A letter report issued by the Government Accountability Office with an abstract that begins "Concierge care is an approach to medical practice in which physicians charge their patients a membership fee in return for enhanced services or amenities. The recent emergence of concierge care has prompted federal concern about how the approach might affect beneficiaries of Medicare, the federal health insurance program for the aged and some disabled individuals. Concerns include the potential that membership fees may constitute additional charges for services that Medicare already pays physicians for and that concierge care may affect Medicare beneficiaries' access to physician services. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 directed GAO to study concierge care and its relationship to Medicare. Using a variety of methods, including a nationwide literature search and telephone interviews, GAO identified 146 concierge physicians and surveyed concierge physicians in fall 2004. GAO analyzed responses from 112 concierge physicians. GAO also reviewed relevant laws, policies, and available data on access to physician services and interviewed officials at the Department of Health and Human Services (HHS) and representatives of Medicare beneficiary advocacy groups."

A letter report issued by the Government Accountability Office with an abstract that begins "Perchlorate is both a man-made and naturally occurring chemical. It is used in rocket fuel, explosives, fireworks, and other products. Naturally occurring perchlorate is produced through atmospheric processes and then settles on surface water or land. Perchlorate can disrupt the uptake of iodide in the thyroid, potentially interfering with thyroid function and negatively affecting fetal and infant brain development and growth. As of June 2010, there is no federal regulatory standard for perchlorate in drinking water, and the Environmental Protection Agency (EPA), which has the authority to regulate contaminants in public drinking water systems, had not determined whether to establish one. The Department of Defense (DOD), the National Aeronautics and Space Administration (NASA), and the Department of Energy (DOE) are the primary federal users of perchlorate. GAO was asked to examine (1) what is known about the extent to which perchlorate occurs in the nation's water and food supply and its likely sources; (2) what actions DOD, NASA, and DOE have taken to respond to or lessen perchlorate releases; and (3) what actions states, such as California and Massachusetts, have taken to regulate perchlorate. To address …

A letter report issued by the Government Accountability Office with an abstract that begins "Three agencies of the Department of Homeland Security (DHS) have primary responsibility for securing the nation's borders--the U.S. Coast Guard (USCG), Customs and Border Protection (CBP), and Immigration and Customs Enforcement (ICE). Together, they enforce security across 7,500 miles of land border between the United States and Mexico and Canada, and protect more than 361 seaports and 95,000 miles of coastline. To fulfill their missions, these agencies deploy a variety of valuable air and marine assets. In this report, GAO analyzed (1) what efforts DHS has undertaken to facilitate coordination of the air and marine assets of the three agencies and (2) how the agencies' local air and marine units have, in selected areas, coordinated the use of assets and what challenges they faced."

A letter report issued by the Government Accountability Office with an abstract that begins "The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) directed the Department of Health and Human Services (HHS) to develop a program to give physicians confidential feedback on the resources used to provide care to Medicare beneficiaries. In response, HHS's Centers for Medicare & Medicaid Services (CMS) has established and implemented the Physician Feedback Program by distributing feedback reports to an increasing number of physicians that provided data on resources used and the quality of care. MIPPA mandated that GAO conduct a study of this program. To address this mandate, GAO identified (1) methodological challenges CMS faces in developing feedback reports and approaches CMS has tested to address them and (2) challenges CMS faces in distributing feedback reports and CMS's plans to address them. GAO interviewed CMS officials and representatives from the program contractor and reviewed relevant documentation."

A letter report issued by the Government Accountability Office with an abstract that begins "Comprehensive Outpatient Rehabilitation Facilities (CORF) are highly concentrated in Florida. These facilities, which provide physical therapy, occupational therapy, speech-language pathology services, and other related services, have been promoted as lucrative business opportunities for investors. Aware of such promotions, the Chairman, Senate Committee on Finance, raised concerns about whether Medicare could be vulnerable to overbilling for CORF services. In this report, focusing our review on Florida, we (1) compared Medicare's outpatient therapy payments to CORFs in 2002 with its payments that year to other facility-based outpatient therapy providers and (2) assessed the program's effectiveness in ensuring that payments to CORFs complied with Medicare rules."

A letter report issued by the Government Accountability Office with an abstract that begins "Delays in processing federal equal employment opportunity (EEO) complaints, apparent or perceived lack of fairness and impartiality in complaint processing, and fear of retaliation in the workplace have been long-standing concerns of the Equal Employment Opportunity Commission (EEOC), other federal agencies, and Congress. Based on a Notification and Federal Employee Antidiscrimination and Retaliation Act mandate, GAO analyzed (1) factors that EEO practitioners have identified as impeding the fair, prompt, and impartial processing of federal EEO complaints and (2) actions that EEO practitioners and other stakeholders think could be taken to help address those factors. GAO also identified actions that EEOC is taking to improve the federal complaint process. GAO surveyed 65 EEO practitioners representing a wide cross section of professionals knowledgeable about the federal EEO complaint process, who were selected from 16 federal agencies that accounted for about 88 percent of complaints filed in fiscal year 2005, EEOC, and private sector attorneys' offices. GAO did not assess the validity of practitioners' views or evaluate the effectiveness of initiatives."

A letter report issued by the Government Accountability Office with an abstract that begins "The Environmental Protection Agency (EPA) has made substantial progress in addressing more than half of the recommendations GAO made in a January 2010 report concerning the agency's efforts to protect children's health. Specifically, EPA has fully implemented five of the eight recommendations made by GAO. For example, for a recommendation that EPA ensure that its strategic plan expressly articulate children-specific goals, objectives, and targets, in September 2010, EPA issued an agency-wide strategic plan that identifies children's health as a top agency priority with goals, objectives, and targets. In addition, EPA took some steps to address the remaining three recommendations from GAO's January 2010 report but has not fully implemented them, including a recommendation that the agency strengthen the data system that identifies and tracks development of rulemakings and other actions to ensure they comply with the 1995 policy on evaluating health risks to children."

A letter report issued by the Government Accountability Office with an abstract that begins "Terrorist incidents in the United States and abroad have underscored the Department of Defense's (DOD) need to safeguard military personnel and facilities from potential terrorist attacks involving chemical, biological, radiological, and nuclear weapons and high-yield explosive devices. In the 2003 National Defense Authorization Act, Congress directed DOD to develop a comprehensive plan to help guide departmentwide efforts in improving installation preparedness against such attacks. The act also directed GAO to assess DOD's plan. DOD submitted its report to Congress in September 2003. This review addresses two questions: (1) Does DOD's report represent a comprehensive plan that can guide installation preparedness efforts? and (2) What obstacles, if any, hinder DOD's ability to develop and effectively implement a comprehensive approach to installation preparedness?"

A letter report issued by the Government Accountability Office with an abstract that begins "In its transformation to a more responsive and mobile force, the Army plans to form 6 Stryker Brigade Combat teams equipped with a new family of armored vehicles known as Strykers. The Stryker--which provides transport for troops, weapons, and command and control--was required by the Army to weigh no more than 38,000 pounds and be transportable in theater by C-130 cargo aircraft arriving ready for immediate combat operations. The Army plans to equip its future force with a new generation of vehicles--Future Combat Systems--to also be transportable by C-130s. GAO was asked to assess (1) the current status of Stryker vehicle acquisition, including the most current Stryker vehicle program and operating cost estimates; (2) the status and results of Stryker vehicle tests; and (3) the ability of C-130 aircraft to transport Stryker vehicles within a theater of operations. This report also addresses the transportability of the Army's Future Combat Systems on C-130 aircraft."

Correspondence issued by the Government Accountability Office with an abstract that begins "In October 2002 we reported that inadequate linkage existed between near-term munitions needs of the combatant commanders and the purchases made by the military services. The Department of Defense (DOD) concurred with our recommendations and took steps to address them by rewriting the overarching DOD Instruction for determining munitions requirements. Related to our ongoing work on prepositioned stocks, we assessed whether DOD's efforts thus far and initiatives planned for the future will ensure the required linkage since successful implementation of operational war plans is contingent on the availability of the right mix and quantity of munitions. To make our assessment, we obtained and analyzed information from cognizant organizations within DOD, Joint Chiefs of Staff (JCS), Headquarters and subordinate units of the Military Services, and U.S. Forces Korea (USFK). We conducted our analysis of DOD's munitions requirements process in accordance with generally accepted government auditing standards."

A letter report issued by the Government Accountability Office with an abstract that begins "Power plants emit pollutants that have been linked to various negative health effects. In 2003, two new power plants, owned by Sempra Energy and Intergen, began operations 3 miles south of the U.S.-Mexico border near Imperial County, California. The county does not meet some federal and state air quality standards and may be further impacted by the emissions from these plants. Although these plants export most of the electricity they produce to the United States, they are not currently required to meet any U.S. or California emissions standards. GAO was asked to determine (1) how emissions from the two plants compare with emissions from recently permitted plants in California and emissions from sources in Imperial County, and what emissions standards they would be subject to if they were located in Imperial County; (2) the health impacts of emissions from the plants on Imperial County residents; and (3) options available to U.S. policymakers to ensure that emissions from these plants do not adversely affect the health of Imperial County residents. In commenting on a draft of this report, DOE disagreed with our characterization of the limitations of …

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Deposit Insurance Corporation (FDIC) has a demanding responsibility enforcing banking laws, regulating financial institutions, and protecting depositors. Because of the importance of FDIC's work, effective information security controls are essential to ensure that the corporation's systems and information are adequately protected from inadvertent misuse, fraudulent use, or improper disclosure. As part of its audits of the 2010 financial statements of the Deposit Insurance Fund and the Federal Savings & Loan Insurance Corporation Resolution Fund administrated by FDIC, GAO assessed the effectiveness of the corporation's controls in protecting the confidentiality, integrity, and availability of its financial systems and information. To perform the audit, GAO examined security policies, procedures, reports, and other documents; tested controls over key financial applications; and interviewed key FDIC personnel."

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. and foreign tax regimes influence decisions of U.S. multinational corporations (MNC) regarding how much to invest and how many workers to employ in particular activities and in particular locations. Tax rules also influence where corporations report earning income for tax purposes. The average effective tax rate, which equals the amount of income taxes a business pays divided by its pretax net income (measured according to accounting rules, not tax rules), is a useful measure of actual tax burdens. In response to a request from U.S. Senate Committee on Finance, this report provides information on the average effective tax rates that U.S.-based businesses pay on their domestic and foreign-source income and trends in the location of worldwide activity of U.S.-based businesses. GAO analyzed Internal Revenue Service (IRS) data on corporate taxpayers, including new data for 2004 and Bureau of Economic Analysis data on the domestic and foreign operations of U.S. MNCs. Data limitations are noted where relevant. GAO is not making any recommendations in this report."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on the Department of Housing and Urban Development's Supportive Housing Program, focusing on the: (1) characteristics of Supportive Housing Program applicants; (2) types of programs and services for homeless people that this program supports; (3) importance of Supportive Housing Program grants to applicants' programs for the homeless; and (4) various funding sources, in addition to Supportive Housing Program grants, that applicants rely on for their programs and services for homeless people."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the National Academy of Sciences March 1998 report on the Environmental Protection Agency's (EPA) plans to monitor particulate matter smaller than 2.5 microns (PM2.5), focusing on: (1) EPA's actions in response to the Academy's concerns with the planned PM2.5 monitoring program; and (2) the challenges that state and local agencies face in establishing and operating the PM2.5 monitoring program, as well as EPA's response to these challenges."

A letter report issued by the Government Accountability Office with an abstract that begins "This report updates information in our 1999 publication, Federal Debt: Answers to Frequently Asked Questions--An Update (GAO/OCG-99-27, May 28, 1999). At the time of our last publication, the federal government was running budget surpluses, and debt held by the public was projected to drop to historically low levels. This report provides updated information to reflect the changes in the nation's fiscal condition and outlook. Our update addresses frequently asked questions about the federal debt, deficits, and surpluses. In this update, we present current information on how federal debt is defined and measured, the relationship between federal debt and the budget and the economy, federal debt management and ownership, and future policy issues regarding federal debt."

A letter report issued by the Government Accountability Office with an abstract that begins "According to U.S. government officials, sub-Saharan Africa's (SSA) textile and apparel industry has not achieved the growth anticipated under the African Growth and Opportunity Act (AGOA). Despite the tariff reductions under AGOA, after an initial surge, U.S. imports of these products from beneficiary countries have declined in recent years (see figure). In view of this outcome, the 2008 Andean Trade Preference Extension legislation required GAO to prepare a report identifying changes to U.S. trade preference programs "to provide incentives to increase investment and other measures necessary to improve the competitiveness of [SSA] beneficiary countries in the production of yarns, fabric, and other textile and apparel inputs." This report is intended to provide Congress a range of options put forward by experts for (1) possible changes to AGOA or other U.S. trade preference programs and (2) other measures the U.S. government could take to help increase investment in and improve competitiveness of SSA textile and apparel inputs production."

Correspondence issued by the Government Accountability Office with an abstract that begins "In May 2005, we issued our report expressing an opinion on the Securities and Exchange Commission's (SEC) fiscal year 2004 financial statements and an opinion on SEC's internal control as of September 30, 2004. We also reported on the results of our tests of SEC's compliance with selected provisions of laws and regulations during fiscal year 2004. Our report on SEC's fiscal year 2004 financial statements identified reportable conditions in the internal controls over financial reporting that we considered to be material weaknesses. These weaknesses related to SEC's controls over (1) recording and reporting disgorgements and penalties, (2) information security, and (3) preparing financial statements and related disclosures. We issued two separate reports providing recommendations to address those weaknesses. The purpose of this report is to provide recommendations for those issues identified during our audit that, although not material in relation to the financial statements, we believe warrant management's attention."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on the government's rights to inventions under the Bayh-Dole Act and Executive Order 12591, focusing on whether federal agencies: (1) ensure that contractors and grantees are complying with the provisions of the Bayh-Dole Act and Executive Order 12591 on the disclosure, reporting, retention, and licensing of inventions created under federally funded projects; and (2) exercise their rights to use the royalty-free licenses to which they are entitled."