00:00Thank you, Mr. Dodaro, for being here today.
00:11I have a lot of questions.
00:13I don't know that I'm going to be able to get to all of them in the five minutes, but
00:16I would like to first talk about the student loan income-driven repayment plans.
00:23For federal students, the borrowers can apply for income-driven repayment plans, which use
00:28the borrowers, supposedly, their taxable income and their family size to determine what the
00:35pay rate is.
00:37GAO recommended that the Department of Education obtain data to verify income information for
00:43borrowers that were reporting zero income on income-driven repayment applications.
00:51What's been the result of that recommendation?
00:54Due to implementation of our recommendations, the Congress had given education the authority
01:03to use IRS data to verify income if the applicants for the income-driven payment program would
01:12agree to allow their tax data to be accessed by IRS.
01:18That was part of the law.
01:19Wouldn't that be a tacit consent if they're making the application that they understand
01:25that their data would be accessed?
01:27No.
01:28No.
01:29They have to give permission in order to do it.
01:31There are criminal penalties for IRS sharing tax data without appropriate authority.
01:37So that was a safeguard put into place.
01:39So that's in place now.
01:42But what isn't in place is for the people who don't agree to have their tax data accessed.
01:51What is education going to do to verify their income?
01:55They can get commercial sources.
01:57There are plenty available for that.
01:59They can use, if they get authority from the Congress, the new hire database that the HHS,
02:08Health and Human Services, has, it has the most up-to-date wage information for people
02:14in the country.
02:15It's used for child enforcement purposes.
02:18But it can be used.
02:19That's what we used when we compared that data to what people had put in their applications
02:25at education.
02:28That's where we found 95,000 plans were reporting zero income, but that data showed that that
02:35wasn't necessarily the case.
02:37So what, does the Department of Education have the authority, if they were to be able
02:43to get this private sector data and compare that with the claims, and then if you have
02:51incongruency, what would the next steps be?
02:55Could they require at that point, or deny them unless they provide their tax forms?
03:01They could provide additional support.
03:03And is that happening?
03:06We don't know yet.
03:07We're going to look at this.
03:08This is just newly implemented.
03:09You know, there was a pause during COVID for people in the repayment of their income-driven
03:16payment plan.
03:17So that's just started up most recently.
03:20And people have to recertify every year.
03:22So we're going to look at this and see what they're doing at the Education Department
03:27to handle this particular gap.
03:29And then I have two more questions.
03:31One, I was intrigued by the discussion about our universities and your recommendations
03:35to secure the, make sure that our intellectual property, the security of the United States
03:42is protected at our research facilities.
03:46What, and it sounds like there are some recommendations that will require steps from Congress.
03:53Can you elaborate on that?
03:55I'm not sure.
04:01Yeah, our recommendations really were to the executive branch, is what I thought, that
04:07there'd be more efforts on foreign, to determine foreign ownership and control or influence
04:14over these particular areas.
04:17Now what we found is that some agencies were doing a good job and using intelligence information
04:23and others, but there was no sharing going on across the government.
04:27So one agency might be making a grant to the same place that our agency wouldn't do so
04:33because they had concerns and had additional information.
04:37So we asked the Office of Science, Technology and Policy in the White House, which is supposed
04:42to put out government-wide guidance on this, to put out better guidance.
04:46So there's more thorough vetting ahead of time because the agencies have a lot of questions.
04:53And then within my short time, this is a big question, you mentioned that there's potential
04:58saving opportunities with the Medicaid systems that states, for states to modernize.
05:04Can you elaborate on those and if there's any action we need to take in Congress?
05:08Yeah, I think the main action is oversight.
05:11I think the Medicaid program needs a lot more oversight about what's going on.
05:16For example, they estimate there was $50 billion in improper payments last year.
05:24That's mostly in the fee-for-service portion.
05:26In the Medicaid Advantage portion, which as you know is almost half of the amount of spending
05:31now in Medicaid, there's really not very good auditing of what's going on in the Medicare
05:37Advantage program.
05:38We've encouraged and CMS has started to do more audits over there and they're finding
05:43some of the same overpayment problems and preliminary estimates in that area.
05:48But Congress can do a lot more.
05:51Also Congress can require that any Medicaid demonstration, about half of Medicaid spending
05:58right now is because the states came to the federal government and they said, you know,
06:03we want to try this new process and if we do so, we think we could better serve the
06:08public.
06:09Waiver program.
06:10Waiver, yeah, exactly, the waiver program.
06:13But the waiver program was supposed to be budget neutral, so it wasn't supposed to cost
06:17more money and it has, big time.
06:21And so we're allowing waivers that are costing more and they're not really, in many cases,
06:32demonstrating the benefits.
06:33Better outcomes.
06:34Better outcomes, exactly.
06:36So that program, and it's fast growing, it's fast growing.
06:40And I think it's always used to help during economic downturns and other things.
06:46We have a recommendation that Congress act to provide, during economic downturns, a formula
06:54that would be put in place to more timely provide assistance, you know, during high
06:59periods of unemployment for people that would then require Medicaid be more efficient and
07:04effective than some of the approaches Congress uses in times of economic crisis.
07:12Thank you.
07:13I have an opportunity, and I thank you, I put the wrong talk on.
07:25Mr. Dodaro, I want to go back to, there's been some bit of discussion about health care
07:31here today, and probably four or five specific areas you've spoken of.
07:37I wondered if you would walk through.
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