A letter report issued by the Government Accountability Office with an abstract that begins "This report responds to section 112, Division B, of the Consolidated Appropriations Act of 2004, which directs GAO to review federal programs benefiting rural communities in Alaska. After discussions with congressional staff, GAO agreed to examine federal programs benefiting Alaska Native villages. Specifically, this report (1) provides information on the amount of federal assistance provided to Alaska Native villages during fiscal years 1998 through 2003, (2) describes how selected federal funds have been used to assist Alaska Native villages, and (3) provides data on the number and average cost of houses built by villages and Alaska Native regional housing authorities."

Correspondence issued by the Government Accountability Office with an abstract that begins "In response to a Congressional request, we issued a report in June 2005 on the Department of Defense's (DOD) progress in determining and allocating resources needed to implement the New Triad today and in the future. In that report, we made recommendations to the Secretary of Defense to provide greater visibility of the projected spending and future investments for DOD's efforts to create the New Triad and acquire future capabilities. On April 28, 2005, we provided DOD with a draft of that report for review and comment. DOD did not provide comments in time to incorporate them in that report, which went to printing on June 24, 2005. DOD provided its comments to us on June 30, 2005. To present DOD's comments and provide our perspective on them, this report briefly summarizes our June 2005 report's objectives, results, and recommendations, along with DOD's comments and our evaluation of the comments."

Correspondence issued by the Government Accountability Office with an abstract that begins "Alaska currently holds 35 trillion cubic feet of proven recoverable natural gas resources, about 19 percent of total U.S. reserves. Efforts to construct a pipeline to transport this natural gas from Alaska's North Slope to the lower 48 states have been stalled since 1982. The recent increase in natural gas prices has renewed interest in completing the pipeline, a project that is estimated to cost up to $20 billion. In addition to providing access to significant natural gas reserves, some expect the project to generate thousands of jobs and billions of dollars in revenues for the federal government and the State of Alaska. This report responds to a mandate in the Alaska Natural Gas Pipeline Act (the Pipeline Act) that we conduct a study to determine the extent to which small business concerns have participated in the construction of oil and gas pipelines. The Pipeline Act includes a "sense of Congress" provision that the sponsors of the Alaska natural gas pipeline should maximize the participation of small business concerns in contracts and subcontracts awarded for the project. This provision, while setting out a statement of congressional opinion, does …

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. airlines are increasingly relying on code-share partnerships with foreign carriers to provide additional sources of revenue. Code-sharing is a marketing arrangement in which an airline places its designator code on a flight operated by another airline and sells and issues tickets for that flight. To determine whether the foreign code-share partners of U.S. airlines meet an acceptable level of safety, in 2000, the Department of Transportation (DOT) established the Code-Share Safety Program, which requires U.S. airlines to conduct safety audits of their foreign code-share partners as a condition of code-share authorization. GAO's objective was to assess the federal government's efforts to provide reasonable assurance of safety and security on foreign code-share flights. GAO reviewed (1) the extent to which DOT's code-share authorization process is designed to consider safety and security, (2) the Federal Aviation Administration's (FAA) management of the Code-Share Safety Program, and (3) the implementation of the program by airlines and the results."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) operates one of the nation's largest health care systems. In 1999, GAO reported on VA's aged, obsolete capital assets, noting that better management of these assets could significantly reduce VA's operating costs. GAO also noted that VA could reinvest the savings to enhance veterans' health care. In response, VA initiated its Capital Asset Realignment for Enhanced Services (CARES) process to identify what health care services it should provide in which locations through fiscal year 2022. CARES resulted in decisions to realign inpatient services at some VA facilities and to leave services as currently aligned at others. VA did not complete inpatient alignment decisions across VA for long-term care and mental health services and for inpatient services at some facilities because VA lacked sufficient information on demand for such care and other factors. GAO was asked to examine key challenges VA will face in completing and implementing CARES. This report discusses three key challenges: (1) developing information to complete inpatient alignment decisions, (2) improving management of excess property, and (3) determining priorities for purchasing care to improve access. GAO's analysis is …

A letter report issued by the Government Accountability Office with an abstract that begins "In December 2002, the U.S. Department of State (State) established the Middle East Partnership Initiative (MEPI) to promote democracy in the Middle East and North Africa. MEPI provides assistance for political, economic, and educational reform and women's empowerment. In fiscal years 2002-2004, State and the U.S. Agency for International Development (USAID) reviewed U.S. bilateral economic assistance programs in the region to ensure they were aligned with the new U.S. policy focus on promoting democracy and reform. In this report, GAO (1) describes MEPI's structure for managing projects and allocating funding, (2) examines MEPI's uses of the reviews, and (3) evaluates MEPI's project monitoring."

A letter report issued by the Government Accountability Office with an abstract that begins "The trend toward globalization has intensified the debate about the proper role of business and government in global "corporate social responsibility" (CSR),which involves business efforts to address the social and environmental concerns associated with business operations. The growth in global trade and the dramatic increase in foreign direct investment in developing countries raise questions regarding CSR-related issues such as labor, environment, and human rights. U.S. firms with operations in many countries employ millions of foreign workers and conduct a range of CSR activities to address these issues. However, there is controversy as to the proper government role. GAO describes (1) federal agency policies and programs relating to global CSR and (2) different perspectives regarding the appropriate U.S. government role and views on the impact of current federal activities on corporate global CSR efforts."

A letter report issued by the Government Accountability Office with an abstract that begins "Recent increases in child obesity have sparked concerns about competitive foods--foods sold to students at school that are not part of federally reimbursable school meals. The nutritional value of these foods is largely unregulated, and students can often purchase these foods in addition to or instead of school meals. In our April 2004 report on competitive foods (GAO-04-673), we reported that several states had enacted competitive food policies that were more restrictive than federal regulations. However, these policies differed widely in the type and extent of restrictions. In addition, it was unclear how and to what extent states were monitoring compliance with these policies. GAO was also asked to provide a national picture of competitive foods in schools, as well as strategies that districts and schools themselves are taking to limit the availability of less nutritious competitive foods. This report provides information from two nationally representative surveys about the prevalence of competitive foods in schools, competitive foods restrictions and groups involved in their sale, and the amounts and uses of revenue generated from the sale of competitive foods. It also provides information about strategies schools have …

A letter report issued by the Government Accountability Office with an abstract that begins "The Social Security Administration (SSA) at some point touches the life of nearly every American. Each day thousands of people contact SSA to file claims, update records, and request information from its 1,300 field offices, website, and national toll-free 800 number. Implemented nationwide in 1989, SSA's 800-number has become a principal contact point for millions of individuals seeking agency services. Congressional requesters asked GAO to review the quality of SSA's 800 number in terms of caller access and agent accuracy of response and courtesy."

A letter report issued by the Government Accountability Office with an abstract that begins "Problems in the supply distribution system dating back to the Persian Gulf War have impeded the ability of the Department of Defense (DOD) to provide effective and timely logistics support to the warfighter. DOD has taken actions to improve the distribution system by assigning new organizational responsibilities, including designating U.S. Transportation Command as the "Distribution Process Owner" (DPO); issuing a new logistics transformation strategy; and undertaking specific improvement initiatives. GAO's objectives were to (1) assess DOD's organizational structure and transformation strategy to improve the distribution system and (2) determine the status of, and timelines for completing, specific DOD distribution initiatives. agreed with the latter two."

A letter report issued by the Government Accountability Office with an abstract that begins "Power plants emit pollutants that have been linked to various negative health effects. In 2003, two new power plants, owned by Sempra Energy and Intergen, began operations 3 miles south of the U.S.-Mexico border near Imperial County, California. The county does not meet some federal and state air quality standards and may be further impacted by the emissions from these plants. Although these plants export most of the electricity they produce to the United States, they are not currently required to meet any U.S. or California emissions standards. GAO was asked to determine (1) how emissions from the two plants compare with emissions from recently permitted plants in California and emissions from sources in Imperial County, and what emissions standards they would be subject to if they were located in Imperial County; (2) the health impacts of emissions from the plants on Imperial County residents; and (3) options available to U.S. policymakers to ensure that emissions from these plants do not adversely affect the health of Imperial County residents. In commenting on a draft of this report, DOE disagreed with our characterization of the limitations of …

A letter report issued by the Government Accountability Office with an abstract that begins "Three agencies of the Department of Homeland Security (DHS) have primary responsibility for securing the nation's borders--the U.S. Coast Guard (USCG), Customs and Border Protection (CBP), and Immigration and Customs Enforcement (ICE). Together, they enforce security across 7,500 miles of land border between the United States and Mexico and Canada, and protect more than 361 seaports and 95,000 miles of coastline. To fulfill their missions, these agencies deploy a variety of valuable air and marine assets. In this report, GAO analyzed (1) what efforts DHS has undertaken to facilitate coordination of the air and marine assets of the three agencies and (2) how the agencies' local air and marine units have, in selected areas, coordinated the use of assets and what challenges they faced."

Correspondence issued by the Government Accountability Office with an abstract that begins "In October 2002 we reported that inadequate linkage existed between near-term munitions needs of the combatant commanders and the purchases made by the military services. The Department of Defense (DOD) concurred with our recommendations and took steps to address them by rewriting the overarching DOD Instruction for determining munitions requirements. Related to our ongoing work on prepositioned stocks, we assessed whether DOD's efforts thus far and initiatives planned for the future will ensure the required linkage since successful implementation of operational war plans is contingent on the availability of the right mix and quantity of munitions. To make our assessment, we obtained and analyzed information from cognizant organizations within DOD, Joint Chiefs of Staff (JCS), Headquarters and subordinate units of the Military Services, and U.S. Forces Korea (USFK). We conducted our analysis of DOD's munitions requirements process in accordance with generally accepted government auditing standards."

Correspondence issued by the Government Accountability Office with an abstract that begins "In May 2005, we issued our report expressing an opinion on the Securities and Exchange Commission's (SEC) fiscal year 2004 financial statements and an opinion on SEC's internal control as of September 30, 2004. We also reported on the results of our tests of SEC's compliance with selected provisions of laws and regulations during fiscal year 2004. Our report on SEC's fiscal year 2004 financial statements identified reportable conditions in the internal controls over financial reporting that we considered to be material weaknesses. These weaknesses related to SEC's controls over (1) recording and reporting disgorgements and penalties, (2) information security, and (3) preparing financial statements and related disclosures. We issued two separate reports providing recommendations to address those weaknesses. The purpose of this report is to provide recommendations for those issues identified during our audit that, although not material in relation to the financial statements, we believe warrant management's attention."

A letter report issued by the Government Accountability Office with an abstract that begins "Concierge care is an approach to medical practice in which physicians charge their patients a membership fee in return for enhanced services or amenities. The recent emergence of concierge care has prompted federal concern about how the approach might affect beneficiaries of Medicare, the federal health insurance program for the aged and some disabled individuals. Concerns include the potential that membership fees may constitute additional charges for services that Medicare already pays physicians for and that concierge care may affect Medicare beneficiaries' access to physician services. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 directed GAO to study concierge care and its relationship to Medicare. Using a variety of methods, including a nationwide literature search and telephone interviews, GAO identified 146 concierge physicians and surveyed concierge physicians in fall 2004. GAO analyzed responses from 112 concierge physicians. GAO also reviewed relevant laws, policies, and available data on access to physician services and interviewed officials at the Department of Health and Human Services (HHS) and representatives of Medicare beneficiary advocacy groups."

A letter report issued by the Government Accountability Office with an abstract that begins "Data mining--a technique for extracting knowledge from large volumes of data--is being used increasingly by the government and by the private sector. Many federal data mining efforts involve the use of personal information, which can originate from government sources as well as private sector organizations. The federal government's increased use of data mining since the terrorist attacks of September 11, 2001, has raised public and congressional concerns. As a result, GAO was asked to describe the characteristics of five federal data mining efforts and to determine whether agencies are providing adequate privacy and security protection for the information systems used in the efforts and for individuals potentially affected by these data mining efforts."

A letter report issued by the Government Accountability Office with an abstract that begins "Congress is concerned about the health care spending burden facing the Federal Employees Health Benefits Program (FEHBP), the largest private health insurance program in the country. Health care spending per person varies geographically, and the underlying causes for the spending variation have not been fully explored. Understanding market forces and other factors that may influence health care spending may contribute to efforts to moderate health care spending. Health care spending varies across the country due to differences in its components, the utilization and price of health care services. A wide body of research describes extensive geographic variation in utilization. However, less is known about private sector geographic variation in prices. This report examined prices and spending in FEHBP Preferred Provider Organizations (PPOs) to determine (1) the extent to which hospital and physician prices varied geographically, (2) which factors were associated with geographic variation in hospital and physician prices, and (3) the extent to which hospital and physician price variation contributed to geographic variation in spending. We analyzed claims data from several large national PPOs participating in FEHBP. We used 2001 data, the most current data available …

A letter report issued by the Government Accountability Office with an abstract that begins "Prescription drug spending has been the fastest growing segment of national health expenditures. As the federal government assumes greater financial responsibility for prescription drug expenditures with the introduction of Medicare part D, federal policymakers are increasingly concerned about prescription drug prices. GAO was asked to examine the change in retail prices and other pricing benchmarks for drugs frequently used by Medicare beneficiaries and other individuals with health insurance from 2000 through 2004. To examine the change in retail prices from 2000 through 2004, we obtained usual and customary (U&C) prices from two state pharmacy assistance programs for drugs frequently used by Medicare beneficiaries and non-Medicare enrollees in the 2003 Blue Cross and Blue Shield (BCBS) Federal Employee Program (FEP). The U&C price is the price an individual without prescription drug coverage would pay at a retail pharmacy. Additionally, we compared the change in U&C prices for brand drugs from 2000 through 2004 to the change in two pricing benchmarks: average manufacturer price (AMP), which is the average of prices paid to manufacturers by wholesalers for drugs distributed to the retail pharmacy class of trade, and average …

A letter report issued by the Government Accountability Office with an abstract that begins "Congress authorized the creation of risk retention groups (RRG) to increase the availability and affordability of commercial liability insurance. An RRG is a group of similar businesses that creates its own insurance company to self-insure its risks. Through the Liability Risk Retention Act (LRRA), Congress partly preempted state insurance law to create a single-state regulatory framework for RRGs, although RRGs are multistate insurers. Recent shortages of affordable liability insurance have increased RRG formations, but recent failures of several large RRGs also raised questions about the adequacy of RRG regulation. This report (1) examines the effect of RRGs on insurance availability and affordability; (2) assesses whether LRRA's preemption has resulted in significant regulatory problems; and (3) evaluates the sufficiency of LRRA's ownership, control, and governance provisions in protecting the best interests of the RRG insureds."

A letter report issued by the Government Accountability Office with an abstract that begins "The Temporary Assistance for Needy Families (TANF) program introduced specific work requirements and benefit time limits. However, the Family Violence Option (FVO) requires states that adopt the FVO to screen TANF clients for domestic violence and grant waivers from program requirements for clients in domestic violence situations. TANF also allows the use of TANF funds for marriage and responsible fatherhood programs. Given states' broad discretion in implementing the TANF program, including most aspects of the FVO and marriage and responsible fatherhood programs, this report examines (1) how states identify victims of domestic violence among TANF recipients, (2) how states address domestic violence among TANF recipients once they are identified, and (3) the extent to which states spend TANF funds on marriage and responsible fatherhood programs, and how, if at all, these programs are addressing domestic violence."

A letter report issued by the Government Accountability Office with an abstract that begins "The burden of cleaning up Superfund and other hazardous waste sites is increasingly shifting to taxpayers, particularly since businesses handling hazardous substances are no longer taxed under Superfund and the backlog of sites needing cleanup is growing. While key environmental laws rely on the "polluter pays" principle, the extent to which liable parties cease operations or restructure--such as through bankruptcy--can directly affect the cleanup costs faced by taxpayers. GAO was asked to (1) determine how many businesses with liability under federal law for environmental cleanups have declared bankruptcy, and how many such cases the government has pursued in bankruptcy court; (2) identify challenges the Environmental Protection Agency (EPA) faces in holding bankrupt and other financially distressed businesses responsible for their cleanup obligations; and (3) identify actions EPA could take to better ensure that such businesses pay for their cleanups."

A letter report issued by the Government Accountability Office with an abstract that begins "The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) significantly reformed contracting for the administration of claims for Part A, Medicare's hospital insurance, and Part B, which covers outpatient services such as physicians' care. The MMA required the Centers for Medicare & Medicaid Services (CMS)--the agency within the Department of Health and Human Services (HHS) that administers Medicare--to conduct full and open competition for all of its claims administration contracts and to transfer the work to Medicare administrative contractors (MAC) by October 2011. The MMA required the Secretary of HHS to submit a report to the Congress and GAO on the plan for implementing Medicare contracting reform and for GAO to evaluate the plan. To address this mandate, GAO reviewed the extent to which (1) the plan provides an appropriate framework for implementing Medicare contracting reform and (2) the plan's cost and savings estimates are sound enough to support decisions on implementation."

A letter report issued by the Government Accountability Office with an abstract that begins "As the frontline regulator of mutual funds, the Securities and Exchange Commission (SEC) plays a key role in protecting the nearly half of all U.S. households owning mutual funds, valued around $8 trillion in 2005. Mutual fund abuses raised questions about the integrity of the industry and quality of oversight provided by SEC and self-regulatory organizations (SRO) that regulate broker-dealers selling funds. This report assesses (1) changes SEC has made to, or is planning for, its mutual fund exam program; (2) key aspects of SEC's quality control framework for routine fund exams; and (3) the adequacy of SEC's oversight of NASD and the New York Stock Exchange in protecting shareholders from mutual fund sales abuses."

Correspondence issued by the Government Accountability Office with an abstract that begins "On June 28, 2005, GAO testified before Congress at a hearing on "Access Delayed: Fixing the Security Clearance Process." This letter responds to a Congressional request that GAO provide answers to Senator Frank R. Lautenberg's questions for the record."