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Military Bases: Opportunities Exist to Improve Future Base Realignment and Closure Rounds (open access)

Military Bases: Opportunities Exist to Improve Future Base Realignment and Closure Rounds

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) developed and used a quantitative model known as the Cost of Base Realignment Actions (COBRA), which GAO has found to be a reasonable estimator for comparing potential costs and savings among candidate alternatives, to estimate the costs and savings associated with Base Realignment and Closure (BRAC) 2005 recommendations. However, DOD’s process for providing the BRAC Commission with cost and savings estimates was hindered in many cases by underestimating recommendation specific requirements that were entered into the COBRA model. For example, military construction costs for BRAC 2005 increased from $13.2 billion estimated by the BRAC Commission in 2005 to $24.5 billion after implementation ended in 2011. Most of this 86 percent increase was caused by requirements that were added or identified after implementation began. While GAO recognizes that some military construction requirements were added after DOD submitted its initial cost estimates to the BRAC Commission, GAO found that other cost estimates increased because requirements were initially understated or not identified as inputs into COBRA. DOD also did not fully anticipate information technology requirements for many recommendations. For example, the initial information technology …
Date: March 7, 2013
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Housing and Urban Development: Strategic Human Capital and Workforce Planning Should be an Ongoing Priority (open access)

Housing and Urban Development: Strategic Human Capital and Workforce Planning Should be an Ongoing Priority

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Department of Housing and Urban Development (HUD) reports that it is moving forward with strategic human capital and workforce planning efforts after several years of delays. HUD's most recent workforce plan expired in 2009 and since then HUD has launched several planning efforts. According to HUD, these efforts were preempted by other important priorities, such as responding to the economic crisis. HUD undertook initiatives such as training key program office staff on the need to determine up front the staff HUD could afford to hire. In HUD's latest effort, a contractor is expected to complete human capital and workforce plans no later than fiscal year 2014. In June 2012, an Office of Personnel Management (OPM) review found that HUD's human capital and workforce planning activities did not always follow key principles for planning, implementing, and evaluating the results of human capital management policies and practices. For example, the review found that HUD's human resources policies and programs are not aligned with the organization's mission, strategic goals, or performance outcomes. As a result of these weaknesses, OPM concluded that HUD cannot continually assess and improve …
Date: March 15, 2013
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
VA Health Care: VA Has Taken Steps to Make Services Available to Women Veterans, but Needs to Revise Key Policies and Improve Oversight Processes (open access)

VA Health Care: VA Has Taken Steps to Make Services Available to Women Veterans, but Needs to Revise Key Policies and Improve Oversight Processes

A letter report issued by the Government Accountability Office with an abstract that begins "In 2008, VA provided health care to over 281,000 women veterans, a fast growing subgroup of veterans. Women veterans seeking VA health care need access to an array of services and Congress has raised concerns about how well VA is prepared to meet the physical and mental health care needs of women. GAO was asked to examine (1) the on-site availability of health care services at VA facilities for women veterans, (2) the extent to which VA facilities are following VA policies that apply to the delivery of health care to women veterans, and (3) key challenges that VA facilities face in providing health care to women veterans and how VA is addressing these challenges. GAO reviewed applicable laws and VA policies, interviewed officials, and visited a judgmental sample of 9 VA medical centers (VAMC) and 10 community-based outpatient clinics (CBOC) chosen, in part, based on the number of women using services. GAO also visited 10 VA counseling centers (Vet Centers)."
Date: March 31, 2010
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
DOE Nuclear Waste: Better Information Needed on Waste Storage at DOE Sites as a Result of Yucca Mountain Shutdown (open access)

DOE Nuclear Waste: Better Information Needed on Waste Storage at DOE Sites as a Result of Yucca Mountain Shutdown

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy's (DOE) Office of Environmental Management (EM) is responsible for storing and managing a total of about 13,000 metric tons of nuclear waste--spent nuclear fuel and high-level waste--at five DOE sites in Colorado, Idaho, New York, South Carolina, and Washington. Also, a joint DOE-Navy program stores spent nuclear fuel from warships at DOE's Idaho site. DOE and the Navy intended to permanently dispose of this nuclear waste at a repository planned for Yucca Mountain in Nevada. However, that plan is now in question because of actions taken to terminate the site. This report assesses (1) agreements DOE and the Navy have with states at the five sites and the effects a termination of the Yucca Mountain repository would have on their ability to fulfill these agreements; (2) the effects a termination would have on DOE's and the Navy's operations and costs for storing the waste; and (3) DOE's and the Navy's plans to mitigate these potential effects. GAO reviewed state agreements and DOE plans, visited waste facilities, and interviewed federal and state officials."
Date: March 23, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Information Technology: Better Informed Decision Making Needed on Navy's Next Generation Enterprise Network Acquisition (open access)

Information Technology: Better Informed Decision Making Needed on Navy's Next Generation Enterprise Network Acquisition

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of the Navy (DON), a major component of the Department of Defense (DOD), has launched its Next Generation Enterprise Network (NGEN) program to replace the Navy Marine Corps Intranet (NMCI) program. NGEN capabilities, such as secure transport of voice and data, data storage, and e-mail, are to be incrementally acquired through multiple providers. As planned, the first increment is expected to provide comparable NMCI capabilities, additional information assurance, and greater DON network control, at a cost of about $50 billion through fiscal year 2025. Given the size, importance, and complexity of NGEN, GAO was asked to determine whether DON has sufficiently analyzed alternative acquisition approaches and has a reliable schedule for executing the program, and whether program acquisition decisions have been performance- and risk-based. To do this, GAO reviewed the NGEN analysis of alternatives, integrated master schedule, and key milestone decisions."
Date: March 11, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
401(K) Plans: Certain Investment Options and Practices That May Restrict Withdrawals Not Widely Understood (open access)

401(K) Plans: Certain Investment Options and Practices That May Restrict Withdrawals Not Widely Understood

A letter report issued by the Government Accountability Office with an abstract that begins "401(k) plan sponsors are responsible for offering an array of appropriate investment options, and participants are responsible for directing their investments among those options. While participants expect to be able to switch investment options or withdraw money from their accounts, during the recent economic downturn, some 401(k) plan sponsors and participants found that they were restricted from doing so. GAO was asked to (1) identify some of the specific investments and practices that prevented plan sponsors and participants from accessing their 401(k) plan assets and (2) determine any changes the Department of Labor (Labor) could make to assist sponsors in understanding the challenges posed by the investments and practices that restricted withdrawals. To do this, GAO reviewed relevant federal laws and regulations and consulted with experts, federal officials, service providers, and plan sponsors."
Date: March 10, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
2013 Sequestration: Agencies Reduced Some Services and Investments, While Taking Certain Actions to Mitigate Effects (open access)

2013 Sequestration: Agencies Reduced Some Services and Investments, While Taking Certain Actions to Mitigate Effects

A letter report issued by the Government Accountability Office with an abstract that begins "Fiscal year 2013 sequestration reduced or delayed some public services and disrupted some operations in the 23 federal agencies GAO reviewed, even though agencies took actions to minimize the effects. For example, agencies reported that sequestration reduced assistance for education, housing, and nutrition, as well as health and science research and development grants. Agencies also reported delaying investments such as information technology and facilities projects. Some federal services also experienced backlogs and delays as a result of personnel actions including limiting hiring and furloughing employees. However, many of the effects of sequestration could not be quantified or will not be known until future years, if at all, for a number of reasons including the timing of when funds are disbursed (such as grant cycles that start late in the fiscal year), challenges in isolating the effects from other factors, and the lack of currently available performance data for some programs. Moreover, congressional and agency actions mitigated some potential effects by shifting funds to higher priorities while deferring or reducing funding for lower priorities."
Date: March 6, 2014
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
End-Stage Renal Disease: CMS Should Improve Design and Strengthen Monitoring of Low-Volume Adjustment (open access)

End-Stage Renal Disease: CMS Should Improve Design and Strengthen Monitoring of Low-Volume Adjustment

A letter report issued by the Government Accountability Office with an abstract that begins "The low-volume payment adjustment (LVPA) did not effectively target low-volume facilities that had high costs and appeared necessary for ensuring access to care. Nearly 30 percent of LVPA-eligible facilities were located within 1 mile of another facility in 2011, and about 54 percent were within 5 miles, indicating these facilities might not have been necessary for ensuring access to care. Furthermore, in many cases, LVPA-eligible facilities were located near high-volume facilities. Among the freestanding facilities in GAO's analysis, LVPA-eligible facilities had substantially higher costs per dialysis treatment than the average facility ($272 compared with $235); however, so did other facilities that provided a relatively low volume of treatments (and were isolated) but were ineligible for the LVPA. The design of the LVPA gives facilities an adverse incentive to restrict service provision because facilities could lose a substantial amount of Medicare revenue over 3 years if they reach the treatment threshold. In another payment system, the Centers for Medicare & Medicaid Services (CMS) implemented a tiered adjustment that decreases as facility volume increases. Such an adjustment could diminish the incentive for dialysis facilities to limit service provision …
Date: March 1, 2013
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Education of Military Dependent Students: Better Information Needed to Assess Student Performance (open access)

Education of Military Dependent Students: Better Information Needed to Assess Student Performance

A letter report issued by the Government Accountability Office with an abstract that begins "Since the early 1990s, Congress has supplemented the Department of Education's (Education) Impact Aid program by providing funds for the Department of Defense's (DOD) Impact Aid program to compensate school districts with a high number of military dependent students. The National Defense Authorization Act for Fiscal Year 2010 required GAO to review the use of these funds. GAO reviewed (1) what is known about the utilization and effectiveness of DOD Impact Aid funds, (2) the challenges faced by school districts in serving military dependent students, and (3) how DOD and Education have collaborated on their assistance. To address these issues, GAO conducted a Web-based survey of all 154 school districts that received DOD Impact Aid in any year from 2001 to 2009, with a response rate of 77 percent. GAO also interviewed officials from DOD and Education and seven school districts in five states, ranging in school district size, location, and percentage of military dependent students. The findings from these visits cannot be projected nationwide, but illustrate valuable perspectives."
Date: March 1, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Information Security: IRS Needs to Enhance Internal Control over Financial Reporting and Taxpayer Data (open access)

Information Security: IRS Needs to Enhance Internal Control over Financial Reporting and Taxpayer Data

A letter report issued by the Government Accountability Office with an abstract that begins "The Internal Revenue Service (IRS) has a demanding responsibility in collecting taxes, processing tax returns, and enforcing the nation's tax laws. It relies extensively on computerized systems to support its financial and mission-related operations and on information security controls to protect financial and sensitive taxpayer information that resides on those systems. As part of its audit of IRS's fiscal years 2010 and 2009 financial statements, GAO assessed whether controls over key financial and tax processing systems are effective in ensuring the confidentiality, integrity, and availability of financial and sensitive taxpayer information. To do this, GAO examined IRS information security policies, plans, and procedures; tested controls over key financial applications; and interviewed key agency officials at four sites."
Date: March 15, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Toxic Substances: EPA Has Increased Efforts to Assess and Control Chemicals but Could Strengthen Its Approach (open access)

Toxic Substances: EPA Has Increased Efforts to Assess and Control Chemicals but Could Strengthen Its Approach

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2009, the Environmental Protection Agency (EPA) has made progress implementing its new approach to managing toxic chemicals under its existing Toxic Substances Control Act (TSCA) authority; particularly by increasing efforts to obtain chemical toxicity and exposure data and initiating chemical risk assessments--which EPA uses, along with other information, to decide what regulatory or other actions, if any, are warranted. The results of EPA's data collection activities, in most cases, have yet to be realized, and it may take several years before EPA obtains much of the data it is seeking. Also, EPA has not pursued some opportunities to obtain chemical data that companies submit to foreign governments or to obtain data from chemical processors that prepare chemical substances after their manufacture for distribution in commerce--some of which could help support the agency's risk assessment activities. Of the 83 chemicals EPA has prioritized for risk assessment, it initiated 7 assessments in 2012 and plans to start 18 additional assessments in 2013 and 2014. However, it may take several years to complete these initial risk assessments and, at the agency's current pace, over a decade to complete …
Date: March 22, 2013
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Motor Carrier Safety: New Applicant Reviews Should Expand to Identify Freight Carriers Evading Detection (open access)

Motor Carrier Safety: New Applicant Reviews Should Expand to Identify Freight Carriers Evading Detection

A letter report issued by the Government Accountability Office with an abstract that begins "FMCSA does not determine the total number of chameleon carriers within the motor carrier industry. Such a determination would require FMCSA to investigate each of the tens of thousands of new applicants that register annually and then complete a legal process for some of these suspected chameleon carriers, an effort for which FMCSA does not have sufficient resources. Rather, FMCSA’s attempt to identify chameleon carriers among new applicants, referred to as the vetting program, is limited to bus companies (passenger carriers) and movers (household goods carriers). These two relatively small groups, representing only 2 percent of all new applicants in 2010, were selected because they present consumer protection and relatively high safety risks. Through the vetting program, FMCSA conducts electronic matching of applicant registration data against data on existing carriers and investigates each application from these two small groups, but does not determine whether all other new applicants, including freight carriers, may be attempting to assume a new identity. Federal internal control standards direct agencies to assess the risks they face to determine the most effective allocation of federal resources, including how best to distribute resources …
Date: March 22, 2012
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
End-Stage Renal Disease: CMS Should Assess Adequacy of Payment When Certain Oral Drugs Are Included and Ensure Availability of Quality Monitoring Data (open access)

End-Stage Renal Disease: CMS Should Assess Adequacy of Payment When Certain Oral Drugs Are Included and Ensure Availability of Quality Monitoring Data

A letter report issued by the Government Accountability Office with an abstract that begins "For most individuals with end-stage renal disease (ESRD), Medicare purchases a bundle of dialysis-related services using a single payment. In 2014, the Centers for Medicare & Medicaid Services (CMS) plans to include in this bundled payment "oral-only" ESRD drugs used to treat mineral and bone disorder. Currently, Medicare generally pays for these drugs only if the beneficiary has Part D prescription drug coverage. This report (1) describes the rationales for including oral-only ESRD drugs in the bundled payment, (2) examines dialysis organizations' recent experience providing oral-only ESRD drugs and their future ability to provide these drugs, (3) examines the data sources that CMS could use to account for oral-only ESRD drugs in the bundled payment, and (4) examines CMS's ability to monitor treatment of mineral and bone disorder. GAO interviewed CMS officials, experts in mineral and bone disorder, and representatives of 4 large and 16 small dialysis organizations. GAO also reviewed ESRD payment regulations, related reports, clinical guidelines, and state pharmacy licensure requirements in 10 selected states."
Date: March 23, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
DHS Asset Forfeiture: Additional Actions Could Help Strengthen Controls over Equitable Sharing (open access)

DHS Asset Forfeiture: Additional Actions Could Help Strengthen Controls over Equitable Sharing

A letter report issued by the Government Accountability Office with an abstract that begins "From fiscal years 2003 through 2013, Department of Homeland Security (DHS) components that participate in the Treasury Forfeiture Fund—U.S. Immigration and Customs Enforcement (ICE), the U.S. Secret Service (USSS), U.S. Customs and Border Protection (CBP), and the U.S. Coast Guard (USCG)—contributed approximately $3.6 billion in revenues to the fund and obligated about $2.6 billion from the fund for forfeiture-related activities. These obligations included, among other things, approximately $1.2 billion that DHS components shared with state, local, federal, and foreign law enforcement agencies that participated in forfeiture efforts. Also, during this period, DHS components used about $348 million from the fund to support various law enforcement activities and projects, such as the construction of Border Patrol facilities along the southwest border."
Date: March 28, 2014
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
DOD and VA Health Care: Federal Recovery Coordination Program Continues to Expand but Faces Significant Challenges (open access)

DOD and VA Health Care: Federal Recovery Coordination Program Continues to Expand but Faces Significant Challenges

A letter report issued by the Government Accountability Office with an abstract that begins "In 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, the Departments of Defense (DOD) and Veterans Affairs (VA) jointly developed the Federal Recovery Coordination Program (FRCP) to coordinate the clinical and nonclinical services needed by severely wounded, ill, and injured servicemembers and veterans. The FRCP, which continues to expand, is administered by VA, and the care coordinators, called Federal Recovery Coordinators (FRC), are VA employees. This report examines (1) whether servicemembers and veterans who need FRCP services are being identified and enrolled in the program, (2) staffing challenges confronting the FRCP, and (3) challenges facing the FRCP in its efforts to coordinate care for enrollees. GAO reviewed FRCP policies and procedures and conducted over 170 interviews of FRCP officials, FRCs, headquarters officials and staff of DOD and VA case management programs, and staff at medical facilities where FRCs are located."
Date: March 23, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Food Safety: Preslaughter Interventions Could Reduce E. coli in Cattle (open access)

Food Safety: Preslaughter Interventions Could Reduce E. coli in Cattle

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. Department of Agriculture (USDA) and university researchers identified several treatments administered before cattle are slaughtered, or preslaughter interventions, that could reduce Shiga toxin-producing Escherichia coli (STEC) in cattle. Such preslaughter interventions include bacteriophages (viruses that infect and kill bacteria), probiotics (live bacteria that can benefit the digestive system), vaccines (biological preparations that alter the immune system), and sodium chlorate (chemical that kills the STEC O157:H7 strain). However, few manufacturers have submitted applications for preslaughter intervention products to target STEC according to officials from USDA and the Food and Drug Administration. One exception is for vaccines to reduce STEC O157:H7."
Date: March 9, 2012
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Homeland Defense: DOD Needs to Take Actions to Enhance Interagency Coordination for Its Homeland Defense and Civil Support Missions (open access)

Homeland Defense: DOD Needs to Take Actions to Enhance Interagency Coordination for Its Homeland Defense and Civil Support Missions

A letter report issued by the Government Accountability Office with an abstract that begins "Numerous occurrences in the United States--both scheduled events and emergencies--require the Department of Defense (DOD) to coordinate, integrate, and synchronize its homeland defense and civil support missions with a broad range of U.S. federal agencies. In response to congressional inquiry, GAO examined the extent to which DOD has (1) identified clearly defined roles and responsibilities for DOD entities to facilitate interagency coordination for homeland defense and civil support missions, (2) articulated to its federal partners the DOD entities' approach toward interagency coordination, and (3) adopted key practices for managing homeland defense and civil support liaisons. GAO reviewed numerous DOD policy and guidance documents and interviewed officials from DOD and its partner agencies, including the departments of Homeland Security, Justice, Health and Human Services, and Agriculture; and the Office of the Director of National Intelligence."
Date: March 30, 2010
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Warfighter Support: DOD's Urgent Needs Processes Need a More Comprehensive Approach and Evaluation for Potential Consolidation (open access)

Warfighter Support: DOD's Urgent Needs Processes Need a More Comprehensive Approach and Evaluation for Potential Consolidation

A letter report issued by the Government Accountability Office with an abstract that begins "Forces in Iraq and Afghanistan have faced significant risks of mission failure and loss of life due to rapidly changing enemy threats. In response, the Department of Defense (DOD) established urgent operational needs processes to rapidly develop, modify, and field new capabilities, such as intelligence, surveillance and reconnaissance (ISR) technology, and counter-improvised explosive devices (IED) systems. However, GAO, the Defense Science Board, and others have raised concerns about the effectiveness, efficiency, and oversight of DOD's various urgent needs processes. GAO conducted this review to determine (1) what various entities exist within DOD for responding to urgent operational needs, and the extent to which there is fragmentation, overlap, or duplication; (2) the extent to which DOD has a comprehensive approach for managing and overseeing its urgent needs activities; and (3) the extent to which DOD has evaluated the potential for consolidations. To conduct this review, GAO examined DOD's urgent needs processes and collected and analyzed data from urgent needs entities."
Date: March 1, 2011
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
DOE Loan Guarantees: Further Actions Are Needed to Improve Tracking and Review of Applications (open access)

DOE Loan Guarantees: Further Actions Are Needed to Improve Tracking and Review of Applications

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy (DOE) has made $15 billion in loan guarantees and conditionally committed to an additional $15 billion, but the program does not have the consolidated data on application status needed to facilitate efficient management and program oversight. For the 460 applications to the Loan Guarantee Program (LGP), DOE has made loan guarantees for 7 percent and committed to an additional 2 percent. The time the LGP took to review loan applications decreased over the course of the program, according to GAO’s analysis of LGP data. However, when GAO requested data from the LGP on the status of these applications, the LGP did not have consolidated data readily available and had to assemble these data over several months from various sources. Without consolidated data on applicants, LGP managers do not have readily accessible information that would facilitate more efficient program management, and LGP staff may not be able to identify weaknesses, if any, in the program’s application review process and approval procedures. Furthermore, because it took months to assemble the data required for GAO’s review, it is also clear that the data were not …
Date: March 12, 2012
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Military Housing: Information on the Privatization of Unaccompanied Personnel Housing (open access)

Military Housing: Information on the Privatization of Unaccompanied Personnel Housing

A letter report issued by the Government Accountability Office with an abstract that begins "Since Congress enacted the Military Housing Privatization Initiative (MHPI) in 1996, the military services conducted several analyses and considered other factors to determine whether to privatize housing for unaccompanied personnel. These analyses were conducted between 1997 and 2011. The Army's and the Navy's analyses compared different scenarios--such as whether to rely on privatization or use traditional military construction funding to improve housing quality--and considered information from multiple installations in these analyses. In contrast, the Air Force and Marine Corps analyzed the feasibility of privatizing unaccompanied housing at a few selected installations. For example, the Air Force based its initial analysis on information for two locations, while the Marine Corps based its 2008 analysis on information specific to one installation. The Navy and Army concluded that privatization could be used under a narrow set of circumstances at specific installations, such as where unaccompanied servicemembers were already receiving the basic allowance for housing (BAH). The Air Force and Marine Corps concluded that privatization was not suitable for meeting any of their housing needs. For example, an April 2000 Air Force memorandum indicated that privatization could have a negative …
Date: March 18, 2014
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Medicaid: Enhancements Needed for Improper Payments Reporting and Related Corrective Action Monitoring (open access)

Medicaid: Enhancements Needed for Improper Payments Reporting and Related Corrective Action Monitoring

A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services' (CMS) methodology for estimating a national improper payment rate for the Medicaid program is statistically sound. However, CMS's procedures did not provide for updating state data used in its methodology to recognize significant corrections or adjustments after the cutoff date. The Office of Management and Budget (OMB) requires that federal agencies establish a statistically valid methodology for estimating the annual amount of improper payments in programs and activities susceptible to significant improper payments. CMS developed the Payment Error Rate Measurement (PERM) program in order to comply with improper payment estimation and reporting requirements for the Medicaid program. Under the PERM methodology, CMS places states in one of three cycles, and each year one of the cycles reports new state-level data based on the previous year's samples. CMS then calculates the national Medicaid program improper payment estimate using these new data for one-third of the states and older data for the other two-thirds of the states. CMS's estimated national improper payment error rate for fiscal year 2011 for the Medicaid program was 8.1 percent, or $21.9 billion. However, CMS's procedures …
Date: March 29, 2013
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Electronic Health Records: HHS Strategy to Address Information Exchange Challenges Lacks Specific Prioritized Actions and Milestones (open access)

Electronic Health Records: HHS Strategy to Address Information Exchange Challenges Lacks Specific Prioritized Actions and Milestones

A letter report issued by the Government Accountability Office with an abstract that begins "Providers and stakeholders GAO interviewed in four states with ongoing electronic health information exchange efforts cited key challenges to exchange, in particular, issues related to insufficient standards, concerns about how privacy rules can vary among states, difficulties in matching patients to their records, and costs associated with exchange. Officials from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC)—agencies within the Department of Health and Human Services (HHS)—noted that they have several ongoing programs and initiatives to help address some aspects of these key challenges, but concerns in these areas continue to exist. For example, several providers GAO interviewed said that they have difficulty exchanging certain types of health information due to insufficient health data standards. Although HHS has begun to address insufficiencies in standards through its Medicare and Medicaid Electronic Health Record (EHR) programs, such as through the introduction of new 2014 standards for certified EHR technology, it is unclear whether its efforts will lead to widespread improvements in electronic health information exchange. In addition, providers GAO interviewed reported challenges covering costs associated with …
Date: March 24, 2014
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Defense Contracting: Actions Needed to Increase Competition (open access)

Defense Contracting: Actions Needed to Increase Competition

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense’s (DOD) competition rate for all contract obligations declined over the past five fiscal years, from 62.6 percent in fiscal year 2008 to 57.1 percent in fiscal year 2012. GAO also found that the competition rate in fiscal year 2012 varied by specific DOD component with the Air Force having the lowest at 37.1 percent and the Defense Logistics Agency the highest at 83.3 percent. The majority of the noncompetitive awards cited the availability of only one responsible source to meet the government’s needs as the reason for using noncompetitive procedures."
Date: March 28, 2013
Creator: United States. Government Accountability Office.
System: The UNT Digital Library
Export Controls: Proposed Reforms Create Opportunities to Address Enforcement Challenges (open access)

Export Controls: Proposed Reforms Create Opportunities to Address Enforcement Challenges

A letter report issued by the Government Accountability Office with an abstract that begins "Agencies use a risk-based approach, including workload and threat assessment data, to allocate resources, but most do not fully track those used for export control enforcement activities. As their missions are broader than export controls, agencies can use staff resources for other activities based on need, making tracking resources used solely for export control enforcement difficult. Only Commerce’s Office of Export Enforcement allocates its resources exclusively to export control enforcement as that is its primary mission. Other agencies, such as State and the Treasury, have relatively few export control enforcement staff to track. While several agencies acknowledge the need to better track export enforcement resources and have taken steps to do so, they do not know the full extent of their use of these resources and do not use this information in resource allocation decisions. In some cities, agencies are informally leveraging export enforcement resources through voluntarily created local task forces that bring together enforcement resources to work collectively on export control cases."
Date: March 27, 2012
Creator: United States. Government Accountability Office.
System: The UNT Digital Library