Biosurveillance: DHS Should Reevaluate Mission Need and Alternatives before Proceeding with BioWatch Generation-3 Acquisition (open access)

Biosurveillance: DHS Should Reevaluate Mission Need and Alternatives before Proceeding with BioWatch Generation-3 Acquisition

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security (DHS) approved the Generation-3 (Gen-3) acquisition in October 2009, but it did not fully engage in the early phases of its acquisition framework to ensure that the acquisition was grounded in a justified mission need and that it pursued an optimal solution. Critical processes in the early phases of DHS's framework are designed to (1) justify a mission need that warrants investment of resources and (2) select an optimal solution by evaluating viable alternatives based on risk, costs, and benefits. BioWatch program officials said that these early acquisition efforts were less comprehensive and systematic than the DHS framework calls for because there was already departmental consensus around the solution. Without a systematic effort to justify the need for the acquisition in the context of its costs, benefits, and risks, DHS has pursued goals and requirements for Gen-3 with limited assurance that they represent an optimal solution. Reevaluating the mission need and systematically analyzing alternatives could provide better assurance of an optimal solution."
Date: September 10, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Mobile Device Location Data: Additional Federal Actions Could Help Protect Consumer Privacy (open access)

Mobile Device Location Data: Additional Federal Actions Could Help Protect Consumer Privacy

A letter report issued by the Government Accountability Office with an abstract that begins "Using several methods of varying precision, mobile industry companies collect location data and use or share that data to provide users with location-based services, offer improved services, and increase revenue through targeted advertising. Location-based services provide consumers access to applications such as real-time navigation aids, access to free or reduced-cost mobile applications, and faster response from emergency services, among other potential benefits. However, the collection and sharing of location data also pose privacy risks. Specifically, privacy advocates said that consumers: (1) are generally unaware of how their location data are shared with and used by third parties; (2) could be subject to increased surveillance when location data are shared with law enforcement; and (3) could be at higher risk of identity theft or threats to personal safety when companies retain location data for long periods or share data with third parties that do not adequately protect them."
Date: September 11, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Operational Contract Support: Sustained DOD Leadership Needed to Better Prepare for Future Contingencies (open access)

Operational Contract Support: Sustained DOD Leadership Needed to Better Prepare for Future Contingencies

Testimony issued by the Government Accountability Office with an abstract that begins "Future overseas contingencies are inherently uncertain, but effective planning for operational contract support can help reduce the risks posed by those uncertainties. The Department of Defense (DOD) has made an effort to emphasize the importance of operational contract support at the strategic level through new policy and guidance and ongoing efforts. For example, in January 2011, the Secretary of Defense issued a memorandum outlining actions and indicating a need to influence a cultural shift in how the department manages contracted support in a contingency environment. DOD has also recognized the need to translate strategic requirements into plans at the operational level, but GAO's past work has shown that DOD's progress in anticipating contractor support in sufficient detail in operation plans has been slow. As a result, DOD has risked not fully understanding the extent to which it will be relying on contractors to support combat operations and being unprepared to provide the necessary management and oversight of deployed contractor personnel. One way to help address this risk is to ensure military commanders and senior leaders are cognizant of the roles contractors have in supporting DOD's efforts and the …
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Millennium Challenge Corporation: Results of Transportation Infrastructure Projects in Seven Countries (open access)

Millennium Challenge Corporation: Results of Transportation Infrastructure Projects in Seven Countries

A letter report issued by the Government Accountability Office with an abstract that begins "The Millennium Challenge Corporation (MCC)--a U.S. government corporation-- recognizes the importance of a disciplined, transparent, and accountable approach to tracking compact results. However, it reduced the scopes of its early transportation infrastructure projects and reports mixed success in meeting key performance targets. In addition, problems with data quality call into question the reliability of those reported results. GAO found the following for the seven compacts ending in 2010 and 2011, each with a road project or a port project. Road Projects: (1) MCC reduced kilometers to be paved under six compacts--Honduras, Cape Verde, Nicaragua, Vanuatu, Georgia, and Armenia--by a combined 63 percent (from about 1,800 to 600 km) because of increased construction costs and political problems in partner governments. MCC reported meeting reduced targets for five compacts. However, for three compacts, MCC did not consistently account for kilometers completed with funding from third parties. (2) MCC reported meeting revised targets for road roughness--a measure of pavement quality--for five of the compacts. However, reported data have quality issues, including the inconsistent application of measurement methodologies and calculation errors that resulted in overstated results. (3) MCC reported meeting …
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Airport Noise Grants: FAA Needs to Better Ensure Project Eligibility and Improve Strategic Goal and Performance Measures (open access)

Airport Noise Grants: FAA Needs to Better Ensure Project Eligibility and Improve Strategic Goal and Performance Measures

A letter report issued by the Government Accountability Office with an abstract that begins "The number of people in the United States exposed to significant airport noise has steadily declined from roughly 7 million people in 1975 to about 309,000 today. This change reflects large decreases in the size of areas that are exposed to significant airport noise and is primarily due to improvements in aircraft technology."
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Grants to State and Local Governments: An Overview of Federal Funding Levels and Selected Challenges (open access)

Grants to State and Local Governments: An Overview of Federal Funding Levels and Selected Challenges

A letter report issued by the Government Accountability Office with an abstract that begins "Federal outlays for grants to state and local governments totaled more than $606 billion in fiscal year 2011. Over the last three decades, these grants have consistently been a significant component of federal spending, but the focus of this spending has changed over time. For example, during this period the proportion of federal outlays to state and local governments dedicated to Medicaid grants more than tripled, rising from 2.4 percent of total federal government outlays in 1980 to 7.6 percent in 2011. The increase in federal outlays for Medicaid and other health-related grant programs was offset by an approximately equivalent decrease in grants to state and local governments targeted for other areas such as transportation, education, and regional development."
Date: September 25, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Federal Real Property Security: Interagency Security Committee Should Implement A Lessons-Learned Process (open access)

Federal Real Property Security: Interagency Security Committee Should Implement A Lessons-Learned Process

A letter report issued by the Government Accountability Office with an abstract that begins "Based on GAO’s previous work and the information obtained from other agencies, GAO identified eight individual practices that can be combined and considered steps within an overall lessons-learned process—that is, a systematic means for agencies to learn from an event and make decisions about when and how to use that knowledge to change behavior. Not all of the agencies with which GAO spoke used all of the practices, and the application of the practices varied among agencies. For example, to collect information about an incident—the first step of the process—the Bureau of Diplomatic Security within the Department of State collects incident reports, footage from security cameras, and interviews witnesses. To disseminate lessons learned—the fifth step—the Los Angeles Police Department produces a formal document after a critical incident that captures the lessons learned and disseminates the document to its units for use in planning, preparation, and coordination exercises."
Date: September 10, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Homeland Security: DHS Requires More Disciplined Investment Management to Help Meet Mission Needs (open access)

Homeland Security: DHS Requires More Disciplined Investment Management to Help Meet Mission Needs

Testimony issued by the Government Accountability Office with an abstract that begins "In summary, we found that 68 of the 71 programs that responded to our survey reported that they experienced funding instability, faced workforce shortfalls, or that their planned capabilities changed after initiation. Most respondentsreported a combination of these challenges. We have previously reported that these challenges increase the likelihood acquisition programs will cost more and take longer to deliver capabilities than expected. Although DHS largely does not have reliable cost estimates and realistic schedules to accurately measure program performance, we used our survey results, cost information DHS provided to Congress, and an internal DHS review to identify 42 programs that experienced cost growth, schedule slips, or both. Further, using DHS's future-years funding plans - which aggregate funding levels to produce total project costs - we gained insight into the magnitude of the cost growth for 16 of the 42 programs. The total project costs for these 16 programs increased from $19.7 billion in 2008 to $52.2 billion in 2011, an aggregate increase of 166 percent."
Date: September 21, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Critical Infrastructure Protection: DHS Is Taking Action to Better Manage Its Chemical Security Program, but It Is Too Early to Assess Results (open access)

Critical Infrastructure Protection: DHS Is Taking Action to Better Manage Its Chemical Security Program, but It Is Too Early to Assess Results

Testimony issued by the Government Accountability Office with an abstract that begins "The November 2011 memorandum that discussed the management of the Chemical Facility Anti-Terrorism Standards (CFATS) program was prepared based primarily on the observations of the former Director of the Department of Homeland Security’s (DHS) Infrastructure Security Compliance Division (ISCD), a division of the Office of Infrastructure Protection (IP) within the National Protection and Programs Directorate (NPPD). The memorandum was intended to highlight various challenges that have hindered ISCD efforts to implement the CFATS program. According to the former Director, the challenges facing ISCD included not having a fully developed direction and plan for implementing the program, hiring staff without establishing need, and inconsistent ISCD leadership—factors that the Director believed place the CFATS program at risk. These challenges centered on three main areas: (1) human capital issues, including problems hiring, training, and managing ISCD staff; (2) mission issues, including problems reviewing facility plans to mitigate security vulnerabilities; and (3) administrative issues, including concerns about NPPD and IP not supporting ISCD’s management and administrative functions."
Date: September 11, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Federal Tax Debts: Factors for Considering a Proposal to Report Tax Debts to Credit Bureaus (open access)

Federal Tax Debts: Factors for Considering a Proposal to Report Tax Debts to Credit Bureaus

A letter report issued by the Government Accountability Office with an abstract that begins "At the end of fiscal year 2011, individuals and businesses owed a total of about $373 billion in federal unpaid tax debts--$258 billion in individual debt and $115 billion in business debt. How much of this debt would be suitable to report to credit bureaus could depend on the purpose of the reporting proposal, such as to collect more debts or simply to inform other potential creditors of the existence of tax debts. Most of debts were relatively small in size. Well over half of individuals and businesses with tax debts owed less than $5,000. However, much of the aggregate debt is concentrated among those owing relatively large amounts. Debts over $25,000 add up to a total of $310 billion. Some debts were in the collection process where the Internal Revenue Service (IRS) notifies the taxpayer of the debt and were subject to dispute by the taxpayer, while other debts were covered by installment agreements--about $60 billion of the debts owed were in these two categories. About $110 billion of the total debt was classified by IRS as uncollectable. IRS files tax liens on some tax …
Date: September 10, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Aviation Security: 9/11 Anniversary Observations on TSA's Progress and Challenges in Strengthening Aviation Security (open access)

Aviation Security: 9/11 Anniversary Observations on TSA's Progress and Challenges in Strengthening Aviation Security

Testimony issued by the Government Accountability Office with an abstract that begins "The Transportation Security Administration (TSA) has taken actions to validate the science underlying its behavior-based passenger screening program, the Screening of Passengers by Observation Techniques, or SPOT, program, but more work remains. GAO reported in May 2010 that (1) TSA deployed SPOT before first determining whether there was a scientifically valid basis for using behavior and appearance indicators to reliably identify passengers who may pose a risk; and (2) it is unknown if the SPOT program has ever resulted in the arrest of anyone who is a terrorist, or who was planning to engage in terrorist related activity, although there is other evidence that terrorists have transited through SPOT airports. GAO recommended in May 2010 that the Department of Homeland Security (DHS) convene an independent panel of experts to review the methodology of the ongoing validation study on the SPOT program to determine whether it is sufficiently comprehensive to validate the program. DHS concurred and subsequently revised its validation study to include an independent expert review. DHS's study, completed in April 2011, found that SPOT was more effective than random screening to varying degrees; however, DHS noted limitations …
Date: September 11, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Human Capital: DOD Needs Complete Assessments to Improve Future Civilian Strategic Workforce Plans (open access)

Human Capital: DOD Needs Complete Assessments to Improve Future Civilian Strategic Workforce Plans

A letter report issued by the Government Accountability Office with an abstract that begins "Over the last decade, Congress has passed legislation requiring the Department of Defense (DOD) to conduct human capital planning efforts for the department's civilian workforce. Specifically, section 115b of Title 10 of the United States Code, enacted in October 2009, requires DOD to develop and submit to congressional defense committees a strategic workforce plan to shape and improve the department's civilian workforce. Among other things, the law requires DOD to report on the mission-critical skills, competencies, and gaps in its existing and future civilian workforces; the appropriate mix of military, civilian, and contractor personnel capabilities; and the department's progress in implementing its strategic workforce plan using results-oriented performance measures. While DOD has addressed some of its reporting requirements to some extent, it has not addressed others."
Date: September 27, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Securities Investor Protection Corporation: Customer Outcomes in the Madoff Liquidation Proceeding (open access)

Securities Investor Protection Corporation: Customer Outcomes in the Madoff Liquidation Proceeding

A letter report issued by the Government Accountability Office with an abstract that begins "GAO's analysis of Madoff account data shows that more than three-fourths of the firm's customers were individuals and families (individuals). The remaining accounts were held by institutions, such as pension funds and charities. A higher proportion of accounts held by an individual (60 percent) were "net winners" based on their net equity position--meaning they had withdrawn more from their accounts than they had deposited--compared to accounts held by institutions (50 percent). Correspondingly, 40 percent of institutional accounts were "net losers" that had deposited more into their accounts than they had withdrawn, compared to 29 percent of individuals' accounts that were net losers. However, individual and institutional accounts had similar deposit and withdrawal activity from 1981 through 2008, including increased withdrawals immediately before the firm's failure in December 2008."
Date: September 13, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Energy-Water Nexus: Coordinated Federal Approach Needed to Better Manage Energy and Water Tradeoffs (open access)

Energy-Water Nexus: Coordinated Federal Approach Needed to Better Manage Energy and Water Tradeoffs

A letter report issued by the Government Accountability Office with an abstract that begins "As GAO’s past work has shown, and other studies and specialists have confirmed, there are a number of key energy-water nexus issues that Congress and federal agencies need to consider when developing and implementing national policies for energy and water resources. Specifically:"
Date: September 13, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
The Distribution of Federal Economic Development Grants to Communities with High Rates of Poverty and Unemployment (open access)

The Distribution of Federal Economic Development Grants to Communities with High Rates of Poverty and Unemployment

Correspondence issued by the Government Accountability Office with an abstract that begins "The distribution of grant funding per person in poverty in cities was not consistently aligned with overall poverty rates. Most cities, with the exception of those cities with the highest poverty rates, received roughly the same amount of economic development funding per person living in poverty. Further, when we examined how grant funds are distributed to cities based on their unemployment rates, we also found that some cities with higher unemployment rates received less funding per unemployed person than other cities with lower unemployment rates. However, we did find that a small number of cities (17 out of a total of 465 cities) with the highest unemployment rates received funding that was roughly 40 percent higher than the average for unemployed populations in all cities."
Date: September 14, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Information Technology: Census Bureau Needs to Implement Key Management Practices (open access)

Information Technology: Census Bureau Needs to Implement Key Management Practices

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Census Bureau (Census Bureau) has drafted a new investment management plan, system development methodology, and requirements development and management processes to improve its ability to manage information technology (IT) investments and system development, but additional work is needed to ensure these processes are effective and successfully implemented across the bureau. GAO and others have identified the importance of implementing critical processes within an agency to allow it to select, control, and evaluate its IT investments and effectively manage system development. The bureau has developed a new draft investment management plan which contains policies and guidance for managing IT projects; however, the plan does not explain when investments with cost or schedule variances should be escalated to higher-level boards for review, or when managers should provide updated investment information to a planned bureau-wide tracking tool. The bureau has also developed a new system development methodology guide, but the guide has critical gaps. For example, although there are five development process models allowed, including the traditional sequential approach and newer more iterative approaches, the guide does not explain how to adapt processes and related work products …
Date: September 18, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Health Information Technology: CMS Took Steps to Improve Its Beneficiary Eligibility Verification System (open access)

Health Information Technology: CMS Took Steps to Improve Its Beneficiary Eligibility Verification System

A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare and Medicaid Services (CMS) currently offers to Medicare providers and Medicare Administrative Contractors the use of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Eligibility Transaction System (HETS) in a real-time data processing environment. HETS is operational 24 hours a day, 7 days a week, except during regularly scheduled maintenance Monday mornings, from midnight until 5:00 a.m., and when CMS announces other maintenance periods during one or two weekends each month. According to program officials, 244 entities were using HETS in 2012, including about 130 providers, 104 clearinghouses that provide data exchange services to about 400,000 health care providers, and 10 Medicare contractors that help CMS process claims for services. From January through June 2012, HETS processed each month an average of 1.7 million to 2.2 million queries per day with most of the queries submitted between the hours of 8:00 a.m. and 4:00 p.m. eastern time. The users with whom we spoke confirmed that operational problems they experienced with the system in 2010 and the first few months of 2011 were resolved in spring 2011 after CMS implemented several …
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Department of Homeland Security: Taking Further Action to Better Determine Causes of Morale Problems Would Assist in Targeting Action Plans (open access)

Department of Homeland Security: Taking Further Action to Better Determine Causes of Morale Problems Would Assist in Targeting Action Plans

A letter report issued by the Government Accountability Office with an abstract that begins "Department of Homeland Security (DHS) employees reported having lower average morale than the average for the rest of the federal government, but morale varied across components and employee groups within the department. Data from the 2011 Office of Personnel Management (OPM) Federal Employee Viewpoint Survey (FEVS)--a tool that measures employees' perceptions of whether and to what extent conditions characterizing successful organizations are present in their agencies--showed that DHS employees had 4.5 percentage points lower job satisfaction and 7.0 percentage points lower engagement in their work overall. Engagement is the extent to which employees are immersed in their work and spending extra effort on job performance. Moreover, within most demographic groups available for comparison, DHS employees scored lower on average satisfaction and engagement than the average for the rest of the federal government. For example, within most pay categories DHS employees reported lower satisfaction and engagement than non-DHS employees in the same pay groups. Levels of satisfaction and engagement varied across components, with some components reporting scores above the non-DHS averages. Several components with lower morale, such as Transportation Security Administration (TSA) and Immigration and Customs Enforcement …
Date: September 28, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Aviation Safety: Additional FAA Efforts Could Enhance Safety Risk Management (open access)

Aviation Safety: Additional FAA Efforts Could Enhance Safety Risk Management

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Aviation Administration (FAA) and its business lines and offices are in different stages of their implementation of Safety Management Systems (SMS). FAA finalized its agency-wide implementation plan in April 2012, and the Air Traffic Organization (ATO) has completed its SMS implementation, but other FAA SMS efforts are in the early stages. FAA business lines, such as the Aviation Safety Organization (AVS) and the Office of Airports (ARP), have SMS guidance and plans largely in place and have begun to integrate related practices into their operations, but many implementation tasks remain incomplete, and officials and experts project that full SMS implementation could take many years."
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Military Training: DOD Met Annual Reporting Requirements and Improved Its Sustainable Ranges Report (open access)

Military Training: DOD Met Annual Reporting Requirements and Improved Its Sustainable Ranges Report

Correspondence issued by the Government Accountability Office with an abstract that begins "In our view, DOD's 2012 sustainable ranges report meets the annual statutory reporting requirements that DOD describe its progress in implementing its sustainable ranges plan and any additional actions taken or to be taken in addressing training constraints caused by limitations on the use of military lands, marine areas, and airspace. DOD's 2012 report also provides updates to several elements of the plan that the act required DOD to include in its original submission in 2004. These elements include (1) proposals to enhance training range capabilities and address any shortfalls in resources, (2) goals and milestones for tracking planned actions and measuring progress, and (3) projected funding requirements for implementing planned actions, among others. Taken together, these elements of DOD's 2012 sustainable ranges report describe the department's progress in implementing its comprehensive plan and addressing training constraints at its ranges, thus meeting the annual reporting requirements of the act."
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Civilian Service Contract Inventories: Opportunities Exist to Improve Agency Reporting and Review Efforts (open access)

Civilian Service Contract Inventories: Opportunities Exist to Improve Agency Reporting and Review Efforts

A letter report issued by the Government Accountability Office with an abstract that begins "Civilian agencies did not fully comply with statutory requirements for compiling fiscal year 2011 service contract inventories. For example, because the information is not currently readily available, the Office of Management and Budget (OMB) directed the 49 agencies that were required to submit inventories to defer the collection of three statutorily required data elements for each contract--the role the services played in achieving agency objectives, the total dollar amount invoiced for services under the contracts, and the number and work locations of contractor and subcontractor personnel. Progress, however, is being made to collect this information for future inventories. OMB directed agencies to start collecting information on the role services play in achieving agency objectives for new contracts awarded on or after March 1, 2012. A proposed Federal Acquisition Regulation rule was published in April 2011 to start collecting the remaining two data elements directly from contractors. We also found several instances where agencies significantly underreported obligations in their inventories, either because they misinterpreted or did not follow OMB guidance. For example, the General Services Administration underreported obligations by approximately $6.4 billion. Without complete and accurate service …
Date: September 27, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions (open access)

Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions

A letter report issued by the Government Accountability Office with an abstract that begins "From 2004 through 2010, the number of self-referred and non-self-referred advanced imaging services--magnetic resonance imaging (MRI) and computed tomography (CT) services--both increased, with the larger increase among self-referred services. For example, the number of self-referred MRI services increased over this period by more than 80 percent, compared with an increase of 12 percent for non-self-referred MRI services. Likewise, the growth rate of expenditures for self-referred MRI and CT services was also higher than for non-self-referred MRI and CT services."
Date: September 28, 2012
Creator: United States. Government Accountability Office.
Object Type: Report
System: The UNT Digital Library
Next Generation Air Transportation System: FAA Faces Implementation Challenges (open access)

Next Generation Air Transportation System: FAA Faces Implementation Challenges

Testimony issued by the Government Accountability Office with an abstract that begins "Delivering and demonstrating the Next Generation Air Transportation System's (NextGen) benefits: The Federal Aviation Administration (FAA) must deliver capabilities that provide aircraft operators with a return on their investments in NextGen avionics to convince operators to continue making equipment investments. However, operators have expressed concerns that FAA has not produced the navigational procedures needed to achieve benefits from existing avionics, such as reduced fuel burn and flight time. To help produce more beneficial procedures, FAA is, among other things, involving air traffic controllers and other stakeholders in the design of new procedures."
Date: September 12, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library
Medicare Private Health Plans: Selected Current Issues (open access)

Medicare Private Health Plans: Selected Current Issues

Testimony issued by the Government Accountability Office with an abstract that begins "In March 2012, GAO issued a report on the Centers for Medicare & Medicaid Services’ (CMS) Medicare Advantage (MA) quality bonus payment demonstration—a demonstration CMS initiated rather than implementing the quality bonus program established under the Patient Protection and Affordable Care Act (PPACA). Compared to the PPACA quality bonus program, CMS’s demonstration increases the number of plans eligible for a bonus, enlarges the size of payments for some plans, and accelerates payment phase-in. CMS stated that the demonstration’s research goal is to test whether scaling bonus payments to quality scores MA plans receive increases the speed and degree of annual quality improvements for plans compared with what would have occurred under PPACA. GAO reported that CMS’s Office of the Actuary estimated that the demonstration would cost $8.35 billion over 10 years—an amount greater than the combined budgetary impact of all Medicare demonstrations conducted since 1995. In addition, GAO also found several shortcomings of the demonstration design that preclude a credible evaluation of its effectiveness in achieving CMS’s stated research goal. In July 2012, GAO sent a letter to the Secretary of Health and Human Services (HHS), the head …
Date: September 21, 2012
Creator: United States. Government Accountability Office.
Object Type: Text
System: The UNT Digital Library