A letter report issued by the Government Accountability Office with an abstract that begins "Medicare's payments for the costs physicians incur in operating their practices are based on two sets of estimates: total practice expenses and resource estimates for individual services. Total practice expense estimates were derived from American Medical Association (AMA) physician surveys, which the Centers for Medicare & Medicaid Services (CMS) refines with supplemental data submitted by medical specialty societies. Resource estimates for individual services were developed by expert panels and refined by CMS with recommendations from another expert panel. In response to a mandate in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, GAO evaluated CMS's processes for updating total practice expense and resource estimates and whether CMS will have the data necessary to update the fee schedule at least every 5 years as mandated by law."

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, 1,964 hospitals and 45,962 professionals were awarded a total of approximately $2.7 billion in Medicaid EHR incentive payments for 2011. These 1,964 hospitals, which represented 39 percent of the 5,013 eligible hospitals, were awarded a total of $1.7 billion in Medicaid EHR incentive payments for 2011. While the amount of Medicaid EHR incentive payments awarded to each hospital ranged from $7,528 to $7.2 million, the median payment amount was $613,512. Participation rates, as well as total payments, were higher for hospitals in the Medicaid EHR program when compared to the Medicare EHR program, though the median payment amount in the Medicaid EHR program was less than half as large. About 50 percent of hospitals accounted for about 80 percent of the total amount of Medicaid incentive payments awarded to hospitals. Among hospitals awarded a Medicaid EHR incentive payment for 2011, we found that"

Testimony issued by the Government Accountability Office with an abstract that begins "The devastation and dislocation of individuals experienced throughout the Gulf Coast in Louisiana, Mississippi, Alabama, and Texas in the wake of Hurricanes Katrina and Rita has raised concern about both the charitable sector's and the government's abilities to effectively respond to such disasters. To strengthen future disaster response and recovery operations, the government needs to understand what went right and what went wrong, and to apply these lessons. The National Response Plan outlines the roles of federal agencies and charities in response to national disasters. Recognizing the historically large role of charities in responding to disasters, the plan included charities as signatories and gave them considerable responsibilities. In addition to carrying out the responsibilities outlined in the National Response Plan, charities served as partners to the federal government in providing both immediate and long-term assistance following Hurricanes Katrina and Rita. GAO was asked to provide an overview of lessons learned from charities' response to previous disasters as well as preliminary observations about the role of charities following the Gulf Coast hurricanes. As part of our ongoing work, GAO will continue to analyze federal and charitable efforts following the …

Correspondence issued by the Government Accountability Office with an abstract that begins "Until World War II U.S. Navy battleships provided an impressive show of force and outgunned and outmaneuvered their ocean-going enemies. From World War II until the Persian Gulf War in 1991, the Navy's Iowa class battleships provided Naval Surface Fire Support capabilities with their 16-inch guns. Naval Surface Fire Support, together with land- and air-based components, makes up the joint "fires triad", which is used to support Marine Corps amphibious assault operations. The last Iowa class battleship was decommissioned in 1992. In 1996, congressional authorizers became concerned that the Navy would not be able to produce a replacement Naval Surface Fire Support capability comparable to the battleships until well into the twenty-first century and directed the Secretary of the Navy to restore at least two Iowa class battleships to the naval vessel registry until the Secretary of the Navy certified that a capability had been developed equal to or greater than that provided by the battleships. Two Iowa class battleships--the U.S.S. Wisconsin and the U.S.S. Iowa--remain on the naval vessel registry in inactive status. Both ships are considered "in reserve", meaning they are being retained for reactivation in …

A letter report issued by the Government Accountability Office with an abstract that begins "Mileage-based user fee initiatives in the United States and abroad show that such fees can lead to more equitable and efficient use of roadways by charging drivers based on their actual road use and by providing pricing incentives to reduce road use. Mileage fees for passenger vehicles, however, continue to face significant public concerns related to privacy as well as cost challenges. Privacy concerns are particularly acute when Global Positioning System (GPS) units are used to track the location of passenger vehicles. Reliable cost estimates for mileage fee systems are not available, but implementing a system to collect fees from 230 million U.S. passenger vehicles is likely to greatly exceed the costs of collecting fuel taxes. Commercial truck user fee systems in Germany and New Zealand have achieved substantial revenues and benefits such as reduced road damage and emissions with fewer privacy concerns, but ensuring compliance in a cost effective manner presents trade-offs. Few commercial truck mileage fee pilots have been conducted in the United States, but efforts in two states suggest such fees pose fewer privacy and cost challenges than passenger vehicle fees."

Correspondence issued by the General Accounting Office with an abstract that begins "This report provides information on (1) the structure and operations of the New Hampshire-Vermont Solid Waste Project; (2) how the project's structure and operations compare to those of other interstate waste management projects; and (3) issues that need to be addressed in the future, as the expiration of the incineration contract approaches and the districts consider their options. In addressing the second question, we were unable to identify any other congressionally approved interstate solid waste compacts. However, we identified 10 interstate compacts for the management of low-level radioactive waste and one solid waste agreement that was not congressionally approved and used them as a basis for comparison."

A letter report issued by the Government Accountability Office with an abstract that begins "Unmanned aircraft systems (UAS) consist of an unmanned aircraft; sensor, communications, or weapons, carried on board the aircraft, collectively referred to as payloads; and ground controls. UAS have been used successfully in recent operations, and are in increasingly high demand by U.S. forces. To meet the demand, the Department of Defense (DOD) is increasing its investment in and reliance on UAS, and often deploying them while still in development. GAO has previously found that DOD's approach to developing and fielding UAS risked interoperability problems which could undermine joint operations. GAO was asked to review (1) UAS performance in recent joint operations and (2) the soundness of DOD's approach to evaluating joint UAS operational performance."

A letter report issued by the Government Accountability Office with an abstract that begins "Certified registered nurse anesthetists (CRNA), registered nurses who have completed a master's degree program in nurse anesthesia, provide the majority of anesthesia care veterans receive in VA medical facilities. While the demand for CRNAs is anticipated to increase, many CRNAs employed by VA--VA CRNAs--are nearing retirement eligibility age. Concerns have been raised about the challenges VA may face in maintaining its VA CRNA workforce. GAO (1) identified VA CRNA workforce challenges that VA medical facilities may experience related to VA CRNAs, (2) identified the key mechanisms that VA medical facilities can use to recruit and retain VA CRNAs, and (3) determined the extent to which facilities use the key mechanisms. To identify VA CRNA workforce challenges, GAO analyzed Web-based surveys it sent to VA chief anesthesiologists, VA human resources officers, and VA CRNAs, with survey response rates of 92, 85, and 76 percent, respectively. GAO also identified the key mechanisms VA medical facilities can use to recruit and retain VA CRNAs and the extent that these mechanisms are used."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Justice (DOJ) has reported that crime rates experienced by American Indians are two and a half times higher than those experienced by the general population in the United States. Specifically, from 1992 to 2001 American Indians experienced violent crimes at a rate of 101 violent crimes per 1,000 person annually, compared to the national rate of 41 per 1,000 persons. The federal government plays a major role in prosecuting crimes committed in Indian country. For example, unless a federal statute has granted the state jurisdiction, the federal government has exclusive jurisdiction to prosecute non-Indians who commit crimes against Indians in Indian country, while the federal government and tribal governments both have jurisdiction to prosecute Indian offenders who commit crimes in Indian country. Federal prosecution, however, carries with it the possibility of greater terms of imprisonment, as tribal courts are statutorily limited to a maximum of 3 years imprisonment per offense, regardless of the severity of the offense, for example, a homicide. Because of such jurisdictional and sentencing limitations, tribal communities rely on the federal government to investigate and prosecute a variety of crimes in Indian …

Correspondence issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins "What GAO Found"

Correspondence issued by the General Accounting Office with an abstract that begins "As part of its involvement with the Navy Personal Property Working Group, GAO reviewed the Department of the Navy's implementation of the Defense Property Accountability System (DPAS). As requested by the working group, GAO visited six Navy activities to evaluate DPAS implementation at those selected locations. GAO found that (1) physical wall-to-wall inventories of personal property were not being done properly; (2) personal property items were not being included in DPAS at a component level to ensure accountability; and (3) policies, procedures, and training were not in place to ensure the sustainability of the property database."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO has previously reported that the lack of control over inventory shipments increases the Department of Defense's (DOD) vulnerability to undetected loss or theft. GAO evaluated the Army's effectiveness in maintaining accountability of inventory shipped to repair contractors. To conduct its review, GAO analyzed shipment data for fiscal year 2004, surveyed repair contractors that were recipients of inventory shipments, and assessed the Army's adherence to internal control procedures. Inventory shipments included both secondary repair items--components, assemblies, and subassemblies, other than major end items, which may be sent to commercial facilities for repair, alteration, or modification--and government-furnished materiel--assemblies, parts, and other items provided in support of this work."

A letter report issued by the Government Accountability Office with an abstract that begins "Incorporated under Alaska state law, regional Alaska Native corporations share fundamental characteristics, although they have chosen a variety of governance practices. Like other Alaska corporations, the regional corporations are subject to the state's corporate laws (with limited exceptions) and are run by an elected board of directors. Nevertheless, each regional corporation has chosen its own organization and governance approach in terms of board operations, executive and board compensation, board elections, and shareholder involvement."

A letter report issued by the Government Accountability Office with an abstract that begins "The six federal veterans' employment and training programs offer similar employment services, but largely target different groups. Among these programs, the Department of Labor's (Labor) Disabled Veterans' Outreach Program has the greatest potential for overlap with other veterans' programs and Labor's employment programs for the general population. Federal law governing the Disabled Veterans' Outreach Program makes all veterans who meet the broad definition of "eligible veteran" eligible for its services, but gives disabled veterans and economically and educationally disadvantaged veterans the highest priority for services. However, Labor's guidance does not provide states--who administer the program using federal funds--criteria for prioritizing services. The law also generally requires that program staff provide participants with intensive services (e.g., individual employment plans), but Labor's data indicate that nationally 28 percent of participants received such services in 2011. In explaining this statistic, Labor officials said one possible explanation was that staff are enrolling people who do not need intensive services. Labor said it plans to develop guidance on prioritizing services, and it also has a six-state pilot to improve monitoring, but neither of these efforts has been completed."

A letter report issued by the General Accounting Office with an abstract that begins "In 1998, the State Department stockpiled anthrax vaccine and antibiotics at several diplomatic posts near Iraq. In the event of an anthrax attack by Iraq, this stockpile was to be used for post-exposure immunization and treatment. In 1999, the State announced that it was starting a voluntary Anthrax Immunization Program for U.S. government employees, their dependents, and other personnel overseas. According to the Food and Drug Administration (FDA), full pre-exposure protection from anthrax requires six vaccinations given over an 18-month period, followed by an annual booster. Because the supplies of vaccines approved by FDA were insufficient, State decided to suspend plans to expand the program beyond the pilot site until more vaccine was available. GAO found that both the State Department's prepositioning of anthrax vaccine at diplomatic missions and the voluntary anthrax immunization program have been poorly implemented. Specifically, the vaccine was not properly stored or refrigerated, requirements for the voluntary program were not accurately estimated, and surveillance procedures used in the pilot program to monitor reactions to the vaccine were inadequate."

A letter report issued by the General Accounting Office with an abstract that begins "The Economic Growth and Tax Relief Reconciliation Act of 2001 directed the Treasury to issue advance 2001 tax refunds to individual taxpayers who filed a tax year 2000 return. As a result, the Internal Revenue Service (IRS) had to identify eligible taxpayers so that checks could be sent to these taxpayers by December 31, 2001. The Department of the Treasury's Financial Management Service was to issue the checks on behalf of IRS, with the first checks to be received during the week of July 23, 2001. As of September 30, 2001, 84 million taxpayers were to have received $36 billion in advance tax funds. IRS offset about $2.1 billion from these advance tax refunds to recover delinquent federal taxes. IRS spent $104 million to run the program through September 2001, which included IRS staffing costs as well as the costs associated with contracts, postage, and printing. The Treasury Inspector General for Tax Administration identified two initial problems that affected either the accuracy or timeliness of the advance refund notices. One involved computer programming errors that resulted in 523,000 taxpayers receiving notices indicating that they would receive …

A letter report issued by the General Accounting Office with an abstract that begins "In 1998, the Transportation Equity Act for the 21st Century (TEA-21), authorized the states to retain the federal share of proceeds from the sale or lease of real property that had been purchased with federal-aid funds. It also required the states to use the federal share on other highway projects eligible for funding under the federal-aid highway program. GAO determined (1) the extent to which states are selling, leasing, or disposing of real property purchased with federal-aid funds and (2) how the proceeds generated from the sale or lease of real property are being used, including whether they are being used in accordance with TEA-21. GAO issued a related legal opinion in September 2002."

A letter report issued by the General Accounting Office with an abstract that begins "Government purchase cards have streamlined the process of acquiring goods and services by allowing employees to purchase directly from merchants rather than going through the regular procurement process. The government spent $13.8 billion using purchase cards in fiscal year 2001. However, the government does not know how purchase card spending impacts small businesses and other socioeconomic categories, such as woman-owned small businesses, and small disadvantaged businesses. Because of these uncertainties, the General Services Administration (GSA), which administers the purchase card program, has begun to collect socioeconomic data on merchants doing business with the federal government through purchase cards. This report assesses GSA's efforts and identifies the challenges to collecting and reporting this data."

A letter report issued by the General Accounting Office with an abstract that begins "In connection with fulfilling our requirement to audit the financial statements of the U.S. government, we audit the Schedules of Federal Debt Managed by the Bureau of the Public Debt, which includes testing compliance with the debt ceiling. To assist us in this testing and because of the nature of and sensitivity towards actions taken during a debt issuance suspension period, we (1) developed a chronology of significant events, (2) analyzed the financial aspects of Treasury's actions taken during the debt issuance suspension periods and assessed the legal basis of these actions, and (3) analyzed the impact of the policies and procedures used by Treasury to manage the debt during the debt issuance suspension periods."

A letter report issued by the General Accounting Office with an abstract that begins "Information technology (IT) will play a critical role in strengthening our nation's homeland security against potential future attacks. Specifically, IT will help enable the nation to identify potential threats, share information more readily, provide mechanisms to protect our homeland, and develop response capabilities. The Permanent Subcommittee on Investigations of the Senate Committee on Governmental Affairs requested that we identify, for fiscal years 2002 and 2003, IT funding targeted for purposes related to homeland security in those departments and agencies that play a key role in this mission area and, using our prior work, report on the IT management issues facing these organizations. In commenting on a draft of this report, agencies provided technical comments that were incorporated in the report, as appropriate."

Other written product issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on inpatient hospital deductible and hospital extended care services coinsurance amounts for 2000. GAO noted that: (1) the rule would announce the inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services furnished in calendar year 2000 under Medicare's hospital insurance program; (2) the Medicare statute specifies the formula used to determine these amounts; and (3) HCFA complied with applicable requirements in promulgating the rule."

A letter report issued by the General Accounting Office with an abstract that begins "About one-third of terrorist attacks worldwide target transportation systems, and transit systems are the mode most commonly attacked. In light of the history of terrorism against mass transit and the terrorist attacks on September 11, GAO was asked to examine challenges in securing transit systems, steps transit agencies have taken to improve safety and security, and the federal role in transit safety and security. To address these objectives, GAO visited 10 transit agencies and surveyed a representative sample of transit agencies, among other things."

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO reviewed the Health Care Fraud and Abuse Control (HCFAC) program, focusing on : (1) the amounts deposited to the Federal Hospital Insurance Trust Fund pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the sources of such amounts; (2) the amounts appropriated from the trust fund for HCFAC program and the justification for the expenditures of such amounts; (3) expenditures from the trust fund for HCFAC activities not related to Medicare; (4) any savings to the trust fund, as well as other savings, resulting from expenditures from the trust fund for the HCFAC program; and (5) other aspects of the operation of the trust fund."