A letter report issued by the Government Accountability Office with an abstract that begins "Overall, trends in dental coverage show little change from 1996 to 2010--around 62 percent of individuals had coverage. The percentage of the population with private dental coverage decreased from 53 to 50 percent. Dental coverage through Medicaid or the State Children's Health Insurance Program (CHIP), which was established in 1997, rose from 9 to 13 percent. The increase was due primarily to an increase in the number of children covered by these federal-state health programs with mandated pediatric dental coverage. Individuals with no dental coverage decreased from 28 to 25 percent, and coverage for 10 to 12 percent of the population was unknown. Use of dental services--the percentage of individuals who had at least one dental visit--also remained relatively unchanged at around 40 percent from 1996 to 2010. Medicaid and CHIP beneficiaries, children in particular, showed increases in the use of dental services (from 28 to 37 percent), but still visited the dentist less often than privately insured children (58 percent in 2010)."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense's (DOD) rationale for waiving the competitive prototyping requirement in the Weapon Systems Acquisition Reform Act of 2009, as amended (WSARA), for the VXX program addresses one of the two bases provided in the statute; namely that the cost of producing competitive prototypes exceeds the expected life-cycle benefits (in constant dollars) of producing the prototypes. The VXX program's acquisition strategy provided the primary justification for the prototyping waiver. According to the waiver, VXX requirements can be met by integrating an existing, in-production, flight-proven aircraft with mature mission systems. The Navy in its waiver request also concluded that the integration activities planned for the VXX program do not require additional technology maturation or risk reduction beyond that already being accomplished by the government through its own prototyping of certain critical mission subsystems. Recognizing that the intent of competitive prototyping is to reduce cost and risk, DOD took other actions that could arguably achieve these goals. Specifically, DOD decided to reduce requirements, use an existing aircraft, and mature critical subsystems before integrating them on the aircraft. In the waiver, DOD also found reasonable the Navy's cost-benefit analysis, …

A letter report issued by the Government Accountability Office with an abstract that begins "As of January 7, 2013, the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) had finished initial, but not final, review steps for most of about 3,800 submissions for new tobacco products (those not on the market on February 15, 2007). Ninety-nine percent of the submissions received by FDA were made under the substantial equivalence (SE) pathway. CTP determines whether the new tobacco product in an SE submission has the same characteristics as a predicate tobacco product (a product commercially marketed in the United States on February 15, 2007, or previously found by FDA to be substantially equivalent) or has different characteristics that do not raise different questions of public health. Initial review steps include CTP's determination of whether the new product is a type regulated by FDA and whether the submission is missing information. For most SE submissions, CTP took more than a year and a half from the date a submission was received to the date these initial steps were completed. Of the 3,788 SE submissions, 3,165 were received by FDA prior to a statutory deadline (March 22, 2011) allowing the product …

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO's oversight has been comprehensive. To date, we have issued 65 products on the Troubled Asset Relief Programs (TARP) and activities and we have made 99 performance and financial statement audit recommendations. Our reviews have focused on several key areas, including the activities initiated under TARP and the challenges encountered in implementing them, Treasury's process for deciding how to unwind TARP programs and investments and the actions taken to terminate the programs and exit the investments, indicators of credit conditions in markets targeted by TARP programs, the management infrastructure for TARP programs, and the status of our recommendations to Treasury. Some of our reports have identified findings related to the effectiveness, accountability, and transparency of Treasury's management of TARP programs and its communication strategy."

A letter report issued by the Government Accountability Office with an abstract that begins "From 1994 through 2011, the multifamily loan activities of Fannie Mae and Freddie Mac (the enterprises) generally increased. In this period, Fannie Mae held a lower percentage of multifamily loans in its portfolio than Freddie Mac. While the enterprises’ multifamily business operations generally were profitable, both enterprises reported losses in 2008 and 2009."

A letter report issued by the Government Accountability Office with an abstract that begins "The rates Bureau of Prisons (BOP) inmates pay to make phone calls generate revenue that funds inmate wages and other amenities; however, inmates' contraband cell phone use is growing. The Cell Phone Contraband Act of 2010 criminalized cell phone possession in federal prisons and mandated that GAO study related issues. In response to the mandate, this report addresses (1) how telephone rates for BOP inmates compare with other correctional systems and the implications of lowering rates; (2) the number of cell phones confiscated in BOP and selected states, and any reported impact; and (3) the extent to which BOP and selected states have taken actions to minimize cell phone smuggling, these actions' effectiveness, and how BOP has coordinated internal and state information sharing. GAO reviewed BOP's policies, procedures, and cell phone confiscation data (2008-2010). GAO also interviewed BOP officials within BOP's 6 regions and 4 of its 116 institutions--as well as officials from 8 state correctional departments--selected for their cell phone detection efforts or challenges faced. The results are not generalizable, but provide insights."

A letter report issued by the Government Accountability Office with an abstract that begins "The FBI has spent over $900 million on the Trilogy and Sentinel information technology (IT) projects intended to provide FBI with an upgraded IT infrastructure and an automated case management system to support FBI agents and analysts. In February 2006 and July 2008, GAO reported on significant internal control weaknesses related to FBI's contract administration, processing of contractor invoices, and accountability for equipment acquired for these projects. GAO made 27 recommendations to the FBI to address these deficiencies. The FBI concurred with all 27 recommendations. This report provides an assessment of (1) the FBI's corrective actions to address GAO's 27 recommendations and (2) whether there were any indications of implementation issues related to the policies and procedures the FBI developed to address 17 of the 27 recommendations. GAO reviewed FBI policies and procedures, performed walk-throughs, and conducted detailed tests on statistically and nonstatistically selected samples of transactions."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2009, GAO reported on doctor shopping in Medicaid, where individuals see several doctors and pharmacies, receiving more of a drug than was intended by any single physician. Questions have been raised about whether similar activity exists in Medicare Part D. GAO was asked to (1) determine the extent to which Medicare beneficiaries obtained frequently abused drugs from multiple prescribers, (2) identify examples of doctor shopping activity, and (3) determine the actions taken by the Centers for Medicare & Medicaid Services (CMS) to limit access to drugs for known abusers. To meet the objectives, GAO analyzed Medicare Part D claims for calendar year 2008 to identify potential doctor shoppers. To identify examples, GAO chose a nonrepresentative selection of 10 beneficiaries based on a number of factors, including the number of prescribers. GAO also interviewed policy officials from CMS and from prescription drug plans that administer the drug benefit program."

Testimony issued by the Government Accountability Office with an abstract that begins "By the end of this fiscal year--in less than one month--the U.S. Postal Service (USPS) projects that it will incur a $9 billion loss; reach its $15 billion borrowing limit; not make its $5.5 billion retiree health benefits payment; and thus, become insolvent. USPS recently summarized this situation as the equivalent of facing Chapter 11 bankruptcy. In August 2011, USPS outlined new proposals to address the crisis. USPS seeks legislation to remove itself from the federal health benefit program and sponsor its own program; change pension benefits for new employees; and eliminate the layoff provisions it negotiated with its unions in collective bargaining to accelerate its delivery, processing, and retail network and workforce downsizing. Other USPS proposals, such as moving to 5-day delivery, and pending legislation include additional options for consideration. This statement discusses (1) updated information on USPS's financial crisis and (2) GAO's review and analysis of proposals to address this crisis, including USPS's new proposals, and options in current legislation. The testimony is based primarily on GAO's review of pending legislation, past and ongoing work related to postal issues, as well as USPS's recent financial results …

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security's (DHS) recent 4-year anniversary provides an opportunity to reflect on the progress DHS has made. The creation of DHS was one of the largest federal reorganizations in the last several decades, and GAO has reported that it was an enormous management challenge and that the size, complexity, and importance of the effort made the challenge especially daunting and critical to the nation's security. Our prior work on mergers and acquisitions has found that successful transformations of large organizations, even those faced with less strenuous reorganizations than DHS, can take at least 5 to 7 years to achieve. This testimony is based on our August 2007 report evaluating DHS's progress since March 2003. Specifically, it addresses DHS's progress across 14 mission and management areas and key themes that have affected DHS's implementation efforts."

A letter report issued by the Government Accountability Office with an abstract that begins "In recent years, considerable debate has centered on companies using the chapter 11 bankruptcy reorganization process to reduce or eliminate employer-sponsored benefits in an effort to become more competitive. Congress recently enacted several laws, in part, to help address this issue. Most notably, Congress passed the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 (BAPCPA) and the Pension Protection Act of 2006 (PPA). BAPCPA contained provisions related to chapter 11 business bankruptcies and sought to address the treatment of benefits during the bankruptcy process. In addition, the PPA amended several Employee Retirement Income Security Act of 1974 (ERISA) provisions related to defined benefit (DB) plans in bankruptcy. This report addresses (1) how, if at all, recent legislative changes affected the treatment of pension and health benefits during chapter 11 bankruptcies, and (2) what is known about the extent to which businesses have modified employee or retiree pension and health benefits. GAO reviewed filings of 115 public companies that filed for bankruptcy between October 17, 2004 and October 17, 2006, and conducted interviews with various experts on the treatment of benefits in the bankruptcy process. Relevant …

Correspondence issued by the Government Accountability Office with an abstract that begins "This correspondence follows up an August 1, 2007, meeting to discuss concerns about changes in the cost and savings estimates and the potential loss of expertise and experience from the closure of Fort Monmouth, New Jersey, among other issues, since the recommendation to close Fort Monmouth as part of the Department of Defense's (DOD) 2005 Base Realignment and Closure (BRAC) round became effective. The work since the independent Defense Base Closure and Realignment Commission's (the Commission) recommendations became effective has been done under the authority of the Comptroller General to conduct reviews on his own initiative and has focused on the implementation of realignment and closure actions. This brief summary reviews our public observations made in 2005 about the 2005 BRAC round, specifically those related to Fort Monmouth. Also reviewed, under the Comptroller General's authority to conduct reviews on his own initiative, is the methodology of a forthcoming DOD report on the transfer of technical capabilities from Fort Monmouth to Aberdeen Proving Ground, Maryland."

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Communications Commission (FCC) is charged with regulating interstate and international communications by radio, television, wire, satellite, and cable. The Telecommunications Act of 1996 established that FCC should promote competition and reduce regulation to secure lower prices and higher-quality services for American consumers. FCC implements its policy aims through rulemaking, whereby the agency notifies the public of a proposed rule and provides an opportunity for the public to participate in the rule's development. These rulemakings are documented within a public docket that contains the rulemaking record. In response to a congressional request on FCC rulemaking, GAO (1) described FCC's rulemaking process; (2) determined, for specific rulemakings, the extent to which FCC followed its process; and (3) identified factors that contributed to some dockets and rulemakings remaining open. GAO reviewed recent FCC rules, interviewed FCC officials and stakeholders, and conducted case studies of rulemakings."

A letter report issued by the Government Accountability Office with an abstract that begins "Hurricane Katrina was the largest, most destructive natural disaster in our nation's history. The problems experienced in responding to Katrina resulted in a number of investigations--by congressional committees, the White House Homeland Security Council, and others--regarding the preparations for and response to Katrina. GAO assisted the congressional investigations and, under the Comptroller General's authority, initiated a number of Katrina-related reviews. In March 2006 testimony, GAO provided its preliminary observations to Congress. The purpose of this report is to summarize what went well and why, what did not go well and why, and what changes are needed to improve the nation's readiness to respond to a catastrophic disaster; and to identify selected issues associated with the Gulf Coast's recovery. This report is based on GAO's prior work on catastrophic disasters, including Hurricane Andrew in 1992, the over 30 GAO reports completed to date on Hurricanes Katrina and Rita, ongoing GAO work, and other Hurricane Katrina reviews and lessons learned."

A letter report issued by the Government Accountability Office with an abstract that begins "Hurricane Katrina devastated the Gulf Coast region of the United States and caused billions of dollars in damage. Hurricanes Rita and Wilma further exacerbated damage to the region. The Federal Emergency Management Agency (FEMA), within the Department of Homeland Security (DHS), was tasked with the primary role of managing the federal relief and recovery efforts. This review was performed under the Comptroller General's authority because of widespread congressional interest in the response to this disaster. GAO examined whether the federal government was adequately tracking and reporting on the use of the funding provided in the four emergency supplemental appropriations acts enacted as of June 2006. GAO analyzed the emergency supplemental appropriations acts and conference reports, reviewed FEMA's required weekly reports, and interviewed federal agency officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Fish and Wildlife Service and the National Marine Fisheries Service (the services) are responsible for administration and implementation of the Endangered Species Act of 1973. The act generally requires the services to develop recovery plans for endangered and threatened species--species facing extinction or likely to face extinction, respectively. Recovery plans identify threats to the species' survival and the actions needed to mitigate those threats. Proposed amendments to the act are under consideration and GAO was asked to provide information to facilitate this effort. In April 2006, GAO issued a report providing high-level information on the extent to which recovery plans contain estimates of when species are expected to be recovered, among other things. This follow-on report provides more detailed information on the factors that affect species recovery and the importance of recovery plans in recovery efforts. For 31 species--selected because they were nearing recovery, or had significant attention devoted to them and thus would be expected to be making progress towards recovery--GAO (1) identifies factors affecting the length of time to recover the species and (2) describes the role recovery plans have played in …

A letter report issued by the Government Accountability Office with an abstract that begins "The Army considers its modular force transformation its most extensive restructuring since World War II. Restructuring units from a division-based force to a modular brigade-based force will require an investment of over $52 billion, including $41 billion for equipment, from fiscal year 2005 through fiscal year 2011, according to the Army. Because of broad congressional interest in this initiative, GAO prepared this report under the Comptroller General's authority and assessed (1) the Army's progress and plans for equipping modular combat brigades, (2) progress made and challenges to managing personnel requirements of the modular force, and (3) the extent to which the Army has developed an approach for assessing the results of its modular conversions and the need for further changes to designs or implementation plans."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Oceanic and Atmospheric Administration (NOAA) plans to procure the next generation of geostationary operational environmental satellites, called the Geostationary Operational Environmental Satellites-R series (GOES-R). This new series is considered critical to the United States' ability to maintain the continuity of data required for weather forecasting through the year 2028. GAO was asked to (1) determine the status of and plans for the GOES-R series procurement, and (2) identify and evaluate the actions that the program management team is taking to ensure that past problems experienced in procuring other satellite programs are not repeated."

Testimony issued by the Government Accountability Office with an abstract that begins "The U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 authorizes the President's Emergency Plan for AIDS Relief (PEPFAR). It promotes the ABC model (Abstain, be faithful, or use Condoms); recommends that 20 percent of funds appropriated pursuant to the act be spent on prevention; and requires that, starting in fiscal year 2006, 33 percent of prevention funds appropriated pursuant to the act be spent on abstinence-until-marriage activities. The Office of the U.S. Global AIDS Coordinator (OGAC) oversees PEPFAR and administers the Global HIV/AIDS Initiative (GHAI) account, the main repository for PEPFAR funds. For our April 2006 report, GAO reviewed PEPFAR prevention funding trends; described the PEPFAR strategy to prevent sexual transmission of HIV; and examined related challenges. The report recommended that the Coordinator collect and report information on the effects of the abstinence-until-marriage spending requirement and use it to, among other things, assess whether the requirement should apply only to the GHAI account. OGAC agreed to collect information but disagreed with applying the requirement only to certain funds; GAO modified the recommendation. GAO also suggested Congress use the information to assess how well the requirement supports …

A letter report issued by the Government Accountability Office with an abstract that begins "Hurricane Katrina's storm surge and floodwaters breached levees and floodwalls causing billions of dollars of property damage, and more than 1,300 deaths. Under the Comptroller General's authority to conduct reviews on his own initiative, GAO reviewed the Army Corps of Engineers (Corps) (1) progress in repairing damage to hurricane protection projects by June 1, 2006; (2) plans and estimated costs to make other repairs and complete five existing hurricane protection projects; and (3) plans and estimated costs to add enhancements and strengthen hurricane protection for the region. GAO reviewed related laws and regulations, Corps planning documents and repair tracking reports, observed ongoing repair work, and met with key agency officials and other stakeholders."

Correspondence issued by the Government Accountability Office with an abstract that begins "On March 9, 2006, we testified before Congress at a hearing entitled, "Reporting Improper Payments: A Report Card on Agencies' Progress." At the hearing, we discussed our findings on federal agencies' challenges in meeting the requirements of the Improper Payments Information Act (IPIA) of 2002 based on our review of agencies' fiscal year 2005 performance and accountability reports (PAR) and annual reports. We were asked to provide answers to the following follow-up questions relating to our March 9, 2006, testimony: (1) What concerns does GAO have regarding not only DHS' inability to comply with the Improper Payments Information Act; but on a greater scale with their overall financial management? (2) About which Agencies that reported in their fiscal year 2005 Performance and Accountability Report that they had no programs susceptible to significant improper payments does GAO have concerns about? (3) Should "unavoidable overpayment" statistics at the Social Security Administration (SSA) be reported to the Office of Management and Budget, and if so why would this be important, and how could the Social Security Administration implement such a process? (4) What concerns does GAO have with the Agency for …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security (DHS) Financial Accountability Act, Public Law Number 108-330, requires DHS management to provide an assertion on the internal control that applies to financial reporting for fiscal year 2005 and to obtain an auditor's opinion on the department's internal control over its financial reporting for fiscal year 2006. The act also directs the Chief Financial Officers (CFO) Council and the President's Council on Integrity and Efficiency (PCIE) to conduct a joint study, and report to the Congress and to the Comptroller General of the United States, on the potential costs and benefits of requiring agencies subject to the Chief Financial Officers Act of 1990 to obtain audit opinions of their internal control over financial reporting. The DHS Financial Accountability Act also requires that the Comptroller General of the United States review the joint study and report the results of this analysis to the Congress. In December 2005, we briefed available committee staff on our preliminary analysis of the joint study. This report provides further details on our review and on our views regarding a requirement for federal agencies to obtain audit opinions on their …

A letter report issued by the Government Accountability Office with an abstract that begins "Since 1990, GAO has considered Medicare at high risk for fraud, waste, abuse, and mismanagement. The Medicare Integrity Program (MIP) provides funds to the Centers for Medicare & Medicaid Services (CMS--the agency that administers Medicare--to safeguard over $300 billion in program payments made on behalf of its beneficiaries. CMS conducts five program integrity activities: audits; medical reviews of claims; determinations of whether Medicare or other insurance sources have primary responsibility for payment, called secondary payer; benefit integrity to address potential fraud cases; and provider education. In this report, GAO determined (1) the amount of MIP funds that CMS has allocated to the five program integrity activities over time, (2) the approach that CMS uses to allocate MIP funds, and (3) how major changes in the Medicare program may affect MIP funding allocations."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Congress continues to be concerned about the underrepresentation of U.S. professionals in some UN organizations and that insufficient progress has been made to improve U.S. representation. In 2001, GAO reported that several UN agencies fell short of their targets for U.S. representation and had not developed strategies to employ more Americans. This report reviews (1) U.S. representation status and employment trends at five UN agencies, (2) factors affecting these agencies' ability to meet employment targets, and (3) the U.S. Department of State's (State) efforts to improve U.S. representation and additional steps that can be taken. We reviewed five UN agencies that together comprise about 50 percent of total UN organizations' professional staff."