Tuesday, April 18, 2017
Grassley: Trump’s H-1B Executive Order Protects American Workers; Prioritizes Visas for Most-Qualified Applicants
WASHINGTON – Senate Judiciary Committee Chairman Chuck Grassley, an author of legislation to reform the H-1B and L-1 skilled work visa programs, made the following statement regarding President Trump’s executive order to protect American workers and prioritize H-1B visas for the most-skilled applicants:
“The H-1B program was designed to fill gaps in America’s workforce with highly-skilled foreign workers, but as we’ve seen in recent years, the program has been abused and exploited at the expense of American workers and most-qualified foreign workers. We’ve seen companies use the program to fire American workers and replace them with lower-paid foreign counterparts. The visa lottery system makes this problem worse by rewarding visas randomly, instead of prioritizing foreign workers with greater experience, skill, and qualifications.
“I’ve introduced bipartisan legislation with Senator Durbin to address these problems, and I’ve expressed to President Trump the need to take action to restore the integrity in the H-1B Program. I’m grateful that President Trump has taken my suggestions to heart by taking steps today to protect American workers and preserve limited H-1B visas for truly qualified, high-skilled foreign workers,”
Grassley and Senator Dick Durbin introduced legislation earlier this year to protect American workers form H-1B abuse and prioritize visas based on the applicant’s merits rather than the general lottery system.
Last Congress, the Senate Judiciary Committee held a hearing exploring H-1B abuse and its impact on American workers, and recent media accounts have illustrated how such schemes are costing American workers their jobs.
Related: Grassley, Durbin: New H-1B Oversight Measures a Welcomed Step
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Grassley Seeks Answers on Reported “Brand Penalty” Charged to Patients Over Name Brand Prescription Drugs
WASHINGTON – Sen. Chuck Grassley is asking a health insurer to explain an apparent practice of charging customers more for receiving a brand name prescription drug than a generic drug when the insurer’s own doctors explicitly prescribed the brand name drug for medical reasons. This “brand penalty” reportedly is the difference between the price of the branded drug and the generic drug. The increased cost is expensive for patients and has medical implications because a brand name drug works better than the generic in some cases. Grassley also noted due process concerns about this potential practice if the insurer, CareFirst, is not complying with its own policies.
“The imposition of a brand penalty causes due process concerns,” Grassley wrote to Chet Burrell, president and chief executive officer of CareFirst, Inc. “If CareFirst has entered into thousands of contracts with individuals based upon a certain set of policy promises, it must provide proper notice to policyholders when contracted-for terms change. It is not clear whether CareFirst is providing notice, and it would be helpful to the Committee if it could describe, in detail, how it handles the notice requirement and whether it comports with the standard in the industry.
“… The issues at stake not only have a financial impact but a medical impact. Many patients have tested generics but have found that their body simply does not react positively to them and therefore require brand name drugs. Understanding how CareFirst, and the industry in general, approaches these situations is important not only to the consumer but Congress as well.”
Grassley noted that a brand penalty appears to be in conflict with CareFirst’s own guidelines and possibly federal law. He asked the company several questions to better understand its policies and practices in this area, as well as the general practice in the industry.
Grassley wrote to CareFirst because individuals reported to him that the insurer charged them a brand penalty even when the branded drug was deemed medically necessary by doctors.
Grassley’s letter is available here.
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Wednesday, April 19, 2017
Grassley, Leahy, Goodlatte, Conyers Remain Committed to Good-Faith Talks to Reform Investor Visa Program Ahead of Expiration
EB-5 reforms needed to curb fraud, abuse, national security risks
WASHINGTON – Bipartisan, bicameral Judiciary Committee leaders today reaffirmed their commitment to reform the troubled EB-5 investor visa program ahead of its scheduled expiration on April 28, or to let the flawed program expire if reforms are not possible. Senate Judiciary Committee Chairman Chuck Grassley and Senator Patrick Leahy, along with House Judiciary Committee Chairman Bob Goodlatte and Ranking Member John Conyers reiterated requirements of any meaningful negotiation as they continue to search for a compromise on EB-5 reform. The program has longstanding, well-documented fraud, abuse and national security concerns, and has drifted away from Congress’ original intent: spurring job creation in rural and economically depressed areas.
“Despite the well-documented and rampant abuse of the EB-5 Regional Center Program that we have exposed in recent years, we remain committed to working in good faith with our colleagues and industry stakeholders to bring about much needed reforms to this troubled program. However, as we have made clear time and time again, any reforms must contain genuine and sincere changes to allow rural and distressed urban areas, the very communities this program is supposed to benefit, to compete for investment dollars. In addition, any reforms must address the many national security and fraud concerns by containing – without loopholes – compliance measures, background checks, and transparency provisions,” the lawmakers said.
“Just a few weeks ago, we were encouraged by a reasonable proposal offered by IIUSA, the nation’s largest EB-5 industry trade association, containing significant reforms to the program. The proposal was a good faith effort to address our concerns and provide long-term stability to the program, and could have served as a basis for reform negotiations.
“As we have in the past, we remain willing to work with our colleagues and industry groups to produce meaningful reform. This must include strong transparency and anti-fraud measures, meaningful investment differentials, adjustments of the investment amounts to appropriately account for inflation, adequate set asides for both rural and urban distressed areas, and an end to the program’s abusive gerrymandering practices.”
In a recent letter to congressional leadership, the lawmakers, along with Senate Judiciary Committee Ranking Member Dianne Feinstein, stated that the program should expire absent these reforms.
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Grassley Continues Oversight of Medicare Advantage Payments, Seeks Updates, Answers from New Administration
WASHINGTON – Sen. Chuck Grassley continues his oversight of whether the taxpayers are overpaying insurers in Medicare Advantage, seeking updates and answers from the Centers for Medicare and Medicaid Services (CMS) on what the agency is doing to prevent insurance company risk score gaming to get higher payments.
“By all accounts, risk score gaming is not going to go away,” Grassley wrote to CMS Administrator Seema Verma. “Therefore, CMS must aggressively use the tools at its disposal to ensure that it is efficiently identifying fraud and subsequently implementing timely and fair remedies. The use of these tools is all the more important as Medicare Advantage adds more patients and billions of dollars of taxpayer money is at stake.”
In response to a prior Grassley inquiry, CMS noted prior audits of Medicare Advantage organizations and the recovery of taxpayer money. However, CMS failed to note an initial overpayment assessment of $128 million for five health plans in 2007, compared to the $3.4 million actually recovered by the government in 2012. The overpayment assessment came to light only through investigative reporting by the Center for Public Integrity.
“The difference in the assessment and the actual recovery is striking and demands an explanation,” Grassley wrote. “Further, in light of the $70 billion in risk score overpayments between 2008-2013 reported by the Center for Public Integrity, CMS’s 2007 overpayment estimate of $128 million appears low and could very well be just the tip of the iceberg.”
Grassley asked a series of question on what CMS is doing to ensure that insurance companies are not gaming Medicare, why CMS under the Obama Administration didn’t disclose the $128 million over-payment assessment, why the prior administration recovered $3.4 million instead of $128 million, how many Medicare Advantage audits have been performed and how many are ongoing, and whether CMS’ position remains that it obligates $30 million per year auditing Medicare Advantage.
Grassley’s letter is available here. A prior CMS response to Grassley is available here.
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