Correspondence issued by the General Accounting Office with an abstract that begins "GAO reviewed several issues concerning service contracting trends and challenges facing the government. The government has had long-standing difficulties in managing service contracts, and it is clear that agencies are not doing all they can to ensure that they are acquiring services that meet their needs in a timely and cost-effective manner. Agencies have begun efforts to address their strategic human capital needs; however, no agency has completed a strategic human capital management plan for their acquisition workforce. Overall, agencies' plans reflected different levels of attention to human capital, ranging from merely identifying human capital challenges to putting forward solutions to address those challenges, such as by defining actual plans, committing resources, and assigning accountability."

A letter report issued by the General Accounting Office with an abstract that begins "Congress and the Health Care Financing Administration recognized that certain services needed to be excluded from the skilled nursing facility (SNF) prospective payment system (PPS) rate to help ensure beneficiary access to appropriate care and to financially protect the SNFs that take care of high-cost patients. The criteria used to identify services--high cost, infrequently provided during a SNF stay and likely to be overprovided--and the services currently excluded appear reasonable. Even so, questions remain about whether beneficiaries have appropriate access to services that are covered in the rate or whether additional services should have been excluded. A second concern is that Medicare coverage for excluded facility services has been shifted from part A to part B, which will increase beneficiary liability. and program spending might increase because certain services are excluded only when provided in hospital settings, thus discouraging the use of less expensive, clinically appropriate sites of service. Finally, excluding services from the PPS rate when they are provided in emergency rooms may lead to overuse of emergency rooms, unnecessarily increasing Medicare spending. The Centers for Medicare and Medicare Services (CMS) does not plan to …