Correspondence issued by the Government Accountability Office with an abstract that begins "Medicare--the federal health insurance program that covers the nation's elderly and disabled--annually processes over 1 billion medical claims for services provided to beneficiaries. The Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), administers the Medicare program with the assistance of its claims administration contractors. These contractors are charged with processing and paying claims that are properly submitted and that are for medically necessary and covered services. The contractors also deny payment for claims considered invalid, incomplete, or otherwise improper. Medicare beneficiaries and providers have the right to appeal denied claims through a multilevel administrative process that includes a decision by an administrative law judge (ALJ). In fiscal year 2004, CMS's contractors denied over 158 million Medicare claims, about 5 million of which resulted in the initiation of appeals. In the same year, about 113,000 denied claims were appealed to ALJs. Two federal agencies--HHS and the Social Security Administration (SSA)--play a role in resolving Medicare appeals, but neither agency manages the entire process. In recent years, the Medicare appeals process has been the subject of widespread concern because of …

A letter report issued by the Government Accountability Office with an abstract that begins "Over the years, the Department of Defense (DOD) has recorded billions of dollars of disbursements and collections in suspense accounts because the proper appropriation accounts could not be identified and charged. DOD has also been unable to resolve discrepancies between its and Treasury's records of checks issued by DOD. Because documentation that would allow for resolution of these payment recording problems could not be found after so many years, DOD requested and received legislative authority to write off certain aged suspense transactions and check payment differences. The conference report (H.R. Conf. Rep. No. 107-772) that accompanied the legislation (Pub. L. No. 107-314) required GAO to review and report on DOD's use of this write-off authority."

Correspondence issued by the Government Accountability Office with an abstract that begins "Medicare pays hospitals for drugs that beneficiaries receive as part of their treatment in hospital outpatient departments. Specifically, the Centers for Medicare & Medicaid Services (CMS) in the Department of Health and Human Services (HHS) uses an outpatient prospective payment system (OPPS) to pay hospitals fixed, predetermined rates for services. These services include drugs given to beneficiaries in outpatient settings. When OPPS was first developed as directed by the Balanced Budget Act of 1997, the rates for hospital outpatient services and drugs were based on hospitals' 1996 median costs. However, these rates prompted concerns that payments to hospitals would not reflect the cost of newly introduced pharmaceutical products--drugs, biologicals, and radiopharmaceuticals--used to treat, for example, cancer, rare blood disorders, and other serious conditions. In turn, congressional concerns were raised that beneficiaries might lose access to some of these products if hospitals avoided providing them because of a perceived shortfall in payments. In response to these concerns, the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 authorized pass-through payments, which are a way to augment, on a temporary basis, the OPPS payments for newly introduced pharmaceutical products …

Correspondence issued by the Government Accountability Office with an abstract that begins "In February 2005, we issued our opinions on the calendar year 2004 financial statements of the Bank Insurance Fund (BIF), the Savings Association Insurance Fund (SAIF), and the FSLIC Resolution Fund (FRF). We also issued our opinion on the effectiveness of the Federal Deposit Insurance Corporation's (FDIC) internal controls as of December 31, 2004, and our evaluation of FDIC's compliance with significant provisions of selected laws and regulations for the three funds for the year ended December 31, 2004. The purpose of this report is to discuss issues identified during our audits of the 2004 financial statements regarding accounting procedures and internal controls that could be improved, and to recommend improvements to address these issues. Although these issues were not material in relation to the financial statements, we believe they warrant management's attention."

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO reviewed the audit reports covering the financial statements of the Congressional Medal of Honor Society of the United States of America, for fiscal year 2003. GAO found no reportable instances of noncompliance. The audit reports included the auditors' opinions that the financial statements of the corporation were presented fairly in accordance with generally accepted accounting principles."

A letter report issued by the Government Accountability Office with an abstract that begins "There has been long-standing congressional interest in whether the Department of Defense (DOD) could use the Department of Veterans Affairs (VA) Consolidated Mail Outpatient Pharmacy (CMOP) system as a cost-effective alternative to beneficiaries picking up outpatient refill prescriptions at DOD military treatment facilities (MTF). To evaluate this possibility, DOD and VA conducted a pilot program in fiscal year 2003 in which a VA CMOP provided outpatient pharmaceutical refill services to DOD beneficiaries served through three MTFs. GAO was asked to estimate cost savings that could be achieved if DOD used VA's CMOP instead of MTF pharmacies for outpatient refill prescriptions, and what other benefits were achieved at the three pilot sites. To estimate potential cost savings and determine what other benefits were achieved, GAO reviewed pilot and pharmacy program documentation and interviewed DOD and VA officials responsible for purchasing and dispensing drugs. GAO also compared drug and administrative costs of dispensing outpatient refills through the fiscal year 2003 pilot program with the costs of dispensing the refills at the three DOD MTFs that participated in the pilot."

A letter report issued by the Government Accountability Office with an abstract that begins "Reports of ineligible persons registering to vote raised concerns about state processes for verifying voter registration lists. States base voter eligibility generally on the voter's age, U.S. citizenship, mental competence, and felon status. Although states run elections, Congress has authority to affect the administration of elections. The Help America Vote Act of 2002 (HAVA) sets a deadline for states to have a statewide voter registration list and list verification procedures. For this report, GAO selected seven states (AZ, CA, MI, NY, TX, VA, and WI) to represent a range of characteristics relevant to voter registrations, such as whether a statewide voter list existed prior to HAVA. This report discusses how these states verify voter registration eligibility; the challenges they face in maintaining accurate voter lists; the progress toward implementing HAVA registration requirements; and identifies federal data sources that might be used to help verify voter registration eligibility."

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO reviewed the audit reports covering the financial statements of the Air Force Sergeants Association for fiscal years 2004 and 2003. GAO found no reportable instances of noncompliance. The audit reports included the auditors' opinion that the financial statements of the corporation were presented fairly in accordance with generally accepted accounting principles."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Secretary of the Treasury, in coordination with the Director of the Office of Management and Budget (OMB), is required to annually prepare and submit audited financial statements of the U.S. government to the President and the Congress. We are required to audit these consolidated financial statements (CFS) and report on the results of our work. In connection with fulfilling our requirement to audit the fiscal year 2004 CFS, we evaluated the Department of the Treasury's (Treasury) financial reporting procedures and related internal control over the process for compiling the CFS, including the management representation letter provided us by Treasury and OMB. Written representation letters from management, required by U.S. generally accepted government auditing standards, ordinarily confirm oral representations given to the auditor, indicate and document the continuing appropriateness of those representations, and reduce the possibility of a misunderstanding between management and the auditor. The purpose of this report is to communicate our observations on the Department of State's (DOS) fiscal year 2004 management representation letter. Our objective is to help ensure that future management representation letters submitted by DOS are sufficient to help support Treasury and OMB's …

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Citizenship and Immigration Services (USCIS) bureau within the Department of Homeland Security (DHS) provides toll-free telephone assistance through call centers to immigrants, their attorneys, and others seeking information about U.S. immigration services and benefits. As the volume of calls increased--from about 13 million calls in fiscal year 2002 to about 21 million calls in fiscal year 2004--questions were raised about USCIS's ability to ensure the reliability and accuracy of the information provided at call centers run by an independent contractor. This report analyzes: (1) the performance measures established by USCIS to monitor and evaluate the performance of contractor-operated call centers; (2) how performance measures were used to evaluate the contractor's performance; and (3) any actions USCIS has taken, or plans to take, to strengthen call center operations."

A letter report issued by the Government Accountability Office with an abstract that begins "The Homeland Security Act of 2002 mandated the merging of 22 federal agencies and organizations to create the Department of Homeland Security (DHS), whose mission, in part, is to protect our homeland from threats and attacks. DHS relies on a variety of computerized information systems to support its operations. GAO was asked to review DHS's information security program. In response, GAO determined whether DHS had developed, documented, and implemented a comprehensive, departmentwide information security program."

Correspondence issued by the Government Accountability Office with an abstract that begins "The September 11, 2001, terrorist attacks on the World Trade Center exposed the vulnerability of the financial markets to disruption by such events. As part of a series of reviews we have performed at the request of Members of Congress, we have examined and reported on the adequacy of the steps that financial market participants have taken to reduce their vulnerability to attacks and to be better able to recover from such events when they occur. In addition to taking steps to reduce the likelihood that physical attacks will damage their facilities, financial market organizations must also implement protections to reduce the potential for electronic attacks to disrupt their operations. Electronic attacks can be the result of individuals (such as hackers) or groups, such terrorist organizations or foreign governments, attempting to gain unauthorized access to a specific organization's networks or systems or from malicious computer programs or codes, such as viruses or worms, that seek to damage data or deny access to legitimate users. Given the importance of this topic, Congress asked us to review the measures taken by selected critical financial market organizations, including exchanges, clearing organizations, …

Correspondence issued by the Government Accountability Office with an abstract that begins "On April 12, 2005, the Comptroller General testified before Congress at a hearing on "NSPS: The New Department of Defense Civilian Personnel System--Reaching Readiness." This letter responds to a request that GAO provide answers to questions for the record. The questions covered major areas of concern for the Department of Defense's National Security Personnel System (NSPS)."

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO reviewed the audit reports covering the financial statements of the Military Order of the World Wars for fiscal year 2003. GAO found no reportable instances of noncompliance. The audit reports included the auditors' opinion that the financial statements of the corporation were presented fairly on a modified cash basis of accounting."

A letter report issued by the Government Accountability Office with an abstract that begins "Rising U.S. energy consumption and concerns about dependency on foreign energy sources have prompted the administration to aggressively pursue domestic oil and gas production, including production on public lands, which in turn has generated concern that the impacts of this activity may compromise the use of public land for other purposes. GAO determined (1) the extent to which the level of oil and gas development on public lands managed by the Bureau of Land Management (BLM) has changed in recent years, and how the change has affected BLM's ability to mitigate impacts; (2) what policy changes related to oil and gas development BLM recently made and how these policies affected BLM's environmental mitigation activities; and (3) what challenges BLM faces in managing its oil and gas program."

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO reviewed the audit reports covering the financial statements of the Italian American War Veterans of the United States, for fiscal year 2001. GAO found no reportable instances of noncompliance. The audit reports included the auditors' opinions that the financial statements of the corporation were presented fairly on a modified cash basis of accounting."

A letter report issued by the Government Accountability Office with an abstract that begins "Some U.S. companies allege that unfair subsidies are a factor in Chinese success in U.S. markets. U.S. producers injured by subsidized imports may normally seek countervailing duties (CVD) to offset subsidies, but the United States does not apply CVDs against countries, including China, that the Department of Commerce classifies as "nonmarket economies" (NME). In this report, GAO (1) explains why the United States does not apply CVDs to China, (2) describes alternatives for changing this policy, (3) explores challenges that would arise in applying CVDs, and (4) examines the implications for duty rates on Chinese products."

A letter report issued by the Government Accountability Office with an abstract that begins "The Army has embarked on a major transformation of its force. Central to this transformation is the Future Combat Systems (FCS), a $108 billion effort to provide warfighters with the vehicles, weapons, and communications needed to identify and respond to threats with speed, precision, and lethality. Establishing reliable, robust communications and networking capabilities is key to FCS's success. Each of the systems integral to the FCS communications network--the Joint Tactical Radio System (JTRS), the Warfighter Information Network-Tactical (WIN-T), and the System of Systems Common Operating Environment (SOSCOE)--rely on significant advances in current technologies and must be fully integrated to realize FCS. Given the complexity and costs of this undertaking, GAO was asked to review each of these key development efforts to identify any risks that may jeopardize the successful fielding of FCS."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Secretary of the Treasury, in coordination with the Director of the Office of Management and Budget (OMB), is required to annually prepare and submit audited financial statements of the U.S. government to the President and the Congress. We are required to audit these consolidated financial statements (CFS) and report on the results of our work. In connection with fulfilling our requirement to audit the fiscal year 2004 CFS, we evaluated the Department of the Treasury's (Treasury) financial reporting procedures and related internal control over the process for compiling the CFS, including the management representation letter provided us by Treasury and OMB. Written representation letters from management, required by U.S. generally accepted government auditing standards, ordinarily confirm oral representations given to the auditor, indicate and document the continuing appropriateness of those representations, and reduce the possibility of a misunderstanding between management and the auditor. The purpose of this report is to communicate our observations on the Department of Health and Human Services's (HHS) fiscal year 2004 management representation letter. Our objective is to help ensure that future management representation letters submitted by HHS are sufficient to help support …

Correspondence issued by the Government Accountability Office with an abstract that begins "According to the Office of Personnel Management (OPM), a "conversion" occurs whenever an employee changes from one personnel "status" or "service" to another without a break in federal government service of more than 3 days. There are many kinds of conversions. This report focuses on one type of conversion, i.e., employees converting from noncareer to career positions. Conversions of individuals from noncareer to career positions must conform to applicable regulations and qualification requirements. As requested, we are providing Congress with information on the number of employees who were converted from noncareer to career positions during the 32-month period from May 1, 2001, through December 31, 2003, as reported to us by 41 departments and agencies. The types of positions this letter covers and a definition of each, along with the criteria we used to select the 41 departments and agencies, are listed in the scope and methodology section. As agreed with Congress, we will report at a later date on conversions reported by departments and selected agencies from May 1, 2001, through April 30, 2005. That report will discuss (1) the number of all conversions occurring during that …

A letter report issued by the Government Accountability Office with an abstract that begins "Chemicals play an important role in everyday life, but some may be harmful to human health and the environment. Chemicals are used to produce items widely used throughout society, including consumer products such as cleansers, paints, plastics, and fuels, as well as industrial solvents and additives. However, some chemicals, such as lead and mercury, are highly toxic at certain doses and need to be regulated because of health and safety concerns. In 1976, the Congress passed the Toxic Substances Control Act (TSCA) to authorize the Environmental Protection Agency (EPA) to control chemicals that pose an unreasonable risk to human health or the environment. GAO reviewed EPA's efforts to (1) control the risks of new chemicals not yet in commerce, (2) assess the risks of existing chemicals used in commerce, and (3) publicly disclose information provided by chemical companies under TSCA."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Mall in Washington, D.C., encompasses some of our country's most treasured icons and serves as a public gathering place for millions of visitors each year. The National Air and Space Museum, for example, was the most visited museum worldwide in 2003, hosting 9.4 million visitors. Federal agencies with facilities on the National Mall have begun implementing physical security enhancements to protect their facilities and the visiting public. This report responds to Congressional interest in the efforts and expenditures pertaining to these security enhancements and discusses (1) the physical security enhancements that have been implemented on the National Mall since September 11, 2001, the additional enhancements planned, and the costs of these enhancements; (2) the considerations given to incorporating access and aesthetics into the design and approval of these security enhancements, and how issues of access and aesthetics are perceived by visitors in relation to these enhancements; and (3) examples of how federal agencies are using key practices to implement the enhancements, and any challenges the agencies are experiencing in using these key practices. In commenting on a draft of this report, the Smithsonian Institution, …

A letter report issued by the Government Accountability Office with an abstract that begins "On September 30, 2002, the most recent date for which Department of Health and Human Services (HHS) data were available, about 126,000 foster children were waiting to be adopted. Estimates suggest that a significant portion of these children had one or more special needs, such as a medical condition or membership in a minority group, that may discourage or delay their adoption. Federal support in the form of adoption subsidies and incentive payments to states is available to promote special needs adoption. This report (1) identifies the major challenges to placing and keeping special needs children in adoptive homes, (2) examines what states and HHS have done to facilitate special needs adoptions, and (3) assesses how well the Adoption Assistance Program and the Adoption Incentives Program have worked to facilitate special needs adoptions, and determines if changes might be needed."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Census Bureau (Bureau) conducted the Count Question Resolution (CQR) program to correct errors in the count of housing units as well as dormitories and other group living facilities known as group quarters. GAO was asked to assess whether CQR was consistently implemented across the country, paying particular attention to whether the Bureau identified census errors that could have been caused by more systemic problems. GAO also evaluated how well the Bureau transitioned to CQR from an earlier quality assurance program called Full Count Review."