A letter report issued by the Government Accountability Office with an abstract that begins "The Medicare program makes about $500 billion in payments per year and continues to have a significant amount of improper payments--almost $48 billion in fiscal year 2010. The Centers for Medicare & Medicaid Services' (CMS) Medicare Integrity Program (MIP) is designed to identify and address fraud, waste, and abuse, which are all causes of improper payments. MIP's authorizing legislation provided funding for its activities and subsequent legislation provided additional funding. GAO was asked to report on how effectively CMS is using MIP funding to address Medicare program integrity. GAO examined (1) how CMS used MIP funding to support the program's activities from fiscal years 2006 through 2010, (2) how CMS assesses the effectiveness of MIP, and (3) factors CMS considers when allocating MIP funding. GAO analyzed CMS budget and other documents, interviewed CMS officials, and examined the agency's method of calculating return on investment (ROI), a performance measure used by CMS to measure the effectiveness of MIP activities."

Correspondence issued by the Government Accountability Office with an abstract that begins "Recent catastrophic flooding in Arkansas, Louisiana, Mississippi, Missouri, and Tennessee caused levee breaches and forced mandatory evacuations; while record flooding along the Mississippi and lower Ohio River valleys prompted the U.S. Army Corps of Engineers (Corps) to rupture the Bird's Point-New Madrid Levee, resulting in the flooding of more than 130,000 acres of Missouri farmland. The destruction is estimated to have caused hundreds of millions in property damages. These events underscore the importance of the nation's levee system and the role federal agencies play in assessing levee integrity and assisting communities in the aftermath of levee failure. Levees are found in approximately 22 percent of U.S. counties, where almost half of the U.S. population resides and are, for the most part, owned and maintained by the locality in which they are located. The Federal Emergency Management Agency (FEMA), a component of the Department of Homeland Security (DHS), is responsible for mapping flood-prone areas across the country and issuing levee accreditations for the purposes of the National Flood Insurance Program (NFIP). Under the NFIP regulations, FEMA requires that levee owners or community officials seeking to demonstrate the flood protection …

Correspondence issued by the Government Accountability Office with an abstract that begins "This report responds to Congress' March 2010 request related to the Federal Emergency Management Agency's (FEMA) efforts to delegate grants administration responsibilities to its regions. Specifically, we are reporting on (1) the extent to which FEMA has operationalized delegation of grants administration responsibilities for preparedness grants to the regions, and (2) the extent to which FEMA has assessed the regions' capacity to assume increased responsibility for administration of preparedness grants."

A letter report issued by the Government Accountability Office with an abstract that begins "To help ensure that Americans receive value for their premium dollars, the Patient Protection and Affordable Care Act (PPACA) established minimum "medical loss ratio" (MLR) standards for health insurers. The MLR is a basic financial indicator, traditionally referring to the percentage of premiums spent on medical claims. The PPACA MLR is defined differently from the traditional MLR. Beginning in 2011, insurers must meet minimum MLR requirements or pay rebates to enrollees. While insurers' first set of data subject to the MLR requirements will be for 2011, and is not due until June 2012, insurers prepared preliminary PPACA MLR data for 2010. GAO examined: (1) what can be learned from the traditional MLR data reported by health insurers prior to PPACA; (2) what factors might affect the MLRs that insurers will report under PPACA; and (3) what changes in business practices, if any, have insurers made or planned to make in response to the PPACA MLR requirements. GAO analyzed premiums, claims, and traditional MLR data for nearly all insurers for 2006- 2009 and interviewed a judgmental sample of seven insurers--selected to provide a range based on their …

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. assistance through the President's Emergency Plan for AIDS Relief (PEPFAR) has helped provide treatment, care, and prevention services overseas to millions affected by HIV/AIDS. In 2008, Congress reauthorized PEPFAR with the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (2008 Leadership Act). The act requires the Department of State's Office of the U.S. Global AIDS Coordinator (OGAC) to report to Congress annually on PEPFAR performance. The U.S. Agency for International Development (USAID) and the Health and Human Services (HHS) Centers for Disease Control and Prevention (CDC) also report on PEPFAR program performance. Responding to legislative directives, GAO (1) described key procedures for planning and reporting on PEPFAR performance and (2) examined published PEPFAR performance plans and reports. GAO analyzed performance management documents and interviewed officials at OGAC, USAID, and CDC."

A letter report issued by the Government Accountability Office with an abstract that begins "From 2005 to 2010, 24 U.S. agencies provided more than $9 billion in trade capacity building (TCB) assistance to help more than 100 countries reduce poverty, increase economic growth, and achieve stability through trade. To report on TCB funding, the U.S. government conducts an annual survey of agencies and publicly reports the data in a TCB database administered by the U.S. Agency for International Development (USAID). GAO examined (1) how agencies' TCB activities are aligned with the agencies' goals, (2) the extent to which the TCB database provides sufficient information on key trends and funding, and (3) the extent to which USAID monitors and evaluates the effectiveness of its TCB activities. GAO focused on the agencies that reported the most funding for TCB activities since 2005--the Departments of the Army and State, the Millennium Challenge Corporation (MCC), and USAID--and the Office of the U.S. Trade Representative (USTR). GAO analyzed U.S. government data; reviewed agencies' strategic, budget, and program documents; and met with U.S. and foreign government officials in select countries."

A letter report issued by the Government Accountability Office with an abstract that begins "The Departments of Defense (DOD) and State (State) and the U.S. Agency for International Development (USAID) and others are involved in economic development activities in Iraq and Afghanistan. In June 2006, DOD established the Task Force for Business and Stability Operations (Task Force) to support its related efforts. The National Defense Authorization Act (NDAA) for Fiscal Year 2011 required that DOD, State, and USAID jointly develop a plan to transition Task Force activities to State, with a focus on potentially transitioning activities to USAID. Under the authority of the Comptroller General of the United States to conduct work on his own initiative and with additional congressional direction, GAO identified (1) factors to consider in planning any transition of Task Force activities and (2) the extent to which the Task Force established guidance to manage its activities and has shared information with other federal agencies. GAO analyzed documents and interviewed multiple agency officials in Washington, D.C., Iraq, and Afghanistan."

A letter report issued by the Government Accountability Office with an abstract that begins "With premiums increasing for private health insurance, questions have been raised about the extent to which increases are justified. Oversight of the private health insurance industry is primarily the responsibility of states. In 2010, the Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to award grants to assist states in their oversight of premium rates. GAO was asked to provide information on state oversight of premium rates. In this report, GAO describes (1) states' practices for overseeing health insurance premium rates in 2010, including the outcomes of premium rate reviews; and (2) changes that states that received HHS rate review grants have begun making to enhance their oversight of premium rates. GAO surveyed officials from insurance departments in 50 states and the District of Columbia (referred to as states) about their practices for overseeing premium rates in 2010 and changes they have begun making to enhance their oversight. GAO received responses from all but one state. GAO also interviewed officials from California, Illinois, Maine, Michigan, and Texas to gather additional information on state practices. GAO selected these states based …

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter discusses the Department of Defense's (DOD) cyber and information assurance budget for fiscal year 2012 and future years defense spending. The objectives of this review were to (1) assess the extent to which DOD has prepared an overarching budget estimate for full-spectrum cyberspace operations across the department; and (2) identify the challenges DOD has faced in providing such estimates. The President has identified the cyber threat as one of the most serious national security challenges that the nation faces. In February 2011 the Deputy Secretary of Defense said that more than 100 foreign intelligence agencies have tried to breach DOD computer networks, and that one was successful in breaching networks containing classified information. To aid its efforts in countering cyberspace threats, DOD established the U.S. Cyber Command in 2010 and is currently undertaking departmentwide efforts to defend against cyber threats. DOD has defined some key cyber-related terms. Cyberspace operations is defined as the employment of cyber capabilities where the primary purpose is to achieve military objectives or effects in or through cyberspace. Such operations include computer network operations and activities to operate and defend the global …