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Medicare Physician Fee Schedule: CMS Needs a Plan for Updating Practice Expense Component
A letter report issued by the Government Accountability Office with an abstract that begins "Medicare's payments for the costs physicians incur in operating their practices are based on two sets of estimates: total practice expenses and resource estimates for individual services. Total practice expense estimates were derived from American Medical Association (AMA) physician surveys, which the Centers for Medicare & Medicaid Services (CMS) refines with supplemental data submitted by medical specialty societies. Resource estimates for individual services were developed by expert panels and refined by CMS with recommendations from another expert panel. In response to a mandate in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, GAO evaluated CMS's processes for updating total practice expense and resource estimates and whether CMS will have the data necessary to update the fee schedule at least every 5 years as mandated by law."
Date:
December 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Workplace Safety and Health: OSHA's Oversight of Its Civil Penalty Determination and Violation Abatement Processes Has Limitations
A letter report issued by the Government Accountability Office with an abstract that begins "This report presents the findings of our study of the Department of Labor's Occupational Safety and Health Administration's (OSHA) determination of civil penalties and abatement of violations. The objective of the study was to assess the extent of OSHA's oversight of the civil penalty determination and the violation abatement processes. In addition, we developed a statistical model, known as a multivariate analysis, to better understand factors that influenced variation in penalty amounts. On July 7, 2004, we briefed Labor officials on the results of our study. This letter report formally conveys the information we presented at that briefing. To assess the extent of OSHA's oversight of the civil penalty determination and violation abatement processes, we (1) reviewed 2002 and 2003 regional audits from the five regions with the most inspections, (2) visited one of these regional offices and one area office within this region to interview officials and review documents and procedures, (3) conducted telephone interviews with the four remaining regional offices and one area office within each of those regions, (4) interviewed OSHA officials to identify relevant policies and procedures, and (5) reviewed relevant policies …
Date:
August 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Financial Audit: Federal Deposit Insurance Corporation Funds' 2003 and 2002 Financial Statements
A letter report issued by the General Accounting Office with an abstract that begins "GAO is required to annually audit the financial statements of the Bank Insurance Fund (BIF), Savings Association Insurance Fund (SAIF), and FSLIC Resolution Fund (FRF), which are administered by the Federal Deposit Insurance Corporation (FDIC). GAO is responsible for obtaining reasonable assurance about whether FDIC's financial statements for BIF, SAIF, and FRF, are presented fairly in all material respects, in conformity with U.S. generally accepted accounting principles, whether it maintains effective internal controls, and whether FDIC has complied with selected laws and regulations. Created in 1933 to insure bank deposits and promote sound banking practices, FDIC plays an important role in maintaining public confidence in the nation's financial system. In 1989, legislation to reform the federal deposit insurance system created three funds to be administered by FDIC: BIF and SAIF, which protect bank and savings deposits, and FRF, which was created to close out the business of the former Federal Savings and Loan Insurance Corporation."
Date:
February 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Nonproliferation: Further Improvements Needed in U.S. Efforts to Counter Threats from Man-Portable Air Defense Systems
A letter report issued by the General Accounting Office with an abstract that begins "The proliferation of man-portable air defense systems (MANPADS) has been of growing concern to the United States and other governments. The United States is pursuing a wide variety of activities internationally and domestically to address this threat. GAO was asked to assess efforts by (1) the State Department to control global proliferation of MANPADS, (2) the Department of Defense (DOD) to monitor end-use of U.S.-exported Stingers, and (3) the Department of Homeland Security (DHS) to develop technical countermeasures to minimize the threat of a MANPADS attack."
Date:
May 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Tax Policy: Historical Tax Treatment of INTELSAT and Current Tax Rules for Satellite Corporations
A letter report issued by the Government Accountability Office with an abstract that begins "The International Telecommunications Satellite Organization (INTELSAT)--an intergovernmental organization launched in 1964 to design, develop, and operate a commercial telecommunications satellite system--enjoyed certain privileges that domestic companies do not, including some related to taxation. Each member nation designated a Signatory to participate as an investor. The U.S. Signatory was COMSAT, a private corporation. Intelsat privatized in 2001, and its tax situation changed. In response to congressional requests for information on whether Intelsat could continue to enjoy any preferential tax treatment as a foreign corporation, GAO did this study to describe how INTELSAT and COMSAT were treated for U.S. tax purposes prior to INTELSAT'S privatization and to describe how current U.S. tax treatment for a domestically incorporated satellite company in the United States compares to current U.S. tax treatment for a foreign corporation with operations, services, and revenue in the United States."
Date:
September 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Rural Housing Service: Updated Guidance and Additional Monitoring Needed for Rental Assistance Distribution Process
A letter report issued by the Government Accountability Office with an abstract that begins "The Rural Housing Service's (RHS) Section 521 rental assistance program provides rental subsidies for about 250,000 rural tenants. Because the program has a waiting list of 80,000 eligible tenants and there are over 1.3 million rural low-income renters eligible for housing subsidies, it is important to effectively distribute resources to extend assistance to as many needy tenants as possible. Therefore, GAO was asked to assess (1) how RHS distributes rental assistance funds to properties and tenants, (2) how RHS monitors the use of rental assistance funds, and (3) whether there are sufficient internal controls in place to ensure that these funds are being effectively administered and used."
Date:
September 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Electricity Markets: Consumers Could Benefit from Demand Programs, but Challenges Remain
A letter report issued by the Government Accountability Office with an abstract that begins "The efficient and reliable functioning of the more than $200 billion electric industry is vital to the lives of all Americans. As demonstrated in the 2003 black- out in the Northeast and the 2001 energy crisis in the West, changes in the cost and availability of electricity can have significant impacts on consumers and the national economy. The Federal Energy Regulatory Commission (FERC) supports using demand-response programs as part of its effort to develop and oversee competitive electricity markets. GAO was asked to identify (1) the types of demand-response programs currently in use, (2) the benefits of these programs, (3) the barriers to their introduction and expansion, and (4) instances where barriers have been overcome. Additionally, GAO examined the federal government's participation in these programs through the General Services Administration (GSA)."
Date:
August 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Military Operations: DOD's Fiscal Year 2003 Funding and Reported Obligations in Support of the Global War on Terrorism
A letter report issued by the General Accounting Office with an abstract that begins "The Global War on Terrorism--principally involving operations in Afghanistan and Iraq--was funded in fiscal year 2003 by Congress's appropriation of almost $69 billion. To assist Congress in its oversight of spending, GAO is undertaking a series of reviews relating to contingency operations in support of the Global War on Terrorism. In September 2003, GAO issued a report that discussed fiscal year 2003 obligations and funding for the war through June 2003. This report continues the review of fiscal year 2003 by analyzing obligations reported in support of the Global War on Terrorism and reviews whether the amount of funding received by the military services was adequate to cover DOD's obligations for the war from October 1, 2002, through September 30, 2003. GAO will also review the war's reported obligations and funding for fiscal year 2004."
Date:
May 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Telecommunications: Intelsat Privatization and the Implementation of the ORBIT Act
A letter report issued by the Government Accountability Office with an abstract that begins "In 2000, the Congress passed the Open-market Reorganization for the Betterment of International Telecommunications Act (ORBIT Act) to help promote a more competitive global satellite services market. The ORBIT Act called for the full privatization of INTELSAT, a former intergovernmental organization that provided international satellite services. GAO agreed to provide federal officials' and stakeholders' views on (1) whether the privatization steps required by the ORBIT Act have been implemented and whether there were potential inconsistencies between ORBIT Act requirements and U.S. obligations made in international trade agreements; (2) whether access by global satellite companies to non-U.S. markets has improved since the enactment of the ORBIT Act and, if so, to what is this generally attributed; and (3) if any market access problems remain, what role does the Federal Communications Commission (FCC) have in addressing those problems under the ORBIT Act."
Date:
September 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Defense Management: Tools for Measuring and Managing Defense Agency Performance Could Be Strengthened
A letter report issued by the Government Accountability Office with an abstract that begins "GAO was mandated to assess the effectiveness of defense agency performance contracts as management tools. As agreed, GAO also reviewed other tools (performance plans and balanced scorecards) and focused on three defense agencies--the Defense Logistics Agency (DLA), the Defense Information Systems Agency (DISA), and the Department of Defense Education Activity (DODEA). GAO addressed (1) the extent that the defense agencies initially used performance contracts, including whether this tool addressed attributes associated with results-oriented management; (2) defense agencies' efforts to implement performance plans using lessons learned from the initial contracts; and (3) the extent DOD established mechanisms to share lessons learned. GAO reviewed the content of these tools, but not the actual or reported performance. DISA has not yet finalized its scorecard, thus this report discusses only DISA's plans for its scorecard."
Date:
September 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Workforce Training: Almost Half of States Fund Employment Placement and Training through Employer Taxes and Most Coordinate with Federally Funded Programs
A letter report issued by the General Accounting Office with an abstract that begins "As technological and other advances transform the U.S. economy, many of the nation's six million employers may have trouble finding employees with the skills to do their jobs well. Some experts indicate that such a skill gap already affects many employers. To help close this skill gap, both federal- and state-funded programs are providing training and helping employers find qualified employees. In 2002, the federal government spent about $12 billion on workforce programs, and there are various studies on these programs. States also raised revenues in 2002--from taxes levied on employers--to fund their own workforce programs. However, little is known about these state programs. GAO was asked to provide information on how many states use these employer taxes to fund their own employment placement and training programs, what services are provided, the extent to which these state programs coordinate with federal programs, and how states assess the performance of these programs."
Date:
February 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Immigration Benefits: Eleventh Report Required by the Haitian Refugee Immigration Fairness Act of 1998
Correspondence issued by the Government Accountability Office with an abstract that begins "This report responds to certain requirements of the Haitian Refugee Immigration Fairness Act (HRIFA) of 1998 that authorized certain Haitian nationals and their dependents to apply to adjust their status to legal permanent residence. Section 902(k) of the act requires the Comptroller General to report every 6 months on the number of Haitian nationals who have applied and been approved to adjust their status to legal permanent residence. The reports are to contain a breakdown of the number of Haitians who applied and the number who were approved as asylum applicants, parolees, children without parents, orphaned children, or abandoned children; or as the eligible dependents of these applicants, including spouses, children, and unmarried sons or daughters. Reports are to be provided until all applications have been finally adjudicated. This is our eleventh report."
Date:
August 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Force Structure: Department of the Navy's Tactical Aviation Integration Plan Is Reasonable, but Some Factors Could Affect Implementation
A letter report issued by the Government Accountability Office with an abstract that begins "The Fiscal Year 2004 Defense Appropriations Act and the Senate Report for the 2004 National Defense Authorization Act mandated that GAO examine the Navy and Marine Corps' Tactical Aviation Integration Plan. In response to these mandates, this report addresses (1) how Navy and Marine Corps operational concepts, force structure, and procurement costs change; (2) the methodology and assumptions the services used to analyze the potential for integrating the forces; (3) the analytical process the services used to decide which reserve squadrons to decommission; and (4) other factors that might affect implementation of the Plan."
Date:
August 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Guardianships: Collaboration Needed to Protect Incapacitated Elderly People
A letter report issued by the Government Accountability Office with an abstract that begins "As people age, some become incapable of managing their personal and financial affairs. To protect these people, state laws provide for court appointment of guardians to act on their behalf. In many cases federal programs provide these incapacitated people financial benefits. GAO was asked to examine: (1) what state courts do to ensure that guardians fulfill their responsibilities, (2) what guardianship programs recognized as exemplary do to ensure that guardians fulfill their responsibilities, and (3) how state courts and federal agencies work together to protect incapacitated elderly people."
Date:
July 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Aviation Security: Computer-Assisted Passenger Prescreening System Faces Significant Implementation Challenges
A letter report issued by the General Accounting Office with an abstract that begins "The security of U.S. commercial aviation is a long-standing concern, and substantial efforts have been undertaken to strengthen it. One of these efforts is the development of a new Computer-Assisted Passenger Prescreening System (CAPPS II) to identify passengers requiring additional security attention. The development of CAPPS II has raised a number of issues, including whether individuals may be inappropriately targeted for additional screening, and whether data accessed by the system may compromise passengers' privacy. GAO was asked to determine (1) the development status and plans for CAPPS II; (2) the status of CAPPS II in addressing key developmental, operational, and public acceptance issues; and (3) other challenges that could impede the successful implementation of the system."
Date:
February 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Maritime Security Fleet: Many Factors Determine Impact of Potential Limits on Food Aid Shipments
A letter report issued by the Government Accountability Office with an abstract that begins "Food aid cargo must generally be carried on U.S.-flag ships under requirements set by the cargo preference program. Two groups of carriers compete for this cargo: (1) those that participate in the Maritime Security Program and receive an annual government subsidy--generally liners operating on scheduled routes and (2) those that do not--generally carriers operating on a charter basis. Congress directed GAO to study (1) how the cargo preference and Maritime Security programs are designed and who participates;(2) the nature and extent of MSF and non-MSF carrier participation and competition in the food aid program; and (3) how a tonnage limitation on bagged preference cargo for MSF vessels could affect MSF, other U.S.-flag ships, the cargo preference food aid program, and the ports servicing these ships."
Date:
September 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Border Security: Additional Actions Needed to Eliminate Weaknesses in the Visa Revocation Process
A letter report issued by the Government Accountability Office with an abstract that begins "The National Strategy for Homeland Security calls for preventing foreign terrorists from entering our country and using all legal means to identify; halt; and where appropriate, prosecute or bring immigration or other civil charges against terrorists in the United States. GAO reported in June 2003 that the visa revocation process needed to be strengthened as an antiterrorism tool and recommended that the Department of Homeland Security (DHS), in conjunction with the Departments of State (State) and Justice, develop specific policies and procedures to ensure that appropriate agencies are notified of revocations based on terrorism grounds and take proper actions. GAO examined whether weaknesses in the visa revocation process identified in its June 2003 report were addressed."
Date:
July 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
U.S. Postal Service: USPS Needs to Clearly Communicate How Postal Services May Be Affected by Its Retail Optimization Plans
A letter report issued by the Government Accountability Office with an abstract that begins "A key element of the ongoing postal reform deliberations before Congress is the U.S. Postal Service's (USPS) ability to carry out its mission of providing universal mail delivery and retail services at reasonable rates. Many are concerned that USPS's mission is at risk in the current operating environment of increasing competition and decreasing mail volumes. Preserving universal service, particularly in rural areas, is a goal of postal reform. GAO was asked to discuss (1) how USPS provides universal mail delivery services and access to postal services in both rural and urban areas; (2) what changes USPS is making or plans to make related to providing postal services, including changes that may affect rural areas; and (3) what are the major issues that have been raised related to how USPS provides postal services."
Date:
July 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
U.S. Coast Guard National Pollution Funds Center: Improvements Are Needed in Internal Control Over Disbursements
Correspondence issued by the General Accounting Office with an abstract that begins "The Oil Spill Liability Trust Fund (Fund) is a $1 billion fund that has two major components: the Emergency Fund and the Principal Fund. The Emergency Fund is used for paying for federal removal actions and the initiation of natural resource damage assessments by designated federal, state, or Indian tribe officials, resulting from oil spills or the substantial threat of oil spills to the waters or shorelines of the United States. The Principal Fund is used for paying certain claims for uncompensated removal costs and damages resulting from oil spills or the substantial threat of oil spills to the waters or shorelines of the United States. The Fund is administered by the National Pollution Funds Center (NPFC) of the U.S. Coast Guard (USCG). In May 2002, we issued a legal opinion related to the uses and limitations of the Fund and concluded that the Fund is not available to pay employee salaries and other operating expenses. The USCG reported that from fiscal years 1998 through 2002, $32.8 million from the Fund was used to pay costs associated with processing claims, including salaries and other operating expenses. In April …
Date:
January 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Text
System:
The UNT Digital Library
HHS's Efforts to Promote Health Information Technology and Legal Barriers to Its Adoption
Correspondence issued by the Government Accountability Office with an abstract that begins "Studies published by the Institute of Medicine and others have indicated that fragmented, disorganized, and inaccessible clinical information adversely affects the quality of health care and compromises patient safety. Health information technology (IT)--technology used to collect, store, retrieve, and transfer clinical, administrative, and financial health information electronically--is seen as a promising solution to this problem. Technologies such as electronic health records (EHR) and bar coding of certain human drug and biological product labels have been shown to save money and reduce medical errors. However, only a small number of U.S. health care providers have fully adopted health IT. Significant financial, technical, cultural, and legal barriers to the adoption of health IT exist. The Department of Health and Human Services (HHS), as a regulator, purchaser, health care provider, and sponsor of research, education, and training, has been working to promote the use of IT in public and private health care settings. There is no comprehensive catalogue of HHS' health IT efforts, however, and little is known about the nature and extent of the legal barriers and HHS's efforts to address them. The Chairman, Senate Committee on Health, Education, Labor, …
Date:
August 13, 2004
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Business-Owned Life Insurance: More Data Could Be Useful in Making Tax Policy Decisions
A letter report issued by the General Accounting Office with an abstract that begins "Business-owned life insurance is permanent insurance held by employers on the lives of their employees, and the employer is the beneficiary of these policies. Its attractive features, common to all permanent life insurance, generally include both tax-deferred accumulation of earnings on the policies' cash value and tax-free receipt of the death benefit. Legislators have expressed concerns about the ability of employers to receive tax-favored treatment from insuring their employees' lives. GAO was asked to discuss (1) the prevalence and use of business-owned life insurance, (2) federal and state regulation and oversight of these policies, and (3) the potential usefulness of and costs associated with obtaining more comprehensive data on business-owned life insurance."
Date:
May 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Weapons Of Mass Destruction: Defense Threat Reduction Agency Addresses Broad Range of Threats, but Performance Reporting Can Be Improved
A letter report issued by the General Accounting Office with an abstract that begins "The Defense Threat Reduction Agency (DTRA), within the Department of Defense (DOD), plays a key role in addressing the threats posed by weapons of mass destruction (WMD). Since the September 11, 2001, attacks, the visibility of DTRA's role has increased as federal agencies and military commanders have looked to the agency for additional support and advice. GAO was asked to report on DTRA's (1) mission and the efforts it undertakes to fulfill this mission; (2) relationship with other government entities, specifically the Department of Energy and the Department of Homeland Security (DHS); and (3) process that it uses to prioritize resources and assess progress toward organizational goals."
Date:
February 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
United Nations: Reforms Progressing, but Comprehensive Assessments Needed to Measure Impact
A letter report issued by the General Accounting Office with an abstract that begins "The U.N. Secretary General launched two reform agendas, in 1997 and 2002, to address the U.N.'s core management challenges--poor leadership of the Secretariat, duplication among its many offices and programs, and the lack of accountability for staff performance. In 2000, GAO reported that the Secretary General had reorganized the Secretariat's leadership and structure, but that the reforms were not yet complete. As the largest financial contributor to the United Nations, the United States has a strong interest in the completion of these reforms. GAO was asked to assess the (1) overall status of the 1997 and 2002 reforms, (2) implementation of reforms in four key areas, and (3) potential challenges to reform."
Date:
February 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library
Medicaid: Improved Federal Oversight of State Financing Schemes Is Needed
A letter report issued by the General Accounting Office with an abstract that begins "For years, some states have taken advantage of a loophole in Medicaid law that allows them to claim billions of dollars in excessive federal matching funds by exploiting the "upper payment limit" (UPL), which is intended to be a ceiling on federal cost sharing. Congress and the Centers for Medicare & Medicaid Services (CMS) acted to curtail UPL financing schemes through law in 2000 and regulation in 2001. CMS recognized that some states had developed a long-standing reliance on UPL funds. The law and regulation authorized transition periods of up to 8 years for states to phase out excessive UPL claims. GAO was asked to examine CMS's oversight of nursing home UPL arrangements, including the status of and the basis for transition period decisions."
Date:
February 13, 2004
Creator:
United States. General Accounting Office.
Object Type:
Report
System:
The UNT Digital Library