there were an opportunity to vol- AMASH usually gets rated by the Na- portunity for us as a nation to say, ‘‘No unteer, Mack was first in line. For over tional Journal as one of the more lib- more.’’ We are going to come together 70 years, he was a member of the eral when he is, if not the most con- in a national effort and say: Sexual vi- Nahunta Friends Meeting, where he servative, one of the most conserv- olence is not acceptable; domestic vio- served in many capacities. At his ative. So we have known that National lence is not acceptable. We are going to church, Mack served as an elder and as Journal reporting in some areas has discuss it openly and amongst our a finance committee member. He sang been very suspect, but that is just as country and fellow countrymen in a in the choir, taught Sunday school, and sleazy as it gets. A front-page, top- way that ultimately will lead to there mentored young folks at the church. In story apology to JUSTIN AMASH is owed being no more. the community, Mack was a founding by the National Journal. That is the In having had to experience this member of the Nahunta Fire Depart- least they can do. firsthand for the last 12 months, I can ment. He served as a trustee at the Since we are part of the government tell you that it is time. nearby Mount Olive College, and he sat here in Congress, it is important to On behalf of my niece and my family, on the board of directors of the BB&T note when things go well, and it is im- Mr. Speaker, I ask all Members and all Bank. At home, he and his wife, Jean, portant to note when things don’t go people across the country to look at spent 61 wonderful years together. well and when there are problems. the NO MORE campaign and to look at They had two sons, Larry and Freddie, There was a major story yesterday this symbol and to discuss it with your and four grandchildren. Mack cher- afternoon. The Daily Caller reports sons, your daughters, your sisters, your ished his role as a husband, as a father, ‘‘Health and Human Services Official brothers, your mothers, and your fa- and as a grandfather. Resigns, Pens a Must-Read Rebuke of thers and say: We can’t accept this any In his lifetime, Mack Pierce enriched Federal Bureaucracy.’’ It is an article longer. the community of Nahunta in too posted by Caroline May, and its origi- Then we end sexual violence once and many ways to count, and he will be nal publication is in AAAS for all, because now is the time to say, greatly missed. news.sciencemag.org by Jocelyn Kai- ‘‘No more.’’ Mr. GOHMERT. Thank you. ser. God bless my niece. God bless my Mr. Speaker, there are many great This story from The Daily Caller re- family. God bless this great country. Americans. There are some who are ex- ports:

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00038 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.032 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2475 A Health and Human Services official has to do a couple of times, they are not target, it said. They were trying to ad- resigned after dealing with the frustration of going to have to actually sign an order just down the amount of time it took the ‘‘profoundly dysfunctional’’ Federal bu- sentencing somebody to death, but it is to get surgery or treatment or what- reaucracy which left him ‘‘offended as an basically not that different. When you ever a doctor prescribed after it was American taxpayer.’’ In a resignation letter obtained by say someone who must have a pace- prescribed. They knew it wouldn’t be ScienceInsider, David Wright, Director of maker in order to live can’t have it, done overnight, but if everybody the Office of Research Integrity, ORI, which you might as well be signing a death pitched in, everybody worked hard, oversees and monitors possible research mis- penalty order. they thought they might get the delay conduct, offers a scathing rebuke of the un- b 1200 in getting the surgery or treatment wieldy and inefficient bureaucracy that he you needed down to a 10-month wait. If dealt with for the 2 years he served in that This is an organization that cannot everybody worked hard, eventually position. get their act together—not to build a In his letter to Assistant Secretary for they could get it down to 10 months. Web site, not to protect people’s most I thought, Good grief. And you want Health Howard Koh, Wright explains that personal information, not to even get a the 35 percent of his job that was spent work- to do that to America? You don’t have ing with science investigators in his depart- $35 authorization to convert cassettes to wait 10 months for a mammogram or ment ‘‘has been one of the greatest pleasures to CD. If they can’t do that, do you surgery or a biopsy, if it’s needed. of my long career.’’ The majority of his du- really want them deciding whether you These people that keep saying, You ties, however, represented his worst job ever. get a pacemaker or not? Whether you Republicans have no alternatives. We ‘‘The rest of my role as ORI Director has get a bypass surgery you need or not? have all kinds of alternatives. been the very worst job I have ever had, and A conversation with somebody in my it occupies up to 65 percent of my time. That What I keep encouraging our con- district who came from Canada keeps ference and the RSC to do—and I am part of the job is spent navigating the re- coming back to me. He told me about markably dysfunctional HHS bureaucracy to hoping one of our groups here is going secure resources and to, yes, get permission his father, in the Canadian glorious to do it—is start having informal hear- for ORI to serve the research community. I health care system that everybody got ings and bring in witnesses so that we knew coming into this job about the bureau- shoved under, where the government do what President Obama promised cratic limitations of the Federal Govern- controlled who got pacemakers, who when he was a senator. If I am Presi- ment, but I had no idea how stifling it would got surgery, who got what, needed by- dent, he promised us, we are going to be.’’ pass surgery, and was on a list. Two have debate over health care. We are I want to add parenthetically here years later, he didn’t get it. And he going to do it on C–SPAN. We want the that he is talking about the remark- died because he hadn’t had bypass sur- whole country to see who is standing ably dysfunctional Health and Human gery. up for whom. Services Department that wants to I said, Well, that is amazing. I didn’t That is what I want. That is what we make your decisions for you about know it took 2 years. What was the need. Let America see who stands for your health care. They want to tell you problem? He said, They kept moving them and who stands for the big, bloat- and have told millions and millions of people on the list in front of him. I ed, secret priority-listed bureaucracies Americans that your health insurance said, My understanding is it is a crime like Health and Human Services. is no good even though most Ameri- in Canada to give anything of value to This article goes on about HHS. cans liked the insurance they had and get someone to move you up the list. David Wright, who has now resigned, wanted to keep it and were promised He said, That’s right, but there is a said: by the President and so many friends panel that moves people up the list as across the aisle, if they liked it, they they feel appropriate. They didn’t On another occasion I asked your deputy why you didn’t conduct an evaluation by the could keep it. It turns out that was ab- move my father up the list. He didn’t Op Division of the immediate office adminis- solutely not true. get bypass surgery for 2 years. And so trative services to try to improve them. She The HHS, the Health and Human he died. responded that that had been tried a few Services Department, in being as bu- If someone, unknown of whether he years ago and the results were so negative reaucratic, as negligent, and as dys- has insurance or not, were to go into a that no further evaluations have been con- functional as they are, is what every hospital here in Washington or in my ducted. Democrat in this body and in the Sen- hometown in Tyler, Texas, or Long- David Wright closed by saying he ate and without a single Republican view, or basically anywhere, and he is plans to publish his daily log to further vote wanted to shove in control of immediately found to need a bypass, shed light on his work. He said: every American’s health care. Now we they are going in and doing the bypass. As for the rest, I’m offended as an Amer- are finding out just how disastrous But not in Canada. Not in England. ican taxpayer that the Federal bureauc- that was. And not here in the United States, racy—at least the part I’ve labored in—is so This article about Director Wright once the group that shoved ObamaCare profoundly dysfunctional. I’m hardly the goes on to read: down the throats of the American peo- first person to have made that discovery, but I’m saddened by the fact that there is so lit- According to Wright, activities that in his ple have their way and this bureauc- tle discussion, much less outrage, regarding capacity as an academic administrator took racy with secret priority lists gets to the problem. To promote healthy and pro- a day or two, took weeks and months in the tell you what you get or don’t get in ductive discussion, I intend to publish a Federal Government. He recalled an instance the way of health care. version of the daily log I’ve kept as ORI Di- in which he could not get approval for a $35 I just cannot imagine thinking Amer- rector in order to share my experience and cost to have cassette tapes converted to CDs. observations with my colleagues in govern- He eventually was able to get them con- icans wanting the government, and ment and with members of the regulated re- verted in 20 minutes for free by a university. particularly Health and Human Serv- search community. In another instance, he ‘‘urgently needed to ices, making those kind of decisions. fill a vacancy,’’ but was told there was a se- We found out this week, when my These people at HHS, who couldn’t cret priority list. Sixteen months later, he friend TOM PRICE asked how many peo- find their rear end with both hands, are wrote, the position was still unfilled. ple have paid for their health insur- going to tell you what you can have Again, parenthetically as to this ar- ance, they couldn’t tell us. Secretary done to your body? ticle about HHS dysfunctionality, it is Sebelius doesn’t know. Can’t know. I have heard friends across the aisle important to note that these people Do you think they are going to know for so many years now talk about how who took 16 months and still didn’t fill when you, Mr. Speaker, need bypass they want the government out of our a position because they had a secret surgery? They won’t. bedroom. Are you kidding me? With priority list are the same ones who are Some will say, Well, in Congress they ObamaCare, they are in your bedroom, going to have a list as to who can get probably get special treatment. They they are in your nightstand, they are what surgery at what age. Some people have no idea. We won’t get special in your bathroom, your kitchen cabi- bristled when Sarah Palin called it a treatment. We will end up like the peo- net. They are everywhere in your house ‘‘death panel,’’ but they are going to ple in Canada, going on a list. and outside your house you try to go. decide who can get a pacemaker, at I read an article sometime back This puts them in charge of your most what age, and who cannot. So, as I had about England. They have got a new personal private matters.

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00039 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.034 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2476 CONGRESSIONAL RECORD — HOUSE March 14, 2014 It is time to repeal ObamaCare. It is What is going on is outrageous. And So this article goes on. It says: time to have an alternative that some just when we think it wouldn’t get I have been an attorney in the IRS Office of us have brought to the front. much worse, we have this article in of Chief Counsel for over 26 years. Over a One of the things we need to do is not Power Line, ‘‘Bill Henck: Inside the number of years, I have attempted, largely make sure everybody has high cost in- IRS,’’ by Scott Johnson. He notes: unsuccessfully, to alert the public to abuse within the IRS. One of my kids suggested I surance. It is to make sure everybody As noted at the top, William Henck has has accessible, affordable health care. contact a blog, and Power Line has gra- worked inside the IRS office . . . ciously agreed to publish this account. When you combine all the money the And that is the IRS office. How is the I do not personally know whether the IRS Federal Government and the State gov- IRS linked to a discussion about health has targeted conservative groups or individ- ernments spend providing Medicare care? They are going to enforce uals, but I do know that the environment and Medicaid and you divide it by the ObamaCare. We have got the IRS, as if within the agency, the IRS, is ripe for such number of households in America that activity, and there is nothing to prevent it they don’t have enough power now, is from occurring. have someone on Medicare or Medicaid, going to be in charge of enforcing which my office tried to do back in 2009 As stated in more detail below, I have per- health care. sonally witnessed improper giveaways of bil- and 2010, it was tough getting the infor- Most of the Republicans I know want lions of dollars to taxpayers with inside ac- mation on how much we are spending to eliminate the IRS. Some want to go cess at the agency, bullying of elderly tax- on all this. People could only give you to a fair tax. I would like to have a flat payers, the coverup of managerial embezzle- an estimate. The same people that tax. I think it is time to have that de- ment and misappropriation of thousands of want to run your life and tell you what dollars in government funds, and a retalia- bate and go to whichever wins the de- you can have in health care can’t even tory audit. bate and gets rid of the IRS. I have also heard credible accounts of, tell you what they are doing. My brilliant friend—and I am sur- But the best estimates we can get among other things, further improper give- prised he let’s me call him his friend, aways, blatant sexual harassment, and anti- from these government sources and the but he is a brilliant man—Arthur Semitism. All of these have been swept best estimates from the Census Bu- Laffer, the genius behind turning the under the rug. reau—because they couldn’t give us an devastating economy around under Parenthetically, in this article, exact number—indicates that back 4 where this person, this attorney in the years ago we were spending about President Carter, I talked to Arthur about this and I said, I would like to go Office of Chief Counsel for over 26 $20,000 to $30,000 per household for peo- years, points out, anti-Semitism in the ple that had somebody on Medicare and to a flat tax—I know a lot of people want to go to a fair tax—so we can get IRS? We are seeing it grow. Medicaid. It was most likely closer to I mean, when I heard, as a child, in the $30,000 number. rid of the IRS, but somebody is going to have to enforce it. How would we do history class, about the Holocaust, and That is what inspired me. I told Newt I read that Eisenhower required that Gingrich about it, and he said, You that if there were no IRS? Arthur says, I have got it all spelled out. I have got people in the community be required to have got to get that in bill form and come help clean up these horrid con- get it scored. It may change the whole it written out. I am hoping some of my colleagues centration camps where gas ovens and debate in Congress about health care. other ways were used to torture and This is nearly a year before ObamaCare here will meet with Arthur and let him give them the one, two, threes. kill Jews, I thought, for Eisenhower to was passed. order that, that is a little rough, you So we got it in bill form, and it in- He said, You don’t need an IRS. He said, The big mistake with the IRS is know, for these people to have to come cluded giving seniors the option for the out and clean that up. I mean, nobody first time since the sixties to really that the Federal Government set up an entity that not only gets to pick and will ever deny there was a Holocaust. control their own health care. Because There is too much information about we would buy them not bronze or some choose whom they audit, they get to enforce what they find and what they it. other kind of health insurance, we Now we have people denying there is do. would buy them the best Cadillac in- a Holocaust, and as I understand it, So they can pick either at random or surance you can get. We wouldn’t re- there are five main Jewish groups that intentionally and maliciously. Even quire that they had to have maternity support Israel, and all of them are though that violates the law—we have care, because there are not that many being mistreated by the IRS, and they seen it happen already—they can pick 80- and 90-year-old people that need the don’t want anybody to talk about it be- who they want to audit, whose life they maternity care that this administra- cause they don’t want to get targeted want to make miserable. And then if tion is forcing. any more than they already have. It would give them Cadillac insur- they don’t comply with what they find Then we see, from an attorney in the ance for what they did need, and give and what they order, even though it Office of the Chief Counsel, or general them a high deductible. At this point, may be very wrong, then they are capa- counsel, for 26 years, he says, I have we might say the deductible would be ble or have the authority to take ev- seen the anti-Semitism within the IRS. $5,000, $7,000, or something like that. erything they have. So I hope my Jewish friends on the Whatever the amount the high deduct- That is why my brilliant friend, Ar- other side of the aisle, my Jewish ible was, my bill, my proposal, was we thur Laffer, says, You set up a very friends across the country that have are better off giving every senior on small auditing entity, but you cannot not been involved in politics, will wake Medicare or Medicaid cash in a health give them the power to enforce their up and help us clean up the mess in the savings account with a debit card that audits. That is too much power for one Federal Government by speaking up is coded so it will only pay for purely government agency. about the prejudice and the bias that health care items, and you empower a b 1215 they have had to live with. senior to get what they need—to go to This article goes on: the doctor or health care provider they So you have a very small auditing A number of years ago, a manager in my want to go to and not need some bu- agency and, as Arthur said, you don’t allow them to ever pick who they want office, there in the Chief Counsel’s Office, reaucratic fool in HHS to tell you the IRS, was embezzling thousands of dollars whether or not you can see this person. to audit. Every audit is selected at ran- in travel funds. His actions were common We have got to get power back into dom, so they don’t get to pick on peo- knowledge, but other managers, including a the hands of our seniors and into the ple they dislike. They only audit what- currently high-ranking executive in the Of- hands of the poor. They are entitled to ever person or entity randomly is se- fice of Chief Counsel, did not report him. be able to choose who they want to go lected by the system. And if they were I did report his conduct to the Treasury In- to, I would think. to do otherwise, they would break the spector General for Tax Administration, but Let’s empower people and quit pun- law and be subject to punishment they did not investigate the matter for a ishing people simply because they are themselves. considerable length of time. After I com- plained to my local Congressman’s office, middle class and they have got a job These days, now, if somebody calls the Treasury Inspector General for Tax Ad- and they are paying taxes. Let them the IRS out, then they are normally ministration finally forwarded the matter to have the same opportunities as those going to get hit up with an audit and the Office of Chief Counsel to be handled in- they are paying for. be treated maliciously by the IRS. ternally.

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00040 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.035 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2477 Eventually, the Office of Chief Counsel vidual return that had been judged to be some think it is okay, to bully elderly made the manager pay the money back, but clean. because they are elderly and they will took no other disciplinary action, even So David Wright says: get scared and they will pay the gov- though others who committed the same type I contacted , gave ernment rather than have the govern- of scheme were punished severely. them my privacy waiver to discuss our tax The manager in question has led a charmed ment come down on them. So even returns with the Service. When the Post pre- life. Several years after this episode he de- though they don’t owe it, we can scare sented that waiver to the Service, they cided to retire, but was starting a new job at them into paying money because they quickly dropped our audit. a different city 2 months before he was eligi- are elderly. ble to retire. Now, I happen to know many IRS I mean, Americans ought to be up in He could have retired early and taken an- agents who are decent, good, hard- arms over this kind of abuse. And to nual leave for 2 months before retiring. How- working, honorable people. They are think that a majority in Congress in ever, he did not want to take annual leave the kind of people I would want work- 2010 wanted this same government con- because Federal employees can cash out an- ing in an auditing agency like Arthur trolling everybody’s health care? nual leave when they retire. Laffer has talked about because I know Rather than have him burn at least $20,000 Americans need to wake up. This is a in annual leave, the IRS transferred him they would be fair, they are honest. danger to their life and their liberty. back to the new city, but did not give him These are the kind of people that He goes on and points out more any work, allowing him to work at his new complained to me when the Secretary abuses that shock the conscience. It is job while still receiving a government pay- of the Treasury was given to Tim outrageous what the IRS—I am sorry— check. Geithner, even though he had signed, 4 some in the IRS have been able to get I obtained an email from this manager in years in a row, under oath, under pen- away with, this same government that which he admitted that he had no work, that alty of perjury, that he would pay the a majority in 2010 trusted with every the IRS was not planning to give him any tax on the funds the International work in the new city, and that he was work- American’s health care. Monetary Fund were paying him if ing on matters related to his new job while b 1230 at the IRS. they would not deduct the money he I forwarded this email to the Treasury In- was supposed to pay, so he swore he We have a story this week from spector General for Tax Administration, would pay it personally. And then he Breitbart. Robert Wilde reports that TIGTA, but of course was ignored by both blamed it on TurboTax, and he paid it there are emails now that reveal the TIGTA and the Office of Chief Counsel. back after he was appointed Secretary Obama administration shut down the TIGTA has a well-deserved reputation for of the Treasury. World War II Memorial, knowing the protecting IRS managers. In fact, a TIGTA But there were IRS agents, honest, World War II veterans were coming. agent once stated that ‘‘We don’t investigate One email that they cite from a gov- IRS managers.’’ honorable, decent IRS agents all over At the same time, the manager was embez- the country who were outraged that ernment official says: zling travel funds. I was working on a case Timothy Geithner was appointed to the While I understand that these memorials involving what I call the Elmer’s Glue scam. Secretary of the Treasury, to be the have remained accessible to the public dur- Tax shelter operators misused synthetic fuel boss of people, these people, these ing past shutdowns (I’d imagine with the credit. front-line workers in the IRS, who Mall being so open, it’d probably be more manpower-intensive to try to completely And for those who don’t know what made it very clear, if they ever even close them), I wanted to do my due diligence that means, that is part of the green underpaid, so they had to pay addi- and make 100 percent sure that people could economy that this administration tional taxes at the end of the year, visit the outdoor memorials on the National wants us all to participate in. The bot- they would be fired. Mall in the event of a shutdown. tom line is, it gives them more control And here was a guy who didn’t pay I can say, from having been out there over our personal lives. That is what his taxes for 4 years, not until he got on October 1 and having pulled one of the movement is about. appointed to be Secretary of the Treas- the two barricades aside so that our But nonetheless, there are some that ury, that was put in charge of all of World War II veterans could go through are dedicated to it that really believe these very honest, upright, decent peo- the open-air memorial dedicated to in it. But the people at the top, they ple who happen to work at an agency them and to their friends that died know it is all about more government that includes some who are incredibly serving with them—and I saw that, controlling people’s lives. corrupt and who protect the corruption wow, they have shut down an open-air, But anyway, he says: as David Wright is pointing out. open-sidewalk, walk-through, roll- Tax shelter operators misused a synthetic Well, David Wright goes on and says: through in your wheelchair memorial. fuel credit by spraying watered down house- Within the past few years, the IRS has It has cost them money to bring in hold glue on marketable coal, degrading the used a ‘‘cadre’’ to pursue a particular type of all these barricades, and I have been coal, but producing huge tax credits for in- case. I was assigned one of those cases that there at all hours of the day and night, vestors. This was costing the Treasury at was in Tax Court. I believed we should con- least $3 billion a year. The IRS turned a cede the case in question because our legal to the Lincoln Memorial, to the World blind eye toward this activity and harassed position was incorrect. As a result, I was War II Memorial; and most of the time, those of us in the agency who were trying to called a quitter and a coward, was threat- it is hard to see a park employee out stop it. ened with retaliation and, in fact, suffered there, but eventually, if you look hard Since I had witnessed TIGTA help cover up retaliation. enough, you will see one or two out embezzlement, I decided to go to the press The cadre—he says I hate that term, but there. about the Elmer’s Glue scam. The Wall that is what they call themselves, pushed The day after the gentleman from Street Journal published a story about it, cases with an obvious legal defect. Taxpayers Mississippi, Steve Palazzo, and I picked but the scam continued. were denigrated in writing as ‘‘upper class As a result of complaining about TIGTA’s twits.’’ And one cadre member stated that, those barricades up and moved them inaction regarding embezzlement that is despite the weakness in our legal position, back after I cut the yellow tape, the within the IRS, and speaking out about the the taxpayers in these cases were typically next day, I counted them—16 Park Elmer’s Glue scam, my wife and I were sub- elderly, and could be forced into settling Service police—many of them on jected to a retaliatory IRS audit. their cases. mounted horses that you never see out After an experienced revenue agent from I stated my ethical concerns to manage- there, out there to try to intimidate Fairfax spent an entire day auditing our tax ment, and they were answered with a short World War II veterans from being able non-response and did not even bother to ask returns, he stated that they were clean. Soon to go through for the one time they thereafter, he called me and apologetically for the name of the cadre member who stated stated that his ‘‘special projects’’ manager that we could bully elderly taxpayers into were in Washington in their lives to see had ordered him to return to Richmond and settling their cases. those places that listed where they keep digging into our returns. He stated that He adds, the Tax Court ultimately rejected fought and where friends died. his regular manager would not have ordered the Service’s position regarding that legal As one man with tears told me—he this. issue. pointed to the islands in the Pacific In parentheses David Wright says: I mean, it ought to scare Americans that were listed, the names of his I believe that because in 26 years at the profoundly that the IRS that is going friends who fought with him and died IRS, I have never heard of an agent being to be in charge of enforcing the health on each of those islands, and this ad- sent back to continue a straightforward indi- care law thinks it is okay, at least ministration, which wants to control

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00041 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.037 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2478 CONGRESSIONAL RECORD — HOUSE March 14, 2014 everybody’s health care, wanted to de- that we cannot allow a President to clique that gave refuge to Osama bin prive those World War II veterans— usurp more and more power away from Laden. knowingly deprive them of just this Congress, it showed us that he knew Most importantly, Pakistan has not one chance to roll through in a wheel- right from wrong in this government. been acting as our friend—not just that chair and see what was dedicated to Now, the same President is, by execu- clique, but the government itself of them. It is tragic, what is going on. It tive order, changing the law repeat- Pakistan; and we don’t need to be is time Americans awoke. edly, and it is time this House rose up supplementing the countries and sup- Ben Franklin is credited with saying, and said: we are not funding one single porting the countries and giving aid to in essence, those who are willing to part of the executive branch that the countries that are hostile to Amer- give up liberty for security deserve nei- usurps power that is not afforded it in ica’s interests and hateful of our way ther. We are seeing that. Americans the Constitution. of life. have given up so much liberty over and We have the power to do that. Why? It is a charade to believe that our aid over, saying: well, at least it is going Because the Founders put it in the is buying Pakistan’s cooperation in to keep me safer. Constitution, and just like our Creator hunting down terrorists, as Secretary At what point do you say enough giv- endowed us with certain inalienable Kerry stated yesterday. Frankly, that ing the Federal Government power? We rights, just like some parents have is wishful thinking, but that is not fac- want our liberty that the Founders es- plenty to endow to their children when ing the reality of what we confront in tablished in the Constitution, that war they die, the children don’t enjoy those South Asia. after war was fought to provide, that benefits if they won’t claim them and A Pakistani commission reported on the Declaration acknowledged were be willing to fight for them. the bin Laden raid—the raid that rights that were endowed by our Cre- There are always people—evil people brought bin Laden, the murderer of so ator. who want to take away those benefits, many Americans, to justice—and the Some ask: Well, if these rights are take away those rights; so no matter Pakistani commission points out nega- endowed by our Creator to life, liberty, what someone inherits, if they don’t tive developments in U.S.-Pakistan re- and pursuit of happiness, why doesn’t accept it, claim it, and be willing to lations in recent years, and it is, in everybody in the world have them? fight for it, they will not keep those their view, ‘‘a growing American It is real easy. God, the Creator, gave benefits. threat’’ to Pakistani interests. These are not the sentiments of a re- us freedom of choice. We are free to We owe the next generation what we gime that wants to work with us. choose things that would do us harm were given and better, and until we These are not the sentiments of and free to choose the right way that start holding the executive branch ac- friends. would lead to life, liberty, and pursuit countable—at least those in it that are Remember, when our SEAL teams of happiness. not complying with the law, that are went to get Osama bin Laden, the Pak- We happen to have been blessed by ei- violating the law—we are destined to istani Government took the wreckage ther being born here or have come to a be that evil, narcissistic, self-serving of one of our helicopters—a stealth hel- Nation where we had those liberties, generation that leaves the country icopter, cutting-edge technology that where they were fought for, where the worse off than we found it. was used in that raid—and gave it to things that were taught in church, that Mr. Speaker, I hope and pray that the Communist Chinese. were spoken of in the Bible—the Bible enough of us will arise to prevent that Of course, the Pakistanis call the is the most quoted book in the history from happening. Chinese their all-weather friend, and of this Chamber, especially in the first With that, I yield back the balance of we are supposedly just their fair- 150 years, and especially by those who my time. weather friend; yet we should be giv- fought against slavery, saying: How f ing, according to this administration, can we expect God to continue blessing AID TO PAKISTAN over $881 million more in aid, on top of America when we are putting our the billions that we have already given brothers and sisters in chains and The SPEAKER pro tempore. Under the Pakistanis. bondage? the Speaker’s announced policy of Jan- Indeed, a study by the Pew Research Those individuals laid the ground- uary 3, 2013, the Chair recognizes the Center’s Global Attitudes Project work—the foundation for us to have gentleman from California (Mr. ROHR- found that 81 percent of those surveyed this life, liberty, and pursuit of happi- ABACHER) for 30 minutes. in Pakistan were favorable to Com- ness. We owe them to leave it to the Mr. ROHRABACHER. Mr. Speaker, munist China—Communist China— next generation. for 2 months, public attention has been which represses its own Muslim popu- Poll after poll say this is probably riveted on Ukraine. Today, I suggest it lation, murders Christians, and is a the first time in American history that is harmful to our security to just focus dictatorship of a clique—of a crony a generation will leave a country less on Ukraine and ignore the battle capitalist clique that controls that free, with less opportunity to their against radical Islam and the ensuing country. children. threat of China that is far more dan- When 81 percent of those surveyed in That is why I ran for Congress. I gerous to us than which direction Cri- Pakistan are favorable to that country, want to do everything I can to keep mea goes. while only 11 percent are favorable to that from happening. Yesterday, Secretary of State John the United States, should we be spend- I was taught as a Boy Scout—espe- Kerry requested that Congress approve ing money that we are borrowing from cially as an Eagle Scout—we were aid to Pakistan. That is foreign aid to China, in order to give money to a never to leave a place worse off than Pakistan. The administration is re- country that likes China more than it we found it; and if we don’t turn this questing $881.8 million for aid to Paki- likes the United States, and we end up thing around, we will be the generation stan. The Congress and the American giving money to the country and to the that does that. God help us and God people should pay attention to this re- people that don’t like us? forgive us if we do. We simply cannot quest. Well, no. We should cut off our aid to do that. Since 9/11, the United States has Pakistan because it is not an ally, and When we have people who have given Pakistan over $25 billion, with any money we send to them only stepped forward, as these in the IRS over $17 billion of that going to the strengthens their ability to act against and Health and Human Services have, Pakistani security services, services us and against our friends in Afghani- to say: Warning, red flag, red light, that target and kill American soldiers stan and elsewhere. stop. There is too much abuse here. De- through helping those elements in that We cannot buy the friendship of the mand your freedom back. Quit turning part of the world that kill American people of Pakistan, nor can we buy the it over to Federal agencies. soldiers and terrorize civilian popu- friendship of the Government of Paki- When those people are rising up and lations. stan. These are people who feel that saying wake up, America, we had bet- Our generosity has only emboldened their core interests and their values go ter wake up. When we have a President Pakistan’s military clique—that clique totally against what we believe in and who said, over and over as a Senator, that actually rules the country, that who we are, as a country.

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00042 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.039 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2479 At a time of tight budgets, we should have not only abandoned him, but Con- claimed by Pakistan, Iran, and Afghan- reserve our aid for friends and allies. gress is considering, as I say, giving istan. But in Pakistan in particular, We should never give assistance to even more, hundreds of millions of dol- they comprise an important segment of those who target and kill Americans or lars. In fact, the total amount of aid the population, and they live in the even support those elements that do that they want to give to Pakistan this least developed province. Unfortu- target and kill Americans. Perhaps we year is $1.3 billion in American aid to nately, it may be the least developed could reexamine our motives and our Pakistan. province, and it is where the poorest of ability to provide such assistance This is an abomination. It is shame- all Pakistanis reside. All of that, if you throughout the world. ful. It is cowardly. It is a cowardly be- take a look at being the poorest and Obviously, we can’t be supporting our trayal of a man who risked his life for least developed, but you also look at enemies like this; but even with our us. Who else, who will stand with us in one other factor, it is the richest in friends in friendly countries, we are the future if we treat our friends this natural resources of all the provinces having to borrow money from China way? of Pakistan. So what we have is a and elsewhere, in order to give money, America all so often treats our looting of Balochistan by that clique as aid, to other countries. That makes friends in a shabby way, abandons that runs the Pakistani Government in no sense to me. them at a time, and then our govern- a way that does not, of course, benefit ment has the gall to request that we b 1245 the people of Balochistan. give aid to those people who are the Until the arrival of the British Em- We need to restructure our aid situa- tormentors of Dr. Afridi. In fact, these pire, the Baloch people had organized tion. Yes, America does have a moral are the men who we know this govern- themselves into sort of a confederation obligation to try to help others in ment in Pakistan is run by and con- of tribal chiefs. That is where the need, but perhaps we should focus on trolled by a clique of people who hid power was, very similar to Afghani- emergency situations and limit our aid Osama bin Laden, gave refuge to the stan’s tribal and village system. And to those countries who have tsunamis murderer of 3,000 Americans for years, these people, the Balochi, who recog- or earthquakes or other catastrophes and then, of course, they claim they nize themselves as a national entity, in which much of their population is in didn’t know he was there—there—right they would like to control their own grave danger or is suffering. That type next to the school where they train all destiny again. But the Balochi people of foreign aid is something we can be of their military officers. have been terrorized and beaten into proud of, and we can channel it to any Pakistan is supporting America’s en- submission by the Pakistani military. group of people in the world who are emies who are attacking American sol- We provide the Pakistani military ordinary people who are in danger. We diers in Afghanistan and have targeted with the weapons and the resources can then reach out and show our gen- and, of course, brutally murdered other they need to conduct their terrorism erosity, and perhaps we will receive Americans and brutally murdered not only against their neighbors, not some gratitude from people who are in other people throughout that region only against Christians throughout the a desperate situation rather than who are hostile to their radical Islamic world, but against their own people. transferring our money to governments terrorist agenda. The Pakistani military has been unre- that are often anti, against, everything Secretary Kerry says that we must lenting in its attacks and targeted ter- America stands for. give support to placate the positive ror raids against the Baloch popu- How do we know that Pakistan still elements in Pakistan. It sort of re- lation. Baloch aspirations for independ- has a government that considers—at minds me of when somebody was say- ence have been checked by force and by least a clique that runs their govern- ing back before World War II, we better denying basic human rights and the ment and that tells their government— try to get with Hitler because there are unleashed brute force against them by that considers the United States less some really bad guys in the Nazi Party, a basically state terrorist repression of than a friend, perhaps an enemy? It is even worse than Hitler. Give me a their people by their own government. very easy to see. break. Hitler was an evil man, and the One particularly grotesque method of We should never forget. And the real people in Pakistan, the clique that intimidation of the Baloch is called bellwether for this is the treatment of runs that country and engages in ter- ‘‘kill and dump.’’ That is when the Dr. Afridi. As we ponder our policies, rorism is an evil clique, and we should body of a man or woman who has dis- let us not forget Dr. Afridi, the heroic not be providing them the resources appeared from a village is later dumped Pakistani doctor who was instrumental they need to build their military capa- in the middle of that village. And who in the effort to capture or kill bin bilities. do you think is doing this? We are Laden. Dr. Afridi was arrested on May Well, Pakistan’s fight against mili- talking about the Pakistani military 22, 2011, 3 weeks after the United States tancy is, of course, against our mili- authorities who are conducting this raid which brought Osama bin Laden to tary. It is very evident because what type of terrorism on their own people, justice. He has been in a Pakistani jail we have got is attacks being conducted even, as we have said, the same people ever since. He was initially held be- by what? By people who are stationed, who gave safe haven to bin Laden who neath the ISI’s headquarters in whose operations they are operating had massacred 3,000 Americans, the Islamabad. There he was tortured and out of areas in Pakistan. And that has same people who offered their territory kept blindfolded for 8 months and been going on for years. Well, trying to as a staging area to launch attacks handcuffed for a year, leaving physical give them money, from the United into Afghanistan supporting the damage on this heroic friend of Amer- States to the Pakistani Government, is Taliban. ica. not buying us friendship, and it is not This abysmal human rights record is This man is a hero who risked his life buying future or even current peace. the record of the Pakistani Govern- to bring to justice the terrorist mon- By the way, the money that we give ment, and it is shameful. It is shameful ster who organized the 9/11 attack that them that isn’t being used to attack that we are even considering giving a killed 3,000 Americans. Dr. Afridi Americans and friends of ours is being government like this more American risked his life to bring justice, and we used to butcher their own people and aid, and we are even going to have to leave him in Pakistan in a dungeon. We suppress the opposition within Paki- borrow that aid from China to give it abandon him. We leave him to rot in stan to this brutal regime. They are to them. that dungeon. In May 2012, Dr. Afridi terrorizing; the Pakistani Government It is even worse, of course, because was moved to the Peshawar Central is terrorizing whole populations of American foreign and military aid con- Jail after being sentenced to 33 years their country like the Balochis and the tributes to the security forces which, in jail. Sindhis. of course, are killing the Baloch. We Dr. Afridi told FOX News he helped The Balochis and the Sindhis are peo- are not just giving foreign aid; we are the CIA out of love for the United ple that would prefer not to be under giving military aid as well. The Baloch States and swore that he would help the heel of a Pakistani Government people have a right to self-determina- America again despite the fact that run in Islamabad. The Baloch people tion and not to live under the control these people were torturing him. We live in an area of South Asia now of Islamabad if that is what they

VerDate Mar 15 2010 01:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00043 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.040 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2480 CONGRESSIONAL RECORD — HOUSE March 14, 2014 choose. At the very least, no military Pakistan is in partnership with ter- emboldening the radical Islamic ter- aid should be given to Pakistan to be rorist groups like the Taliban, and that rorist elements who now will target used against its own people, whether is very clear to people who are active Egypt because we are hesitant to get they be Baloch or Sindhi or any other in that part of the world. We should behind General al-Sisi and the Egyp- minority. not be treating this enemy as a friend. tian military, who, by the way, are I have already proposed legislation, In fact, we should reach out to India committed to bringing back demo- H.R. 1790, to end all aid to Pakistan, and try to reestablish, just to estab- cratic elections and having democratic and have also offered amendments to lish—perhaps not reestablish, but to es- elections and a democratic process as both the Defense and State Depart- tablish a positive relationship that will compared to the regime that they will ment authorization bills to end this lead to a stronger stance for peace and be replacing, which was dedicated to aid, but what needs to be seriously dis- stability in that part of the world as establishing an Islamic caliphate and cussed is not just ending aid. We need we offset the terrorist support that is was in the process of trimming back to seriously discuss a fundamental coming from Pakistan. the democratic capabilities of the shift in America’s policy towards Egyptian people. b 1300 South Asia, a strategy. We have had How ironic is it that if Egypt falls, the same strategy since the cold war, We should not be treating an enemy there will be chaos and radical Islamic but those policies that we established country like Pakistan as a friend. It expansionism in that part of world, and during the cold war no longer make will not make them our friend. It will, how important it is for us not to have sense. instead, make them disdain us. They that for world stability and our own In the 1960s, China fought battles in will disdain our giving people money national security. How ironic is it that both India and the Soviet Union. The who are our enemies. They will look at we are holding back, but Russia, under India-Soviet alignment at that point it as we are cowardly; and it is an ex- Mr. Putin, just last month provided, alienated the United States during the ample of such cowardice. We are giving maybe 2 months ago, went over to cold war, and what resulted was clearly billions to a military and a government Egypt and provided $2 billion worth of an adversarial relationship with India. that is controlled by a military clique military aid to help them defeat rad- When the Soviets invaded Afghani- that despises us and is cooperating ical Islam. Russia’s proposed arms deal stan in 1979, the U.S. and Pakistan with those who would destroy us. Not with Egypt and its endorsement of worked together to support the Afghan one cent to Pakistan. The money going Egypt’s military ruler, General al-Sisi, insurgents who were then battling to Pakistan is going contrary to our and his efforts to run for President is a against Soviet occupation troops. Yes, interests, to our security, and to the signal to the Arab leaders that, unlike during the cold war, Pakistan was an stability of South Asia. Let us double the United States, Russia will back those courageous enough to take on ally, but the cold war is over. And even our efforts to work with India and the radical Islamic threat to human then when we fought with them, when other countries in South and Central Asia that truly desire to be America’s freedom and human progress. they helped us support the mujahideen The Egyptian people were saved from friends. fight against the Soviet occupation of Islamic extremist rule. They were And nowhere, of course, is our hesi- Afghanistan, they channeled our saved by a small group of people who tancy to do that, to reach out and to money, they channeled the lion’s share we are putting roadblocks in the way try to support our friends, nowhere is of our support to radical Islamist ter- of General al-Sisi. We actually con- that hesitancy more evident than now rorists who should never have had any vinced the Egyptian military to be de- and what we are doing with Egypt. I support from the United States. Much pendent on the United States over the would call the attention of the Amer- of it went to a fellow named Gulbuddin years, and now, when they are in a cri- ican people to what is going on in Hekmatyar. This man is horrendous. sis, we are refraining from selling them Egypt. In terms of the long run, it is He has a horrendous record. Even then the helicopters and the spare parts they knew that, when this man was in far more important to American secu- they need to thwart the radical Islamic college, he would throw acid into the rity and the stability of the world and terrorists who threaten a battle in the faces of young women who refused to world peace what is going on in Egypt Sinai desert. If we let the Egyptian wear burkas. And we were giving our right now than what is happening in military down and we send that signal, aid to Pakistan who gave it to a man the Crimea right now. we abandon them, as we have aban- like that? The Egyptian army is the most po- doned Dr. Alfridi. No one in the world Well, the cold war is over, and there tent force standing between radical will ever trust us again. There will be is no reason for us to give them aid Islam and its objective to terrorize and a major expansion of radical Islamic that they can pass on to terrorists any subjugate whole populations through- terrorist regimes, and the world we more. Yes, the cold war is over, and out the Middle East and thus put them- know will be far less stable and far less since the Soviet Union’s collapse in the selves into a position of facing down secure. Our country, and other demo- early 1990s, basic elements of American and defeating Western civilization. cratic countries in the world, will be in security have fundamentally changed. We are talking about radical dramatic danger. The Pakistani-China friendship since Islamists who believe in what they be- The Egyptian people were saved from that time has deepened. And who is our lieve in. Just as in the cold war, the Islamic extremist rule by a very coura- adversary today? It is no longer—Rus- communists believed in that gobbledy- geous group of people. We can’t let sia gets in the news, but who is really gook. But the fact is, radical Islam sees them hang out on a branch by them- our threat? Radical Islam and an that, and they see Western civilization selves. And yes, the United States and emerging China that is much more ag- as the enemy, and the United States as the rest of the world were saved by the gressive than the Russians could con- the foundation of Western civilization, actions of a small group of people who ceive of being. and they see any government that is stood up as Morsi and the former gov- It is ever more intense and is now trying to be democratic as their adver- ernment was cutting away the freedom clearer that an alliance with India sary and enemy. of those people and establishing this against Pakistan is in the interest of It is clear the Egyptian people under- radical Islamic caliphate. Well, a small the United States because Pakistan is stood that when they rejected the rad- group of courageous people stood up to clearly moving in the direction of be- ical overtures of the former regime side with the people who had gone into coming a self-declared enemy of the that was in power in Egypt. They rose the streets to oppose that and said, No, United States even as we give them up against that government, the Morsi we are not going to let this govern- military and other types of aid. Paki- government, and right now whether or ment superimpose this type of regime. stan’s gut hostility towards India and not Egypt is a sucked into a turmoil It is contrary to the will of the Egyp- its shaping of its now ever-increasing and whether radical Islam takes over tian people. And they have, I might alliance with China puts them not only that country, it is now in the hands of add, put Egypt back on a course to- as an enemy to India, but as an adver- a very few leaders of that country who wards free elections. sary at the very least, an adversary to are we shunning. It is clear that our re- Egypt, of course, is one of the most the United States. luctance to back the stance of Egypt is strategic countries. Yet, as I say, we

VerDate Mar 15 2010 02:01 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00044 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.042 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2481 don’t hear our administration, this ad- culture,’’ this system is hampered by a p.m.), under its previous order, the ministration, coming here to plead the strict adherence to train schedules; a House adjourned until Tuesday, March case about giving aid to those brave safety apparatus that does not seek out 18, 2014, at 1 p.m. people in Egypt who are fighting rad- potentially dangerous situations, but f ical Islamic terrorism. Instead, they instead responds to complications after OATH FOR ACCESS TO CLASSIFIED are requesting hundred of millions of they arise; and inadequate training INFORMATION dollars, yes, over a billion dollars in procedures. aid to Pakistan, which is aiding radical These ailments are indefensible and Under clause 13 of rule XXIII, the fol- Islamic terrorists and siding with unwarranted. The FRA’s report states: lowing Members executed the oath for China. Detectable safety issues exist across mul- acess to classified information: Well, if you think that none of this tiple disciplines that should have been dis- Robert B. Aderholt, Rodney Alexander*, makes sense, you are right, it doesn’t, covered by the Metro-North management. Justin Amash, Mark E. Amodei, Robert E. but it is up to us, the American people, That is an indictment of Metro- Andrews*, Michele Bachmann, Spencer Bach- to hold our own government account- us, Ron Barber, Lou Barletta, Garland North’s management. No people should ‘‘Andy’’ Barr, John Barrow, Joe Barton, able, to make sure that we do not give be killed because of incompetence. No aid to our enemies and to make sure Karen Bass, Joyce Beatty, Xavier Becerra, people should have been killed because Dan Benishek, Kerry L. Bentivolio, Ami that our government is doing things the person driving the train apparently Bera, Gus M. Bilirakis, , Sanford that make sense. We should be sticking fell asleep. Metro-North’s failure to D. Bishop, Jr., Timothy H. Bishop, Diane with our friends and opposing our en- monitor potential safety hazards is Black, Marsha Blackburn, Earl Blumenauer, emies. How much more common sense downright reckless. According to the John A. Boehner, Suzanne Bonamici, Jo does it take, although our government Metropolitan Transit Authority, ap- Bonner*, Madeleine Z. Bordallo, Charles W. Boustany, Jr., Kevin Brady, Robert A. has not been operating that way. It is proximately 281,000 travelers use up to us, the American people, to make Brady, Bruce L. Braley, Jim Bridenstine, Mo Metro-North trains every week, and Brooks, Susan W. Brooks, Paul C. Broun, sure that we do not give aid to Paki- those passengers’ commutes are at risk stan and we support those people who Corrine Brown, Julia Brownley, Vern from these safety hazards cited in the Buchanan, Larry Bucshon, Michael C. Bur- would have Western democratic gov- report. gess, , G. K. Butterfield, Bradley ernment in Egypt, and to support the Getting people in and out of New Byrne, Ken Calvert, Dave Camp, John Camp- people like the Baloch and the Sindhis, York City, in and out of Manhattan, is bell, , Shelley Moore Capito, Lois who are struggling under the oppres- ´ an important task, and if it can’t be Capps, Michael E. Capuano, Tony Cardenas, sion of radical Islamic terrorist re- John C. Carney, Jr., Andre´ Carson, John R. done safely, then what good it is. gimes, to try to find their own way and Carter, Matt Cartwright, Bill Cassidy, Kathy The FRA’s report makes several rec- have their own government and have Castor, Joaquin Castro, Steve Chabot, Jason ommendations that, if implemented, their own democratic system Chaffetz, Donna M. Christensen, Judy Chu, With that, Mr. Speaker, I yield back might help prevent accidents in the fu- David N. Cicilline, Katherine M. Clark, the balance of my time. ture. According to the report, Metro- Yvette D. Clarke, Wm. Lacy Clay, Emanuel North is plagued by three fundamental Cleaver, James E. Clyburn, Howard Coble, f problems: a destructive emphasize on Mike Coffman, , Tom Cole, Chris METRO-NORTH TRAIN SAFETY timely departures and arrivals; the ab- Collins, Doug Collins, K. Michael Conaway, Gerald E. Connolly, , Jr., Paul The SPEAKER pro tempore. Under sence of proactive rather than reactive Cook, Jim Cooper, Jim Costa, Tom Cotton, the Speaker’s announced policy of Jan- responses to safety concerns; and defec- Joe Courtney, Kevin Cramer, Eric A. ‘‘Rick’’ uary 3, 2013, the Chair recognizes the tive training procedures. Four serious Crawford, Ander Crenshaw, Joseph Crowley, gentleman from New York (Mr. ENGEL) Metro-North accidents occurred just Henry Cuellar, John Abney Culberson, Elijah for 30 minutes. last year, and that is four too many. E. Cummings, Steve Daines, Danny K. Davis, Mr. ENGEL. Mr. Speaker, the Fed- I call upon Metro-North to imme- Rodney Davis, Susan A. Davis, Peter A. eral Railroad Administration’s exam- diately begin implementing the safety DeFazio, Diana DeGette, John K. Delaney, ination of the Metro-North railroad recommendations contained in the Rosa L. DeLauro, Suzan K. DelBene, Jeff Denham, Charles W. Dent, Ron DeSantis, safety apparatus has been completed. FRA report. The safety of thousands of Scott DesJarlais, Theodore E. Deutch, Mario I begin by offering my sincere condo- passengers and Metro-North employees Diaz-Balart, John D. Dingell, Lloyd Doggett, lences to the family and friends of Mr. depends on it. Michael F. Doyle, , Sean James Romansoff, a Metro-North em- Mr. Speaker, I yield back the balance P. Duffy, Jeff Duncan, John J. Duncan, Jr., ployee and a constituent of mine, a of my time. Donna F. Edwards, Keith Ellison, Renee L. Ellmers, Jo Ann Emerson*, Eliot L. Engel, Yonkers resident, who died Monday f after being hit by a train while per- William L. Enyart, Anna G. Eshoo, Elizabeth forming track maintenance. My LEAVE OF ABSENCE H. Esty, Eni F. H. Faleomavaega, Blake thoughts go out to his relatives and all By unanimous consent, leave of ab- Farenthold, Sam Farr, Chaka Fattah, Ste- who knew him, and I am deeply sorry phen Lee Fincher, Michael G. Fitzpatrick, sence was granted to: Charles J. ‘‘Chuck’’ Fleischmann, John for the family’s loss. Mr. CULBERSON (at the request of Mr. Fleming, Bill Flores, J. , Jeff This morning, the U.S. Department CANTOR) for today on account of sick- Fortenberry, , Virginia Foxx, Lois of Transportation’s Federal Railroad ness. Frankel, Trent Franks, Rodney P. Freling- Administration released a report to Mr. DANNY K. DAVIS of Illinois (at the huysen, Marcia L. Fudge, Tulsi Gabbard, Congress entitled, ‘‘Operation Deep request of Ms. PELOSI) for today. Pete P. Gallego, John Garamendi, Joe Gar- Dive: Metro-North Commuter Railroad cia, Cory Gardner, Scott Garrett, Jim Ger- f Safety Assessment.’’ This report was lach, Bob Gibbs, Christopher P. Gibson, Phil prompted by the horrific train derail- SENATE ENROLLED JOINT Gingrey, Louie Gohmert, Bob Goodlatte, ment that occurred in my district on RESOLUTION SIGNED Paul A. Gosar, Trey Gowdy, Kay Granger, Sam Graves, Tom Graves, Alan Grayson, Al December 1, 2013, which killed four and The Speaker announced his signature Green, Gene Green, Tim Griffin, H. Morgan wounded dozens. to an enrolled joint resolution of the Griffith, Rau´ l M. Grijalva, Michael G. I am sure I speak for all of my col- Senate of the following title: Grimm, Brett Guthrie, Luis V. Gutie´rrez, leagues when I say that the safety and S.J. Res. 32. Joint resolution providing for Janice Hahn, Ralph M. Hall, Colleen W. welfare of my constituents, of all of the reappointment of John W. McCarter as a Hanabusa, Richard L. Hanna, Gregg Harper, our constituents, is our number one citizen regent of the Board of Regents of the Andy Harris, Vicky Hartzler, Alcee L. Has- priority. That is why I was dismayed to Smithsonian Institution. tings, Doc Hastings, Denny Heck, Joseph J. Heck, Jeb Hensarling, Jaime Herrera learn of the profoundly ineffective f standards under which Metro-North—a Beutler, Brian Higgins, James A. Himes, ADJOURNMENT Rube´n Hinojosa, George Holding, Rush Holt, rail system that thousands of my con- Michael M. Honda, Steven A. Horsford, stituents depend on daily—has been op- Mr. ENGEL. Mr. Speaker, I move Steny H. Hoyer, Richard Hudson, Tim erating. that the House do now adjourn. Huelskamp, Jared Huffman, Bill Huizenga, According to the FRA’s report, which The motion was agreed to; accord- , Duncan Hunter, Robert concentrated on Metro-North’s ‘‘safety ingly (at 1 o’clock and 11 minutes Hurt, Steve Israel, Darrell E. Issa, Sheila

VerDate Mar 15 2010 01:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00045 Fmt 4634 Sfmt 0634 E:\CR\FM\K14MR7.043 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2482 CONGRESSIONAL RECORD — HOUSE March 14, 2014 Jackson Lee, Hakeem S. Jeffries, Lynn Jen- ler, George Miller, Jeff Miller, Gwen Moore, Bradley S. Schneider, Aaron Schock, Kurt kins, Bill Johnson, Eddie Bernice Johnson, James P. Moran, Markwayne Mullin, Mick Schrader, Allyson Y. Schwartz, David Henry C. ‘‘Hank’’ Johnson, Jr., Sam John- Mulvaney, Patrick Murphy, Tim Murphy, Schweikert, Austin Scott, David Scott, Rob- son, David W. Jolly, Walter B. Jones, Jim Jerrold Nadler, Grace F. Napolitano, Richard ert C. ‘‘Bobby’’ Scott, F. James Sensen- Jordan, David P. Joyce, Marcy Kaptur, Wil- E. Neal, Gloria Negrete McLeod, Randy brenner, Jr., Jose´ E. Serrano, Pete Sessions, liam R. Keating, Mike Kelly, Robin L. Kelly, Neugebauer, Kristi L. Noem, Richard M. Terri A. Sewell, Carol Shea-Porter, Brad Joseph P. Kennedy III, Daniel T. Kildee, Nolan, Eleanor Holmes Norton, Richard B. Sherman, , Bill Shuster, Mi- , Ron Kind, Peter T. King, Nugent, , Alan Nunnelee, Pete chael K. Simpson, Kyrsten Sinema, Albio Steve King, Jack Kingston, , Olson, Beto O’Rourke, William L. Owens, Sires, Louise McIntosh Slaughter, Adam Ann Kirkpatrick, John Kline, Ann M. Steven M. Palazzo, Frank Pallone, Jr., Bill Smith, Adrian Smith, Christopher H. Smith, ´ Kuster, Raul R. Labrador, Doug LaMalfa, Pascrell, Jr., Ed Pastor, Erik Paulsen, Don- Jason T. Smith, Lamar Smith, Steve Doug Lamborn, Leonard Lance, James R. ald M. Payne, Jr., Stevan Pearce, Nancy Southerland II, Jackie Speier, Chris Stewart, Langevin, , , Pelosi, Ed Perlmutter, Scott Perry, Gary C. Steve Stivers, Steve Stockman, Marlin A. John B. Larson, Tom Latham, Robert E. Peters, Scott H. Peters, Collin C. Peterson, Stutzman, Eric Swalwell, Mark Takano, Lee Latta, Barbara Lee, Sander M. Levin, John Thomas E. Petri, Pedro R. Pierluisi, Chellie Terry, Bennie G. Thompson, Glenn Thomp- Lewis, Daniel Lipinski, Frank A. LoBiondo, Pingree, Robert Pittenger, Joseph R. Pitts, David Loebsack, Zoe Lofgren, Billy Long, Mark Pocan, Ted Poe, Jared Polis, Mike son, Mike Thompson, Mac Thornberry, Pat- Alan S. Lowenthal, Nita M. Lowey, Frank D. Pompeo, Bill Posey, David E. Price, Tom rick J. Tiberi, John F. Tierney, Scott R. Tip- Lucas, Blaine Luetkemeyer, Ben Ray Luja´ n, Price, Mike Quigley, Trey Radel*, Nick J. ton, Dina Titus, Paul Tonko, Niki Tsongas, Michelle Lujan Grisham, Cynthia M. Lum- Rahall II, Charles B. Rangel, Tom Reed, Michael R. Turner, Fred Upton, David G. mis, Stephen F. Lynch, Daniel B. Maffei, David G. Reichert, James B. Renacci, Reid J. Valadao, Chris Van Hollen, Juan Vargas, Carolyn B. Maloney, Sean Patrick Maloney, Ribble, Tom Rice, Cedric L. Richmond, E. Marc A. Veasey, Filemon Vela, Nydia M. Kenny Marchant, Tom Marino, Edward J. , Martha Roby, David P. Roe, Vela´ zquez, Peter J. Visclosky, Ann Wagner, Markey*, Thomas Massie, Jim Matheson, Harold Rogers, Mike Rogers, Mike Rogers, Tim Walberg, Greg Walden, Jackie Walorski, Doris O. Matsui, Vance M. McAllister, Caro- Dana Rohrabacher, Todd Rokita, Thomas J. Timothy J. Walz, Debbie Wasserman lyn McCarthy, Kevin McCarthy, Michael T. Rooney, Peter J. Roskam, Ileana Ros- Schultz, Maxine Waters, Melvin L. Watt*, McCaul, Tom McClintock, Betty McCollum, Lehtinen, Dennis A. Ross, Keith J. Rothfus, Henry A. Waxman, Randy K. Weber, Sr., James P. McGovern, Patrick T. McHenry, Lucille Roybal-Allard, Edward R. Royce, Daniel Webster, Peter Welch, Brad R. Mike McIntyre, Howard P. ‘‘Buck’’ McKeon, Raul Ruiz, Jon Runyan, C. A. Dutch Rup- Wenstrup, Lynn A. Westmoreland, Ed Whit- David B. McKinley, Cathy McMorris Rod- persberger, Bobby L. Rush, , Tim field, Roger Williams, Frederica S. Wilson, gers, Jerry McNerney, Mark Meadows, Pat- Ryan, Gregorio Kilili Camacho Sablan, Matt Joe Wilson, Robert J. Wittman, Frank R. rick Meehan, Gregory W. Meeks, Grace Salmon, Linda T. Sa´ nchez, Loretta Sanchez, Wolf, Steve Womack, Rob Woodall, John A. Meng, Luke Messer, John L. Mica, Michael Mark Sanford, John P. Sarbanes, Steve Sca- Yarmuth, Kevin Yoder, Ted S. Yoho, C. W. H. Michaud, Candice S. Miller, Garyh G. Mil- lise, Janice D. Schakowsky, Adam B. Schiff, Bill Young*, , Todd C. Young. EXPENDITURE REPORTS CONCERNING OFFICIAL FOREIGN TRAVEL Reports concerning the foreign currencies and U.S. dollars utilized for Official Foreign Travel during the first quarter of 2014 pursuant to Public Law 95–384 are as follows:

REPORT OF EXPENDITURES FOR OFFICIAL FOREIGN TRAVEL, BARTON FORSYTH, HOUSE OF REPRESENTATIVES, EXPENDED BETWEEN JAN. 31 AND FEB. 3, 2014

Date Per diem 1 Transportation Other purposes Total U.S. dollar U.S. dollar U.S. dollar U.S. dollar Name of Member or employee Country Foreign equivalent Foreign equivalent Foreign equivalent Foreign equivalent Arrival Departure currency or U.S. currency or U.S. currency or U.S. currency or U.S. currency 2 currency 2 currency 2 currency 2

Barton Forsyth ...... 1/31 2/3 Germany ...... 1,812.36 ...... 423.73 ...... 1,303.04 ...... 3,539.13

Committee total ...... 1,812.36 ...... 423.73 ...... 1,303.04 ...... 3,539.13

1 Per diem constitutes lodging and meals. 2 If foreign currency is used, enter U.S. dollar equivalent; if U.S. currency is used, enter amount expended. BARTON FORSYTH, Mar. 4, 2014.

REPORT OF EXPENDITURES FOR OFFICIAL FOREIGN TRAVEL, DELEGATION TO SWITZERLAND, GERMANY, AND POLAND, HOUSE OF REPRESENTATIVES, EXPENDED BETWEEN JAN. 22 AND JAN. 27, 2014

Date Per diem 1 Transportation Other purposes Total U.S. dollar U.S. dollar U.S. dollar U.S. dollar Name of Member or employee Country Foreign equivalent Foreign equivalent Foreign equivalent Foreign equivalent Arrival Departure currency or U.S. currency or U.S. currency or U.S. currency or U.S. currency 2 currency 2 currency 2 currency 2

Hon. Eric Cantor ...... 1/23 1/25 Switzerland ...... 2,010.00 ...... 3 35.00 ...... 2,045.00 Hon. Jeb Hensarling ...... 1 /23 1 /25 Switzerland ...... 1,390.00 ...... 3 5,769.30 ...... 7,159.30 Hon. Kay Granger ...... 1/23 1/25 Switzerland ...... 888.00 ...... 3 6,379.90 ...... 7,267.90 Hon. Mario Diaz-Balart ...... 1/23 1/25 Switzerland ...... 888.00 ...... 3 5,417.20 ...... 6,305.20 Hon. Darrell Issa ...... 1 /22 1 /25 Switzerland ...... 1,512.00 ...... 3 1,273.45 ...... 2,785.45 Hon. Patrick McHenry ...... 1/23 1/25 Switzerland ...... 1,310.00 ...... 3 4,654.90 ...... 5,964.90 Rory Cooper ...... 1/23 1/25 Switzerland ...... 1,310.00 ...... 3 35.00 ...... 1,345.00 Robert Karem ...... 1/23 1/25 Switzerland ...... 1,390.00 ...... 3 35.00 ...... 1,425.00 Hon. Eric Cantor ...... 1/25 1/26 Germany ...... 362.00 ...... (3) ...... 362.00 Hon. Carolyn Maloney ...... 1/25 1/26 Germany ...... 362.00 ...... 3 666.70 ...... 1,028.70 Hon. Darrell Issa ...... 1 /25 1 /26 Germany ...... 362.00 ...... (3) ...... 362.00 Rory Cooper ...... 1/25 1/26 Germany ...... 362.00 ...... (3) ...... 362.00 Robert Karem ...... 1/25 1/26 Germany ...... 362.00 ...... (3) ...... 362.00 Hon. Eric Cantor ...... 1/26 1/27 Poland ...... 295.68 ...... (3) ...... 295.68 Hon. Carolyn Maloney ...... 1/26 1/27 Poland ...... 295.68 ...... (3) ...... 295.68 Hon. Darrell Issa ...... 1 /26 1 /27 Poland ...... 295.68 ...... (3) ...... 295.68 Rory Cooper ...... 1/26 1/27 Poland ...... 295.68 ...... (3) ...... 295.68 Robert Karem ...... 1/26 1/27 Poland ...... 295.68 ...... (3) ...... 295.68

Committee total ...... 4 13,986.40 ...... 24,266.45 ...... 38,252.85

1 Per diem constitutes lodging and meals. 2 If foreign currency is used, enter U.S. dollar equivalent; if U.S. currency is used, enter amount expended. 3 Military air transportation. 4 Actual lodging costs authorized as necessary by the U.S. Department of State. HON. ERIC CANTOR, Feb. 26, 2014.

VerDate Mar 15 2010 01:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00046 Fmt 4634 Sfmt 8634 E:\CR\FM\A14MR7.017 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2483 EXECUTIVE COMMUNICATIONS, 121018563-3148-02] (RIN: 0648-XD111) received AA87) received February 26, 2014, pursuant to ETC. March 5, 2014, pursuant to 5 U.S.C. 5 U.S.C. 801(a)(1)(A); to the Committee on 801(a)(1)(A); to the Committee on Natural Transportation and Infrastructure. Under clause 2 of rule XIV, executive Resources. 5013. A letter from the Director, Regu- communications were taken from the 5004. A letter from the Acting Deputy Di- latory Management Division, Environmental Speaker’s table and referred as follows: rector, Office of Sustainable Fisheries, Protection Agency, transmitting the Agen- cy’s final rule — Effluent Limitations Guide- 4995. A letter from the Chief Counsel, NMFS, National Oceanic and Atmospheric lines and Standards for the Construction and FEMA, Department of Homeland Security, Administration, transmitting the Adminis- Development Point Source Category [EPA- transmitting the Department’s final rule — tration’s final — rule Fisheries of the Carib- HQ-OW-2010-0884; FRL-9906-51-OW] (RIN: 2040- Suspension of Community Eligibility [Dock- bean, Gulf of , and South Atlantic; Coastal Migratory Pelagic Resources of the AF44) received March 4, 2014, pursuant to 5 et ID: FEMA-2013-0002] [Internal Agency U.S.C. 801(a)(1)(A); to the Committee on Docket No.: FEMA-8323] received March 5, Gulf of Mexico and South Atlantic [Docket No.: 101206604-1758-02] (RIN: 0648-XC464) re- Transportation and Infrastructure. 2014, pursuant to 5 U.S.C. 801(a)(1)(A); to the 5014. A letter from the Chief, Publications Committee on Financial Services. ceived February 26, 2014, pursuant to 5 U.S.C. 801(a)(1)(A); to the Committee on Natural and Regulations, Internal Revenue Service, 4996. A letter from the Director, Regula- transmitting the Service’s final rule — tions Policy and Management Staff, Depart- Resources. 5005. A letter from the Deputy Director, Of- Method Changes for Tangible Property Dis- ment of Health and Human Services, trans- positions (Rev. Proc. 2014-17) received March mitting the Department’s final rule — Irra- fice of Sustainable Fisheries, NMFS, Na- tional Oceanic and Atmospheric Administra- 6, 2014, pursuant to 5 U.S.C. 801(a)(1)(A); to diation in the Production, Processing, and the Committee on Ways and Means. tion, transmitting the Administration’s final Handling of Food [Docket No.: FDA-1999-F- 5015. A letter from the Chief, Publications 2405 (formerly 1999F-5522)] received March 5, rule — Fisheries of the Exclusive Economic and Regulations Branch, Internal Revenue 2014, pursuant to 5 U.S.C. 801(a)(1)(A); to the Zone Off Alaska; Pacific Cod by Catcher Ves- Service, transmitting the Service’s final rule Committee on Energy and Commerce. sels Greater Than or Equal to 60 feet Length — Annual price inflation adjustments for 4997. A letter from the Director, Regu- Overall Using Pot Gear in the Bering Sea passenger automobiles first placed in service latory Management Division, Environmental and Aleutian Islands Management Area or leased in 2014 (Rev. Proc. 2014-21) received Protection Agency, transmitting the Agen- [Docket No.: 121018563-3148-02] (RIN: 0648- February 27, 2014, pursuant to 5 U.S.C. cy’s final rule — Approval and Promulgation XD101) received February 26, 2014, pursuant 801(a)(1)(A); to the Committee on Ways and of Implementation Plans; State of Missouri to 5 U.S.C. 801(a)(1)(A); to the Committee on Means. [EPA-R07-OAR-2013-0698; FRL-9907-32-Region Natural Resources. 5006. A letter from the Deputy Assistant f 7] received March 4, 2014, pursuant to 5 Administrator for Regulatory Programs, U.S.C. 801(a)(1)(A); to the Committee on En- REPORTS OF COMMITTEES ON NMFS, National Oceanic and Atmospheric ergy and Commerce. PUBLIC BILLS AND RESOLUTIONS Administration, transmitting the Adminis- 4998. A letter from the Director, Regu- tration’s final rule — National Appeals Of- Under clause 2 of rule XIII, reports of latory Management Division, Environmental fice Rules of Procedure [Docket No.: committees were delivered to the Clerk Protection Agency, transmitting the Agen- 101019524-3999-02] (RIN: 0648-BA36) received for printing and reference to the proper cy’s final rule — Approval and Promulgation February 26, 2014, pursuant to 5 U.S.C. of Implementation Plans; Washington: State calendar, as follows: 801(a)(1)(A); to the Committee on Natural Implementation Plan Miscellaneous Revi- Mr. CAMP: Committee on Ways and Resources. sions [EPA-R10-OAR-2013-0628; FRL-9907-38- 5007. A letter from the Attorney-Advisor, Means. H.R. 2810. A bill to amend title Region 10] received March 4, 2014, pursuant Department of Homeland Security, transmit- XVIII of the Social Security Act to re- to 5 U.S.C. 801(a)(1)(A); to the Committee on ting the Department’s final rule — Safety form the sustainable growth rate and Energy and Commerce. Zone for Ice Conditions; Baltimore Captain Medicare payment for physicians’ serv- 4999. A letter from the Director, Regu- of the Port Zone [Docket Number: USCG- ices, and for other purposes, with an latory Management Division, Environmental 2013-0509] (RIN: 1625-AA00) received February amendment (Rept. 113–257 Pt. 2) Re- Protection Agency, transmitting the Agen- 25, 2014, pursuant to 5 U.S.C. 801(a)(1)(A); to cy’s final rule — Fluopicolide; Pesticide Tol- ferred to the Committee of the Whole the Committee on Transportation and Infra- House on the state of the Union. erances [EPA-HQ-OPP-2012-0941; FRL-9906-19] structure. received March 4, 2014, pursuant to 5 U.S.C. 5008. A letter from the Attorney-Advisor, f 801(a)(1)(A); to the Committee on Energy and Department of Homeland Security, transmit- PUBLIC BILLS AND RESOLUTIONS Commerce. ting the Department’s final rule — Safety; 5000. A letter from the Director, Regu- Alaska Marine Highway System Port Valdez Under clause 2 of rule XII, public latory Management Division, Environmental Ferry Terminal, Port Valdez; Valdez, AK bills and resolutions of the following Protection Agency, transmitting the Agen- [Docket No.: USCG-2012-0365] (RIN: 1625- titles were introduced and severally re- cy’s final rule — Metconazole; Pesticide Tol- AA00) received February 26, 2014, pursuant to ferred, as follows: erances [EPA-HQ-OPP-2013-0656; FRL-9906-13] 5 U.S.C. 801(a)(1)(A); to the Committee on By Mr. PASCRELL (for himself and received March 4, 2014, pursuant to 5 U.S.C. Transportation and Infrastructure. 801(a)(1)(A); to the Committee on Energy and Mr. ROONEY): 5009. A letter from the Attorney-Advisor, H.R. 4251. A bill to direct the Secretary of Commerce. Department of Homeland Security, transmit- Health and Human Services, acting through 5001. A letter from the Director, Regu- ting the Department’s final rule — Security the Director of the Centers for Disease Con- latory Management Division, Environmental Zone; , New Orleans, LA trol and Prevention, to establish a surveil- Protection Agency, transmitting the Agen- [Docket No.: USCG-2013-0994] (RIN: 1625- lance system regarding traumatic brain in- cy’s final rule — Triflumizole; Pesticide Tol- AA87) received February 26, 2014, pursuant to jury, and for other purposes; to the Com- erances [EPA-HQ-OPP-2012-0949; FRL-9906-47] 5 U.S.C. 801(a)(1)(A); to the Committee on mittee on Energy and Commerce. received March 4, 2014, pursuant to 5 U.S.C. Transportation and Infrastructure. By Mr. ROTHFUS: 801(a)(1)(A); to the Committee on Energy and 5010. A letter from the Attorney-Advisor, H.R. 4252. A bill to amend the Federal De- Commerce. Department of Homeland Security, transmit- posit Insurance Act to allow mutual capital 5002. A letter from the Deputy Assistant ting the Department’s final rule — Security certificates to satisfy capital requirements Administrator for Regulatory Programs, Zone, Potomac and Anacostia Rivers; Wash- for mutual depositories, to amend the Re- NMFS, National Oceanic and Atmospheric ington, DC [Docket No.: USCG-2013-1050] vised Statutes of the United States to estab- Administration, transmitting the Adminis- (RIN: 1625-AA87) received February 26, 2014, lish mutual national banks, and for other tration’s final rule — Fisheries of the Carib- pursuant to 5 U.S.C. 801(a)(1)(A); to the Com- purposes; to the Committee on Financial bean, Gulf of Mexico, and South Atlantic; mittee on Transportation and Infrastruc- Services. Revisions to Headboat Reporting Require- ture. By Mr. BISHOP of Utah (for himself, ments for Species Managed by the Gulf of 5011. A letter from the Attorney-Advisor, Mr. AMODEI, Mr. PEARCE, and Mr. Mexico Fishery Management Council [Dock- Department of Homeland Security, transmit- YOUNG of Alaska): et No.: 130802673-4053-02] (RIN: 0648-BD49) re- ting the Department’s final rule — Security H.R. 4253. A bill to permanently withdraw, ceived March 5, 2014, pursuant to 5 U.S.C. Zone; North American International Auto reserve, and transfer Bureau of Land Man- 801(a)(1)(A); to the Committee on Natural Show; Detroit River, Detroit, MI [Docket agement lands used for military purposes in Resources. No.: USCG-2013-0034] (RIN: 1625-AA87) re- Alaska, Nevada, and New Mexico to the ap- 5003. A letter from the Acting Deputy Di- ceived February 26, 2014, pursuant to 5 U.S.C. propriate Secretary of the military depart- rector, Office of Sustainable Fisheries, 801(a)(1)(A); to the Committee on Transpor- ment concerned; to the Committee on Nat- NMFS, National Oceanic and Atmospheric tation and Infrastructure. ural Resources, and in addition to the Com- Administration, transmitting the Adminis- 5012. A letter from the Attorney Advisor, mittee on Armed Services, for a period to be tration’s final rule — Fisheries of the Exclu- Department of Homeland Security, transmit- subsequently determined by the Speaker, in sive Economic Zone Off Alaska; Reallocation ting the Department’s final rule — Security each case for consideration of such provi- of Pacific Cod in the Bering Sea and Aleu- Zone; On the Waters in Kailua Bay, Oahu, HI sions as fall within the jurisdiction of the tian Islands Management Area [Docket No.: [Docket No.: USCG-2013-0934] (RIN: 1625- committee concerned.

VerDate Mar 15 2010 01:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00047 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.016 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2484 CONGRESSIONAL RECORD — HOUSE March 14, 2014 By Mr. ROYCE (for himself, Mr. terials; to the Committee on Education and prove teacher and principal effectiveness, LOWENTHAL, Mr. WOLF, and Ms. LO- the Workforce. and for other purposes; to the Committee on RETTA SANCHEZ of California): By Mrs. ELLMERS (for herself, Mr. Education and the Workforce. H.R. 4254. A bill to impose sanctions on in- THOMPSON of Mississippi, and Ms. By Mr. RENACCI (for himself, Mr. dividuals who are complicit in human rights EDDIE BERNICE JOHNSON of Texas): HIMES, Mr. CONAWAY, Mr. PETERSON, abuses committed against nationals of Viet- H.R. 4260. A bill to ensure that the Ryan Mr. MURPHY of Florida, Mr. FLORES, nam or their family members, and for other White Comprehensive AIDS Resources Emer- and Mr. SHERMAN): purposes; to the Committee on Foreign Af- gency Act program is as effective as possible H.R. 4270. A bill to clarify that funding for fairs, and in addition to the Committees on in saving lives and preventing the spread of the standard setting body designated pursu- the Judiciary, Ways and Means, and Finan- the HIV epidemic by ensuring that funding ant to section 19(b) of the Securities Act of cial Services, for a period to be subsequently allocations are evidenced-based and by pro- 1933, the Securities Investor Protection Cor- determined by the Speaker, in each case for moting greater utilization of patient-cen- poration, and the Public Company Account- consideration of such provisions as fall with- tered care; to the Committee on Energy and ing Oversight Board is not subject to the se- in the jurisdiction of the committee con- Commerce. quester; to the Committee on the Budget. cerned. By Mr. COFFMAN (for himself, Mrs. By Mr. RUIZ (for himself, Mr. MCGOV- By Mr. CARTWRIGHT (for himself, Mr. KIRKPATRICK, and Mr. MICHAUD): ERN, Ms. KUSTER, and Mr. GARCIA): HORSFORD, Mr. CONNOLLY, Mr. H.R. 4261. A bill to improve the research of H.R. 4271. A bill to authorize the Export- GEORGE MILLER of California, Mrs. Gulf War Illness, the Research Advisory Import Bank of the United States to use 3 NAPOLITANO, Mr. GRIJALVA, Mr. VAN Committee on Gulf War Veterans’ Illnesses, percent of its profits for administrative ex- HOLLEN, Mr. NOLAN, Ms. HAHN, Ms. and for other purposes; to the Committee on penses; to the Committee on Financial Serv- SLAUGHTER, Ms. LEE of California, Veterans’ Affairs. ices. Mr. FARR, Mr. HONDA, Ms. LORETTA By Mr. DUFFY: By Mr. WALDEN: SANCHEZ of California, Ms. ESHOO, H.R. 4262. A bill to apply the requirements H.R. 4272. A bill to stop implementation Ms. SPEIER, Mr. HASTINGS of Florida, of the Federal Advisory Committee Act to and enforcement of the Forest Service travel Mr. JOHNSON of Georgia, Mr. TONKO, the Bureau of Consumer Financial Protec- management rule and to require the Forest Mr. FATTAH, Mr. BRADY of Pennsyl- tion; to the Committee on Financial Serv- Service to incorporate the needs, uses, and vania, Ms. JACKSON LEE, Ms. EDDIE ices, and in addition to the Committee on input of affected communities before taking BERNICE JOHNSON of Texas, Mr. Oversight and Government Reform, for a pe- any travel management action affecting ac- LYNCH, Ms. BONAMICI, Mr. DEFAZIO, riod to be subsequently determined by the cess to units of the National Forest System Speaker, in each case for consideration of Mr. COHEN, Mr. CA´ RDENAS, Ms. KAP- derived from the public domain, and for such provisions as fall within the jurisdic- TUR, Mr. RUSH, Mr. GARCIA, Mr. other purposes; to the Committee on Natural tion of the committee concerned. NEAL, Ms. PINGREE of Maine, Mr. Resources. By Mrs. BROOKS of Indiana (for her- ELLISON, Mr. PALLONE, Mr. LANGEVIN, By Mr. WALDEN (for himself, Mr. self, Mr. PAYNE, Mr. PALAZZO, and Ms. NORTON, Mr. DOYLE, Ms. CHU, Mr. DEFAZIO, Mr. BLUMENAUER, Ms. Mr. SWALWELL of California): THOMPSON of California, Mr. CON- BONAMICI, and Mr. SCHRADER): H.R. 4263. A bill to amend the Homeland YERS, Ms. CLARK of Massachusetts, H.R. 4273. A bill to name the Department of Security Act of 2002 to authorize the Depart- Mr. RANGEL, Ms. WILSON of Florida, Veterans Affairs community-based out- ment of Homeland Security to establish a so- Ms. SHEA-PORTER, Ms. LOFGREN, Ms. patient clinic in The Dalles, Oregon, as the cial media working group, and for other pur- BROWN of Florida, Mr. CARSON of In- ‘‘Loren R. Kaufman Memorial Veterans’ poses; to the Committee on Homeland Secu- diana, Ms. VELA´ ZQUEZ, Mr. TAKANO, Clinic‘‘; to the Committee on Veterans’ Af- rity. Mr. RUPPERSBERGER, Ms. ROYBAL- fairs. By Mr. FORTENBERRY: By Mr. ROYCE (for himself and Mr. ALLARD, Mr. GENE GREEN of Texas, H.R. 4264. A bill to authorize the Secretary NGEL): Mr. CLAY, and Ms. DELAURO): of Agriculture to enter into a lease involving E H. Res. 520. A resolution calling for an end H.R. 4255. A bill to require the Federal the South Central Agricultural Laboratory to attacks on Syrian civilians and expanded Housing Finance Agency to establish a 6- in Clay County, Nebraska, to facilitate the humanitarian access; to the Committee on month moratorium on foreclosure of mort- improvement of the laboratory to support Foreign Affairs. gages guaranteed by Fannie Mae or Freddie cooperative State and Federal agricultural By Mr. GRIJALVA (for himself, Mr. Mac on homes of individuals who have lost research; to the Committee on Agriculture. LANGEVIN, Mr. DANNY K. DAVIS of Il- Federal unemployment insurance as a result By Mr. HUNTER (for himself, Mr. of the expiration of such program, and for linois, and Mr. TAKANO): GEORGE MILLER of California, Mr. other purposes; to the Committee on Finan- H. Res. 521. A resolution supporting the CALVERT, Mr. PETERS of California, cial Services. goals and ideals of ‘‘National Middle Level Mr. VARGAS, and Mr. COLE): Education Month‘‘; to the Committee on By Mr. STEWART (for himself, Mr. H.R. 4265. A bill to direct the Secretary and BISHOP of Utah, and Mr. CHAFFETZ): the Attorney General to promptly take all Education and the Workforce. H.R. 4256. A bill to amend the Endangered steps necessary or appropriate to execute By Mr. TIBERI (for himself and Mr. Species Act of 1973 to require, in counting and implement the San Luis Rey settlement NEAL): H. Res. 522. A resolution expressing support the number of a species in a State for pur- agreement, and for other purposes; to the for designation of September 2014 as Na- poses of determining whether the species is Committee on Natural Resources. tional Brain Aneurysm Awareness Month; to an endangered or threatened species, inclu- By Ms. MATSUI (for herself, Mr. the Committee on Energy and Commerce. sion of the number of the species on State GARAMENDI, and Mr. BERA of Cali- and private lands as determined by the fornia): f State, and for other purposes; to the Com- H.R. 4266. A bill to amend the Reclamation CONSTITUTIONAL AUTHORITY mittee on Natural Resources. Wastewater and Groundwater Study and Fa- By Mr. CALVERT (for himself, Mr. cilities Act to authorize the Secretary of the STATEMENT ROKITA, Mr. NUNES, Mr. COTTON, Ms. Interior to participate in the design, plan- Pursuant to clause 7 of rule XII of GRANGER, and Mr. ISSA): ning, and construction of the South Sac- the Rules of the House of Representa- H.R. 4257. A bill to provide for a limitation ramento County Agriculture and Habitat on the number of civilian employees at the tives, the following statements are sub- Lands Water Recycling Project in Sac- mitted regarding the specific powers Department of Defense, and for other pur- ramento County, California; to the Com- poses; to the Committee on Armed Services. mittee on Natural Resources. granted to Congress in the Constitu- By Mrs. NAPOLITANO (for herself, Ms. By Mr. MCALLISTER: tion to enact the accompanying bill or GABBARD, Ms. HANABUSA, Mr. CART- H.R. 4267. A bill to amend the Commodity joint resolution. WRIGHT, Mr. COSTA, Mr. HUFFMAN, Exchange Act to provide relief for end users By Mr. PASCRELL: Mr. LOWENTHAL, Mr. CA´ RDENAS, Mr. who use physical contracts with volumetric H.R. 4251. RUIZ, Mr. SIRES, Mr. GRIJALVA, Mr. optionality; to the Committee on Agri- Congress has the power to enact this legis- BEN RAY LUJA´ N of New Mexico, Ms. culture. lation pursuant to the following: LOFGREN, Mr. LARSON of Connecticut, By Mr. NUNNELEE (for himself, Mr. Congress has the power to enact this legis- Ms. HAHN, Mr. PASTOR of Arizona, THOMPSON of Mississippi, Mr. HAR- lation pursuant to Article I, Section 8, Mr. DOGGETT, and Mr. TAKANO): PER, and Mr. PALAZZO): Clause 3 of the United States Constitution. H.R. 4258. A bill to reauthorize and update H.R. 4268. A bill to amend title 23, United By Mr. ROTHFUS: certain provisions of the Secure Water Act; States Code, with respect to United States H.R. 4252. to the Committee on Natural Resources. Route 78 in Mississippi, and for other pur- Congress has the power to enact this legis- By Ms. DELBENE (for herself and Mr. poses; to the Committee on Transportation lation pursuant to the following: HANNA): and Infrastructure. Article I, Section 8, Clause 3 of the Con- H.R. 4259. A bill to amend the Higher Edu- By Mr. POLIS (for himself and Mr. stitution of the United States ‘‘[t]o regulate cation Act of 1965 to lower the cost of college PAYNE): Commerce with foreign Nations, and among education by establishing pilot programs to H.R. 4269. A bill to amend the Elementary the several States, and with the Indian expand student access to digital course ma- and Secondary Education Act of 1965 to im- Tribes.’’

VerDate Mar 15 2010 01:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00048 Fmt 4634 Sfmt 0634 E:\CR\FM\L14MR7.100 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE March 14, 2014 CONGRESSIONAL RECORD — HOUSE H2485 By Mr. BISHOP of Utah: Article I, section 8 of the Constitution of By Mr. RENACCI: H.R. 4253. the United States grants Congress the au- H.R. 4270. Congress has the power to enact this legis- thority to enact this bill. Congress has the power to enact this legis- lation pursuant to the following: By Ms. DELBENE: lation pursuant to the following: The constitutional authority on which this H.R. 4259. Article I, Section 8, Clause 18: The Con- bill rests is found in Article IV, Section 3, Congress has the power to enact this legis- gress shall have Power to make all Laws Clause 2 of the United States Constitution lation pursuant to the following: which shall be necessary and proper for car- which states, ‘‘The Congress shall have the Article I, Section 8 of the United States rying into Execution the foregoing Powers, Power to dispose of and make all needful Constitution. and all other Powers vested by the Constitu- Rules and Regulations respecting the Terri- By Mrs. ELLMERS: tion in the Government of the United States, tory of other Property belonging to the H.R. 4260. or in any Department or Officer thereof. United States’’. Additional constitutional Congress has the power to enact this legis- Article I, Section 9, Clause 7: No Money authority lies with the power of Congress lation pursuant to the following: shall be drawn from the Treasury, but in ‘‘to provide for the common Defence’’, ‘‘to The authority to enact this bill is derived Consequence of Appropriations made by Law; raise and support Armies’’, ‘‘to provide and from, but may not be limited to, Clause 1 of and a regular Statement and Account of the maintain a Navy’’ and ‘‘to make Rules for Section 8 of Article I of the United States Receipts and Expenditures of all public the Government and Regulation of the land Constitution. Congress shall have the power Money shall be published from time to time. and naval Forces’’ as enumerated in Article to provide for the general Welfare of the By Mr. RUIZ: I, section 8 of the United States Constitu- United States as long as it is applied uni- H.R. 4271. tion. formly throughout the United States. In this Congress has the power to enact this legis- By Mr. ROYCE: case, the Ryan White Program provides for lation pursuant to the following: H.R. 4254. the general Welfare of a class of people na- clause 18 of section 8 of article 1 of the Congress has the power to enact this legis- tionwide. Constitution lation pursuant to the following: By Mr. COFFMAN: By Mr. WALDEN: Article 1, Section 8: ‘‘To make all Laws H.R. 4261. H.R. 4272. which shall be necessary and proper for car- Congress has the power to enact this legis- Congress has the power to enact this legis- rying into Execution the foregoing Powers, lation pursuant to the following: lation pursuant to the following: and all other Powers vested by this Article I, Section 8 Article IV, Section 3, Clause 2 (relating to Consitution in the Government of the United By Mr. DUFFY: the power of Congress to dispose of and make H.R. 4262. States or in any Department or Officers all needful rules and regulations respecting Congress has the power to enact this legis- thereof.’’ the territory or other property belonging to lation pursuant to the following: By Mr. CARTWRIGHT: the United States). H.R. 4255. Article 1, Section 8: To make all Laws which shall be necessary and proper for car- By Mr. WALDEN: Congress has the power to enact this legis- H.R. 4273. rying into Execution the foregoing Powers, lation pursuant to the following: Congress has the power to enact this legis- and all other Powers vested by this Constitu- Article I; Section 8; Clause 3 of the Con- lation pursuant to the following: tion in the Government of the United States, stitution states The Congress shall have Article I, Section 8, Clause 18. Power To regulate Commerce with foreign or in any Department or Officer thereof. f Nations, and among the several States, and By Mrs. BROOKS of Indiana: with the Indian Tribes . . . And Article I; H.R. 4263. ADDITIONAL SPONSORS Congress has the power to enact this legis- Section 8; Clause 4 of the Constitution states lation pursuant to the following: Under clause 7 of rule XII, sponsors were The Congress shall have Power To establish Article I, Section 8, To make all Laws added to public bills and resolutions, as fol- an uniform Rule of Naturalization, and uni- which shall be necessary and proper for car- lows: form Laws on the subject of Bankruptcies rying into Execution the foregoing Powers, throughout the United States . . . H.R. 24: Mr. ROTHFUS, Mr. REED, Mr. CON- and all other Powers vested by this Constitu- By Mr. STEWART: AWAY, Mr. NEUGEBAUER, Mr. RICE of South tion in the Government of the United States H.R. 4256. Carolina, Mr. BRIDENSTINE, and Mr. COOK. Congress has the power to enact this legis- By Mr. FORTENBERRY: H.R. 93: Ms. CLARK of Massachusetts. H.R. 4264. lation pursuant to the following: H.R. 523: Mr. ROGERS of Kentucky. Congress has the power to enact this legis- Article I, Section 8, Clause 8 allows Con- H.R. 628: Mr. HONDA, Ms. NORTON, and Mr. lation pursuant to the following: gress ‘‘[t]o make all Laws which shall be nec- HOLT. Article I, Section 8, Clause 1 of the United essary and proper for carrying into Execu- H.R. 721: Ms. TITUS. States Constitution. tion the foregoing Powers, and all other H.R. 755: Mr. LANKFORD. By Mr. HUNTER: H.R. 784: Ms. NORTON. Powers vested by this Constitution in the H.R. 4265. H.R. 822: Mrs. BEATTY. Government of the United States, or in any Congress has the power to enact this legis- H.R. 935: Mr. CRAMER. Department or Officer thereof.’’ lation pursuant to the following: H.R. 942: Mr. THOMPSON of Pennsylvania, Article IV, Section 3 ‘‘The Congress shall Article 1, Section 8 of the United States Mr. GRIFFIN of Arkansas, and Mr. KING of have power to dispose of and make all need- Constitution, which provides Congress with New York. ful Rules and Regulations respecting the the power to regulate commerce and rela- H.R. 1020: Mr. TURNER. Territory or other Property belonging to the tions between the United States and Native H.R. 1070: Mr. GERLACH. United States; and nothing in this Constitu- American Tribes. H.R. 1102: Mr. COHEN. tion shall be so construed as to Prejudice By Ms. MATSUI: H.R. 1180: Mr. RIGELL, Mr. QUIGLEY, Mr. any Claims of the United States, or of any H.R. 4266. BLUMENAUER, and Mr. MORAN. particular State.’’ Congress has the power to enact this legis- H.R. 1186: Mr. WHITFIELD. Article X ‘‘The powers not delegated to the lation pursuant to the following: H.R. 1199: Mr. DAVID SCOTT of Georgia. United States by the Constitution, nor pro- Article 1, Section 8, Clause 3 H.R. 1201: Ms. SCHAKOWSKY. hibited by it to the States, are reserved to By Mr. MCALLISTER: the States respectively, or to the people.’’ H.R. 4267. H.R. 1278: Ms. SLAUGHTER. By Mr. CALVERT: Congress has the power to enact this legis- H.R. 1333: Mr. HOLT. H.R. 4257. lation pursuant to the following: H.R. 1339: Mr. ELLISON and Mr. CARSON of Congress has the power to enact this legis- Clause 3 of Section 8 of Article I of the Indiana. lation pursuant to the following: United States Constitution. H.R. 1386: Mr. ROSKAM. The constitutional authority of Congress By Mr. NUNNELEE: H.R. 1461: Mr. YOUNG of Alaska. to enact this legislation is Section 8 of Arti- H.R. 4268. H.R. 1507: Mr. GUTIE´ RREZ and Mr. YOUNG of cle I of the Constitution, specifically Clauses Congress has the power to enact this legis- Indiana. 1 (relating to providing for the general wel- lation pursuant to the following: H.R. 1523: Ms. TITUS. fare of the United States) and 18 (relating to Article I, Section 8, Clause 3 and Article I, H.R. 1554: Mr. HASTINGS of Florida and Mr. the power to make all laws necessary and Section 8, Clause 17. O’ROURKE. proper for carrying out the powers vested in By Mr. POLIS: H.R. 1555: Mr. O’ROURKE. Congress) of such section. H.R. 4269. H.R. 1556: Mr. O’ROURKE. OR Congress has the power to enact this legis- H.R. 1652: Mr. SCHRADER and Mr. MATHE- The constitutional authority of Congress lation pursuant to the following: SON. to enact this legislation is Article I, Section Article I, Section 8, Clause 1 (relating to H.R. 1666: Mr. ELLISON. 8, Clause 1 and Clause 18. the power of Congress to provide for the gen- H.R. 1698: Mr. HECK of Washington. By Mrs. NAPOLITANO: eral welfare of the United States) and Clause H.R. 1709: Mr. CONYERS, Ms. BROWN of Flor- H.R. 4258. 18 (relating to the power to make all laws ida, and Mr. RICHMOND. Congress has the power to enact this legis- necessary and proper for carrying out the H.R. 1710: Mr. CONYERS, Ms. BROWN of Flor- lation pursuant to the following: powers vested in Congress) ida, and Mr. RICHMOND.

VerDate Mar 15 2010 02:01 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00049 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.021 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE H2486 CONGRESSIONAL RECORD — HOUSE March 14, 2014

H.R. 1725: Mr. HASTINGS of Florida. H.R. 3978: Mr. SCOTT of Virginia and Ms. iel T. Kildee, John Conyers, Jr., Richard M. H.R. 1726: Mr. HUFFMAN and Mr. BERA of BROWNLEY of California. Nolan, Steven A. Horsford, Joe Courtney, California. H.R. 4031: Mr. LATHAM and Mr. NEUGE- Mark Pocan, Linda T. Sa´ nchez, Paul Tonko, H.R. 1738: Mr. BEN RAY LUJA´ N of New Mex- BAUER. Janice Hahn, Jim McDermott, Marc A. ico, Mr. CONYERS, Mr. LANGEVIN, Mr. MORAN, H.R. 4036: Mr. BISHOP of Utah. Veasey, Ann Kirkpatrick, Xavier Becerra, Mr. CLYBURN, Ms. SLAUGHTER, Ms. PINGREE H.R. 4040: Mr. GRAYSON. David Scott, Lois Capps, George Miller, Jose´ of Maine, Mr. PAYNE, Mr. JEFFRIES, Mr. H.R. 4042: Ms. JENKINS. E. Serrano, Alcee L. Hastings, Denny Heck, FARR, and Mr. GEORGE MILLER of California. H.R. 4048: Mr. JOHNSON of Georgia. Derek Kilmer, Suzan K. DelBene, Alan S. H.R. 1915: Mrs. CAROLYN B. MALONEY of H.R. 4060: Mr. PITTENGER and Mr. HECK of Lowenthal, Robin L. Kelly, Gregory W. New York. Nevada. Meeks, Doris O. Matsui, Susan A. Davis, H.R. 2012: Mr. HOLT. H.R. 4067: Mr. HUELSKAMP and Mr. DAINES. Henry C. ‘‘Hank’’ Johnson, Jr., Sean Patrick H.R. 2016: Mr. BLUMENAUER. H.R. 4068: Mr. BROUN of Georgia. Maloney, Carolyn B. Maloney, Joyce Beatty, H.R. 2028: Ms. BROWNLEY of California, Mr. H.R. 4069: Mr. AMODEI. Louise McIntosh Slaughter, Niki Tsongas, MURPHY of Florida, and Mr. BLUMENAUER. H.R. 4070: Mr. CONAWAY, Mr. LONG, and Mr. Tammy Duckworth, Timothy H. Bishop, H.R. 2143: Mr. KING of New York. BENTIVOLIO. H.R. 2240: Ms. NORTON. H.R. 4080: Mr. JOHNSON of Ohio. Hakeem S. Jeffries, Eric Swalwell, Julia H.R. 2328: Ms. BROWNLEY of California. H.R. 4092: Mr. KEATING. Brownley, Michelle Lujan Grisham, Dina H.R. 2377: Mr. Carson of Indiana, Mr. H.R. 4101: Mr. JONES and Mr. MCINTYRE. Titus, John B. Larson, Donna F. Edwards, DELANEY, Mr. GUTIE´ RREZ, and Mr. MCCARTHY H.R. 4102: Mr. COFFMAN. Betty McCollum, John Garamendi, Gene of California. H.R. 4103: Ms. SLAUGHTER. Green, Mark Takano, Mike Thompson, Lu- H.R. 2502: Mr. LOEBSACK. H.R. 4122: Mr. CICILLINE. cille Roybal-Allard, Jared Huffman, Kath- H.R. 2504: Ms. MCCOLLUM, Mr. HORSFORD, H.R. 4143: Mr. COTTON. erine M. Clark, Keith Ellison, Barbara Lee, Ms. EDWARDS, and Mr. KEATING. H.R. 4149: Mr. COLLINS of New York, Ms. Marcia L. Fudge, Cheri Bustos, Robert C. H.R. 2537: Mr. WESTMORELAND. NORTON, and Mr. JONES. ‘‘Bobby’’ Scott, Judy Chu, Elijah E. Cum- H.R. 2540: Ms. BORDALLO. H.R. 4158: Mr. LUETKEMEYER. mings, Donald M. Payne, Jr., Brian Higgins, H.R. 2548: Ms. HERRERA BEUTLER and Mr. H.R. 4163: Mr. FOSTER. Tony Ca´ rdenas, Yvette D. Clarke, Luis V. BARR. H.R. 4188: Mr. REICHERT. Gutie´rrez, James P. Moran, Michael F. H.R. 2654: Mr. GARAMENDI, Mr. CARNEY, and H.R. 4199: Mr. FARENTHOLD, Mr. HINOJOSA, Doyle, Juan Vargas, Steve Cohen, David N. Mr. KEATING. Mr. SAM JOHNSON of Texas, Mr. WILLIAMS, ROWN Cicilline, Al Green, Mike Quigley, Theodore H.R. 2690: Ms. B of Florida and Ms. Mr. CONAWAY, Mr. THORNBERRY, Mr. BRADY ANABUSA E. Deutch, Jim Cooper, John F. Tierney, H . of Texas, Mr. GOHMERT, Mr. BARTON, Mr. H.R. 2707: Mr. MCGOVERN. Frank Pallone, Jr., Bennie G. Thompson, CULBERSON, Mr. WEBER of Texas, Mr. HALL, H.R. 2745: Mr. POSEY. Joaquin Castro, William L. Enyart, Loretta Mr. CARTER, Mr. STOCKMAN, Mr. SMITH of H.R. 2772: Mr. SMITH of Texas. Sanchez, Corrine Brown, Suzanne Bonamici, Texas, Ms. GRANGER, Mr. NEUGEBAUER, Mr. H.R. 2841: Mr. NUGENT. Ann M. Kuster, James P. McGovern, Robert SESSIONS, Mr. DOGGETT, Mr. POE of Texas, H.R. 2901: Mr. VAN HOLLEN, Mr. LARSON of A. Brady, Peter A. DeFazio, Colleen W. Mr. CUELLAR, Mr. HENSARLING, Mr. OLSON, Connecticut, Mr. LEWIS, and Mr. KIND. Hanabusa, Danny K. Davis, Elizabeth H. Mr. BURGESS, Mr. AL GREEN of Texas, Mr. H.R. 2955: Mr. BLUMENAUER. Esty, Ben Ray Luja´ n, Jerry McNerney, Wil- CASTRO of Texas, Mr. VELA, Mr. VEASEY, Mr. H.R. 2957: Mr. GENE GREEN of Texas, Ms. liam L. Owens, Joseph P. Kennedy III, Albio GENE GREEN of Texas, Mr. GALLEGO, Ms. SINEMA, Ms. HANABUSA, Mrs. CHRISTENSEN, EDDIE BERNICE JOHNSON of Texas, Ms. JACK- Sires, Michael H. Michaud, Rush Holt, Bill and Ms. BORDALLO. Foster, Gloria Negrete McLeod, Rau´ l M. Gri- H.R. 2959: Mr. MURPHY of Pennsylvania and SON LEE, Mr. MCCAUL, and Mr. MARCHANT. H.R. 4210: Ms. BONAMICI. jalva, Patrick Murphy, Chris Van Hollen, G. Mr. GOHMERT. K. Butterfield, John C. Carney, Jr., David H.R. 2996: Mr. LUETKEMEYER. H.R. 4213: Mr. LATHAM and Mr. MICHAUD. Loebsack, Bill Pascrell, Jr., Brad Sherman, H.R. 3069: Ms. BROWNLEY of California. H.R. 4225: Mrs. NOEM, Mrs. ELLMERS, and Gerald E. Connolly, Anna G. Eshoo, Ed Pas- H.R. 3090: Ms. MATSUI and Mr. HONDA. Mr. WOLF. H.R. 3133: Mr. SMITH of Texas. H.R. 4228: Mr. HUDSON and Ms. JACKSON tor, Kyrsten Sinema, Stephen F. Lynch, H.R. 3135: Mr. SCHRADER and Mr. BLU- LEE. Allyson Y. Schwartz, Ami Bera, James A. MENAUER. H.R. 4229: Mr. SMITH of New Jersey, Ms. Himes, Henry A. Waxman, Nita M. Lowey, H.R. 3150: Mr. FARR. WILSON of Florida, and Mr. MURPHY of Flor- John A. Yarmuth, Rick Larsen, Daniel B. H.R. 3211: Mr. MARCHANT. ida. Maffei, Timothy J. Walz, John Lewis, Bruce H.R. 3240: Mr. COSTA. H.R. 4240: Mr. PASTOR of Arizona and Mr. L. Braley, Jared Polis, John P. Sarbanes, H.R. 3335: Mr. COBLE. JOHNSON of Georgia. Scott H. Peters, William R. Keating, Karen H.R. 3383: Mr. BLUMENAUER and Mr. PETERS H.J. Res. 50: Mr. MARINO. Bass, Frederica S. Wilson, Michael E. Capu- of California. H. Res. 412: Mr. FARENTHOLD and Mr. ano, Carolyn McCarthy, Nick J. Rahall II, H.R. 3435: Mr. JOHNSON of Georgia. MCGOVERN. Wm. Lacy Clay, Eliot L. Engel, John K. H.R. 3449: Mr. KILMER. H. Res. 418: Mr. TIERNEY and Mr. PETERS of Delaney, Bobby L. Rush, Ron Barber, Jackie H.R. 3461: Mrs. MCCARTHY of New York. California. Speier, Diana DeGette, , Maxine H.R. 3471: Mr. PASTOR of Arizona. H. Res. 476: Mr. BROOKS of Alabama. Waters, Chaka Fattah, James R. Langevin, H.R. 3531: Mr. TURNER. H. Res. 482: Ms. LOFGREN. Gary C. Peters, Ron Kind, Kathy Castor, H.R. 3556: Mr. WHITFIELD. H. Res. 484: Ms. BONAMICI and Mr. PETERS Carol Shea-Porter, Matt Cartwright, Lloyd H.R. 3658: Mr. SALMON, Mr. COOK, Mr. of California. Doggett, Daniel Lipinski, Beto O’Rourke, DESANTIS, Mrs. WALORSKI, Mr. PITTENGER, H. Res. 494: Mr. SESSIONS, Mr. KEATING, Mr. Cedric L. Richmond, Rosa L. DeLauro, Grace Mr. HOLDING, Mr. WENSTRUP, Mr. MULLIN, CICILLINE, Mr. DEUTCH, Ms. JACKSON LEE, Mr. Meng, Michael M. Honda, Earl Blumenauer, Mr. BARTON, Mr. SESSIONS, Mr. POE of Texas, POE of Texas, Mr. CARTER, Mr. DUNCAN of Alan Grayson, Andre´ Carson, Grace F. and Mr. TURNER. Tennessee, Mr. COBLE, and Mr. STOCKMAN. Napolitano, Joe Garcia, Filemon Vela, Henry H.R. 3673: Mr. CLAY and Mr. WILSON of H. Res. 503: Mr. CICILLINE and Ms. LEE of South Carolina. California. Cuellar, Lois Frankel, Chellie Pingree, H.R. 3714: Mr. BENTIVOLIO. H. Res. 505: Mr. GRIFFIN of Arkansas. Debbie Wasserman Schultz, Nancy Pelosi, H.R. 3717: Ms. BROWN of Florida, Mr. HAS- H. Res. 507: Mr. BUTTERFIELD, Mr. MCGOV- Peter Welch, Ed Perlmutter, C. A. Dutch TINGS of Florida, and Mr. WILSON of South ERN, Mr. BERA of California, Ms. HANABUSA, Ruppersberger, Jerrold Nadler, Emanuel Carolina. Mr. SERRANO, Mr. COSTA, and Mr. MCNERNEY. Cleaver, Tulsi Gabbard, David E. Price, Raul H.R. 3728: Mrs. ELLMERS and Mr. NUGENT. H. Res. 519: Mr. CLAY. Ruiz, Tim Ryan, Jim Costa, Richard E. Neal, Gwen Moore, Steve Israel, and Charles B. H.R. 3740: Ms. LEE of California, Ms. f MOORE, Ms. CLARKE of New York, Ms. PIN- Rangel. GREE of Maine, Mr. DOGGETT, Ms. SPEIER, Ms. DISCHARGE PETITIONS ESHOO and Ms. MCCOLLUM. Under clause 2 of rule XV, the fol- f H.R. 3761: Mr. LATTA. H.R. 3776: Mr. HUIZENGA of Michigan. lowing discharge petition was filed: H.R. 3784: Mr. COOK, Mr. ROE of Tennessee, Petition 8, March 12, 2014, by Mr. BRAD- DISCHARGE PETITIONS— Mr. SCHWEIKERT, Mr. GINGREY of Georgia, LEY S. SCHNEIDER on House Resolution ADDITIONS OR DELETIONS and Mr. BENTIVOLIO. 490, was signed by the following Members: H.R. 3859: Mr. CA´ RDENAS, Mr. CARTWRIGHT, Bradley S. Schneider, Steny H. Hoyer, James The following Members added their Ms. CHU, Mr. GRIJALVA, Mr. HANNA, and Mr. E. Clyburn, Sam Farr, Sanford D. Bishop, names to the following discharge peti- POCAN. Jr., Joseph Crowley, Terri A. Sewell, Eddie tion: H.R. 3916: Mr. WELCH. Bernice Johnson, Adam B. Schiff, Sander M. H.R. 3929: Mr. GUTIE´ RREZ. Levin, Sheila Jackson Lee, Nydia M. Petition 7 by Mr. BISHOP of New York, on H.R. 3970: Mr. GRIJALVA and Mr. GEORGE Vela´ zquez, Rube´n Hinojosa, Zoe Lofgren, the bill (H.R. 1010): Carolyn McCarthy, John MILLER of California. Janice D. Schakowsky, Marcy Kaptur, Dan- Barrow, and Ed Pastor.

VerDate Mar 15 2010 02:05 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00050 Fmt 4634 Sfmt 0634 E:\CR\FM\A14MR7.025 H14MRPT1 smartinez on DSK6TPTVN1PROD with HOUSE E PL UR UM IB N U U S Congressional Record United States th of America PROCEEDINGS AND DEBATES OF THE 113 CONGRESS, SECOND SESSION

Vol. 160 WASHINGTON, FRIDAY, MARCH 14, 2014 No. 43 Senate The Senate met at 10:31 and 14 sec- The bill clerk read the following let- Mr. KING thereupon assumed the onds a.m., and was called to order by ter. chair as Acting President pro tempore. the Honorable ANGUS S. KING, a Sen- U.S. SENATE, f ator from the State of Maine. PRESIDENT PRO TEMPORE, Washington, DC, March 14, 2014. ADJOURNMENT UNTIL TUESDAY, f To the Senate: MARCH 18, 2014, AT 10:30 A.M. Under the provisions of rule I, paragraph 3, The ACTING PRESIDENT pro tem- APPOINTMENT OF ACTING of the Standing Rules of the Senate, I hereby pore. Under the previous order, the PRESIDENT PRO TEMPORE appoint the Honorable ANGUS S. KING, a Sen- Senate stands adjourned until Tuesday, The PRESIDING OFFICER. The ator from the State of Maine, to perform the March 18, 2014, at 10:30 a.m. clerk will please read a communication duties of the Chair. Thereupon, the Senate, at 10:31 and 42 to the Senate from the President pro PATRICK J. LEAHY, seconds a.m., adjourned until Tuesday, President pro tempore. tempore (Mr. LEAHY). March 18, 2014, at 10:30 a.m.

∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor.

S1671

.

VerDate Mar 15 2010 23:37 Mar 14, 2014 Jkt 039060 PO 00000 Frm 00001 Fmt 4624 Sfmt 0634 E:\CR\FM\A14MR6.000 S14MRPT1 rfrederick on DSK6VPTVN1PROD with SENATE March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E385 EXTENSIONS OF REMARKS

MCKINNLEY BARTELS States of America (GSUSA). On March 12th, family Godspeed as they begin this new chap- 102 years ago, Juliette Gordon Low held the ter in their respective lives, confident in the HON. ED PERLMUTTER first Girl Scout meeting with the vision of em- understanding and knowledge of the love and OF COLORADO powering women through service, education, support of their late patriarch. May he rest in and community. The Girl Scouts have contin- peace. IN THE HOUSE OF REPRESENTATIVES ued to build on their decorated legacy by in- f Friday, March 14, 2014 stilling their values into the young women who Mr. PERLMUTTER. Mr. Speaker, I rise will grow up to be the leaders and thinkers of A TRIBUTE TO CHERYL DAVIS— today to recognize and applaud McKinnley future generations. 28TH CONGRESSIONAL DISTRICT Bartels for receiving the Arvada Wheat Ridge For over a century, the GSUSA has suc- WOMAN OF THE YEAR Service Ambassadors for Youth award. cessfully spread the principles of egali- McKinnley Bartels is an 8th grader at Everitt tarianism through its leading role in the wom- HON. ADAM B. SCHIFF Middle School and received this award be- en’s movement. The GSUSA has been at the OF CALIFORNIA cause her determination and hard work have forefront of many social justice movements as IN THE HOUSE OF REPRESENTATIVES a result of its longstanding commitment to di- allowed her to overcome adversities. Friday, March 14, 2014 The dedication demonstrated by McKinnley versity and inclusion. Recently, they joined Bartels is exemplary of the type of achieve- with other leaders to call attention to unfair Mr. SCHIFF. Mr. Speaker, I rise today in ment that can be attained with hard work and double standards and stereotypes of women honor of Women’s History Month. Each year, perseverance. It is essential students at all in leadership roles by launching the ‘‘Ban we pay special tribute to the contributions and levels strive to make the most of their edu- Bossy’’ campaign. I applaud the GSUSA for sacrifices made by our nation’s women. It is cation and develop a work ethic which will highlighting the workplace in this regard, and an honor to pay homage to outstanding guide them for the rest of their lives. for demanding equality in all areas of society. women who are making a difference in my I extend my deepest congratulations to The 18-member organization that Juliette Congressional District. I would like to recog- McKinnley Bartels for winning the Arvada Gordon Low started in 1912 has seen partici- nize a remarkable woman, Cheryl Davis of La Wheat Ridge Service Ambassadors for Youth pation of over 60 million women, including 2.3 Crescenta. award. I have no doubt she will exhibit the million current active members. I thank the Ms. Davis was raised in San Jose and same dedication and character in all of her fu- GSUSA for all its active involvement in Wash- moved to Southern California to attend the ture accomplishments. ington’s 7th district and communities through- University of California, , where f out America. I am proud to take part in Girl she earned her Bachelor of Science in Bio- Scout Day, and I wish the GSUSA continued chemistry. Currently, Ms. Davis is a Law Firm RECOGNIZING THE WINTER GAR- success for years to come. Administrator at Bradley & Gmelich in Glen- DEN, TAVARES AND GULF RAIL- f dale. ROAD DEPOT Ms. Davis is very active in her community. HONORING THE LIFE OF MR. She served as President of the Crescenta Val- HON. DANIEL WEBSTER SHIRLEY QUICK ley Town Council for four years, and now OF FLORIDA serves as the Corresponding Secretary. Ms. IN THE HOUSE OF REPRESENTATIVES HON. BRIAN HIGGINS Davis is the current coordinator for the OF NEW YORK Montrose-Glendale Christmas Parade, Treas- Friday, March 14, 2014 IN THE HOUSE OF REPRESENTATIVES urer for Prom Plus and the CV Fireworks As- Mr. WEBSTER of Florida. Mr. Speaker, I am sociation, and Secretary for the Glendale Edu- Friday, March 14, 2014 pleased to recognize Winter Garden, Tavares cational Foundation—Summer School. In addi- and Gulf Railroad Depot on the occasion of its Mr. HIGGINS. Mr. Speaker, I rise today to tion, Ms. Davis is a member of CV DOGS, the 100th anniversary. honor the life of Shirley Kenneth Quick, who volunteer group responsible for establishing The railroad station, built in 1913, was pur- regrettably passed away on March 9, 2014. the first Los Angeles County operated dog chased in 1973 for one dollar by the Central A lifelong resident of Western New York, park at Crescenta Valley Park. Ms. Davis is Florida chapter of the National Railway Histor- Mr. Quick was the husband of the late Cath- also an avid volunteer at the Fire House Youth ical Society. Located in the historic Tavares erine Mack, and was a beloved father to his Center. and Gulf Railroad depot, the Central Florida son Kevin, daughter Karen, and their respec- Ms. Davis and her husband Mark have one Railroad Museum opened in 1983. Through tive spouses Carol and Bill. A grandfather of daughter, Katie, who is a student at Crescenta partnership with the Winter Garden Heritage six, Mr. Quick is also survived by a brother Valley High School. Foundation, extensive private collections of and a sister. I ask all Members to join me in honoring an local, state and national memorabilia have Through my association with others who exceptional woman of California’s 28th Con- been made accessible to the public. knew him well, the word I consistently hear in gressional District, Cheryl Davis. I commend the Winter Garden, Tavares and description of him is ‘‘gentleman.’’ A loving f Gulf Railroad Depot for their preservation of and devoted husband and father, good me- the rich history of Central Florida’s railways. chanically with his hands and patient and kind NICOLE AHRENS f with his words, Mr. Quick was a stalwart resi- dent of neighborhoods in the Black Rock/Riv- HON. ED PERLMUTTER HONORING GIRL SCOUTS OF THE erside neighborhoods of Buffalo and, in his OF COLORADO U.S.A ON THE ANNIVERSARY OF later years, in the town of Hamburg. IN THE HOUSE OF REPRESENTATIVES THEIR FOUNDING Though I did not have the fortune of know- ing Mr. Quick well, I am very well acquainted Friday, March 14, 2014 HON. JIM McDERMOTT with his son and daughter in law, Kevin and Mr. PERLMUTTER. Mr. Speaker, I rise OF WASHINGTON Carol Quick of the town of Tonawanda. Kevin today to recognize and applaud Nicole Ahrens IN THE HOUSE OF REPRESENTATIVES and Carol were devoted children to Mr. Quick for receiving the Arvada Wheat Ridge Service and this loss must surely hit them, and their Ambassadors for Youth award. Nicole Ahrens Friday, March 14, 2014 entire family, very hard. I am honored, Mr. is an 8th grader at Drake Middle School and Mr. MCDERMOTT. Mr. Speaker, I rise today Speaker, to have this opportunity to celebrate received this award because her determination to commemorate Girl Scout Day, the anniver- Mr. Quick’s life with you and with our col- and hard work have allowed her to overcome sary of founding of Girl Scouts of the United leagues in the House, and to wish the Quick adversities.

∑ This ‘‘bullet’’ symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor. Matter set in this typeface indicates words inserted or appended, rather than spoken, by a Member of the House on the floor.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00001 Fmt 0626 Sfmt 9920 E:\CR\FM\K14MR8.027 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E386 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 The dedication demonstrated by Nicole During a recent tour of the Bell Flavors & helped shape the vibrant, thematic program- Ahrens is exemplary of the type of achieve- Fragrances facility, I was struck by the pas- ming that SIG audiences have come to ex- ment that can be attained with hard work and sion and dedication to excellence of all the pect. Ms. Ferris also developed SIG’s pre-con- perseverance. It is essential students at all managers and employees I met and truly im- cert child/parent activities to introduce children levels strive to make the most of their edu- pressed by the outstanding commitment to re- to basic musical concepts such as how to play cation and develop a work ethic which will search and development. notes, how to conduct an orchestra, and how guide them for the rest of their lives. Despite its global footprint, Bell Flavors & to recognize different instruments in the or- I extend my deepest congratulations to Ni- Fragrances remains a truly American success chestra. cole Ahrens for winning the Arvada Wheat story, embedded in the community, employing Through her work organizing free concerts Ridge Service Ambassadors for Youth award. hundreds and working to enrich the area it with Symphony In The Glen, Ms. Ferris has I have no doubt she will exhibit the same dedi- calls home. been instrumental in fulfilling the organization’s cation and character in all of her future ac- Family-owned and operated companies like mission of cultivating new generations of clas- complishments. Bell Flavors & Fragrances, rooted deeply in sical music enthusiasts. Concerts were held at f the community, are the foundation of the the Old Zoo at Griffith Park, on the lawn of the Tenth District’s strength. I am proud that inno- Griffith Observatory, and at the Los Angeles HONORING THE BONHAM POST OF- vative, growing companies like Bell Flavors & Zoo. This year Symphony In The Glen also FICE ON ITS 100TH ANNIVER- Fragrances call the Tenth District home. coordinated the fourth annual ‘‘EEK! at The SARY f Greek,’’ a community Halloween celebration held in collaboration with the Greek Theatre HON. RALPH M. HALL HONORING BYRON MEADOR and Nederlander Concerts. OF TEXAS In addition to her work at SIG, Ms. Ferris is IN THE HOUSE OF REPRESENTATIVES HON. SAM GRAVES also an avid participant in civic life. She has long been involved with the Los Feliz Neigh- Friday, March 14, 2014 OF MISSOURI borhood Council and served a four-year term IN THE HOUSE OF REPRESENTATIVES Mr. HALL. Mr. Speaker, I rise today in honor as Vice President of Administration. In 2011, of the Bonham Post Office, an historic building Friday, March 14, 2014 Ms. Ferris was elected to the Board of the Los that has been an integral part of the Bonham Mr. GRAVES of Missouri. Mr. Speaker, I Feliz Improvement Association, which is the community. proudly pause to recognize Byron Meador. oldest residents’ association in Los Angeles. The Bonham Post Office, which celebrates Byron is a very special young man who has I ask all Members to join me in honoring an its 100th year in March 2014, is a historical exemplified the finest qualities of citizenship exceptional woman of California’s 28th Con- building of which the residents of Bonham are and leadership by taking an active part in the gressional District, Barbara Ferris. proud. Although the interior of the building has Boy Scouts of America, Troop 135, and earn- f been altered to accommodate changing times, ing the most prestigious award of Eagle Scout. the beautiful exterior of the building with gran- ROMAINE AKAKPO Byron has been very active with his troop, ite, large columns and stone remain today. At participating in many scout activities. Over the the time the Bonham Post Office was built, HON. ED PERLMUTTER many years Byron has been involved with top-of-the-line materials were used to make it OF COLORADO scouting, he has not only earned numerous what many thought was the best looking build- IN THE HOUSE OF REPRESENTATIVES merit badges, but also the respect of his fam- ing in the state of Texas. Prior to the building’s ily, peers, and community. Most notably, Friday, March 14, 2014 opening as a working post office, it is esti- Byron has contributed to his community Mr. PERLMUTTER. Mr. Speaker, I rise mated one thousand people visited the new through his Eagle Scout project. Byron con- today to recognize and applaud Romaine building, which exemplifies the significance of structed a set of stairs to the outdoor class- Akakpo for receiving the Arvada Wheat Ridge the grand opening in 1914. The building is a room at Hawthorne Elementary School in Service Ambassadors for Youth award. Ro- reminder of the proud history of Bonham and Kearney, Missouri. maine Akakpo is a 12th grader at Standley Fannin County. Mr. Speaker, I proudly ask you to join me in Lake High School and received this award be- Mr. Speaker, it is my privilege to congratu- commending Byron Meador for his accom- cause her determination and hard work have late the Bonham Post Office on 100 years of plishments with the Boy Scouts of America allowed her to overcome adversities. achievement. I ask my colleagues to join me and for his efforts put forth in achieving the The dedication demonstrated by Romaine in celebrating this important milestone. highest distinction of Eagle Scout. Akakpo is exemplary of the type of achieve- f f ment that can be attained with hard work and HONORING BELL FLAVORS & FRA- perseverance. It is essential students at all GRANCES FOR BEING THE TOP A TRIBUTE TO BARBARA FERRIS— levels strive to make the most of their edu- EXPORTER IN ILLINOIS’ TENTH 28TH CONGRESSIONAL DISTRICT cation and develop a work ethic which will DISTRICT WOMAN OF THE YEAR guide them for the rest of their lives. I extend my deepest congratulations to Ro- HON. ADAM B. SCHIFF maine Akakpo for winning the Arvada Wheat HON. BRADLEY S. SCHNEIDER Ridge Service Ambassadors for Youth award. OF CALIFORNIA OF ILLINOIS I have no doubt she will exhibit the same dedi- IN THE HOUSE OF REPRESENTATIVES IN THE HOUSE OF REPRESENTATIVES cation and character in all of her future ac- Friday, March 14, 2014 Friday, March 14, 2014 complishments. Mr. SCHNEIDER. Mr. Speaker, I am Mr. SCHIFF. Mr. Speaker, I rise today in f pleased to rise today to honor Bell Flavors & honor of Women’s History Month. Each year, IN RECOGNITION OF REVERENDS Fragrances in Northbrook, Illinois (part of the we pay special tribute to the contributions and CLIVE AND RUTH KNIGHTS ON suburban Chicago district I represent) for sacrifices made by our nation’s women. It is THE OCCASION OF ATTAINING being the top exporter in the Congressional an honor to pay homage to outstanding AMERICAN CITIZENSHIP district. women who are making a difference in my After more than 100 years of providing inno- Congressional District. I would like to recog- HON. JEFF MILLER vative and unique flavor services, Bell Flavors nize a remarkable woman, Barbara Ferris of OF FLORIDA & Fragrances today is a global leader in the Los Feliz. IN THE HOUSE OF REPRESENTATIVES field and an example of true success in the Ms. Ferris is the Managing Director of Sym- 21st Century global marketplace. A family- phony In The Glen (SIG), which she co-found- Friday, March 14, 2014 owned company, Bell Flavors & Fragrances ed in 1994 with Arthur B. Rubinstein, a re- Mr. MILLER of Florida. Mr. Speaker, I rise has achieved tremendous success in the food, nowned film and television composer. Since today to recognize two of our country’s newest hygiene, fragrance and many more industries. the organization’s founding, Ms. Ferris has citizens, Reverends Clive and Ruth Knights. Bell Flavors & Fragrances constantly re- fostered cooperative relationships with city For over ten years, Clive and Ruth have been imagines and reinvents its approach and prod- agencies, managed the organization’s fi- an integral part of the Northwest Florida com- ucts, ensuring its ability to enter new markets nances, spearheaded fundraising efforts, and munity, and I am pleased to congratulate them and find success all around the globe. reviewed the day-to-day operations that on their attaining U.S. Citizenship.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00002 Fmt 0626 Sfmt 9920 E:\CR\FM\K14MR8.028 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E387 Clive and Ruth were both born and raised in He graduated from Panther Valley High courageous wife, who has testified before the the United Kingdom. Reverend Clive Knights School in 1999, where he was named the Tom Lantos Human Rights Commission, filed was educated at Edgware School, followed by ‘‘Most Persistent Student.’’ Bobby went on to a complaint to the United Nations, urging it to North London and Salford Universities. He Lehigh County Community College, where he conduct an investigation into his whereabouts. then received ministerial training from St. Al- earned his associate’s degree as a Computer I have ‘‘adopted’’ Gao through the Defend- ban’s Diocese at Stevenage and Madingly Specialist with a concentration in Web Devel- ing Freedoms Project, an initiative of the Lan- Hall, Cambridge University, commencing his opment. After college, Bobby began designing tos Commission, launched in conjunction with Anglican ministry on St. Matthew’s Day, Sep- websites for S & O Computers, LLC. In 2010, the U.S. Commission on International Reli- tember 21, 1987. Reverend Ruth Knights, the he established his own web design business. gious Freedom and Amnesty International. I daughter of a reverend, received her higher To date, Bobby’s company has designed and am committed to continuing work towards the education at Southlands Teacher Training Col- maintained 19 websites for local government day when he can breathe the fresh air of free- lege and Birmingham University, where she offices and small businesses. dom. I echo the sentiments of Mr. Genser, majored in Divinity and Theology. Following Since he was a teenager, Bobby has volun- who concluded in the Journal piece, ‘‘It is time graduation, Ruth taught Religious Studies in teered his time to keep his community safe as to reunite Gao Zhisheng with his family. He high school and became head of a religious a member of the volunteer Diligence Fire and his loved ones have suffered long studies department. Company No. 1 in Summit Hill, Pennsylvania. enough.’’ In 2003, the Lord called Reverends Clive After joining in 1994, he is now a senior mem- DEMANDING JUSTICE FOR GAO ZHISHENG and Ruth Knights to come to the United ber, auditor and trustee of the Fire Company, (By Jared Genser) States. The Knights settled in Northwest Flor- and he contributes his technological expertise Gao Zhisheng, one of China’s most promi- ida, where Reverend Clive Knights became to designing and maintaining the Fire Com- nent and courageous human-rights lawyers Senior Pastor at Chumuckla Community pany’s web page. and prisoners of conscience, has again dis- Church. Reverend Ruth Knights also helped Although cerebral palsy prevents him from appeared into the bowels of the Chinese serve the community’s religious needs when walking and speaking on his own, Bobby is in- state’s security system. For more than a she joined the staff at Gulf Breeze United volved with many outreach programs to year, his family has desperately tried to ac- cess him in Shaya prison in Xinjiang, a re- Methodist Church, where she currently serves spread awareness about disabilities. In 1998, mote province in western China. But all as an Associate Pastor. After nearly a decade he started speaking via the assistance of tech- these efforts have been rebuffed and no one at Chumuckla Community Church, Reverend nology at the Pittsburgh Employment con- has seen or heard from him since January Clive Knights moved to Bagdad United Meth- ference, hosted for speech pathologists and 2013. In response to Mr. Gao’s most recent odist Church, where he is the Senior Pastor. individuals with all kinds of disabilities who use disappearance, his wife on Thursday in Gene- As former President Theodore Roosevelt augmentative communication technologies. va filed a complaint to the United Nations, said, ‘‘Free institutions rest upon the character Bobby was selected in 2007 to receive the urging it to conduct an investigation into of citizenship.’’ Reverends Clive and Ruth Edwin and Ester Prentke AAC Distinguished his whereabouts. A self-taught advocate and legal rights de- Knights exemplify the high character, leader- Lecture Award in Boston, an award presented fender, Mr. Gao was once recognized among ship, and faith that have been the hallmarks of annually to a community activist who uses a the country’s top 10 lawyers by China’s Min- so many great American citizens. On behalf of communication device. He was asked to give istry of Justice. Yet his advocacy for the the entire , my wife a speech at a Massachusetts conference enti- country’s most vulnerable, including factory Vicki and I congratulate Clive and Ruth and tled ‘‘My Life with Assistive Technology and workers, coal miners, victims of land sei- welcome them as fellow citizens of this great Community Interactions.’’ Bobby is also a par- zures, and persecuted Christians and Falun Nation. ticipant of ‘‘Through Their Eyes’’ conference at Gong practitioners, led the authorities to East Stroudsburg University, where he has ad- target Mr. Gao and his family with threats f and intimidation starting in 2005. He has dressed students majoring Speech Pathology. PERSONAL EXPLANATION been in and out of prisons and subject to dis- He is also an ambassador for Prentke Romich appearances and torture for nearly a decade. Company, increasing knowledge across Penn- Officials closed his law firm, disbarred him HON. ZOE LOFGREN sylvania about the assistive technology that and placed his wife, Geng He, and their OF CALIFORNIA helps him communicate. young children under 24-hour surveillance. IN THE HOUSE OF REPRESENTATIVES Bobby O’Gurek’s work throughout his life Police stationed inside the family’s home re- Friday, March 14, 2014 has made his community a safer and brighter peatedly harassed them. In school, the chil- place. His perseverance in overcoming cere- dren were taunted and put under constant Ms. LOFGREN. Mr. Speaker, I would like to watch by the police—even when using the state that on March 4, 2014, I would have bral palsy to get his education and start his restroom. Because of this unbearable treat- voted in favor of H. Res. 488, supporting the own business, his willingness to devote his ment, Geng He and her children fled China people of Venezuela as they protest peace- time and technological skills to serve the Pan- and have since been granted asylum in the fully for democracy, a reduction in violent ther Valley, and his refusal to let his disability United States. crime and calling for an end to recent vio- prevent him from achieving his goals are noth- Mr. Gao’s family is safe now, but he re- mains in danger. In 2006, he made a coerced lence. I am pleased that this resolution ex- ing short of inspirational. I congratulate Bobby O’Gurek on his years of service to his commu- confession to ‘‘inciting subversion’’ and was pressing support for basic human rights given a suspended three-year prison term. In passed the House decisively. nity and wish him many more. 2007, Chinese officials tortured him by shock- f f ing him with electric batons, holding lit cigarettes up to his eyes, and piercing his IN RECOGNITION OF BOBBY DEMANDING JUSTICE FOR GAO genitals with toothpicks. On other occasions, O’GUREK, RECIPIENT OF THE ZHISHENG they put him in restraints and beat him re- PANTHER VALLEY IRISH AMERI- peatedly with handguns. In 2009 and 2010, po- CANS ASSOCIATION SHAMROCK HON. FRANK R. WOLF lice disappeared Mr. Gao and tortured him AWARD OF VIRGINIA further. In December 2011, just before the expira- IN THE HOUSE OF REPRESENTATIVES tion of his suspended sentence and after 20 HON. MATT CARTWRIGHT Friday, March 14, 2014 months of having been held in unknown loca- OF PENNSYLVANIA tions, the Xinhua news agency announced Mr. WOLF. Mr. Speaker, I submit a piece IN THE HOUSE OF REPRESENTATIVES that Mr. Gao would be imprisoned for the re- published in the Wall Street Journal on Feb- Friday, March 14, 2014 mainder of his original sentence. Since then, ruary 27 highlighting the latest disappearance family members have been allowed to visit Mr. CARTWRIGHT. Mr. Speaker, I rise into the Chinese security system of the promi- him only twice for half an hour on each occa- today in honor of Bobby O’Gurek, who on nent human rights defender Gao Zhisheng. It sion. Although scheduled for release on Aug. March 17, 2014 will receive the Shamrock is deeply alarming that Mr. Gao has been in 22, he has now disappeared once again, leav- Award from the Panther Valley Irish Ameri- and out of the Chinese prisons, disappeared, ing his family with renewed and urgent ques- tions about his health and safety. cans Association. Bobby was born on St. Pat- and tortured for almost a decade now. As the Mr. Gao’s imprisonment, torture and dis- rick’s Day in 1982, to Robert and Patricia op-ed piece by Jared Genser, Gao’s pro bono appearances have brought tremendous suf- O’Gurek. He has lived with cerebral palsy legal counsel, notes, ‘‘. . . no one has seen fering to him and his family. In testifying re- since birth, and become an indispensable part or heard from him since January 2013.’’ Fol- cently before the U.S. House Committee on of his community. lowing his most recent disappearance, Gao’s Foreign Affairs, Mr. Gao’s daughter Grace

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00003 Fmt 0626 Sfmt 0634 E:\CR\FM\K14MR8.024 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E388 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 reflected on her family’s insurmountable ing this time, the Coulombes moved to San CELEBRATING THE 125TH ANNI- pain and loneliness. ‘‘I believe that when we Marino, where they raised their three children, VERSARY OF THE MARKET speak out for my father . . . we protect our STREET MISSION own freedom and values,’’ she said. Joe, Charlotte and Madeleine, and eventually Despite Mr. Gao’s latest disappearance, it moved to Pasadena in 1983. is hoped he is managing to endure. But hope A community volunteer for over forty years, HON. RODNEY P. FRELINGHUYSEN must be accompanied by action and it is OF NEW JERSEY Ms. Coulombe is a passionate advocate for more urgent than ever that China not be al- IN THE HOUSE OF REPRESENTATIVES the arts and arts education. She was a found- lowed to disappear Gao Zhisheng again with Friday, March 14, 2014 impunity. ing member and former Chair of the Pasadena On Thursday, his wife lodged a complaint Arts Commission, a member of the City of Mr. FRELINGHUYSEN. Mr. Speaker, I rise with the U.N. Working Group on Enforced Pasadena’s Centennial Committee, and a do- today to honor the Market Street Mission lo- and Involuntary Disappearances, a body of cated in Morris County, New Jersey, as it cent at the Huntington Library, Art Collections the Human Rights Council. The submission celebrates its 125th Anniversary. notes that Mr. Gao’s family is ‘‘distraught and Botanical Gardens for thirty-five years, The Market Street Mission ministers to because they have no idea whether he is even where she helped design its school tours of those who suffer in the battle against alco- alive.’’ It goes on to emphasize the Chinese the Japanese Garden. As a volunteer at the government is violating its own laws allow- holism, drug abuse, and homelessness in the ing for regular family visits, written cor- Music Center of Los Angeles for three dec- northern New Jersey area. The Mission pro- respondence, and access to counsel. ades, Ms. Coulombe served as Chair of Music vides its ministries through physical, emo- Ms. Geng hopes the Working Group will Center Presentations and Coordinator of Vol- tional, and spiritual support that will guide urge the Chinese government to conduct an unteer Activities. those who suffer toward responsible and pro- investigation into Mr. Gao’s disappearance. ductive lives. Although the process itself can take many Ms. Coulombe’s special love is opera, and Established in 1889 by the Reverend Dr. months, the Working Group has a good his- to that end, she was founding president of the F.W. Owen and his wife, Mrs. Louisa Graves tory of receiving specific replies from the Music Center Opera League, as well as one of Chinese government to its concerns. In addi- Owen, the Market Street Mission began as a tion, merely by highlighting Mr. Gao’s dis- the founders of the Los Angeles Opera Com- residential program for alcoholic husbands in appearance publicly and triggering a U.N. in- pany, where she currently serves on its board. the Morristown area. With support from the quiry, his family has put intense pressure on For the past nine years, she has served on South Street Presbyterian Church, the Mission the Chinese government to respond. While the Colburn School Board of Directors as a provided meals, lodging, clothing, and tem- this alone is a helpful step forward, much member of their Governance Committee and porary employment for homeless men. more needs to be done. Throughout its first decade, the Mission start- The international community, including as Chair of the Board Relations Committee. the United States and United Nations, must Additionally, she is President of Metropolitan ed support meetings and programs for the demand proof from the Chinese government homeless and drug addicted. Associates, a local non-profit that raises funds In 1926, a series of explosions at the that Mr. Gao is alive and insist that his fam- to support the arts for children. For her self- ily be granted monthly access to him as is Picatinny Arsenal left many families homeless required by Chinese law. The world must less service to supporting the arts, Ms. and without food or clothes. The Mission was urge Mr. Gao’s immediate and unconditional Coulombe received the YWCA Pasadena- able to help these displaced families by pro- release. Foothill Valley’s Woman of Distinction Award viding them with shelter and other basic ne- At a minimum, foreign leaders should and has been honored by the Los Angeles cessities. press Beijing to release Mr. Gao on time in- During the Great Depression, the Market stead of finding renewed excuses to extend Master Chorale. Street Mission ended its affiliation with the his detention, as it has done in other cases. I ask all Members to join me in honoring an Presbyterian Church and added the ‘‘Industrial Washington must also exert pressure on the exceptional woman of California’s 28th Con- Chinese government to confirm that Mr. Gao Department,’’ a self-supporting thrift store that will be provided a Chinese passport and the gressional District, Alice Steere Coulombe. provided jobs during difficult economic times. ability to travel to America upon his release. Today, residents of the Mission continue to It is time to reunite Gao Zhisheng with his f work at the Industrial Department as part of family. He and his loved ones have suffered the successful ‘‘New Reality of Recovery’’ pro- long enough. SABRINA HILL gram, as well as attend chapel and classes. f The Market Street Mission has added an A TRIBUTE TO ALICE STEERE HON. ED PERLMUTTER Emergency Assistance program that provides COULOMBE—28TH CONGRES- meals and lodging for disadvantaged men, SIONAL DISTRICT WOMAN OF OF COLORADO women, and children. In addition to its growing THE YEAR development thoughout the years, the Mission IN THE HOUSE OF REPRESENTATIVES continues to focus on alcohol and drug treat- Friday, March 14, 2014 ment programs, incorporating new treatments HON. ADAM B. SCHIFF each year. OF CALIFORNIA Mr. PERLMUTTER. Mr. Speaker, I rise The Market Street Mission is proud to cele- IN THE HOUSE OF REPRESENTATIVES today to recognize and applaud Sabrina Hill brate its history and looks forward to its con- Friday, March 14, 2014 for receiving the Arvada Wheat Ridge Service tinuous growth in the future. Mr. Speaker, I urge you and my colleagues Mr. SCHIFF. Mr. Speaker, I rise today in Ambassadors for Youth award. Sabrina Hill is to join me in congratulating the Market Street honor of Women’s History Month. Each year, an 8th grader at Everitt Middle School and re- Mission and their dedicated employees as we pay special tribute to the contributions and ceived this award because her determination they celebrate 125 years of serving the north- sacrifices made by our nation’s women. It is and hard work have allowed her to overcome ern New Jersey community. an honor to pay homage to outstanding adversities. women who are making a difference in my f Congressional District. I would like to recog- The dedication demonstrated by Sabrina Hill THE NEED FOR REFOCUSING nize a remarkable woman, Alice Coulombe of is exemplary of the type of achievement that AMERICAN HUMANITARIAN AID Pasadena. can be attained with hard work and persever- IN SYRIA Born and raised in Ann Arbor, Michigan, Ms. ance. It is essential students at all levels strive Coulombe received her Bachelor’s degree in to make the most of their education and de- HON. ALCEE L. HASTINGS Humanities and her Master’s degree in Edu- velop a work ethic which will guide them for OF FLORIDA cation from Stanford University. At Stanford, the rest of their lives. IN THE HOUSE OF REPRESENTATIVES she met Joe Coulombe, and they got married when both were still students at the university. I extend my deepest congratulations to Friday, March 14, 2014 In 1958, the Coulombes founded Pronto Sabrina Hill for winning the Arvada Wheat Mr. HASTINGS of Florida. Mr. Speaker, I Markets, a chain of grocery stores in Southern Ridge Service Ambassadors for Youth award. rise today to mark the third anniversary of the California. In 1967, Joe, the original Trader I have no doubt she will exhibit the same dedi- ongoing conflict in Syria. As the war stretches Joe, added a South Seas motif to the stores cation and character in all of her future ac- into its fourth year and the regional humani- and changed the name to Trader Joe’s. Dur- complishments. tarian crisis shows little signs of improvement,

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00004 Fmt 0626 Sfmt 9920 E:\CR\FM\A14MR8.002 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E389 the United States must do more to ensure that is essential to expanding assistance inside IN RECOGNITION OF RICHARD F. its aid is utilized to the greatest effect pos- Syria and making every dollar of foreign aid CROSSIN, RECIPIENT OF 2014 THE sible. count. Syrian aid groups are now working in GREATER WILKES-BARRE According to the Syrian Observatory for nearly every sector of the humanitarian re- FRIENDLY SONS OF ST. PATRICK Human Rights, more than 140,000 people, in- sponse, delivering flour to bakeries, medical MAN OF THE YEAR AWARD cluding 7,000 children, have been killed. Near- supplies to field clinics, and helping to protect ly 2.5 million refugees have fled to neighboring refugees. HON. MATT CARTWRIGHT countries, including 1.2 million children. Within Already, USAID and other NGOs in the re- OF PENNSYLVANIA Syria, nearly seven million people have been gion rely on information and distribution net- IN THE HOUSE OF REPRESENTATIVES displaced from their homes and 19 million are works of local aid groups to deliver supplies to in need of emergency food support. It is pro- Friday, March 14, 2014 areas most in need. Empowering these Syrian jected that by the end of this year, 75 percent Mr. CARTWRIGHT. Mr. Speaker, today I groups will make our impact on the region of the Syrian population will need humani- rise in acknowledgment of Richard ‘‘Rich’’ F. even greater. These groups have the most at tarian assistance. Crossin, who on March 14, 2014 will receive stake and work at great personal expense and The civilian population inside Syria faces the Friendly Sons of St. Patrick Man of the risk. systematic starvation, shelling of residential Year award. Each year the Friendly Sons rec- neighborhoods, government use of chemical The Department of State and USAID should ognizes a person who has distinguished them- weapons, and threats from improvised barrel- work together to establish training, capacity selves in the community through hard work bombs filled with explosives and dropped by building, and aid delivery partnerships with and charitable efforts, and Rich Crossin is an military helicopters into residential areas. Syrian relief organizations in order to expand exemplary selection. In the dozens of refugee camps now sur- their operations. With proper oversight and Mr. Crossin is the son of Ann and the late rounding Syria, food remains scarce, access strict training on the international standards Joseph Crossin and a resident of Kingston, to sanitation and clean water is limited, and governing the delivery of aid, the United Pennsylvania. He graduated from Bishop diseases like polio—on the verge of eradi- States can enable hundreds of Syrian civilians O’Reilly High School, and continued his edu- cation worldwide—have resurfaced. to take greater control of their country’s future cation at York College, where he received his The United States has rightly pledged and while assisting those inside Syria who are not Bachelor of Science in Business Administra- contributed a combined $1.7 billion in humani- reachable by other means. tion in 1978. tarian assistance since the start of the crisis. Mr. Speaker, the United States has shown Rich has spent much of his career at Bon- These funds are critical for the Syrian people leadership in providing aid for the humani- ner Chevrolet, Inc., which was started by his caught in the middle of the conflict. Their sur- tarian crisis in Syria, but we must do more grandfather, John R. Bonner, in 1932. Rich vival, and indeed the future stability of the re- with the international community and Syrian now serves as President of the family busi- gion, hangs in the balance. As a leader in the refugee host nations to improve our aid deliv- ness and works alongside his brothers Joe, international community, we must ensure that ery systems while pressuring the Assad re- Tom and Paul. In the past 35 years, Bonner these funds are used efficiently and distributed gime and its supporters. As the war drags on Chevrolet has grown to be one of the largest in a manner that reaches as many people as with no end in sight, time is in fact running new and used automobile inventories in the possible. out. area, under Rich’s leadership. I recently heard a story about a school in Along with being a leader in the business the Aleppo Province that continued to hold f community, Rich has also been a pillar of his classes despite the war raging around it. local service community. He served as presi- When the school’s funding inevitably ran out— COMPREHENSIVE IMMIGRATION dent of the West Side Jaycees and has also and with international aid not immediately REFORM/UI EXTENSION worked with Big Brothers Big Sisters for sev- available—extremists in the area also fighting eral years, helping the group mentor many the Assad regime came forward with the re- disadvantaged youth. sources that the school needed. In return, they HON. BARBARA LEE Rich and his wife Virginia have three chil- demanded that the school dispose of its mod- dren—Andrew, Julia, and Elizabeth—all of erate textbooks for more politically-charged OF CALIFORNIA whom currently attend high school. Andrew, a texts, and required the teaching of the Koran. IN THE HOUSE OF REPRESENTATIVES senior at Holy Redeemer High School, is a Accepting assistance from extremist groups member of the golf team which competed and in exchange for loyalty is a decision faced by Friday, March 14, 2014 won the State Championship title. Rich’s Syrians on a daily basis. For most civilians, daughters Julia and Elizabeth both attend Wy- Ms. LEE of California. Mr. Speaker, as a the radical views expressed by the extremists oming Valley High School, and were longtime member of the Congressional Women’s Work- are not in line with their own moderate views. dancers with the Emerald Isle Step Dancers ing Group on Immigration Reform I rise to Many are simply trying to carry on with their and had the opportunity to dance in the St. support the women in my district and around lives. Patrick’s Day Parade in New York City. Organizations like the United States Agency the country who are fasting for a vote on re- Northeastern Pennsylvania is stronger as a for International Development (USAID) have form legislation. community because of citizens like Rich had considerable success in distributing Mr. Speaker, our system has been broken Crossin, and I am proud to recognize his life’s school materials, food, medical supplies, and for far too long and now is the time to fix it. contributions. vaccines. However, Syria is a war zone, and Every day hardworking women all over f these large-scale operations are often not America are living in fear that they will be sep- equipped to distribute materials and aid at the A TRIBUTE TO NADINE TRU- arated from their family. They have been sys- local level—like the school in Aleppo—where JILLO—28TH CONGRESSIONAL tematically left out of the programs that their they are needed most. DISTRICT WOMAN OF THE YEAR tax dollars help support. But, imagine if these organizations could know which schools had exhausted their re- That is why I am proud to have joined Con- HON. ADAM B. SCHIFF sources, which hospitals were in immediate gresswoman MICHELLE LUJAN GRISHAM to in- OF CALIFORNIA troduce the HEAL Act that would guarantee danger of running out of supplies, and which IN THE HOUSE OF REPRESENTATIVES neighborhoods were being most affected by access to safety net programs like Medicaid the lack of incoming food relief. Making this and the Children’s Health Insurance Program. Friday, March 14, 2014 process more efficient is no small task, but it Mr. Speaker, instead of bringing up bills to Mr. SCHIFF. Mr. Speaker, I rise today in is possible. If we are to avoid greater catas- create jobs and grow the economy, Repub- honor of Women’s History Month. Each year, trophe in Syria, it is also necessary. licans continue to play political games—bring- we pay special tribute to the contributions and Since the beginning of the Syrian conflict, I ing up GOP message bills to nowhere. sacrifices made by our nation’s women. It is have urged Congress and the President’s ad- an honor to pay homage to outstanding ministration to increase cooperation with Syr- It is time to pass comprehensive immigra- women who are making a difference in my ian non-government organizations (NGOs) to tion reform. It is time to pass an extension of Congressional District. I would like to recog- get aid where it needs to go. Increased en- Unemployment Insurance. nize a remarkable woman, Nadine Trujillo of gagement with Syrian and Syrian-run groups We have the votes. Let’s do it now. Silver Lake.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00005 Fmt 0626 Sfmt 9920 E:\CR\FM\A14MR8.004 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E390 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 Ms. Trujillo has lived in Los Angeles since Theo has been very active with his troop, with the new addition. I would also like to con- 1956. In 1993, Ms. Trujillo launched her own participating in many scout activities. Over the gratulate Mary’s three great-grandmothers, business and opened a Mexican restaurant. many years Theo has been involved with Mrs. Marshall J. Parker, Mrs. Ira Lee Arnold, She is the proud owner and operator of the scouting, he has not only earned numerous and Mrs. Edward D. Barnhill, along with the Alegria on Sunset, where she also serves as merit badges, but also the respect of his fam- late Mrs. Kathryn Macaulay DePass, who are its Executive Chef, and can still be found ily, peers, and community. Most notably, Theo all extraordinary role models for their dear cooking for the daily lunch crowd in addition to has contributed to his community through his great-granddaughter. fulfilling her CEO duties. Eagle Scout project. Theo built fire pits for a Ms. Trujillo first got involved in her commu- church camp in Far West, Missouri. f nity by providing local schools, charitable or- Mr. Speaker, I proudly ask you to join me in ganizations and churches with discounted commending Theo Rogers for his accomplish- A TRIBUTE TO SONIA TATULIAN— menus for teachers as well as donations to ments with the Boy Scouts of America and for 28TH CONGRESSIONAL DISTRICT school events. She has continued to give back his efforts put forth in achieving the highest WOMAN OF THE YEAR by volunteering her time and sharing her distinction of Eagle Scout. knowledge of catering and event planning. f She has organized Hollywood Sunset Free HON. ADAM B. SCHIFF Clinic’s annual fundraisers and continues to PERSONAL EXPLANATION support HSFC by providing pozole to over two OF CALIFORNIA hundred ‘‘Pilgrims’’ in the annual observance HON. NYDIA M. VELA´ ZQUEZ IN THE HOUSE OF REPRESENTATIVES of the traditional Mexican Christmas Posada. OF NEW YORK Friday, March 14, 2014 In 2010, Ms. Trujillo joined the Silver Lake IN THE HOUSE OF REPRESENTATIVES Neighborhood Council after she completed Mr. SCHIFF. Mr. Speaker, I rise today in Level One Community Emergency Response Friday, March 14, 2014 honor of Women’s History Month. Each year, Team (CERT) training. She has served as Co- Ms. VELA´ ZQUEZ. Mr. Speaker, on March we pay special tribute to the contributions and Chair of the Public Safety Committee and 12, 2014 I was unavoidably detained for roll today serves as an at large board member. call votes 120–124. Had I been present, this sacrifices made by our nation’s women. It is Ms. Trujillo organized the first annual ‘‘Sep- is how I would have voted: on rollcall vote an honor to pay homage to outstanding tember is National Preparedness Month’’ 120: Conyers of Michigan Amendment, I women who are making a difference in my Expo. Ms. Trujillo and her two daughters are would have voted ‘‘yes’’; on rollcall vote 121: Congressional District. I would like to recog- residents of Silver Lake. Nadler of New York Amendment, I would have nize a remarkable woman, Sonia Tatulian of I ask all Members to join me in honoring an voted ‘‘yes’’; on rollcall vote 122: Jackson Lee Tujunga. exceptional woman of California’s 28th Con- of Texas Amendment, I would have voted Born in Armenia, Ms. Tatulian and her fam- gressional District, Nadine Trujillo. ‘‘yes’’; on rollcall vote 123: Democratic Motion ily immigrated to the United States in 1974 f to Recommit, I would have voted ‘‘yes’’; on when she was a teenager. While attending rollcall vote 124: Final Passage of H.R. 4138, SAYRA ARANA Hollywood High School, she went to work in a Executive Needs to Faithfully Observe and Beverly Hills bridal shop doing a variety of Respect Congressional Enactments of the jobs, including pressing, altering, and selling HON. ED PERLMUTTER Law Act of 2014, I would have voted ‘‘no.’’ wedding gowns. This began her career in the OF COLORADO f retail industry, which would go on to span two IN THE HOUSE OF REPRESENTATIVES decades. Friday, March 14, 2014 PERSONAL EXPLANATION In 1989, Ms. Tatulian bought her home in Mr. PERLMUTTER. Mr. Speaker, I rise HON. BRADLEY S. SCHNEIDER Tujunga, and soon after she obtained her real today to recognize and applaud Sayra Arana estate license and began a part-time flower OF ILLINOIS for receiving the Arvada Wheat Ridge Service business. After changing careers for a position IN THE HOUSE OF REPRESENTATIVES Ambassadors for Youth award. Sayra Arana is with Wells Fargo, Ms. Tatulian realized she a 12th grader at Jefferson High School and re- Friday, March 14, 2014 wanted to help businesses and become more ceived this award because her determination Mr. SCHNEIDER. Mr. Speaker, from March involved in her community. She was able to and hard work have allowed her to overcome 4 through 6, 2014, I was absent from the fulfill this aspiration once she started her new adversities. House due to a sudden, unfortunate family position as Manager at the Sunland Bank of The dedication demonstrated by Sayra America. Ms. Tatulian then became a member Arana is exemplary of the type of achievement matter and missed rollcall Votes 93 through of the Sunland-Tujunga Chamber of Com- that can be attained with hard work and perse- 114. Had I been present, I would have voted merce, Sunland-Tujunga Rotary Club and the verance. It is essential students at all levels ‘‘yea’’ on rollcall votes 95, 96, 97, 98, 102, Sunland-Tujunga Lions Club. She served as strive to make the most of their education and 103, 104, 105, 108, 110, 111, 112, and 114. President of the Sunland-Tujunga Chamber of develop a work ethic which will guide them for I would have voted ‘‘nay’’ on rollcall votes 93, Commerce and increased membership from the rest of their lives. 94, 99, 100, 101, 106, 107, 109, and 113. I extend my deepest congratulations to f 63 to 175 members, all while being the Treas- urer of the Rotary and Lions Clubs. Sayra Arana for winning the Arvada Wheat ON THE BIRTH OF MARY PARKER Ridge Service Ambassadors for Youth award. DEPASS Ms. Tatulian also founded the non-profit or- I have no doubt she will exhibit the same dedi- ganization, the Sunland-Tujunga-Shadow Hills cation and character in all of her future ac- Community Fund, which is the parent com- complishments. HON. JOE WILSON pany of Voice of the Village, a local news- OF SOUTH CAROLINA f paper. The Fund took over the organization of IN THE HOUSE OF REPRESENTATIVES the annual Fourth of July Fireworks event, HONORING THEO ROGERS Friday, March 14, 2014 with the proceeds and matching grants going to Verdugo Hills High School programs. Pro- Mr. WILSON of South Carolina. Mr. Speak- HON. SAM GRAVES ceeds from the newspaper support the high OF MISSOURI er, I am happy to congratulate Emily and Wil- liam Brunson DePass, III, on the birth of their school’s journalism class. Recently, Ms. IN THE HOUSE OF REPRESENTATIVES new baby girl. Mary Parker DePass was born Tatulian founded the ‘‘Welcome to the Foot- Friday, March 14, 2014 at 2:46 p.m. on March 8, 2014 weighing 7 hills’’ company, a free service where she visits Mr. GRAVES of Missouri. Mr. Speaker, I pounds, 6 ounces and measuring 20 and 1/2 new home owners, welcomes them and pro- proudly pause to recognize Theo Rogers. inches long. vides them with important information about Theo is a very special young man who has Mary joins a wonderful family who is de- the community. In addition, she volunteers exemplified the finest qualities of citizenship voted to her well-being and bright future. with the Verdugo Hills Family YMCA. and leadership by taking an active part in the Grandparents Mrs. and Mrs. William B. I ask all Members to join me in honoring an Boy Scouts of America, Troop 125, and earn- (Rusty) DePass, Jr., Mrs. Jane Arnold Barnhill, exceptional woman of California’s 28th Con- ing the most prestigious award of Eagle Scout. and Mr. Edward D. Barnhill, Jr., are thrilled gressional District, Sonia Tatulian.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00006 Fmt 0626 Sfmt 0634 E:\CR\FM\K14MR8.016 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E391 NAYELI LYNCH-BOLANOS the Ranomafana National Park in Madagascar Many know the story of the Nevada con- which she believes has saved three species of stitution being sent to Washington via the HON. ED PERLMUTTER lemur from extinction. She is a professor of newly-invented telegraph machine to expedite OF COLORADO anthropology at Stony Brook. our admission to the Union in late October of IN THE HOUSE OF REPRESENTATIVES It is not surprising that these three eminent 1864. But a lesser known—though not less conservation pioneers have been tapped for important—event in our state’s history will cel- Friday, March 14, 2014 international recognition. Their ongoing efforts ebrate its 150th anniversary next week. Mr. PERLMUTTER. Mr. Speaker, I rise have helped save our planet and its species On March 21, 2014—next Friday—it will today to recognize and applaud Nayeli Lynch- from degradation. They are committed and have been one hundred and fifty years since Bolanos for receiving the Arvada Wheat Ridge passionate about their research. It is through this body voted to allow the People of the Ter- Service Ambassadors for Youth award. Nayeli the efforts of people like these who are able ritory of Nevada to form a Constitution and Lynch-Bolanos is a 7th grader at Wayne Carle to inspire others to see the importance of con- State Government for the purpose of admis- Middle School and received this award be- servation that our oceans, our endangered sion into the Union. cause her determination and hard work have species and biodiversity of our plant will be Nevada’s constitutional convention began allowed her to overcome adversities. preserved. on the fourth of July, 1864. The dedication demonstrated by Nayeli Indeed, these three professors and their tre- Among the first words of our constitution Lynch-Bolanos is exemplary of the type of mendous achievements are most worthy of were the absolute prohibition of slavery, free- achievement that can be attained with hard our recognition and of the Indianapolis Prize. dom of religious worship, and one issue very work and perseverance. It is essential stu- They are representative of the pursuit of ex- near to the work of Nevada’s current Congres- dents at all levels strive to make the most of cellence and world-class research capabilities sional delegation, the ownership status of the their education and develop a work ethic that define Stony Brook’s reputation as a glob- land. which will guide them for the rest of their lives. al leader in innovation and scientific break- The convention adjourned July 28 having I extend my deepest congratulations to throughs. With this achievement, the profes- laid the foundation for Nevada’s admission to Nayeli Lynch-Bolanos for winning the Arvada sors take their place with Stony Brook Univer- the Union and our future governance. Wheat Ridge Service Ambassadors for Youth sity as the pride of Long Island and an exam- Voters of the territory approved the Con- award. I have no doubt she will exhibit the ple for aspiring scientists to follow. stitution the first week of September, paving same dedication and character in all of her fu- Mr. Speaker, on behalf of New York’s first the way for Abraham Lincoln to admit Nevada ture accomplishments. congressional district, I would like to thank as the 36th State on October 31, 1864. f Professors Mittermeier, Safina, and Wright for But all of these events were set in motion the vital work they are doing. The fact that by a bill approved in this very Chamber, Mr. RECOGNIZING RUSSELL A. they are all members of Stony Brook faculty is Speaker. Without this critical first step, the MITTERMEIER, CARL SAFINA, yet another measure of the quality of this fine journey to statehood would not have been AND PATRICIA C. WRIGHT university. possible. f I’m proud to call the Battle Born State home HON. TIMOTHY H. BISHOP and join with Nevadans from Elko to Laughlin OF NEW YORK HONORING SID REYES in celebrating the sesquicentennial of March IN THE HOUSE OF REPRESENTATIVES 21, 1864. Friday, March 14, 2014 HON. SAM GRAVES f OF MISSOURI Mr. BISHOP of New York. Mr. Speaker, it is CONGRATULATING THE CORNING IN THE HOUSE OF REPRESENTATIVES with great pride that I rise to congratulate AREA CHAMBER OF COMMERCE Stony Brook University and its faculty for an Friday, March 14, 2014 unprecedented achievement. Three of the six Mr. GRAVES of Missouri. Mr. Speaker, I HON. TOM REED finalists for the prestigious Indianapolis Prize, proudly pause to recognize Sid Reyes. Sid is OF NEW YORK the world’s leading award for animal conserva- a very special young man who has exempli- IN THE HOUSE OF REPRESENTATIVES tion, are members of Stony Brook’s faculty. fied the finest qualities of citizenship and lead- Friday, March 14, 2014 This is the first time that one university has ership by taking an active part in the Boy had three finalists for the award given by the Scouts of America, Troop 135, and earning Mr. REED. Mr. Speaker, I rise to recognize Indianapolis Zoo for ‘‘extraordinary contribu- the most prestigious award of Eagle Scout. and congratulate the Corning Area Chamber tions to conservation efforts.’’ All three profes- Sid has been very active with his troop, par- of Commerce on its 100th anniversary. Over sors, Russell A. Mittermeier, Carl Safina, and ticipating in many scout activities. Over the the past 100 years, the Corning Area Cham- Patricia C. Wright, hold Ph.D.s and have many years Sid has been involved with scout- ber of Commerce has successfully provided made major contributions to science. Their se- ing, he has not only earned numerous merit small businesses and local entrepreneurs with lection as finalists for this coveted award re- badges, but also the respect of his family, the resources, expertise and advice needed to flects the excellence and dedication of Stony peers, and community. Most notably, Sid has succeed. Brook’s faculty and brings honor to all of Long contributed to his community through his The Corning community is stronger and Island. Eagle Scout project. Sid completed necessary more vibrant because of the Chamber. The Dr. Mittermeier is president of Conservation maintenance on the outdoor classroom at Chamber has proven to be an invaluable re- International and has worked to preserve pri- Hawthorne Elementary School in Kearney, source in promoting business in our commu- mates and turtles in South America, Mada- Missouri. nity through a powerful, united voice—a voice gascar and other places. He has used the Mr. Speaker, I proudly ask you to join me in that successfully advances opportunities for concept of biodiversity ‘‘hotspots’’ to focus commending Sid Reyes for his accomplish- growth time and time again. Due to the Cham- conservation efforts and raise $1 billion for en- ments with the Boy Scouts of America and for ber’s unrelenting work in promoting and assist- dangered habitats. He has an adjunct re- his efforts put forth in achieving the highest ing commerce, local businesses continue to search appointment in the Department of Ana- distinction of Eagle Scout. provide well-paying jobs and high-quality prod- tomical Sciences. f ucts and services to our region. Dr. Safina co-founded Blue Ocean Institute In addition to helping established busi- to raise awareness of threats to the world’s RECOGNIZING NEVADA 150 nesses, the Chamber has a strong history of oceans and inspire solutions to these dangers. providing grants to organizations that assist He is a research professor in Stony Brook’s HON. JOSEPH J. HECK local entrepreneurs in starting new businesses School of Marine and Atmospheric Sciences. OF NEVADA in Corning. The Chamber continues to give Episodes of his show ‘‘Saving the Ocean with IN THE HOUSE OF REPRESENTATIVES Corning citizens the tools necessary to suc- Carl Safina’’ aired nationwide on PBS in 2012. ceed. Dr. Wright discovered a new species of Friday, March 14, 2014 Once again I wish to congratulate the Cor- lemur, the golden bamboo lemur, while work- Mr. HECK of Nevada. Mr. Speaker, I come ning Area Chamber of Commerce on 100 suc- ing in Madagascar in 1986. She also redis- to the floor today to mark the beginning of Ne- cessful years of service and wish them an- covered another species which had been con- vada’s journey to becoming the 36th State ad- other hundred prosperous years in the beau- sidered extinct. Her efforts helped establish mitted to the Union. tiful city we call home.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00007 Fmt 0626 Sfmt 0634 E:\CR\FM\K14MR8.032 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E392 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 A TRIBUTE TO SHELLI-ANNE NICOLE PAPPADAKIS other hand, was a Notre Dame grad. In the COUCH—28TH CONGRESSIONAL Midwest, the Wolverines and Fighting Irish DISTRICT WOMAN OF THE YEAR HON. ED PERLMUTTER mix, at least in athletics, about as well as the OF COLORADO Hatfields and McCoys. In fact, Jim was a physically gifted athlete who played basketball IN THE HOUSE OF REPRESENTATIVES HON. ADAM B. SCHIFF for the Irish. It takes a special individual for OF CALIFORNIA Friday, March 14, 2014 me to put aside a rivalry that runs that deep. Jim Dowdle was that unique. IN THE HOUSE OF REPRESENTATIVES Mr. PERLMUTTER. Mr. Speaker, I rise today to recognize and applaud Nicole I got to know Jim on a professional level. Friday, March 14, 2014 Pappadakis for receiving the Arvada Wheat He was hired by Tribune Company in Chicago Ridge Service Ambassadors for Youth award. in the early 1980s to head its broadcast oper- Mr. SCHIFF. Mr. Speaker, I rise today in Nicole Pappadakis is an 8th grader at Moore ations until his retirement in 1999. Tribune honor of Women’s History Month. Each year, Middle School and received this award be- Company remains the largest media company we pay special tribute to the contributions and cause her determination and hard work have headquartered in the Midwest. Of particular in- sacrifices made by our nation’s women. It is allowed her to overcome adversities. terest to me, Jim engineered the Tribune’s an honor to pay homage to outstanding The dedication demonstrated by Nicole purchase of the Chicago Cubs from the women who are making a difference in my Pappadakis is exemplary of the type of Wrigley family. As a lifelong, diehard Cubs Congressional District. I would like to recog- achievement that can be attained with hard fan, Jim and I agonized over the team’s nize a remarkable woman, Shelli-Anne Couch work and perseverance. It is essential stu- progress many an afternoon at Wrigley Field. of Atwater Village. dents at all levels strive to make the most of Jim also persuaded legendary Hall of Fame As President of Friends of Atwater Elemen- their education and develop a work ethic broadcaster Harry Caray to be the Cubs’ play- tary, Ms. Couch has led the turnaround of this which will guide them for the rest of their lives. by-play announcer on Tribune’s WGN–TV. Title I public elementary school, bringing new I extend my deepest congratulations to Ni- That powerful combination spread WGN’s tele- life to the volunteer support group which cole Pappadakis for winning the Arvada casts throughout the land as cable systems serves nearly 400 families in the Atwater Vil- Wheat Ridge Service Ambassadors for Youth and home satellites grew WGN into a national lage area. She found innovative ways to gen- award. I have no doubt she will exhibit the superstation. What makes the story even more erate new revenue streams, raised over same dedication and character in all of her fu- remarkable is that Jim was a proud Irish- $100,000 in support of enrichment, edu- ture accomplishments. American son of Chicago’s Southside, that cational and capital improvement programs for f sliver of greater Chicagoland where your alle- Atwater Avenue Elementary School, and cre- giance is to the White Sox and whatever team ated strategic partnerships with local, national PERSONAL EXPLANATION is playing the Cubs. Jim used to say, ‘‘Thank and international businesses, non-profit orga- God my father is buried in Calvary Cemetery. nizations and individuals. Ms. Couch has HON. ALLYSON Y. SCHWARTZ If he knew I bought the Cubs, I’m not sure he founded and produced many events and pro- OF PENNSYLVANIA would talk to me.’’ Over the years, Jim gam- grams that support the elementary school, in- IN THE HOUSE OF REPRESENTATIVES bled on the future of television—investing in cluding the First Annual Day of the Dead Fes- little-known cable channels such as the Food tival with celebrity chef Curtis Stone which Friday, March 14, 2014 Network and others, adding to Tribune’s drew close to one thousand attendees and Ms. SCHWARTZ. Mr. Speaker, on rollcall broadcast station holdings, the value of which raised a substantial amount of money for the No. 116, I was unable to attend. Had I been is now in the billions. school. present, I would have voted ‘‘yes.’’ Jim Dowdle’s family and civic legacy is just Ms. Couch also formed a partnership with f as remarkable. He married his beloved Sally Sayers in 1956 shortly after graduating from executives from Paul Mitchell Hair Products PERSONAL EXPLANATION and Enrich LA to sponsor the school’s first Notre Dame. To all, they are known as Honey outdoor classroom program, which provides and Doods. He was the father of five and free tuition for students to learn how to make HON. DONNA F. EDWARDS grandfather of eighteen. At his funeral Mass, healthy life choices by gardening, eating sea- OF MARYLAND nine handsome grandsons, all at least six foot sonal produce, and composting. She also led IN THE HOUSE OF REPRESENTATIVES two, dressed in suits and Kelly green ties, served as pallbearers. At the altar, two Catho- the effort for school uniforms and created a Friday, March 14, 2014 ‘‘Care Closet’’ for families in need. In addition, lic monsignors, twelve priests and his godson she forged partnerships between the school Ms. EDWARDS. Mr. Speaker, due to at- (a deacon) celebrated his Mass before as and local organizations such as the Northland tending a previously scheduled meeting at the many as 1,500 mourners—a powerful, visible Village Church, which provides free weekly tu- White House with President Obama, I was ab- testament to a life well led. Long before I got to know him, Jim had con- toring called ‘‘Homework Helpers,’’ and the sent from votes in the House on Wednesday quered alcohol addiction. For decades, he local Lions Club, which provides scholarships afternoon (March 12) and missed rollcall votes counseled countless others, often complete and free eye tests to students. 1201–124. Had I been present, I would have voted: ‘‘yea’’ on rollcall No. 120 (Conyers strangers. When the word spread that Jim was Prior to her dedicated volunteer work in amendment); ‘‘yea’’ on rollcall No. 121 (Nadler nearing death, the family received numerous Atwater Village, Ms. Couch was an inter- amendment); ‘‘yea’’ on rollcall No. 122 (Jack- calls and messages from people who wanted national business and media executive with son-Lee amendment); ‘‘yea’’ on rollcall No. them to know how Jim Dowdle had impacted over twenty-five years of experience trans- 123 (Motion to Recommit H.R. 4138 with In- them—saving careers, marriages, and lives. forming how companies and people build their structions); and ‘‘nay’’ on rollcall No. 124 (final Without those unsolicited testimonials, no one commerce, content and community, guiding passage of H.R. 4138, the ENFORCE the Law would have known. clients like Universal Studios, Diane Von Act). A former Marine lieutenant, years later, Jim Furstenburg, and the Australian Consulate. f received the Marine Corps’ Semper Fidelis She co-founded Billion Dollar Babes, the Award. He also received the broadcast indus- world’s first global designer fashion sales TRIBUTE TO JAMES C. DOWDLE try’s highest honor, the National Association of event. Her agency’s showrooms in Los Ange- Broadcasters’ Distinguished Service Award, as les, New York and London pioneered celebrity HON. FRED UPTON well as the National Academy of Television dressing and editorial placement. An award- OF MICHIGAN Arts and Sciences’ Trustee Award and induc- winning journalist, Ms. Couch, who moved IN THE HOUSE OF REPRESENTATIVES tion into the Broadcasting and Cable Hall of from her native Australia to Los Angeles in Fame. A devout Catholic, Jim was a director 1997, has been featured in magazines and Friday, March 14, 2014 of Mundelein Seminary’s Board of Advisors newspapers such as Vogue, The New York Mr. UPTON. Mr. Speaker, on February 17th, and Big Shoulders Fund. He served as a Times, The LA Times, and People, and on the we lost an extraordinary American with the former board chairman of Junior Achievement television show, Good Morning America. passing of James C. Dowdle, who was 79. I of Chicago, director of Loyola University’s I ask all Members to join me in honoring an rise today to do something a bit out of char- Health Systems, director of Robert R. McCor- exceptional woman of California’s 28th Con- acter. As many folks know, I am a proud Uni- mick Foundation, director of Hazelden Chi- gressional District, Shelli-Anne Couch. versity of Michigan Wolverine. Jim, on the cago, and trustee of Chicago’s Museum of

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00008 Fmt 0626 Sfmt 9920 E:\CR\FM\K14MR8.018 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E393 Science and Industry. I mention these. There an honor to pay homage to outstanding Standley Lake High School and received this are more. women who are making a difference in my award because her determination and hard Throughout his remarkable life, Jim Dowdle Congressional District. I would like to recog- work have allowed her to overcome adversi- never lost the common touch. He stayed hum- nize a remarkable woman, Martha Burns of La ties. ble. He volunteered. He served. He gave. He Can˜ada Flintridge. The dedication demonstrated by Roseline never forgot what is truly important in life. I Ms. Burns was born and raised in Min- Mugaruka is exemplary of the type of achieve- think the Marine’s motto aptly describes the nesota. She obtained her degree in Mathe- ment that can be attained with hard work and great man: ‘‘Semper Fidelis!’’ Always Faithful! matics from Colorado College, where she perseverance. It is essential students at all It was my great privilege to know him and my joined Kappa Alpha Theta, a sorority she con- levels strive to make the most of their edu- honor to pay tribute. God bless Jim Dowdle. tinues to be active. After graduation, she cation and develop a work ethic which will f worked as a Financial Analyst at General Mills guide them for the rest of their lives. in Minneapolis. Seven years later, she moved I extend my deepest congratulations to RECOGNIZING LORIN LEWIS AS back to Colorado Springs, where she met and Roseline Mugaruka for winning the Arvada THE 2014 OKALOOSA COUNTY, married Tom Burns while both were working Wheat Ridge Service Ambassadors for Youth FLORIDA EDUCATIONAL SUP- for Burroughs Corp. In 1979, a job transfer award. I have no doubt she will exhibit the PORT PERSON OF THE YEAR moved the family to Glendale, and in 1981 same dedication and character in all of her fu- they purchased a home in La Can˜ada ture accomplishments. HON. JEFF MILLER Flintridge. Ms. Burns wasted no time in joining f OF FLORIDA the La Can˜ada Flintridge Newcomers Club IN RECOGNITION OF CHARLES J. IN THE HOUSE OF REPRESENTATIVES and the La Can˜ada Junior Women’s Club. As a young mother, Ms. Burns served as GRIMES, RECIPIENT OF THE 2014 Friday, March 14, 2014 President and Treasurer of the La Can˜ada El- GREATER PITTSTON AREA Mr. MILLER of Florida. Mr. Speaker, I rise ementary School Parent Teacher Association FRIENDLY SONS OF ST. PATRICK to recognize Mrs. Lorin Lewis as the 2014 (PTA). She has also served in various posi- SWINGLE AWARD Okaloosa County Educational Support Person tions with La Can˜ada High School’s PTA and of the Year. For over six years, Mrs. Lewis Can˜ada Council of PTA. Ms. Burns has also HON. MATT CARTWRIGHT has served the students and community of volunteered as a Leader and Den Mother for OF PENNSYLVANIA Okaloosa County, and I am pleased to honor Campfire Girls and Cub Scouts, a Team Mom IN THE HOUSE OF REPRESENTATIVES her achievements. for American Youth Soccer Organization Friday, March 14, 2014 A product of the Okaloosa County School (AYSO), and as a ‘‘Classroom Mother.’’ District, Mrs. Lewis was born and raised in Well-known in the area for her accounting Mr. CARTWRIGHT. Mr. Speaker, today I Crestview, Florida. Upon graduating from and computing skills, Ms. Burns has volun- rise in acknowledgment of Charles J. Grimes, Crestview High School in 2005, she began teered her services to numerous service who on March 17, 2014, will receive the Swin- studying at Northwest Florida State College. groups and businesses. She was the first gle Award from the Greater Pittston Area The following year, she began her profes- woman to lead the softball arm of the La Friendly Sons of St. Patrick. Charles J. Grimes sional career in the Okaloosa County School Can˜ada Jr. Baseball/Softball Association, for was born in Plymouth, Pennsylvania on No- District as a classroom assistant at a Depart- which she also served as Treasurer. She is an vember 9, 1946 to Joseph and Helen Grimes. ment of Juvenile Justice facility. It was in this active member Assistance League of He attended St. Vincent’s Catholic School and capacity that Mrs. Lewis developed a passion Flintridge (ALF) and previously served as Plymouth High School. After school, Charlie for working with at-risk youth. The patience Chairperson of the Summer School Program, began his career in 1970 as a Driver and and compassion she exerted enabled her to Summer School Treasurer, Computer Chair, Sales Representative with Freedman Express. inspire and positively impact the lives of some and Treasurer of ALF’s Auxiliary. She was He later went on to work for Conway Freight of the most vulnerable, despite the rigors of also the Treasurer of the Board of Directors of for 15 years. the challenging environment. the La Can˜ada Flintridge Educational Founda- Charlie has dedicated himself to member- Her love for bettering the lives of students tion, the La Can˜ada Flintridge Chamber of ship and leadership roles in multiple charitable continued to grow, and in 2011, she joined the Commerce, and the La Can˜ada-AM Kiwanis organizations. He currently serves as a sus- faculty at Pryor Middle School as the Dis- Club. Ms. Burns modernized the bookkeeping taining Fourth Degree member of the Presi- cipline Secretary. She became the Book- system for La Can˜ada Congregational and St. dent John F. Kennedy Council 372 Knights of keeper in 2012, where she continues her sup- George’s Episcopal Churches and their pre- Columbus, and previously served as the porting role at the school. In addition to her schools. She has also developed database Grand Knight. He is also a member and past strong faith, Mrs. Lewis credits her success and accounting systems for the Community President of the Friendly Sons of St. Patrick. and achievements to the support provided by Center of La Can˜ada Flintridge and its pre- Charlie also volunteers with Meals on Wheels her colleagues. It is her dedication and com- school. An avid animal lover, Ms. Burns has of Greater Pittston and the Salvation Army. mitment to excellence, however, that has prov- volunteered as a bookkeeper for the Recycled Charlie now resides in Jenkins Township en her to be an invaluable asset to the Pets Rescue Organization and as Treasurer with his wife, Rose Ferentino Grimes. He and Okaloosa County School District and has for the Pasadena Animal League, an auxiliary his wife have six children and thirteen grand- earned her the title of Educational Support of the Pasadena Humane Society. Ms. Burns children, of which they are extremely proud. Person of the Year. also received a La Can˜ada Council of PTA It is a great honor to congratulate Charles J. Mr. Speaker, I am proud to recognize Lorin Service Award and a La Can˜ada Flintridge Grimes on this award to commemorate his Lewis and her great achievements. My wife Coordinating Council Les Tupper Community dedication to charity and community service. Vicki joins me in congratulating Mrs. Lewis Service Award. Charlie is a tribute to the Pittston area, and I and her husband, Bryan, and we wish them all I ask all Members to join me in honoring an thank him for his many valuable contributions the best for continued success. exceptional woman of California’s 28th Con- to the public good. f gressional District, Martha Burns. f A TRIBUTE TO MARTHA BURNS— f HONORING THE JUDGE ADVOCATE 28TH CONGRESSIONAL DISTRICT ROSELINE MUGARUKA GENERAL OF THE UNITED WOMAN OF THE YEAR STATES AIR FORCE, LIEUTEN- HON. ED PERLMUTTER ANT GENERAL RICHARD C. HAR- DING HON. ADAM B. SCHIFF OF COLORADO OF CALIFORNIA IN THE HOUSE OF REPRESENTATIVES IN THE HOUSE OF REPRESENTATIVES Friday, March 14, 2014 HON. MICHAEL R. TURNER Friday, March 14, 2014 OF OHIO Mr. PERLMUTTER. Mr. Speaker, I rise IN THE HOUSE OF REPRESENTATIVES Mr. SCHIFF. Mr. Speaker, I rise today in today to recognize and applaud Roseline honor of Women’s History Month. Each year, Mugaruka for receiving the Arvada Wheat Friday, March 14, 2014 we pay special tribute to the contributions and Ridge Service Ambassadors for Youth award. Mr. TURNER. Mr. Speaker, I rise today to sacrifices made by our nation’s women. It is Roseline Mugaruka is a 12th grader at pay tribute to Lieutenant General Richard C.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00009 Fmt 0626 Sfmt 9920 E:\CR\FM\A14MR8.015 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E394 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 Harding, who is retiring after thirty-four years ship and vision, and wish him all the best as Returning to Morganton in 1946, Mr. Ruther- of accomplished and distinguished military he retires from active duty service to our na- ford worked for Mullis Motor Company, and service. Throughout his career as a senior offi- tion. then spent 30 years at the Esso Exxon station cer, General Harding has provided invaluable f in Lenior. I am proud to honor Mr. Rutherford testimony and advice to this body and in par- today, as he has shown time and again an un- ticular to the Armed Services Committee. Spe- HONORING THE LIFE AND LEGACY wavering commitment to our district. OF ERNEST J. REYES cifically, General Harding has provided his ex- Mr. Speaker, on behalf of the entire 11th pert military advice on a wide range of de- ´ District of North Carolina, I congratulate Mr. fense and national security issues and espe- HON. TONY CARDENAS Rutherford on his milestone 100th birthday OF CALIFORNIA cially on the workings of the military justice and thank him for his service to Western North IN THE HOUSE OF REPRESENTATIVES system in relation to the sexual assault crisis Carolina and to our nation. in which the military finds itself. I think I speak Friday, March 14, 2014 for all of my colleagues on the Armed Serv- Mr. CA´ RDENAS. Mr. Speaker, I rise today f ices Committee when I say that his depth of to honor the life and legacy of our friend Er- knowledge, outstanding leadership and profes- nest J. Reyes who passed away recently at A TRIBUTE TO ALEXANDRA sionalism, and deep respect and consideration the age of 73. Though Mr. Reyes is sorely HELFRICH—28TH CONGRES- for all of our men and women in uniform will missed by friends and family, I know his leg- SIONAL DISTRICT WOMAN OF be greatly missed. acy will endure. He had an illustrious career THE YEAR The son of an Air Force officer and grand- and was a passionate, hard-working advocate. son of a Naval officer, General Harding en- Mr. Reyes, a native of Madera, CA, was tered the Air Force with a direct commission in dedicated to the California real estate commu- HON. ADAM B. SCHIFF 1980 after receiving his Bachelor of Science nity. He was a licensed broker since 1972, OF CALIFORNIA degree and Juris Doctor degree from the Uni- served on the San Diego Real Estate Board, IN THE HOUSE OF REPRESENTATIVES versity of Arkansas. Over the course of his ca- and founded Network Realty, a real estate reer, General Harding served six tours as a brokerage firm. He also tapped into his knowl- Friday, March 14, 2014 staff judge advocate at the unified command, edge of the real estate market to help families major command, numbered air force and wing thrive and realize the American dream of Mr. SCHIFF. Mr. Speaker, I rise today in levels. He also served in a variety of staff po- homeownership. He co-founded the National honor of Women’s History Month. Each year, sitions at Headquarters Air Force and as the Association of Hispanic Real Estate Profes- we pay special tribute to the contributions and Deputy Chief Counsel for U.S. Transportation sionals. Under his leadership, NAHREP has sacrifices made by our nation’s women. It is Command. Before serving as The Judge Ad- become ‘‘The Voice for Hispanic Real Estate’’ an honor to pay homage to outstanding vocate General (TJAG) General Harding was and proud champions of homeownership for women who are making a difference in my the Commander of the Air Force Legal Oper- the Hispanic community.’’ Mr. Reyes was also Congressional District. I would like to recog- ations Agency. Chairman of the San Diego Home Loan Coun- nize a remarkable woman, Alexandra Helfrich During his tenure as TJAG, General Harding seling Center, a non-profit serving low and of Burbank. led the Air Force Judge Advocate General’s moderate-income families through economic Corps during one of the most turbulent periods When her eldest daughter began elemen- literacy education. tary school, Ms. Helfrich learned that the in military law and most challenging budget Additionally, Mr. Reyes was an exceptional crises in history. He innovatively orchestrated school did not have any arts programs. She public servant. He was a member of the Hol- began to fundraise and sought out grant op- the creation and implementation of the Federal lister Elementary School District Board and Government’s first-ever Special Victims’ Coun- portunities to bring arts education back into served as Secretary. And in 1976, the Cali- the classroom. Ms. Helfritch worked with other sel Program, ensuring legal representation for fornia Senate Rules Committee appointed Mr. victims of sexual assault. This Program was parents, the PTA and Booster organizations to Reyes to serve on the Employment Services provide opportunities so every Burbank Unified subsequently adopted by the Secretary of De- Board. He was also appointed by the U.S. fense and implemented across the Depart- School District (BUSD) student could experi- Small Business Administration’s Administrator ence music, visual art, theater, dance, and ment of Defense. Karen G. Mills to Chair the Regulatory Fair- Additionally, General Harding’s focused media arts. Through these collaborations, art ness Board, Region IX. And notably, Mr. processing initiatives revitalized the military programs became available at schools during Reyes served on the staff of the Honorable justice system by drastically reducing court- the school day and after school as well. Leon E. Panetta while he was in Congress. martial processing times. He also resurrected Ms. Helfrich has served as a member of the I extend my sincerest condolences to his the publication of the Air Force’s standards of Board of Directors for the Burbank Arts For All wife of 50 years, Patricia Pedregon Reyes, professional conduct by leading the drafting, Foundation since 2007 and served as its co- along with his children, Denise Johnson and coordinating, and publishing of the first-ever, chair from 2010 to 2013. The Burbank Arts Daren Reyes, and his three grandchildren. Mr. Air Force Instruction 1–1, Air Force Standards, For All Foundation works to ensure every stu- Reyes was an inspiration and I know his loss and he keenly consolidated the Judge Advo- dent in Burbank public schools receives a will be felt by many, including the 29th Con- cate and Inspector General inspection proc- quality arts education as a part of their core gressional District. esses by creating a single two-tiered evalua- curriculum. To support the foundation’s mis- tion system to standardize and improve the f sion, Ms. Helfrich continues to serve on its Ex- delivery of legal services. Finally, General Har- AMOS RUTHERFORD ecutive Committee. Ms. Helfrich’s volunteer ef- ding astutely guided the Air Force through one forts have provided opportunities as well as in- of the most challenging budget crises in his- HON. MARK MEADOWS creased access for children to become cre- tory by providing sage legal support for mul- OF NORTH CAROLINA ative learners. tiple manpower and personnel reductions, IN THE HOUSE OF REPRESENTATIVES Ms. Helfrich has also served the Burbank headquarters reorganizations, and field oper- Friday, March 14, 2014 Unified School District as a parent representa- ating agency consolidations. tive to the District Safety Committee, where Through my role as Member of the Armed Mr. MEADOWS. Mr. Speaker, I rise today to she helped update the Special Education Par- Services Committee I have had the pleasure congratulate Mr. Amos Rutherford on his ent Handbook. She is currently serving on the of working directly with General Harding dur- 100th birthday, which he celebrates today, District Local Control Accountability Plan Com- ing this time. He has faithfully executed his March 14th, 2014. mittee. In addition, Ms. Helfrich, who is a com- oath of office and constitutional duties as the Mr. Rutherford is an exemplary citizen and mitted school fundraiser, has consistently top uniformed military lawyer for the United lifelong resident of Caldwell County. Born in served on Booster Club Boards since 2007. States Air Force and provided this committee Morganton in 1914, Mr. Rutherford joined the and congress with honest, direct, and sound military in 1942. As a medical aidman in World Ms. Helfrich is married to Mark Helfrich, a advice. He will leave a lasting legacy on our War II, Mr. Rutherford was awarded a Good feature film editor and director, and they have Armed Forces. Conduct Medal, American Theatre Service two teenage daughters. For thirty-four years General Harding has Medal, and a Victory Medal. These awards re- I ask all Members to join me in honoring an performed his job professionally, honestly, and flect Mr. Rutherford’s character and the incred- exceptional woman of California’s 28th Con- with great dedication. We will miss his leader- ible size of his heart. gressional District, Alexandra Helfrich.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00010 Fmt 0626 Sfmt 0634 E:\CR\FM\A14MR8.017 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E395 SERGIO MARTINEZ with a job. Insurance was not an industry HONORING JORDAN Jorge had come to know while growing up in FOTHERINGHAME HON. ED PERLMUTTER South America, so while he was initially skep- OF COLORADO tical, he ultimately proved to be a natural at HON. SAM GRAVES IN THE HOUSE OF REPRESENTATIVES selling policies after a few short weeks of get- OF MISSOURI ting accustomed to the nature of the business. IN THE HOUSE OF REPRESENTATIVES Friday, March 14, 2014 Following a tragic event in the community Friday, March 14, 2014 Mr. PERLMUTTER. Mr. Speaker, I rise where an insurance policy had a real impact, today to recognize and applaud Sergio Mar- Jorge became a believer in the industry and Mr. GRAVES of Missouri. Mr. Speaker, I tinez for receiving the Arvada Wheat Ridge developed a passion for the craft. This would proudly pause to recognize Jordan Service Ambassadors for Youth award. Sergio ultimately be the beginning of a long and suc- Fotheringhame. Jordan is a very special Martinez is an 8th grader at Wheat Ridge 5– cessful career. After starting his own agency, young man who has exemplified the finest 8 and received this award because his deter- CPI Financial & Insurance Services, in two lo- qualities of citizenship and leadership by tak- mination and hard work have allowed him to cations and acquiring another agency all with- ing an active part in the Boy Scouts of Amer- overcome adversities. in a matter of 10 years, Jorge became one of ica, Troop 135, and earning the most pres- The dedication demonstrated by Sergio the preeminent insurance agents in the Inland tigious award of Eagle Scout. Martinez is exemplary of the type of achieve- Empire. Jordan has been very active with his troop, ment that can be attained with hard work and Through all of his success, Jorge remained participating in many scout activities. Over the perseverance. It is essential students at all committed to helping others fulfill their ‘‘Amer- many years Jordan has been involved with levels strive to make the most of their edu- ican Dream.’’ By promoting employment op- scouting, he has not only earned numerous cation and develop a work ethic which will portunities within his insurance companies, he merit badges, but also the respect of his fam- guide them for the rest of their lives. has been able to help others looking for a ily, peers, and community. Most notably, Jor- I extend my deepest congratulations to Ser- chance to achieve their own form of success. dan has contributed to his community through gio Martinez for winning the Arvada Wheat From moving to the country virtually penniless, his Eagle Scout project. Jordan constructed a Ridge Service Ambassadors for Youth award. to being responsible for creating economic picnic shelter at Mac Porter Park in Kearney, I have no doubt he will exhibit the same dedi- growth for many in the Inland Empire, Jorge Missouri. cation and character in all of his future accom- proved that it is possible to accomplish your Mr. Speaker, I proudly ask you to join me in plishments. goals with a lot of hard work and dedication. commending Jordan Fotheringhame for his ac- complishments with the Boy Scouts of Amer- f On March 14, 2014, Jorge would have cele- brated his 50th Anniversary in the United ica and for his efforts put forth in achieving the TRIBUTE TO JORGE PAVEZ States of America. highest distinction of Eagle Scout. On March 20, 2014, a memorial honoring f HON. KEN CALVERT Jorge’s extraordinary life will be held. He is IN RECOGNITION OF DR. SHAWN survived by his loving wife and children. Jorge OF CALIFORNIA CASEY, RECIPIENT OF THE 2014 will always be remembered for his incredible IN THE HOUSE OF REPRESENTATIVES FRIENDLY SONS OF ST. PATRICK work ethic, generosity, contributions to the MAN OF THE YEAR AWARD Friday, March 14, 2014 community and love of family. His dedication Mr. CALVERT. Mr. Speaker, I rise today to is a testament to a life lived well and a legacy honor and pay tribute to a dear friend of mine, that will continue. I extend my condolences to HON. MATT CARTWRIGHT Jorge Pavez. Jorge passed away on Saturday, Jorge’s family and friends; although Jorge may OF PENNSYLVANIA IN THE HOUSE OF REPRESENTATIVES March 8, 2014. Riverside County has been be gone, the light and goodness he brought to fortunate to have community members whose the world remain and will never be forgotten. Friday, March 14, 2014 personal stories have contributed immensely f Mr. CARTWRIGHT. Mr. Speaker, today I to the rich history of Southern California. Jorge HONORING ELIZABETH BIESTER rise to honor Dr. Shawn Casey, who will re- Pavez was one of these individuals. He was ceive the 2014 Friendly Sons of St. Patrick truly the definition of the American Dream ful- Man of the Year Award on Monday, March 17, filled and served as an incredible inspiration to HON. MICHAEL G. FITZPATRICK 2014. Dr. Casey was born in Pittston to Su- those around him. A resident of Corona for OF PENNSYLVANIA zanne Walker Malloy and the late George T. over 40 years, Jorge was a pillar of the com- IN THE HOUSE OF REPRESENTATIVES Casey of Pittston. He graduated from Wyo- munity and will be deeply missed. Friday, March 14, 2014 ming Area High School and Wilkes University, The story of Jorge’s incredible life began in Mr. FITZPATRICK. Mr. Speaker, Elizabeth and studied Dentistry at the University of Pitts- 1963 when he boarded a plane in his home Biester is a Bucks County woman who has burgh. After graduation, Dr. Casey returned to nation of Chile, with a one way ticket to Miami. made a difference in the global and local com- the Pittston Area in 1994 to establish his den- He wasn’t sure what the United States of munity with years of leadership, social advo- tal practice. America would hold for him, but was ready to cacy, and volunteerism. She is being honored In 2005, Dr. Casey founded Casey Dental, tackle any challenge that came his way. With with the March 2014 Bucks County Women’s which now employs multiple dentists and spe- only $150 in his pocket upon arrival, success History Month Award. As a volunteer, she has cialists to provide comprehensive dental care proved distant. He struggled without any made an indelible imprint on our community in one location. Dr. Casey’s office also accom- knowledge of the English language and just a and beyond. modates Special Needs Dentistry for individ- small bed at the local YMCA that ran him $5 Elizabeth Biester has advocated on behalf uals with developmental disabilities, which he a night. After a series of unfortunate events, of the children of the world who were aban- dedicated to his aunt, Mary Casey. Recently, Jorge decided to head west to California by doned, orphaned, or experienced discrimina- Casey Dental expanded into Convention Hall driving a Buick convertible there for its owner. tion through her work with the Pearl S. Buck in Pittston Township, where the brand new fa- Jorge, who was still learning English and Foundation/Pearl S. Buck International and cility is equipped with 39 dentists and techni- developing his skills, was not discouraged by Welcome House. cians to meet the growing need of patients in the tough job market, and eventually landed a The local organizations in which she has Northeastern Pennsylvania. job as a parking attendant in Santa Monica. also tirelessly contributed include: American Shawn is a board member of the Pennsyl- He was soon transferred to another parking Red Cross, Network of Victim Assistance, vania Academy of General Dentistry, a mem- lot, and the move proved to be a testament to Teachers for Tomorrow, League of Women ber of the American Dental Association, Acad- fate, when he met his future wife, Joyce, who Voters, YWCA of Bucks County and the Bucks emy of General Dentistry, and Gnothos Ortho- worked in management there. She became re- County Symphony. dontic. He is also an active member of local sponsible for helping him learn English when We recognize a dedicated woman of integ- charities, church organizations, school dis- she gave him a book to assist in the process. rity and generous spirit who brings heart felt tricts, and public service organizations. In par- With the love and support of Joyce, proven compassion to her endeavors. As we also ac- ticular, Shawn takes great pride in his Irish hard work at the parking lot, and a new knowl- knowledge the impact she has had on many heritage and has been an active member with edge of the English language, a neighborhood lives, we are grateful to Elizabeth Biester for the Friendly Sons of St. Patrick for over 20 insurance agent took notice of Jorge’s natural setting an example of service and social advo- years. He won the Swingle Award for commu- work ethic and decided to give him a chance cacy for others to follow. nity service in 2003, and previously served as

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00011 Fmt 0626 Sfmt 9920 E:\CR\FM\K14MR8.035 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E396 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 the President of the organization. He will also tees for Dorris Place Elementary School. Ms. beautiful vistas. Visitors travel from all over to soon accept the organization’s 2014 Man of Lennane and her husband, Chad Gordon, see the breathtaking view from the Johnstown the Year award. have one daughter, Gala Lennane-Gordon. Inclined Plane and the natural beauty of Shawn now resides in Jenkins Township I ask all Members to join me in honoring an Prince Gallitzin State Forest and Laurel Ridge with his wife of 21 years, Michele, and their exceptional woman of California’s 28th Con- State Park. three children, George, Shawna, and gressional District, Blaire Lennane. Cambria County is also fortunate to have Samantha. Since joining in 1992, Shawn now f plentiful natural resources. Our hardworking enjoys yearly banquets and introducing his men and women drove the steel industry that son, George, to the Friendly Sons to carry on PERSONAL EXPLANATION built our Nation and developed its abundant the Casey Tradition. coal and natural gas. Today, many Cambria I proudly offer my congratulations to Dr. HON. CHRIS VAN HOLLEN County residents continue to work in the steel Casey for receiving this award from the OF MARYLAND and energy industries. Friendly Sons of St. Patrick. I applaud his IN THE HOUSE OF REPRESENTATIVES The county was the location of the Johns- commitment to providing dental care to Penn- Friday, March 14, 2014 town Flood, one of the worst natural disasters sylvanians, including those with special needs, in our Nation’s history. In the midst of great and his lifetime of service to the Pittston area. Mr. VAN HOLLEN. Mr. Speaker, on the challenges, the people of Cambria have over- afternoon of March 13, 2014, I was attending f come and pressed on to build the vibrant com- a meeting at the White House to discuss a munity that we celebrate today. A TRIBUTE TO BLAIRE LENNANE— sensitive constituent issue and was absent for Mr. Speaker, and fellow Members, please 28TH CONGRESSIONAL DISTRICT rollcall vote 126. Had I been present for rollcall join me in congratulating Cambria County on WOMAN OF THE YEAR vote 126, on passage of H. Res. 515, I would the 210th anniversary of its founding. have voted ‘‘no.’’ f HON. ADAM B. SCHIFF f OF CALIFORNIA HONORING THE DIRECTOR OF THE OUR UNCONSCIONABLE NATIONAL AIR FORCE SEXUAL ASSAULT IN THE HOUSE OF REPRESENTATIVES DEBT PREVENTION AND RESPONSE OF- Friday, March 14, 2014 FICE, MAJOR GENERAL MAGGIE Mr. SCHIFF. Mr. Speaker, I rise today in HON. MIKE COFFMAN H. WOODWARD honor of Women’s History Month. Each year, OF COLORADO we pay special tribute to the contributions and IN THE HOUSE OF REPRESENTATIVES HON. MICHAEL R. TURNER sacrifices made by our nation’s women. It is Friday, March 14, 2014 OF OHIO an honor to pay homage to outstanding Mr. COFFMAN. Mr. Speaker, on January IN THE HOUSE OF REPRESENTATIVES women who are making a difference in my 20, 2009, the day President Obama took of- Friday, March 14, 2014 Congressional District. I would like to recog- fice, the national debt was nize a remarkable woman, Blaire Lennane of $10,626,877,048,913.08. Mr. TURNER. Mr. Speaker, today I rise to Elysian Valley. Today, it is $17,491,372,091,598.45. We’ve honor Major General Maggie H. Woodward, Since 2011, Ms. Lennane has been an added $6,864,495,042,685.37 to our debt in 5 who is retiring after 31 years of faithful and unstoppable force in the Elysian Valley com- years. This is over $6.8 trillion in debt our na- distinguished service to her nation. Through- munity. Especially dedicated to serving the tion, our economy, and our children could out her career, and especially as a senior offi- area’s youth, she is the Founding President of have avoided with a balanced budget amend- cer, General Woodward has provided invalu- Partners of Dorris (POD). POD is a non-profit ment. able testimony, advice, and service to this organization committed to supporting public body. Specifically and most recently, General education programs affected by budget cuts f Woodward provided updates and insight in re- and the advancement of students at Dorris CONGRATULATING CAMBRIA COUN- lation to sexual assault in the military and on Place Elementary School. POD supports the TY ON ITS 210TH ANNIVERSARY her progress in leading the fight against this school’s teachers and contributes to the beau- scourge as Director of the new Air Force Sex- tification and safety of Elysian Valley through HON. KEITH J. ROTHFUS ual Assault Prevention and Response Office. outreach and volunteerism. A consummate or- OF PENNSYLVANIA Inspired by her grandfather, one of the ganizer, Ms. Lennane has formed partnerships United States’ first military pilots, General IN THE HOUSE OF REPRESENTATIVES with local businesses, non-profit organizations, Woodward sought to fly aircraft in defense of community groups, and corporations to gen- Friday, March 14, 2014 her nation. She entered the Air Force in 1983 erate funds and in-kind donations for the Mr. ROTHFUS. Mr. Speaker, I rise today to as an ROTC graduate of Arizona State Uni- school. She spearheaded the complete congratulate the residents of Cambria County, versity. Over the course of her distinguished makeover and re-opening of the school library, Pennsylvania, who celebrate the 210th anni- career, she commanded at the squadron, partnered with Home Depot to accomplish the versary of the County’s founding on March 26, group, wing, and numbered Air Force levels, leveling, re-building, and planting of the school 2014. Cambria County is nestled in the Laurel including Air Forces Africa in Germany and garden and worked with Office Depot to pro- Highlands of Western Pennsylvania and is the 89th Airlift Wing at Andrews Air Force vide supplies for the entire school. home to many great hard working Americans. base, home of . Ms. Lennane’s greatest achievement On March 26, 1804, the Pennsylvania As- General Woodward flew and commanded in through POD is the Instrumental Music Pro- sembly formed a new county from portions of Operations Just Cause, Northern and South- gram, where she partnered with the non-profit Huntingdon, Somerset, and Bedford Counties. ern Watch, Allied Force, Enduring Freedom group Education Through Music-Los Angeles, They named it Cambria, an old name for and Iraqi Freedom. Additionally, General to bring musical instrument instruction (violin, Wales. To determine the location of the county Woodward served as Coalition Forces Air cello, ukulele, and recorder) to the school, as seat, Cambria County held a census. Because Component Commander during Operation Od- well as organized afterschool ensemble prac- Ebensburg had the largest population of 150 yssey Dawn—the first female Component tice. to Johnstown’s 60, it became the new county Commander in our nation’s history. Her most Ms. Lennane has founded and organized seat. Over two centuries later, Ebensburg re- lasting impact will be the momentum she pro- many events which have become beloved an- mains the county seat. vided in turning back the tide of sexual assault nual traditions highly anticipated by the com- Today, more than 140,000 Pennsylvanians in our military; her compassion for victims, re- munity. Such events include the Training Day call Cambria County home. It contains more lentless pursuit of perpetrators, and dedication Fitness Fair & Walkathon, the Fine Arts Expo, than sixty-three municipalities including thirty- to reinforcing a climate of dignity and respect and the Save the Music Program Fall Festival. two boroughs, thirty townships, and the city of within the Air Force has set a new standard Ms. Lennane is also active with the Elysian Johnstown. The county is home to leading for military leaders everywhere. She retires as Valley Arts Collective, the Los Angeles City hospitals, educational institutions, defense a command pilot with more than 3,800 flying Parks Advisory Board for the Elysian Valley contractors, manufacturers, coal mines, and hours in multiple aircraft, and the respect of Recreation Center, and the Los Angeles Uni- other businesses. both military members and civilians alike. fied School District’s Parent Community Advi- From Northern Cambria to Nanty Glo to For 31 years General Woodward has per- sory Committee. She sits on several commit- Portage, Cambria County is blessed with formed her job professionally, honestly, and

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00012 Fmt 0626 Sfmt 9920 E:\CR\FM\A14MR8.022 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E397 passionately. We will miss her leadership, Center, among others. In addition to all of her from his district to screen applicants and as- courage, and dedication, and wish her all the accomplishments, Ms. Juarez designed a sist with the serious duty of nominating can- best as she retires from active duty service to plaque with an inscribed poem for the City of didates for academy admission. Today, I am our great nation. West Hollywood, which was dedicated in 2009 honored to continue this wise tradition in my f during the Transgender Day of Remembrance, service to the 11th Congressional District. a day to memorialize those who were killed The Academy Review Board is composed of A TRIBUTE TO DRIAN JUAREZ— due to anti-transgender hatred and prejudice. six local citizens who have shown exemplary 28TH CONGRESSIONAL DISTRICT I ask all Members to join me in honoring an service to New Jersey, to their communities, WOMAN OF THE YEAR exceptional woman of California’s 28th Con- and to the continued excellence of education gressional District, Drian Juarez. in our area—many are veterans. Though from HON. ADAM B. SCHIFF f diverse backgrounds and professions, they all OF CALIFORNIA share a common dedication that the best IN THE HOUSE OF REPRESENTATIVES PERSONAL EXPLANATION qualified and motivated graduates attend our academies. And, as true for most volunteer Friday, March 14, 2014 HON. ALLYSON Y. SCHWARTZ panels, their service goes largely unnoticed. Mr. SCHIFF. Mr. Speaker, I rise today in OF PENNSYLVANIA I would like to take a moment to recognize honor of Women’s History Month. Each year, these men and women and thank them pub- IN THE HOUSE OF REPRESENTATIVES we pay special tribute to the contributions and licly for participating in this important panel. sacrifices made by our nation’s women. It is Friday, March 14, 2014 Being on the board requires hard work and an an honor to pay homage to outstanding Ms. SCHWARTZ. Mr. Speaker, on rollcall objective mind. Members have the responsi- women who are making a difference in my No. 117, I was unable to attend. Had I been bility of interviewing upwards of 50 outstanding Congressional District. I would like to recog- present, I would have voted ‘‘yes.’’ high school seniors every year in the academy nize a remarkable woman, Drian Juarez of f review process. Hollywood. The nomination process follows a general Born in Juarez, Mexico and raised by her HONORING THE 2014 ACADEMY timetable. High school seniors mail personal grandmother, a five-year-old Ms. Juarez joined NOMINEES OF THE 11TH CON- information directly to the Military Academy, her mother in the United States after her GRESSIONAL DISTRICT OF NEW the Naval Academy, the Air Force Academy, grandmother’s passing. JERSEY and the Merchant Marine Academy once they Ms. Juarez’s artistic talents were noticed become interested in attending. Information in- early on by many of her teachers. She entered HON. RODNEY P. FRELINGHUYSEN cludes academic achievement, college entry a art contest, won, and OF NEW JERSEY test scores, and other activities. At this time, was awarded with art lessons throughout mid- IN THE HOUSE OF REPRESENTATIVES they also inform my office of their desire to be dle school. With these art lessons, Ms. Juarez nominated. was able to build a portfolio and gain entry Friday, March 14, 2014 The academies then assess the applicants, into the Los Angeles County High School for Mr. FRELINGHUYSEN. Mr. Speaker, every rank them based on the data supplied, and re- the Arts. Upon graduation, she was accepted year, more high school seniors from the 11th turn the files to my office with their notations. to Otis College of Art and Design, where she Congressional District trade in varsity jackets In late November, our Academy Review Board attained a Bachelor’s Degree in Fine Art. for navy pea coats, Air Force flight suits, and interviews all of the applicants over the course In 2005, Ms. Juarez was shot in the face at Army brass buckles than most other districts of 2 days. They assess a student’s qualifica- a Halloween event and lost sight in her right in the country. But this is nothing new—our tions and analyze character, desire to serve, eye. After this tragic incident, Ms. Juarez de- area has repeatedly sent an above average and other talents that may be hidden on cided to make a change in her life. For the portion of its sons and daughters to the na- paper. first time, she connected with Los Angeles tion’s military academies for decades. This year the board interviewed over 40 ap- transgender support groups and increased her This fact should not come as a surprise. plicants. The Board’s recommendations were involvement in local events and activism. She The educational excellence of area schools is then forwarded to the academies by January became a member of the West Hollywood well known and has long been a magnet for 31, where recruiters reviewed files and notified Transgender Task Force, which is now known families looking for the best environment in applicants and my office of their final decision as the West Hollywood Transgender Advisory which to raise their children. Our graduates on admission. Board, and also became a member of the are skilled not only in mathematics, science, As these highly motivated and talented Transgender Service Provider Network. In and social studies, but also have solid back- young men and women go through the acad- 2009, Ms. Juarez was invited to become a grounds in sports, debate teams, and other emy nominating process, never let us forget member of the Transgender Law Center’s extracurricular activities. This diverse upbring- the sacrifice they are preparing to make: to Transgender Leadership Council and the ing makes military academy recruiters sit up defend our country and protect our citizens. Transgender Economic Development Initiative. and take note—indeed, many recruiters know This holds especially true at a time when our For the past 6 years, Ms. Juarez has served our towns and schools by name. nation is fighting the war against terrorism. as Program Manager of the Transgender Eco- Since the 1830’s, Members of Congress Whether it is in Afghanistan or other hot spots nomic Empowerment Project (TEEP) at the have enjoyed meeting, talking with, and nomi- around the world, no doubt we are constantly Legal Services Department of the L.A. & nating these superb young people to our mili- reminded that wars are fought by the young. Lesbian Center. She has demonstrated re- tary academies. But how did this process And, while our military missions are both im- markable entrepreneurial skills and passion for evolve? In 1843, when West Point was the portant and dangerous, it is reassuring to empowering clients who are struggling with sole academy, Congress ratified the nomi- know that we continue to put America’s best immigration, employment, and race issues due nating process and became directly involved and brightest in command. to their identity. in the makeup of our military’s leadership. This ACADEMY NOMINEES FOR 2014, 11TH DISTRICT TEEP, in conjunction with Trans-Unity Pride, was not an act of an imperial Congress bent CONGRESSIONAL DISTRICT held its first job fair in 2008. Since then, TEEP on controlling every aspect of Government. AIR FORCE ACADEMY has collaborated with the West Hollywood Rather, the procedure still used today was, Justin M. Blumas, Roseland, West Essex H.S. Chamber of Commerce on a yearly job fair. As and is, a further check and balance in our de- Jennifer E. Lam, Boonton, Air Force Acad- part of this job fair, Ms. Juarez has provided mocracy. It was originally designed to weaken emy Prep Gender and Sexual Diversity in the Workplace and divide political coloration in the officer Sean M. Lyons, Morristown, Morristown trainings to human resources professionals corps, provide geographical balance to our H.S. and employers. Ms. Juarez has presented armed services, and to make the officer corps Angela E. Martone, Lincoln Park, Trinity over 400 transgender cultural competency more resilient to unfettered nepotism and Christian H.S. Michael J. Predojevic, Woodland Park, trainings to thousands of people, including at handicapped European armies. Passaic Valley H.S. conferences sponsored by the Transgender In 1854, Representative Gerritt Smith of MERCHANT MARINE ACADEMY Service Provider Network and the HIV Drug & New York added a new component to the Justin C. Corio, Bloomfield, Bloomfield Alcohol Task Force, LA Youth at Work, the academy nomination process—the academy H.S. City of L.A. Career Fair, Women’s Resource & review board. This was the first time a Mem- Clay C. Dundas, Sparta, Massachusetts Job Fair, Trans Action/Friends Community ber of Congress appointed prominent citizens Maritime Academy

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00013 Fmt 0626 Sfmt 0634 E:\CR\FM\A14MR8.026 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E398 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 Zachery F. Flake, Denville, Morris Knolls Award, which honors a member for assisting HONORING TYLER THORNE H.S. and giving back to his community. Seung H. Hwang, Wayne, Wayne Hills H.S. Scott R. Johnston, Wayne, Wayne Valley Currently, Joe resides in Hughestown with HON. SAM GRAVES H.S. his wife Anna. They have raised five children: OF MISSOURI Tyler G. Macejka, Pompton Plains, Joseph, John, Brent, Kahli and Aidan. They IN THE HOUSE OF REPRESENTATIVES Pequannock H.S. are also proud grandparents of four grand- Friday, March 14, 2014 Jennifer L. Pezzuti, Riverdale, Pompton Lakes H.S. children: Annabel, Joey, Adeline, and Remy Mr. GRAVES of Missouri. Mr. Speaker, I MILITARY ACADEMY Mack Joyce. proudly pause to recognize Tyler Thorne. Tyler is a very special young man who has ex- Chris-John H. Bosch, Wayne, Seton Hall I am proud to congratulate Mr. Joyce for re- Prep ceiving this acknowledgment from the Greater emplified the finest qualities of citizenship and Anthony Costagliola, Wayne, Wayne Hills Pittston Friendly Sons, and for his many years leadership by taking an active part in the Boy Scouts of America, Troop 135, and earning H.S. of service to the Pittston Area. Michael T. Herbert, Whippany, New Mexico the most prestigious award of Eagle Scout. Military Institute Tyler has been very active with his troop, Daniel K. Iskander, Madison, Madison H.S. f participating in many scout activities. Over the Parker F. Meytrott, Montville, MAPS many years Tyler has been involved with Dylan V. Panicucci, Sparta, Sparta H.S. HONORING PATRICK L. SULLIVAN scouting, he has not only earned numerous John C. Phillips, Sparta, Blair Academy ON THE OCCASION OF HIS RE- merit badges, but also the respect of his fam- Andrew S. Vena, Chatham, Chatham H.S. TIREMENT AS DIRECTOR OF THE ily, peers, and community. Most notably, Tyler Nicholas D. Wilde, Madison, Madison H.S. CAPTAIN JAMES A. LOVELL FED- Austin JC Williams, Verona, Verona H.S. has contributed to his community through his ERAL HEALTH CARE CENTER NAVAL ACADEMY Eagle Scout project. Joshua C. Corbett, Mendham, Gill St. Ber- Mr. Speaker, I proudly ask you to join me in nards commending Tyler Thorne for his accomplish- Patrick E. Dugan, Morristown, Oratory HON. BRADLEY S. SCHNEIDER ments with the Boy Scouts of America and for Prep OF ILLINOIS his efforts put forth in achieving the highest Jacob S. Ferraro, Kinnelon, Kinnelon H.S. distinction of Eagle Scout. Jack W. Frey, Sparta, Pope John XIII H.S. IN THE HOUSE OF REPRESENTATIVES Nicholas R. Maletto, North Haledon, Pas- f saic County Technical Institute Friday, March 14, 2014 HONORING THE LIFE AND DEDI- Michael B. Meisel, Sparta, Sparta H.S. CATED SERVICE OF EVANGELIST Nicholas A. Markferding, Florham Park, Mr. SCHNEIDER. Mr. Speaker, I am Seton Hall Prep pleased to rise today to honor Director Patrick STEVE HILL Michael E. McGlone, Boonton, Iona College L. Sullivan on the occasion of his retirement Dylan P. Pennell, West Orange, West Or- from the Captain James A. Lovell Federal HON. JEFF MILLER ange H.S. Health Care Center in the suburban Chicago OF FLORIDA Patrick K. Stanton, Hopatcong, Hopatcong IN THE HOUSE OF REPRESENTATIVES H.S. district that I represent. Friday, March 14, 2014 f In 2010, the nation’s first integrated Depart- ment of Veterans Affairs (VA)–Department of Mr. MILLER of Florida. Mr. Speaker, I rise IN RECOGNITION OF JOSEPH J. Defense (DoD) federal health care center to recognize the life and dedicated service of JOYCE, JR., RECIPIENT OF 2014 opened its doors with Pat Sullivan as Director. Evangelist Steve Hill, who passed away on THE FRIENDLY SONS OF ST. March 9, 2014, after a courageous battle with PATRICK ACHIEVEMENT AWARD The Lovell Federal Health Care Center (FHCC) at Naval Station Great Lakes was the melanoma. Pastor Hill served as a mentor and culmination of years of vision, planning and an inspiration to countless individuals. The HON. MATT CARTWRIGHT hard work. It was and is an example of excel- loss of a devoted husband, father, and unpar- OF PENNSYLVANIA alleled servant of our Lord and Savior Jesus lence for all other VA and DoD health care fa- Christ is felt not only in Northwest Florida but IN THE HOUSE OF REPRESENTATIVES cilities. Friday, March 14, 2014 throughout this great Nation and around the I am incredibly proud that Illinois’s Tenth world. Mr. CARTWRIGHT. Mr. Speaker, today I District is home to the Lovell FHCC and Naval Pastor Hill was born to a military family in rise in acknowledgment of Joseph J. Joyce, Station Great Lakes, the Navy’s only recruit 1954 in Ankara, Turkey. It was during his teen who will receive the Achievement Award from training command. It’s here that the Navy years, after his family moved to Huntsville, the Greater Pittston Friendly Sons of St. Pat- trains more than 40,000 new sailors each Alabama, where Pastor Hill felt the power of rick on Monday, March 17, 2014. Joe is a year. It’s here that the nation’s first integrated prayer for the first time more than ever. graduate of St. John’s High School, Pittston, federal health care center was created. And it Though, this was only the beginning; Pastor Pennsylvania, and Luzerne County Commu- was here that Director Sullivan’s leadership Hill’s love for God and helping others only nity College, Nanticoke, Pennsylvania. He helped make the vision of an integrated health grew. went on to major in Business Education & Ac- system a reality, raising the bar of achieve- Leaving behind a difficult past, Pastor Hill counting at Bloomsburg University. ment to new heights. attended David Wilkerson’s Twin Oaks Bible In 1989, Joe became licensed in Property Academy located in Lindale, Texas. He met and Casualty, Life, Accident and Health insur- Director Sullivan has done a remarkable job the love of his life there, the former Ms. Jeri ance and joined Joyce Insurance Group. leading an outstanding team of more than Larson, and the two were married in 1979. Today, he focuses his efforts on commercial 3,000 dedicated professionals. His leadership, Both began serving Christ through full-time insurance, overseeing the Commercial Lines drive, determination and forward-thinking ap- ministry with Outreach Ministries of Alabama Division and company-toagency relations, spe- proach have been key to Lovell FHCC’s suc- and then as youth pastors in Panama City and cializing in governmental and self-funded enti- cess and will be sorely missed. Tallahassee, Florida. Pastor Hill and his wife ties. Serving veterans, active duty personnel, then felt the Lord’s calling to serve His people Throughout his life, Joe has done charity military families and recruits each year, the abroad. Within seven years, they had man- work with several organizations. He is a mem- Lovell FHCC demonstrates an unwavering aged to spread God’s Word throughout South ber of St. John’s Roman Catholic Church, commitment to preparing warriors and caring America and Europe, establishing ministries Pittston, PA; the Jolly Boys Association, for heroes. and churches. Avoca, Pennsylvania; the Greater Pittston In 1995, Pastor Hill touched the Northwest Chamber of Commerce; the Avoca Lions Club, Director Sullivan’s accomplishments have Florida community when he spoke at a revival where he served as Secretary to the Board of laid the foundation for the care of many future at Brownsville Assembly of God in Pensacola, Directors; and the Friendly Sons of St. Patrick, generations of sailors, families and veterans. I Florida. Following his sermon, what would be- Greater Pittston Chapter, where he served as want to personally thank Director Sullivan for come known as the Brownsville Revival was President and Treasurer. Among his many ac- everything he has done, and congratulate him ignited, attracting millions of people from all complishments, Joe was the 2012 recipient of at the successful completion of a distinguished over the world. Pastor Hill’s ability to encour- the Friendly Sons of St. Patrick Swingle career with the Lovell FHCC. age and empower those seeking the Lord led

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00014 Fmt 0626 Sfmt 9920 E:\CR\FM\A14MR8.028 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS March 14, 2014 CONGRESSIONAL RECORD — Extensions of Remarks E399 to one of the longest running church revivals The dedication demonstrated by Samantha sory Board Award, and a city proclamation to throughout our Nation’s history. Preaching four Flores is exemplary of the type of achieve- recognize March 15, 2013 as ‘‘Ruth Williams nights a week for five years during the revival ment that can be attained with hard work and Day’’ in honor of her 75th birthday. and leading thousands of individuals to Christ, perseverance. It is essential students at all I ask all Members to join me in honoring an Pastor Hill was inspired to continue the revival levels strive to make the most of their edu- exceptional woman of California’s 28th Con- around the world. cation and develop a work ethic which will gressional District, Ruth Williams. In 2003 and 2004, Pastor Hill established guide them for the rest of their lives. f Heartland World Ministries Church and Heart- I extend my deepest congratulations to A TRIBUTE TO CHRISTY SCHIL- land School of Ministry in Irving, Texas, where Samantha Flores for winning the Arvada LING—28TH CONGRESSIONAL DIS- he served as the senior pastor up until 2012. Wheat Ridge Service Ambassadors for Youth TRICT WOMAN OF THE YEAR Despite facing a difficult health battle, his pas- award. I have no doubt she will exhibit the sion and heart for helping others did not same dedication and character in all of her fu- cease, and his service to Christ continued, as ture accomplishments. HON. ADAM B. SCHIFF OF CALIFORNIA he ministered through his website, f ProdigalsOnly.com; his writing; and television IN THE HOUSE OF REPRESENTATIVES broadcasts. A TRIBUTE TO RUTH WILLIAMS— Friday, March 14, 2014 28TH CONGRESSIONAL DISTRICT For over three decades, Pastor Hill was Mr. SCHIFF. Mr. Speaker, I rise today in WOMAN OF THE YEAR deeply committed to spreading the word of the honor of Women’s History Month. Each year, Lord and helping others find salvation. North- we pay special tribute to the contributions and west Florida and the countless individuals HON. ADAM B. SCHIFF sacrifices made by our nation’s women. It is whose lives were touched by Steve Hill mourn OF CALIFORNIA an honor to pay homage to outstanding the loss of an exceptional man of God. IN THE HOUSE OF REPRESENTATIVES women who are making a difference in my Mr. Speaker, on behalf of the United States Friday, March 14, 2014 Congressional District. I would like to recog- Congress, I am privileged to honor the service nize a remarkable woman, Christy Schilling of and contributions of Evangelist Steve Hill to Mr. SCHIFF. Mr. Speaker, I rise today in Glendale. the Northwest Florida community and around honor of Women’s History Month. Each year, Ms. Schilling grew up in Burbank and Glen- the world. My wife Vicki and I offer our prayers we pay special tribute to the contributions and dale and graduated from Burbank High School to his wife, Jeri; son, Ryan; daughters, Shelby sacrifices made by our nation’s women. It is in 1990. She went on to attend California and Kelsey; and the entire Hill family and an honor to pay homage to outstanding State University, Northridge, where she ma- friends. women who are making a difference in my jored in Sociology/Social Welfare. Ms. Schil- Congressional District. I would like to recog- f ling is dedicated to improving the quality of life nize a remarkable woman, Ruth Williams of for people living throughout the Los Angeles HOBBY LOBBY AND CONESTOGA West Hollywood. area. From childhood, Ms. Schilling has been WOOD SPECIALTIES CASES Ms. Williams is one of the original founders concerned about those less fortunate than of the City of West Hollywood. Incorporated in herself. She interned with the Haven Hills Do- HON. ZOE LOFGREN 1984, West Hollywood has been her home for mestic Violence Shelter, after completing her over sixty years. Her history of activism and OF CALIFORNIA degree in 1995, working to improve the lives volunteerism in West Hollywood is aston- IN THE HOUSE OF REPRESENTATIVES of battered women and their children. She not ishing. She has served as a member of the only counseled victims of domestic violence, Friday, March 14, 2014 Eastside Redevelopment Project Area Com- but also counseled pregnant and parenting Ms. LOFGREN. Mr. Speaker, I rise to ex- mittee since its inception, is a former board teens. press my concerns about two cases being ar- member of Good Neighbors, and has orga- In addition to her other volunteer efforts for gued before the Supreme Court this month, nized the annual Fourth of July Picnic and people, she is a fierce protector of and advo- Sebelius v. Hobby Lobby Stores and Con- Holiday Food Drive for many years. With a cate for animals. As she started volunteering estoga Wood Specialties v. Sebelius. I am a strong commitment to public safety issues, with different animal groups, her passion for strong supporter of our Constitution, which al- Ms. Williams helped create the original Dis- animal welfare grew. She realized that by lows for religious liberty, but religious liberty aster Volunteer Core Committee, worked tire- helping pets, she was helping people and the does not include the right to impose your own lessly with the Los Angeles County Sheriff’s whole community. Ms. Schilling has been an religious beliefs on others. If Hobby Lobby Department to create neighborhood watch avid animal welfare volunteer for more than 15 CEO David Green opposes birth control, he’s groups, and served on West Hollywood’s Pub- years, resulting in her founding of The Animal entitled to his opinion, but he is not entitled to lic Safety Commission. Ms. Williams also Protectorates (TAPS), a non-profit animal ad- impose his beliefs on others by deliberatively founded Citizens for Seniors and helped draft vocacy organization. Ms. Schilling is devoted refusing contraceptive coverage for his female West Hollywood’s first rent control ordinance to educating people about the importance of employees. This coverage makes a difference, while serving on the City’s Rent Stabilization spaying and neutering their animals, adopting especially for women working in entry level Commission. animals, and reducing euthanasia rates in positions that too often leave them below the As Director of Advocacy at the National shelters. TAPS is dedicated to protecting ani- poverty line. Women need to be able to make Council of Jewish Women/Los Angeles mals in every possible way, supports other or- their own decisions about their reproductive (NCJW/LA), Ms. Williams has firsthand knowl- ganizations aligned with the TAPS mission, health care without interference from their edge of the need for providing social services and advocates unity among animal welfare or- bosses. It is their right, and it should not be in the community. She strives to educate the ganizations. With its committed and enthusi- trampled upon. community about current issues such as child astic team and Board of Directors, TAPS is f abuse, human trafficking, domestic violence, making a tremendous and positive difference teen bullying, and human rights, as well as ad- for thousands of animals. SAMANTHA FLORES vocate for domestic violence shelter funding. Ms. Schilling is the voice of abused and Many of the NCJW/LA programs under Ms. helpless creatures, and her contributions are HON. ED PERLMUTTER Williams’ leadership have received statewide reaching far and wide. Her mission to elimi- OF COLORADO and federal recognition. nate the sale of puppy mill pets in Glendale IN THE HOUSE OF REPRESENTATIVES In addition to Ms. Williams’ work in the com- culminated in 2012 when the Glendale City munity and with NCJW/LA, she is also active Council passed its ordinance eliminating the Friday, March 14, 2014 in the Hollywood National Organization for sale of all puppy mill animals in Glendale. Mr. PERLMUTTER. Mr. Speaker, I rise Women, is a former Chair and life member of With the passage of this ordinance, Ms. Schil- today to recognize and applaud Samantha the Fairfax High School Alumni Association, ling’s attention turned to a similar draft of a Flores for receiving the Arvada Wheat Ridge current Vice Chair of the Fairfax Business As- puppy mill ordinance in the City of Burbank, Service Ambassadors for Youth award. sociation, and is involved in various political and Burbank’s City Council passed the ordi- Samantha Flores is a 12th grader at Jefferson organizations. Ms. Williams has received nu- nance as well. High School and received this award because merous awards, including the 2010 Los Ange- Throughout the years, Ms. Schilling has her determination and hard work have allowed les County Older American Recognition Day been a selfless volunteer. Her volunteer activi- her to overcome adversities. Award, a City of West Hollywood Senior Advi- ties have included fundraising for the YMCA

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00015 Fmt 0626 Sfmt 9920 E:\CR\FM\K14MR8.026 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS E400 CONGRESSIONAL RECORD — Extensions of Remarks March 14, 2014 child care programs and capital campaigns, with a local guild of Children’s Hospital Los I ask all Members to join me in honoring an Christmas in April home improvement projects Angeles, and regularly donating blood at the exceptional woman of California’s 28th Con- for low income families, and planting seedlings Glendale American Red Cross. Ms. Schilling gressional District, Christy Schilling. with underprivileged children at Tree People. and her husband, Craig Schilling, live in Glen- Her current volunteer activities include working dale.

VerDate Mar 15 2010 02:46 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00016 Fmt 0626 Sfmt 9920 E:\CR\FM\K14MR8.012 E14MRPT1 jbell on DSK4TPTVN1PROD with REMARKS Friday, March 14, 2014 Daily Digest Senate Chamber Action Committee Meetings The Senate met at 10:31:14 a.m. in pro forma ses- sion, and adjourned at 10:31:42 a.m. until 10:30 (Committees not listed did not meet) a.m. on Tuesday, March 18, 2014. No committee meetings were held. h House of Representatives H. Res. 515, the rule providing for consideration Chamber Action of the bills (H.R. 3189) and (H.R. 4015), was Public Bills and Resolutions Introduced: 23 pub- agreed to yesterday, March 13th. lic bills, H.R. 4251–4273; and 3 resolutions, H. Meeting Hour: Agreed that when the House ad- Res. 520–522 were introduced. Pages H2483–85 journs today, it adjourn to meet at 1 p.m. on Tues- Additional Cosponsors: Pages H2485–86 day, March 18th. Page H2470 Report Filed: A report was filed today as follows: Senate Message: Message received from the Senate H.R. 2810, to amend title XVIII of the Social Se- today appears on page H2470. curity Act to reform the sustainable growth rate and Senate Referrals: S. 1456 and S. 2147 were held at Medicare payment for physicians’ services, and for the desk. Page H2470 other purposes, with an amendment (H. Rept. 113–257 Pt. 2). Page H2483 Quorum Calls—Votes: Two yea-and-nay votes de- veloped during the proceedings of today and appear Speaker: Read a letter from the Speaker wherein he on pages H2469–70 and H2470. There were no appointed Representative Ribble to act as Speaker quorum calls. pro tempore for today. Page H2437 Adjournment: The House met at 9 a.m. and ad- SGR Repeal and Medicare Provider Payment journed at 1:11 p.m. Modernization Act of 2014: The House passed H.R. 4015, to amend title XVIII of the Social Secu- rity Act to repeal the Medicare sustainable growth Committee Meetings rate and improve Medicare payments for physicians and other professionals, by a yea-and-nay vote of 238 APPROPRIATIONS—FY 2015 DEPARTMENT yeas to 181 nays, Roll No. 135. Pages H2439–70 OF AGRICULTURE BUDGET Rejected the Loebsack motion to recommit the Committee on Appropriations: Subcommittee on Agri- bill to the Committee on Ways and Means with in- culture, Rural Development, FDA and Related structions to report the same back to the House Agencies held a hearing on FY 2015 Department of forthwith with an amendment, by a yea-and-nay vote Agriculture Budget. Testimony was heard from of 191 yeas to 226 nays, Roll No. 134. Page H2468 Thomas Vilsack, Secretary, Department of Agri- Pursuant to the rule, the amendment printed in culture; Joseph Glauber, Chief Economist, Depart- part B of H. Rept. 113–379 shall be considered as ment of Agriculture; and Michael Young, Budget adopted. Page H2439 Officer, Department of Agriculture.

D288

VerDate Mar 15 2010 02:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00001 Fmt 0627 Sfmt 0627 E:\CR\FM\D14MR4.REC D14MRPT1 jbell on DSK4TPTVN1PROD with DIGEST March 14, 2014 CONGRESSIONAL RECORD — DAILY DIGEST D289

U.S. CENTRAL COMMAND AND ISAF ported, as amended: H.R. 3584; H.R. 2672; H.R. OVERSIGHT HEARING 3623; H.R. 4164; and H.R. 4167. The Committee Committee on Appropriations: Subcommittee on Defense favorably reported its Views and Estimates for FY held a hearing on U.S. Central Command and ISAF 2015, as amended. Oversight Hearing. Testimony was heard from Gen- THE PROMISE OF THE TAIWAN eral Lloyd J. Austin III, Commander, United States RELATIONS ACT Central Command; and General Joseph F. Dunford, Jr., Commander, International Secretary Assistance Committee on Foreign Affairs: Full Committee held a Force and United States Forces Afghanistan. This hearing entitled ‘‘The Promise of the Taiwan Rela- was a closed hearing. tions Act’’. Testimony was heard from Kin Moy, Deputy Assistant Secretary, Bureau of East Asian and FISCAL YEAR 2015 NATIONAL DEFENSE Pacific Affairs, Department of State. AUTHORIZATION BUDGET REQUEST FROM THE DEPARTMENT OF THE AIR THE ALASKA NATIVE SUBSISTENCE CO- FORCE MANAGEMENT DEMONSTRATION ACT OF Committee on Armed Services: Full Committee held a 2014 hearing on Fiscal Year 2015 National Defense Au- Committee on Natural Resources: Subcommittee on In- thorization Budget Request from the Department of dian and Alaska Native Affairs held a hearing on the Air Force. Testimony was heard from Deborah discussion draft on ‘‘The Alaska Native Subsistence Lee James, Secretary of the Air Force; and General Co-Management Demonstration Act of 2014’’. Testi- Mark A. Welsh III, USAF, Chief of Staff, U.S. Air mony was heard from public witnesses. Force. MISCELLANEOUS MEASURES Joint Meetings Committee on Financial Services: Full Committee con- No joint committee meetings were held. cluded a markup on the following legislation: H.R. f 3623, the ‘‘Improving Access to Capital for Emerg- ing Growth Companies Act’’; H.R. 4164, the ‘‘Small COMMITTEE MEETINGS FOR TUESDAY, Company Disclosure Simplification Act’’; H.R. MARCH 18, 2014 4167, the ‘‘Restoring Proven Financing for American (Committee meetings are open unless otherwise indicated) Employers Act’’; H.R. 2672, the ‘‘CFPB Rural Des- ignation Petition and Correction Act’’; H.R. 3584, Senate the ‘‘Capital Access for Small Community Financial No meetings/hearings scheduled. Institutions Act of 2013’’; and Committee Views and Estimates on the President’s FY 2015 Budget House Submission. The following bills were ordered re- No hearings are scheduled.

VerDate Mar 15 2010 02:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00002 Fmt 0627 Sfmt 0627 E:\CR\FM\D14MR4.REC D14MRPT1 jbell on DSK4TPTVN1PROD with DIGEST D290 CONGRESSIONAL RECORD — DAILY DIGEST March 14, 2014

Next Meeting of the SENATE Next Meeting of the HOUSE OF REPRESENTATIVES 10:30 a.m., Tuesday, March 18 1 p.m., Tuesday, March 18

Senate Chamber House Chamber Program for Tuesday: Senate will meet in a pro forma Program for Tuesday: The House will meet in pro session. forma session at 1 p.m.

Extensions of Remarks, as inserted in this issue

HOUSE Hastings, Alcee L., Fla., E388 Schiff, Adam B., Calif., E385, E386, E388, E389, E390, Heck, Joseph J., Nev., E391 E392, E393, E394, E396, E397, E399, E399 Bishop, Timothy H., N.Y., E391 Higgins, Brian, N.Y., E385 Schneider, Bradley S., Ill., E386, E390, E398 Calvert, Ken, Calif., E395 Lee, Barbara, Calif., E389 Schwartz, Allyson Y., Pa., E392, E397 ´ Cardenas, Tony, Calif., E394 Lofgren, Zoe, Calif., E387, E399 Turner, Michael R., Ohio, E393, E396 Cartwright, Matt, Pa., E387, E389, E393, E395, E398 McDermott, Jim, Wash., E385 Upton, Fred, Mich., E392 Coffman, Mike, Colo., E396 Meadows, Markk, N.C., E394 Edwards, Donna F., Md., E392 Miller, Jeff, Fla., E386, E393, E398 Van Hollen, Chris, Md., E396 Fitzpatrick, Michael G., Pa., E395 Perlmutter, Ed, Colo., E385, E385, E386, E388, E390, Vela´ zquez, Nydia M., N.Y., E390 Frelinghuysen, Rodney P., N.J., E388, E397 E391, E392, E393, E395, E399 Webster, Daniel, Fla., E385 Graves, Sam, Mo., E386, E390, E391, E395, E398 Reed, Tom, N.Y., E391 Wilson, Joe, S.C., E390 Hall, Ralph M., Tex., E386 Rothfus, Keith J, Fla., E396 Wolf, Frank R., Va., E387

E PL UR UM IB N U U S The Congressional Record (USPS 087–390). The Periodicals postage is paid at Washington, D.C. The public proceedings of each House Congressional Record of Congress, as reported by the Official Reporters thereof, are printed pursuant to directions of the Joint Committee on Printing as authorized by appropriate provisions of Title 44, United States Code, and published for each day that one or both Houses are in session, excepting very infrequent instances when two or more unusually small consecutive issues are printed one time. ¶ Public access to the Congressional Record is available online through the U.S. Government Printing Office, at www.fdsys.gov, free of charge to the user. The information is updated online each day the Congressional Record is published. For more information, contact the GPO Customer Contact Center, U.S. Government Printing Office. Phone 202–512–1800, or 866–512–1800 (toll-free). E-Mail, [email protected]. ¶ To place an order for any of these products, visit the U.S. Government Online Bookstore at: bookstore.gpo.gov. Mail orders to: Superintendent of Documents, P.O. Box 979050, St. Louis, MO 63197–9000, or phone orders to 866–512–1800 (toll-free), 202–512–1800 (D.C. area), or fax to 202–512–2104. Remit check or money order, made payable to the Superintendent of Documents, or use VISA, MasterCard, Discover, American Express, or GPO Deposit Account. ¶ Following each session of Congress, the daily Congressional Record is revised, printed, permanently bound and sold by the Superintendent of Documents in individual parts or by sets. ¶ With the exception of copyrighted articles, there are no restrictions on the republication of material from the Congressional Record. POSTMASTER: Send address changes to the Superintendent of Documents, Congressional Record, U.S. Government Printing Office, Washington, D.C. 20402, along with the entire mailing label from the last issue received.

VerDate Mar 15 2010 02:24 Mar 15, 2014 Jkt 039060 PO 00000 Frm 00003 Fmt 0664 Sfmt 0664 E:\CR\FM\D14MR4.REC D14MRPT1 jbell on DSK4TPTVN1PROD with DIGEST