00:00Thank you again, Mr. Chairman. I have a couple of quick questions. I know we are a smaller
00:11committee and I am hoping that we might even get a second round. I want to obviously defer
00:15to both of the members here on my side of the aisle.
00:18I do want to be redundant, maybe deliberately redundant, about a few things. Number one,
00:25I appreciated the testimony that nearly all Medicare and SNAP recipients are eligible
00:32for benefits, which would explode the myth that has been circulating that people are
00:36getting things that are not eligible. I want to underscore again what I heard, that most
00:43improper payments are due to paperwork errors and not necessarily conniving persons trying
00:50to find a way to get a check.
00:54However, what I think I want to stop on more than anything else is the notion that was
01:00just enunciated that we have to stop it before it starts. Mr. Dieffenbach, I appreciate your
01:07comments that we can't play the game of pay and chase. That will go on forever, deplete
01:13resources and frustrate everybody.
01:17I do want to ask if the recommendations that you presented in your Senate testimony can
01:25be made available. I don't know that I have them, but I would like very much to see them.
01:32One overarching question and then I will get out of the way and yield to some of my colleagues.
01:38Can all of you, individually or collectively, give me your assessment of what has happened
01:45and what will happen now that all of these inspector generals are no longer in place
01:51to do the good job that they were doing to point out the crooks and the bad guys and
01:55to follow up with bodies like this, both in the House and Senate, that would allow us
02:00the ability to do what we have been able to do in a bipartisan way?
02:04I know what the effect is, but I need to hear it from the three of you.
02:10Sure, I can start. Certainly, the inspectors general play a key oversight role. They have
02:18responsibilities related to improper payments. Beyond that, they do audits of the programs
02:25day in and day out and can be very helpful in identifying some of the root causes that
02:30may lead to improper payments in the programs. Also, they are really helpful in coming up
02:38with solutions once they identify those root causes, identifying recommendations that the
02:44agencies can take. Certainly, the lack of their presence in some of the agencies would
02:53have a significant impact. In many of the agencies, and I am just trying
02:58to figure out now that they are gone, what do we do? What are agencies faced with and
03:03is there a greater propensity for the kind of fraud and abuse that we have seen?
03:12Congressman Nafume, the loss of the inspectors general was a great loss on a leadership level,
03:17on a productivity level. Our vice chair of the PRAC, Paul Martin, was the USAID inspector
03:22general who was dismissed and we greatly miss his leadership. I think the biggest thing
03:26for the Congress is you are going to have less transparency, less visibility on what
03:30is actually occurring in agencies because that is one of the hallmark principles when
03:34Congress set up the Inspector General Act, was to give you and the taxpaying public more
03:39visibility and transparency on an objective view of what exactly is going on. I think
03:42you are going to have reduced visibility.
03:44Ms. Wagner?
03:46Just to add an example to what my colleagues have said here, the HHS OIG is really important
03:51in supporting and funding state Medicaid fraud control units that investigate and prosecute
03:57Medicaid provider fraud. As I indicated, beneficiary fraud is very low in these programs, but provider
04:02fraud is common. In FY23, these units recovered $1.2 billion in criminal penalties and civil
04:10judgments. Also, the IGs and HHS would audit eligibility determination processes and they
04:19were very effective in identifying major issues in states, such as duplicate payments to managed
04:23care organizations, incorrect interpretations of federal policy and caseworker errors. Identifying
04:29these problems and working with the states to get them addressed is really a key role
04:34that is diminished right now.
04:36I think it would be fair to say that their dismissal has clearly exacerbated a problem
04:42that is clearly out of control now. Mr. Chairman, I yield back. Thank you very much.
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