A statement of record issued by the General Accounting Office with an abstract that begins "Federal research and preparedness activities related to bioterrorism center on detection; the development of vaccines, antibiotics, and antivirals; and the development of performance standards for emergency response equipment. Preparedness activities include (1) increasing federal, state, and local response capabilities; (2) developing response teams; (3) increasing the availability of medical treatments; (4) participating in and sponsoring exercises; (5) aiding victims; and (6) providing support at special events, such as presidential inaugurations and Olympic games. To coordinate their efforts to combat terrorism, federal agencies are developing interagency response plans, participating in various interagency work groups, and entering into formal agreements with other agencies to share resources and capabilities. However, coordination of federal terrorism research, preparedness, and response programs is fragmented, raising concerns about the ability of states and localities to respond to a bioterrorist attack. These concerns include insufficient state and local planning and a lack of hospital participation in training on terrorism and emergency response planning. This testimony summarizes a September 2001 report (GAO-01-915)."

Testimony issued by the General Accounting Office with an abstract that begins "The Balanced Budget Act of 1997 required Medicare to change its payment system for ambulance services. In response, the Health Care Financing Administration (HCFA), now called the Centers for Medicare and Medicaid Services (CMS), proposed a fee schedule to standardize payments across provider types on the basis of national rates for particular services. Under the act, the fee schedule was to have applied to ambulance services furnished on or after January 1, 2000. HCFA published a proposed rule in September 2000 and has received public comment, but it has not yet issued a final rule. This testimony discusses the unique concerns of rural ambulance providers and the likely effects of the proposed fee schedule on these providers. Many rural ambulance providers face a set of unique challenges in implementing an appropriate payment policy. Rural providers--particularly those serving large geographic areas with low population density--tend to have high per-trip costs compared with urban and suburban providers. The proposed Medicare fee schedule does not sufficiently distinguish the providers serving beneficiaries in the most isolated rural areas and may not appropriately account for the higher costs of low-volume providers."