A letter report issued by the General Accounting Office with an abstract that begins "Federal employees' health insurance premiums have increased at double-digit rates for 3 consecutive years. GAO was asked to examine how the Federal Employees Health Benefits Program's (FEHBP) premium trends compared to those of other large purchasers of employer-sponsored health insurance, factors contributing to FEHBP's premium growth, and steps the Office of Personnel Management (OPM) takes to help contain premium increases compared to those of other large purchasers. GAO compared FEHBP to the California Public Employees' Retirement System (CalPERS), General Motors, and a large private-employer purchasing coalition in California as well as data from employee benefit surveys."

A letter report issued by the General Accounting Office with an abstract that begins "This report addresses (1) the relationship between Medicare skilled nursing facility (SNF) payments and the costs of treating Medicare patients in freestanding SNFs, as well as the effect of Medicare SNF payments on the financial condition of these facilities, and (2) the relationship between Medicare SNF payments and the costs of treating patients in hospital-based SNFs, as well as the factors that may account for cost differences between hospital-based and freestanding SNFs."

A letter report issued by the Government Accountability Office with an abstract that begins "Over 100,000 chemicals, pollutants, and toxic substances are used in the United States and regulated by the Environmental Protection Agency (EPA). EPA uses risk assessment to determine the health risk from exposure to these substances, collectively referred to as contaminants. In the last 12 years, independent reviewers have examined this process and made recommendations for how it could be improved. GAO was asked to (1) identify the significant recommendations that have been made to improve human health risk assessment; (2) describe what EPA has done to modify its human health risk assessment process; (3) determine the effects these past modifications have had on the preparation of risk assessments; and (4) identify any additional actions experts believe EPA could take to improve its process, and the barriers it would face in doing so."

A letter report issued by the Government Accountability Office with an abstract that begins "Several information security threats exist that can exploit vulnerabilities in active implantable medical devices, but experts caution that efforts to mitigate information security risks may adversely affect device performance. Threats to active devices—that is, devices that rely on a power source to operate—that also have wireless capability can be unintentional, such as interference from electromagnetic energy in the environment, or intentional, such as the unauthorized accessing of a device. Several experts consider certain threats to be of greater concern than others; for example, experts noted less concern about interference from electromagnetic energy than other threats. Incidents resulting from unintentional threats have occurred, such as a malfunction resulting from electromagnetic interference, but have since been addressed. Although researchers have recently demonstrated the potential for incidents resulting from intentional threats in two devices—an implantable cardioverter defibrillator and an insulin pump—no such actual incidents are known to have occurred, according to the Food and Drug Administration (FDA). Medical devices may have several such vulnerabilities that make them susceptible to unintentional and intentional threats, including untested software and firmware and limited battery life. Information security risks resulting from certain threats …

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Employees Health Benefits Program (FEHBP) recently began offering high-deductible health plans (HDHP) coupled with tax-advantaged health savings accounts (HSA) that enrollees use to pay for health care. Unused HSA balances may accumulate for future use, providing enrollees an incentive to purchase health care prudently. The plans also provide decision support tools to help enrollees make purchase decisions, including health care quality and cost information. Concerns have been expressed that HDHPs coupled with HSAs may attract younger, healthier, or wealthier enrollees, leaving older, less healthy enrollees to drive up costs in traditional plans. Because the plans are new, there is also interest in the plan features and the decision support tools they provide to enrollees. GAO was asked to evaluate the experience of the 14 HDHPs coupled with an HSA that were first offered under the FEHBP in January 2005. GAO compared the characteristics of enrollees in the 14 HDHPs to those of enrollees in another recently introduced (new) plan without a high deductible and to all FEHBP plans. GAO also compared characteristics of the three largest HDHPs to traditional FEHBP plans offered by the …

A letter report issued by the Government Accountability Office with an abstract that begins "Pursuant to a legislative requirement, GAO audited the expenditures of one office of independent counsel and one office of special counsel for the 6 months ended September 30, 2005."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2003, the Bureau of the Census (Bureau) changed the day and location of the release of its Income and Poverty Estimates. Some data users believed the change was an effort to suppress unfavorable news and questioned the Bureau's data dissemination practices. GAO was asked to assess whether (1) the Bureau adhered to its dissemination practices for the 2003 and later releases, and (2) the Bureau and 13 other federal statistical agencies follow data release practices recommended by the National Research Council (NRC). GAO reviewed the Bureau's dissemination process for the 2003 thru 2005 Income and Poverty Estimates."

A letter report issued by the Government Accountability Office with an abstract that begins "Through its Retirement Systems Modernization (RSM) program, the Office of Personnel Management (OPM) is modernizing the paper intensive processes and antiquated information systems it uses to support the retirement of civilian federal employees. RSM is intended to deploy new or modified systems beginning in February 2008 to improve the efficiency and effectiveness of the agency's retirement program. GAO was asked to (1) determine whether OPM is effectively managing the RSM program to ensure that system components perform as intended and (2) evaluate the risks, cost, and progress of the RSM program. To meet these objectives, GAO analyzed program documentation against relevant plans, policies, and practices."

A letter report issued by the Government Accountability Office with an abstract that begins "An outbreak of pandemic flu would require close cooperation between the public and private sectors to ensure the protection of our nation's critical infrastructure, such as drinking water and electricity. Because over 85 percent of the nation's critical infrastructure is owned and operated by the private sector, it is vital that both sectors effectively coordinate to successfully protect these assets. The Department of Homeland Security (DHS) is responsible for coordinating a national protection strategy and government and private sector councils have been created as a collaborating tool. GAO was asked to assess how the federal and private sectors are working together at a national level to protect the nation's critical infrastructure in the event of a pandemic, the challenges they face, and opportunities for addressing these challenges. GAO reviewed 5 of the 17 critical infrastructure sectors. These 5 sectors are energy (electricity), food and agriculture, telecommunications, transportation (highway and motor carrier), and water."

A letter report issued by the Government Accountability Office with an abstract that begins "Twenty-five percent of American students ages 13-17 reported using illicit drugs in 2007. The Drug-Free Communities Support Program provides grants to community coalitions involved in reducing youth substance abuse. The Office of National Drug Control Policy (ONDCP) administers the program. ONDCP selected the Substance Abuse and Mental Health Services Administration (SAMHSA) to operate the grant program in fiscal year 2005. In 2005, ONDCP did not award grants to some coalitions who had previously received grant funds (renewal grantees). GAO was asked to assess (1) the extent to which ONDCP and SAMHSA administered grant-related activities for fiscal years 2005 and 2006 consistent with federal internal control standards, statutory requirements, and other guidance and (2) the steps ONDCP has taken since 2006 regarding its administration of grant-related activities. GAO analyzed and compared program documents and grant activities to established guidance, such as federal internal control standards and statutory requirements, and interviewed key program management officials."

A letter report issued by the Government Accountability Office with an abstract that begins "DHS has generally relied on workforce data and has not regularly included employee input from available sources to identify "triggers," the term EEOC uses for indicators of potential barriers. GAO's analysis of DHS's MD-715 reports showed that DHS generally relied on workforce data to identify 13 of 15 triggers, such as promotion and separation rates. According to EEOC, in addition to workforce data, agencies are to regularly consult a variety of sources, such as exit interviews, employee groups, and employee surveys, to identify triggers. Involving employees helps to incorporate insights about operations from a frontline perspective in determining where potential barriers exist. DHS does not consider employee input from such sources as employee groups, exit interviews, and employee surveys in conducting its MD-715 analysis. Data from the governmentwide employee survey and DHS's internal employee survey are available, but DHS does not use these data to identify triggers. By not considering employee input on DHS personnel policies and practices, DHS is missing opportunities to identify potential barriers. Once a trigger is revealed, agencies are to investigate and pinpoint actual barriers and their causes. In 2007, through its …

A letter report issued by the Government Accountability Office with an abstract that begins "In July 2010, the federal government finalized guidance to address weaknesses in the watchlist nominations process that were exposed by the December 2009 attempted attack and to clarify how agencies are to nominate individuals to the watchlist. The nominating agencies GAO contacted expressed concerns about the increasing volumes of information and related challenges in processing this information. Nevertheless, nominating agencies are sending more information for inclusion in the terrorist watchlist after the attempted attack than before the attempted attack. Agencies are also pursuing staffing, technology, and other solutions to address challenges in processing the volumes of information. In 2011, an interagency policy committee began an initiative to assess the initial impacts the guidance has had on nominating agencies, but did not provide details on whether such assessments would be routinely conducted in the future. Routine assessments could help the government determine the extent to which impacts are acceptable and manageable from a policy perspective and inform future efforts to strengthen the nominations process."

A letter report issued by the Government Accountability Office with an abstract that begins "H.R. 3915 (2007), a bill introduced, but not enacted by the 110th Congress, was intended to reform mortgage lending practices to prevent a recurrence of problems in the mortgage market, particularly in the nonprime market segment. The bill would have set minimum standards for all mortgages (e.g., reasonable ability to repay) and created a "safe harbor" for loans that met certain requirements. Securitizers of safe harbor loans would be exempt from liability provisions, while securitizers of non-safe harbor loans would be subject to limited liability for loans that violated the bill's minimum standards. In response to a congressional request, this report discusses (1) the proportions of recent nonprime loans that likely would have met and not met the bill's safe harbor requirements and factors influencing the performance of these loans, and (2) relevant research and the views of mortgage industry stakeholders concerning the potential impact of key provisions of the bill on the availability of mortgage credit. To do this work, GAO analyzed a proprietary database of securitized nonprime loans, reviewed studies of state and local anti-predatory lending laws, and met with financial regulatory agencies and …

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) created a voluntary outpatient prescription drug benefit as part of the Medicare program, and appropriated up to $500 million for the Social Security Administration (SSA) to fund the start-up administrative costs in meeting its responsibilities to implement MMA. SSA was given a great deal of discretion in how to use the funds and the act provided little detail on how the funds were to be spent. You asked us to review SSA's costs for implementing MMA to determine (1) how the MMA funds were expended, (2) what procedures SSA has in place over the use of those funds, and (3) how SSA complied with those procedures related to contractor and vendor payments."

A letter report issued by the Government Accountability Office with an abstract that begins "In November 2004, as required by law, the Transportation Security Administration (TSA) began allowing all commercial airports to apply to use private screeners in lieu of federal screeners as part of its Screening Partnership Program (SPP). GAO's prior work found that airports and potential private screening contractors had concerns about the SPP, including whether they would be liable in the event of a terrorist attack and how roles and responsibilities would be divided among TSA airport staff and private screening contractors. This report addresses TSA's efforts to (1) provide liability protection to private screening contractors and airports and address other SPP stakeholder concerns; (2) achieve cost-savings through the SPP; and (3) establish performance goals and measures for the SPP."

A letter report issued by the Government Accountability Office with an abstract that begins "For years, the Coast Guard has conducted search and rescue operations from its network of stations along the nation's coasts and waterways. In 2001, reviews of station operations found that station readiness--the ability to execute mission requirements in keeping with standards--was in decline. The Coast Guard began addressing these issues, only to see its efforts complicated by expanded post-September 11, 2001, homeland security responsibilities at many stations. GAO reviewed the impact of changing missions on station needs, the progress made in addressing station readiness needs, and the extent to which plans are in place for addressing any remaining needs."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2004, both houses of Congress approved separate legislation to reauthorize the federal-aid highway program to help meet the Nation's surface transportation needs, enhance mobility, and promote economic growth. Both bills also recognized that the Nation faces significant transportation challenges in the future, and each established a National Commission to assess future revenue sources for the Highway Trust Fund and to consider the roles of the various levels of government and the private sector in meeting future surface transportation financing needs. This report (1) updates information on trends in federal, state, and local capital investment in highways; (2) assesses the influence that federal-aid highway grants have had on state and local highway spending; (3) discusses the implications of these trends for the federal-aid highway program; and (4) discusses options for the federal-aid highway program."

A letter report issued by the Government Accountability Office with an abstract that begins "Preventing the transmission of HIV, the virus that causes AIDS, is an important public health challenge. Researchers have sought to develop a microbicide--a substance to help users protect themselves against HIV. In the mid-1980s, researchers found that Nonoxynol-9 (N-9), a spermicide found in various contraceptive products, showed potential as a microbicide. However, more recent studies raised concerns that N-9 may increase certain users' risk of contracting HIV. GAO was asked to describe federal agencies' and contraceptive product manufacturers' actions related to N-9 and HIV. In this report, GAO reviewed (1) the efforts by federal agencies and manufacturers of contraceptive products to assess the safety of N-9 and its effectiveness as a microbicide for preventing HIV transmission and (2) the information provided to the public about the safety of N-9 and its effectiveness as a microbicide. GAO reviewed journal articles, Federal Register notices, product packaging, educational materials, and other documents. GAO also interviewed officials from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health (NIH), and selected manufacturers of N-9 contraceptive products."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on the amounts of funding available and expended for implementing the states' drinking water programs, focusing on: (1) how the Environmental Protection Agency's (EPA) budget requests for the states' implementation of their drinking water programs compare with the amounts authorized and estimated to be needed; (2) how much the states have spent since the passage of the 1996 amendments to implement these programs and how the expenditures compare with the estimated needs; (3) what effects federal funding levels have had, and may have in the future, on the states' ability to implement their programs; and (4) what existing practices have the potential to help the states implement their drinking water programs more effectively and efficiently."

A letter report issued by the General Accounting Office with an abstract that begins "The Veterans Benefits Administration (VBA) developed a computer-assisted training program, known as the Training and Performance Support System (TPSS), to help its employees become more accurate in processing disability compensation and pension claims. The program seeks to provide uniform and consistent training to employees in 57 regional offices. Although VBA's long-term goal is to attain a 96 percent accuracy rate for claims processing, VBA reported an accuracy rate of only 59 percent for fiscal year 2000. This report reviews (1) the status of the TPSS program's development and implementation and (2) the extent to which TPSS will meet its objectives. GAO found that despite VBA's objective to centrally develop a standardized training program, significant delays in the development of TPSS are hindering the program's ability to provide standardized training to claims processing employees. According to VBA's current schedule, the full development of the program will not be completed until at least 2004, or about two years later than VBA had planned. Although VBA provided nine training modules to regional offices to begin the program, the extent to which the offices implemented them varied considerably. Many offices …

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the budgetary implications of selected program reforms discussed in its past work but not yet implemented or enacted."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO provided information on the status of efforts to implement personnel reductions in the Army Materiel Command (AMC) that were directed by the Quadrennial Defense Review (QDR), focusing on: (1) AMC's plans and timeframe for achieving the reductions; (2) the projected cost savings from such reductions; and (3) the cited impacts the reductions will have on workload and readiness."

A letter report issued by the General Accounting Office with an abstract that begins "Dietary supplements containing ephedra, such as Metabolife 356, have been associated with serious adverse health-related events. In a February 28, 2003, announcement, the Food and Drug Administration (FDA) proposed that dietary supplements containing ephedra include a statement on their label warning that "Heart attack, stroke, seizure, and death have been reported after consumption of ephedrine alkaloids." GAO was asked to review health-related call records that Metabolife International--the manufacturer of Metabolife 356--collected from consumers from May 1997 through July 2002. Most of the records were from calls to a consumer phone line the company maintained. Metabolife International voluntarily provided the call records to GAO. Specifically, GAO (1) examined the extent to which consumer information in the call records was comprehensive, interpretable, and consistently recorded, (2) counted the number of call records reporting types of adverse events that FDA had identified in 1997 as serious or potentially serious, and (3) compared GAO's findings to those of six other reviews of the call records, including one by Metabolife International."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed top-heavy rules in relation to other pension laws and regulations intended to ensure that workers benefit equitably from their pension plans, focusing on: (1) key differences between top-heavy rules and the general rules for nondiscrimination and vesting in contributions and benefits; (2) the most recent data available for GAO analysis on the characteristics of new plans that report being top-heavy; and (3) what is known about the overall effects of top-heavy rules on numbers of plans and participants and on employer costs."