A letter report issued by the General Accounting Office with an abstract that begins "Breast cancer is the second leading cause of cancer deaths among American women. In 2001, 192,200 new cases of breast cancer were diagnosed and 40,200 women died from the disease. The probability of survival increases significantly, however, when breast cancer is discovered in its early stages. Currently, the most effective technique for early detection of breast cancer is screening mammography, an X-ray procedure that can detect small tumors and breast abnormalities up to two years before they can be detected by touch. Nationwide data indicate that mammography services are generally adequate to meet the growing demand. Between 1998 and 2000, both the population of women 40 and older and the extent to which they were screened increased by 15 percent. Although mammography services are generally available, women in some locations have problems obtaining timely mammography services in some metropolitan areas. However, the greatest losses in capacity have come in rural counties. In all, 121 counties, most of them rural, have experienced a drop of more than 25 percent in the number of mammography machines in the last three years. Officials from 37 of these counties reported …

A letter report issued by the Government Accountability Office with an abstract that begins "Few things generate more attention and anxiety among American consumers than the price of gasoline. Periods of price increases are accompanied by high levels of media attention and consumer questioning about the causes and impacts of the price changes. The most recent upsurge in prices is no exception. Between January 3 and April 11, 2005, gasoline prices increased nearly every week, and during this time the average U.S. price for regular unleaded gasoline jumped 50 cents per gallon, adding about $7.8 billion to consumers' total gasoline bill, or about $58 for each passenger car in the United States. Spending billions more on gasoline pinched consumer budgets, leaving less money available for other purchases. Beyond having concerns over price increases, consumers find it difficult to understand how prices can vary so much across the country or even from neighborhood to neighborhood. For example, consumers in San Francisco paid an average of $2.63 per gallon during the week of April 11, 2005, while consumers in Chicago paid $2.33 per gallon; in Denver, $2.25; in New York, $2.19; and in Houston, $2.12. Within the city of Washington, D.C., pump …

A letter report issued by the General Accounting Office with an abstract that begins "The Railroad Revitalization and Regulatory Reform Act of 1976 and the Staggers Rail Act of 1980 gave freight railroads increased freedom to price their services according to market conditions. A number of shippers are concerned that freight railroads have used these pricing freedoms to unreasonably exercise their market power in setting rates for shippers with fewer alternatives to rail transportation. This report updates the rate information in GAO's 1999 report (RCED-99-93) using selected commodities and with effective competitive transportation alternatives. From 1997 through 2000, rail rates generally decreased, both nationwide and for many of the specific commodities and markets that GAO examined. However, rail rates for some commodities and distance categories--such as wheat moving long distances and coal moving short distances--have stayed about the same or increased. In other instances, such as wheat moving medium distances, rail rates stayed about the same or decreased. Overall, the proportion of rail shipments above the Surface Transportation Board's statutory jurisdictional threshold for considering rate relief actions--where railroad revenues for the shipment exceed 180 percent of variable costs--stayed relatively constant at 30 percent from 1997 through 2000. However, the proportion …

A chapter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on: (1) the environment within which railroad rates have been set since 1990; (2) how railroad rates have changed since 1990; (3) how railroad service quality has changed since 1990; and (4) actions taken by the Surface Transportation Board and others to address railroad service quality problems."

A letter report issued by the Government Accountability Office with an abstract that begins "Continued development and efficient performance of the nation's freight transportation system is vital to maintaining a strong U.S. economy and sustaining our nation's competitive position in the global economy. Yet, increasing congestion on our nation's roads and rail lines threatens to undermine the efficiency of our freight transportation system. Although the Department of Transportation (DOT) has taken some steps to enhance freight mobility, there is growing concern that additional action is needed. To assist the Congress in enhancing national freight mobility, GAO reviewed (1) factors that contribute to constrained freight mobility and their effects in areas with nationally significant freight flows, and (2) approaches to address freight mobility in those areas and the challenges decision makers face in implementing those approaches. GAO analyzed freight transportation data and interviewed stakeholders in four areas with large freight flows."

A letter report issued by the Government Accountability Office with an abstract that begins "To help address challenges associated with deteriorating facilities and underused property, the Department of Defense (DOD) has pursued a strategy that includes leasing underused real property to gain additional resources for improving installation facilities. Section 2667 of Title 10, U.S. Code, provides authority to the military departments to lease nonexcess real property, subject to several provisions, in exchange for cash or in-kind consideration. According to the military services, some leases, referred to as enhanced use leases (EUL), are more complex with long terms and could provide hundreds of millions of dollars for in-kind services to improve installation facilities. A committee report accompanying the 2011 defense authorization directed GAO to review the EUL program. This report (1) assesses the extent to which selected EULs complied with section 2667 of Title 10, U.S. Code; (2) determines to what extent the services' expectations for their EULs have been realized; and (3) evaluates the services' management of the EUL program. GAO reviewed information on the services' 17 EULs in place at the end of fiscal year 2010 and selected 9 for detailed case study."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the key elements of partnerships between the federal government and the private sector that were formed to help the government acquire and operate federal real estate and facilities more efficiently and effectively, focusing on the experiences of six federal partnerships formed by the: (1) National Park Service; (2) Department of Veterans Affairs (VA); and (3) Postal Service (USPS)."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2003, Congress established a program to reduce airport ground emissions at commercial service airports in areas failing to meet or maintain air quality standards. The Federal Aviation Administration (FAA) administers the Voluntary Airport Low Emissions (VALE) Program and oversees the program's two sources of funding: Airport Improvement Program (AIP) federal grants or Passenger Facility Charges (PFC), which airports can collect from passengers. Participating airports also receive credits for the emission reductions achieved through VALE projects in accordance with the law and guidance. Airports can use these credits to offset emissions resulting from development projects to comply with federal Clean Air Act requirements. GAO was asked to determine (1) how the VALE program has been implemented, including airport participation levels, types of projects, and program expenditures, and (2) the outcomes attributable to the VALE program. To do this, GAO reviewed FAA data on VALE projects for all nine participating airports; visited two of these airports; obtained information from the remaining seven participating airports and four nonparticipating airports; and interviewed officials from FAA, Environmental Protection Agency (EPA), and airport associations. FAA generally agreed with the report's findings, …

A letter report issued by the Government Accountability Office with an abstract that begins "Military personnel, as well as civilian public safety officers (PSO), risk their lives and face the prospect of incurring disabilities as they protect and defend the general public on a daily basis. To help assess the appropriateness of disability benefits available to military personnel, Congress mandated that GAO study the disability benefits available to federal, state, and local government employees who serve the public in high-risk occupations and are injured in the line of duty. In response, GAO compared the disability benefits available to military personnel with the disability benefits available to civilian PSOs at the federal level, and in six states and six cities that were selected to illustrate the range of benefits provided. This study focuses on benefits provided to law enforcement officers and firefighters at the federal level, to state police at the state level, and to firefighters at the local level. For each program included in the review, GAO identified the benefits available for temporary disability, permanent partial disability, and permanent total disability, and then calculated the lifetime present value of the benefits provided to various hypothetical individuals in different circumstances. Cognizant …

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the Department of Veterans Affairs' (VA) efforts to increase revenues from alternative sources as a way to supplement its medical care appropriations, focusing on trends in third-party collections."

A letter report issued by the Government Accountability Office with an abstract that begins "U.S ports are significant to the U.S. economy, handling more than 2 billion tons of domestic and import/export cargo annually. Since Sept. 11, 2001, much of the national focus on ports' preparedness has been on preventing potential acts of terror, the 2005 hurricane season renewed focus on how to protect ports from a diversity of threats, including natural disasters. This report was prepared under the authority of the Comptroller General to examine (1) challenges port authorities have experienced as a result of recent natural disasters, (2) efforts under way to address these challenges, and (3) the manner in which port authorities plan for natural disasters. GAO reviewed documents and interviewed various port stakeholders from 17 major U.S. ports."

A letter report issued by the Government Accountability Office with an abstract that begins "Medicare spending on home health totaled $12.9 billion in 2006, up 44 percent from 2002. Concerns have been raised that improper payments from practices indicating fraud and abuse may have contributed to Medicare home health spending and utilization. The Centers for Medicare & Medicaid Services (CMS), the agency that administers Medicare, is responsible for minimizing improper payments made on behalf of Medicare beneficiaries. GAO was asked to examine the growth in Medicare home health spending and utilization and the benefit's vulnerability to improper payments. GAO focused on states with the highest growth in Medicare home health spending or utilization; fraudulent and abusive practices contributing to recent spending and utilization; and administrative issues that make it vulnerable to improper payments. GAO analyzed Medicare claims data; reviewed Medicare laws and regulations and CMS documents; and interviewed stakeholders and contractors that administer and protect the home health benefit."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) provides health care to veterans through the $27 billion Veterans Health Administration (VHA) medical programs. VHA administers and operates VA's medical system, providing care to nearly 5 million patients in 2003. As of September 2003, VHA operated 160 hospitals, 847 outpatient clinics, 134 nursing homes, 42 domiciliaries, and 73 comprehensive home care programs, including facilities in every state, Puerto Rico, the Philippines, and Guam. VHA is responsible for effective stewardship of the resources provided to it by Congress, which asked GAO to review internal controls in three areas of operation at selected VHA medical centers. GAO conducted a review to assess the effectiveness of control activities over (1) personal property, (2) drugs returned for credit, and (3) part-time physician time and attendance."

A letter report issued by the Government Accountability Office with an abstract that begins "As demand for transit and competition for available federal funding increases, transit project sponsors are increasingly looking to alternative approaches, such as public-private partnerships, to deliver and finance new, large-scale public transit projects more quickly and at reduced costs. GAO reviewed (1) the role of the private sector in U.S. public transit projects as compared to international projects; (2) the benefits and limitations of and barriers, if any, to greater private sector involvement in transit projects and how these barriers are addressed in the Department of Transportation's (DOT) pilot program; and (3) how project sponsors and DOT can protect the public interest when these approaches are used. GAO reviewed regulations, studies, and contracts and interviewed U.S., Canadian, and United Kingdom officials (identified by experts in the use of these approaches)."

A letter report issued by the Government Accountability Office with an abstract that begins "While the Enhanced Border Security and Visa Protection Act repealed a 45 minute standard for inspecting international passengers, minimizing wait times at airports remains an area of concern for U.S. Customs and Border Protection (CBP). Shortly after its creation in March 2003, CBP assumed inspection functions from the Immigration and Naturalization Service, the U.S. Customs Service, and the Department of Agriculture. The new agency's priority missions are to prevent terrorism and to facilitate travel and trade. To assess CBP's efforts to minimize wait times for international air passengers while ensuring security, this report answers the following questions: (1) What are the wait times at the 20 U.S. international airports that receive most of the international traffic and what factors affect wait times? (2) What steps have airports and airlines taken to minimize passenger wait times? (3) How has CBP managed staffing to minimize wait times across airports?"

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the year 2000 readiness status of 25 of the nation's largest public school districts, focusing on the systems supporting those districts' key business functions."

A letter report issued by the Government Accountability Office with an abstract that begins "Each year, tens of thousands of people who have been persecuted or fear persecution in their home countries apply for asylum in the United States. Immigration judges (IJ) from the Department of Justice's (DOJ) Executive Office for Immigration Review (EOIR) decide whether to grant or deny asylum to aliens in removal proceedings. Those denied asylum may appeal their case to EOIR's Board of Immigration Appeals (BIA). GAO was asked to assess the variability of IJ rulings, and the effects of policy changes related to appeals and claims. This report addresses: (1) factors affecting variability in asylum outcomes; (2) EOIR actions to assist applicants and IJs; (3) effects associated with procedural changes at the BIA; and (4) effects of the requirement that asylum seekers apply within 1 year of entering the country. GAO analyzed DOJ asylum data for fiscal years 1995 through mid-2007, visited 5 immigration courts in 3 cities, including those with 3 of the top 4 asylum caseloads; observed asylum hearings; and interviewed key officials. Results of the visits provided additional information but were not projectable."

A letter report issued by the Government Accountability Office with an abstract that begins "The 2005 Base Realignment and Closure (BRAC) round is the biggest, most complex, and costliest ever. DOD viewed this round as a unique opportunity to reshape its installations, realign forces to meet its needs for the next 20 years, and achieve savings. To realize savings, DOD must first invest billions of dollars in facility construction, renovation, and other up-front expenses to implement the BRAC recommendations. However, recent increases in estimated cost have become a concern to some members of Congress. Under the Comptroller General's authority to conduct evaluations on his own initiative, GAO (1) compared the BRAC Commission's cost and savings estimates to DOD's current estimates, (2) assessed potential for change in DOD's current estimates, and (3) identified broad implementation challenges. GAO compared the BRAC Commission's estimates, which were the closest estimates available associated with final BRAC recommendations, to DOD's current estimates. GAO also visited 25 installations and major commands, and interviewed DOD officials."

Testimony issued by the Government Accountability Office with an abstract that begins "Earlier this month, United Air Lines (United) and Continental Airlines (Continental) announced plans to merge the two airlines and signed a merger agreement. This follows the acquisition of Northwest Airlines by Delta Air Lines (Delta) in 2008, which propelled Delta to become the largest airline in the United States. This latest merger, if not challenged by the Department of Justice (DOJ), would surpass Delta's merger in scope to create the largest passenger airline in terms of capacity in the United States. The passenger airline industry has struggled financially over the last decade, and these two airlines believe a merger will strengthen them. However, as with any proposed merger of this magnitude, this one will be carefully examined by DOJ to determine if its potential benefits for consumers outweigh the potential negative effects. At the Committee's request, GAO is providing a statement for the record that describes (1) an overview of the factors that are driving mergers in the industry, (2) the role of federal authorities in reviewing merger proposals, and (3) key issues associated with the proposed merger of United and Continental. To address these objectives, GAO drew …

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO assessed the Federal Transit Administration's (FTA) new starts program, focusing on identifying those projects that have experienced changes in their baseline cost estimates and the reason for the changes."

A letter report issued by the Government Accountability Office with an abstract that begins "Globally, alien smuggling generates billions of dollars in illicit revenues annually and poses a threat to the nation's security. Creation of the Department of Homeland Security (DHS) in March 2003 has provided an opportunity to use financial investigative techniques to combat alien smugglers by targeting and seizing their monetary assets. For instance, the composition of DHS's largest investigative component--U.S. Immigration and Customs Enforcement (ICE)--includes the legacy Customs Service, which has extensive experience with money laundering and other financial crimes. Another DHS component, U.S. Customs and Border Protection (CBP) has primary responsibility for interdictions between ports of entry. In summer 2003, ICE announced that it was developing a national strategy for combating alien smuggling. Among other objectives, GAO determined the implementation status of the strategy and investigative results in terms of convictions and seized assets."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO has designated the Department of Defense's (DOD) management of support infrastructure as a high risk area, in part because of challenges in reducing excess infrastructure. Operating and maintaining excess facilities consumes resources that could be eliminated from DOD's budget or used for other purposes. In response to direction in House Report 111-491, GAO reviewed DOD's (1) progress toward meeting demolition program targets for fiscal years 2008 through 2013; (2) facility utilization information--a source for identifying additional excess facilities; and (3) plans for managing and disposing of excess facilities after fiscal year 2013. GAO analyzed information on excess facilities, completed demolitions, and underutilized facilities in DOD's real property inventory database; reviewed DOD's plans for demolition after the on-going program ends; and conducted site visits to selected military installations."

A letter report issued by the Government Accountability Office with an abstract that begins "In January 2004, the Office of the Comptroller of the Currency (OCC)--the federal regulator of national banks--issued rules concerning the extent to which federal law preempts state and local banking laws. Some state officials and consumer groups expressed concerns about a perceived loss of consumer protection. GAO identified (1) how OCC's complaint process compares with that of other federal bank regulators, (2) how complaint information informs OCC's supervision of national banks, and (3) issues that consumer advocates and state officials have raised about OCC's consumer protection efforts and OCC's responses to the issues."

A letter report issued by the General Accounting Office with an abstract that begins "Although noise has long been a problem around airports, the anticipated growth in demand for air travel has also raised questions about the effect of airport operations on air quality. Aviation-related emissions of nitrogen oxides, which contribute to the formation of ozone, have been of particular concern to many airport operators. A federal study at 19 airports estimated that, by 2010, aircraft emissions have the potential to significantly contribute to air pollution in the areas around these airports. GAO agreed to review efforts in the United States and other countries to reduce emissions at airports and the effect of improvements in aircraft and engine design on emissions."