A letter report issued by the Government Accountability Office with an abstract that begins "Members of Congress and state agencies have raised questions about complaints that some Medicare Advantage (MA) organizations and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate information about covered benefits and conducting prohibited marketing practices. The Centers for Medicare & Medicaid Services (CMS) is responsible for oversight of MA organizations and their plans. The Government Accountability Office (GAO) was asked to examine (1) the extent to which CMS has taken compliance and enforcement actions, (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered, and (3) information CMS has about the extent of inappropriate marketing. To do this work, GAO reviewed relevant laws and policies; analyzed Medicare data on beneficiary complaints, compliance actions and enforcement actions; and interviewed officials from CMS and selected state departments of insurance, state health insurance assistance programs, and MA organizations."

A letter report issued by the Government Accountability Office with an abstract that begins "To provide safe and secure workplaces for overseas posts, the Department of State (State) has built 64 new embassy compounds (NEC) and other facilities since 1999, has 31 ongoing projects, and plans to build at least 90 more. In 2007, State reported the U.S. contractor pool for building NECs had reached its limit and proposed legislation to amend the criteria to qualify for NEC awards. GAO was asked to examine (1) how contractor participation in the NEC program changed in recent years, (2) the degree to which State assessed the need for and potential outcomes of its proposed amendment, (3) factors contractors consider when deciding to participate in the program, and (4) actions State has taken to address reported declines in contractor participation. GAO examined two indicators of contractor participation; reviewed State documents and proposed legislation; and interviewed State officials and U.S. firms that won NEC awards from 2001-2007."

A letter report issued by the Government Accountability Office with an abstract that begins "Growing ecological challenges ranging from wildland fires to climate change have revived interest in moving the Department of Agriculture's (USDA) Forest Service into the Department of the Interior (Interior). The Forest Service manages almost a quarter of the nation's lands but is the only major land management agency outside Interior. GAO was asked to report on the potential effects of moving the Forest Service into Interior and creating a new bureau equal to Interior's other bureaus, such as the Bureau of Land Management (BLM). GAO was also asked to identify factors that should be considered if such a move were legislated and management practices that could facilitate a move. GAO analyzed five historical proposals to reorganize federal land management agencies; interviewed USDA, Interior, and other officials and outside experts; and studied joint Forest Service- BLM programs to assess efforts to integrate the agencies' work."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Justice (DOJ) estimates that the United States has about a million gang members. While state and local agencies have primary responsibility for combating gang crime, the federal government has key roles to enforce laws and help fund programs to provide alternatives to gang membership for at-risk youth. GAO was asked to examine federal efforts to combat gang crime. This report addresses (1) the roles of DOJ and the Department of Homeland Security (DHS) in combating gang crime and the extent to which DOJ and DHS agencies coordinate their efforts with each other and state and local agencies; (2) the extent to which DOJ and DHS measure their gang enforcement efforts; and (3) how federal grant funding is used to administer or support activities to reduce gang-related crime. GAO reviewed federal agencies' plans, resources, and measures and interviewed federal, state, and local officials in 15 localities with federally led anti-gang task forces representing varying population sizes and locations."

A letter report issued by the Government Accountability Office with an abstract that begins "The Los Alamos National Laboratory (LANL), which is overseen by the National Nuclear Security Administration (NNSA), has experienced a number of security lapses in controlling classified information stored on its classified computer network. GAO was requested to (1) assess the effectiveness of security controls LANL used to protect information on its classified network, (2) assess whether LANL had fully implemented an information security program to ensure that security controls were effectively established and maintained for its classified network, and (3) identify the expenditures used to operate and support its classified network from fiscal years 2001 through 2008. To carry out this work, GAO examined security policies and procedures and reviewed LANL's access controls for protecting information on its classified network."

A letter report issued by the Government Accountability Office with an abstract that begins "Service members found unfit for duty due to a service-related illness or injury may be eligible for military disability retirement. When their disability is not stable, however, they may be placed on the military's Temporary Disability Retired List (TDRL) and granted temporary benefits for as long as 5 years. GAO was asked to respond to concerns about TDRL caseloads, management, and impact on servicemembers. To address these concerns, we analyzed TDRL data; interviewed military officials; reviewed laws, regulations, and other relevant documents; and conducted 12 focus groups with temporary retirees. This report examines (1) recent trends in the TDRL caseload size, (2) recent trends in the characteristics of those placed on the TDRL, (3) disability retirement outcomes for TDRL placements, (4) the adequacy of TDRL management, and (5) the adequacy of information provided to TDRL retirees."

A letter report issued by the Government Accountability Office with an abstract that begins "In February 2007, a series of Washington Post articles disclosed problems at Walter Reed Army Medical Center, particularly with the management of servicemembers receiving outpatient care. In response, the Army established Warrior Transition Units (WTU) for servicemembers requiring complex case management. Each servicemember in a WTU is assigned to a Triad of Care--a primary care manager, a nurse case manager, and a squad leader--who provide case management services to ensure continuity of care. The Army established staff-to-servicemember ratios for each Triad of Care position. This report examines (1) the Army's ongoing efforts to staff WTU Triad of Care positions and (2) how the Army monitors the recovery process of WTU servicemembers. GAO reviewed WTU policies, analyzed Army staffing and monitoring data, interviewed Army officials, and visited five selected WTUs."

A letter report issued by the Government Accountability Office with an abstract that begins "State and local governments spend billions of dollars annually on the construction, renovation, and maintenance of public school facilities, yet concerns persist about the condition of some school facilities, particularly in school districts serving students residing on Indian lands. The Department of Education's (Education) Impact Aid Program provides funding to school districts that are adversely impacted by a lack of local revenue because of the presence of federal land, which is exempt from local property taxes. Impact Aid can be used for school expenses, such as facilities and teacher salaries. In response to concern about school facility conditions and concern that these conditions can affect student outcomes, GAO was asked to describe (1) the physical condition of schools in districts receiving Impact Aid because of students residing on Indian lands and (2) what is known about how school facilities affect student outcomes. GAO interviewed federal, state, and local officials; analyzed available independent school facility assessment data for three states; visited eight school districts that receive Impact Aid; and analyzed studies examining the relationship between school facilities and student outcomes. GAO is not making recommendations in this …

A letter report issued by the Government Accountability Office with an abstract that begins "In recent years, violence along the U.S.-Mexico border has escalated dramatically, due largely to the Mexican government's efforts to disrupt Mexican drug trafficking organizations (DTO). U.S. officials note the violence associated with Mexican DTOs poses a serious challenge for U.S. law enforcement, threatening citizens on both sides of the border, and U.S. and Mexican law enforcement officials generally agree many of the firearms used to perpetrate crimes in Mexico are illicitly trafficked from the United States across the Southwest border. GAO was asked to examine (1) data on the types, sources, and users of these firearms; (2) key challenges confronting U.S. government efforts to combat illicit sales of firearms in the United States and stem the flow of them into Mexico; (3) challenges faced by U.S. agencies collaborating with Mexican authorities to combat the problem of illicit arms; and (4) the U.S. government's strategy for addressing the issue. GAO analyzed program information and firearms data and met with U.S. and Mexican officials on both sides of the border."

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. ports, waterways, and coastal approaches are part of a system handling more than $700 billion in merchandise annually. With the many possible threats--including transportation and detonation of weapons of mass destruction, suicide attacks against vessels, and others--in the maritime domain, awareness of such threats could give the Coast Guard advance notice to help detect, deter, interdict, and defeat them and protect the U.S. homeland and economy. GAO was asked to review the Coast Guard's efforts to achieve awareness about activity in the maritime domain. This report addresses: the extent to which the Coast Guard (1) has vessel tracking systems in place, (2) can use these systems to track vessels that may be threats, and (3) has coordinated the development and implementation of these systems. To answer these questions, GAO analyzed relevant statutes, regulations, and plans for vessel tracking systems, compared the roles of the planned systems, and interviewed appropriate officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Before approving a drug, the Food and Drug Administration (FDA) assesses a drug's effectiveness. This assessment may be based on evidence showing that a drug has a positive impact on a surrogate endpoint--a laboratory measure, such as blood pressure--instead of more direct clinical evidence, like preventing strokes. After approval, FDA often requires or requests a drug sponsor to further study the drug. Concerns have been raised about FDA's reliance on surrogate endpoints and its oversight of postmarketing studies. This report provides information on (1) all drug applications approved based on surrogate endpoints in FDA's accelerated approval process, (2) a subset of applications for potentially innovative drugs approved based on surrogate endpoints under FDA's traditional process, and (3) FDA's oversight of postmarketing studies. GAO identified drugs approved based on surrogate endpoints, obtained the status of related postmarketing studies, and reviewed FDA's oversight of a sample of 35 studies it required under its accelerated approval process, selected to include studies which were at varying levels of completion."

A letter report issued by the Government Accountability Office with an abstract that begins "The federal workforce, like the nation's workforce as a whole, is aging, and increasingly large percentages are becoming eligible to retire. Eventually baby boomers will leave the workforce and when they do, they will leave behind gaps in leadership, skills, and knowledge due to the slower-growing pool of younger workers. GAO and others have emphasized the need for federal agencies to hire and retain older workers to help address these shortages. Building upon earlier testimony, GAO was asked to examine (1) age and retirement eligibility trends of the current federal workforce and the extent to which agencies hire and retain older workers; (2) workforce challenges selected agencies face and the strategies they use to hire and retain older workers; and (3) actions taken by the Office of Personnel Management (OPM) to help agencies hire and retain experienced workers. To address these questions, GAO analyzed data from OPM's Central Personal Data File, interviewed officials at three agencies with high proportions of workers eligible to retire, and identified agencies' promising practices to hire and retain older workers. What GAO Recommends"

A letter report issued by the Government Accountability Office with an abstract that begins "To move passengers and cargo, the Department of Defense (DOD) must supplement its military aircraft with cargo and passenger aircraft from commercial carriers participating in the Civil Reserve Air Fleet (CRAF) program. Carriers participating in CRAF commit their aircraft to DOD to support a range of military operations. In the Fiscal Year 2008 National Defense Authorization Act, Congress required DOD to sponsor an assessment of CRAF and required GAO to review that assessment. GAO briefed congressional staff on its observations. As discussed with the staff, GAO further analyzed some of the issues identified in its review. This report assesses (1) the extent to which DOD has assessed potential risks to the CRAF program, and (2) the extent to which DOD's management of CRAF supports program objectives. For this engagement, GAO reviewed DOD-sponsored CRAF study reports and interviewed study leadership. GAO also interviewed over 20 of 35 CRAF participating carriers that responded to a request for a meeting, DOD officials, and industry officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Surface coal mining in the mountainous areas of Appalachia--often called "mountaintop mining"--generates controversy, in part because of its scale and the post-mining appearance of the land. Yet there is limited public access to information on the size, location, and life span of these operations, or on how the land can be expected to look afterward. The Government Accountability Office (GAO) was asked to report on the characteristics of (1) surface coal mining and (2) reclaimed lands that were disturbed by surface coal mining in the mountainous, eastern part of Kentucky and in West Virginia, where most such mining occurs. Federal and state law requires mining operators to obtain permits before mining. Among other things, the permits identify the acres under open permit (the acres subject to mining associated with a permit that has not been closed) and how the land will be reclaimed--including the post-mining land use, whether the approximate original contour (AOC) of the land will be restored, and the extent to which excess earth, rock, and other materials (known as "spoil") are placed in nearby valleys. For this study, GAO relied on electronic databases …

A letter report issued by the Government Accountability Office with an abstract that begins "The tax credit for qualified research expenses provides significant subsidies to encourage business investment in research intended to foster innovation and promote long-term economic growth. Generally the credit provides a subsidy for research spending in excess of a base amount but concerns have been raised about its design and administrability. Government Accountability Office (GAO) was asked to describe the credit's use, determine whether it could be redesigned to improve the incentive to do new research, and assess whether recordkeeping and other compliance costs could be reduced. GAO analyzed alternative credit designs using a panel of corporate tax returns and assessed administrability by interviewing Internal Revenue Service (IRS) and taxpayer representatives."

A letter report issued by the Government Accountability Office with an abstract that begins "S corporations are one of the fastest growing business types, accounting for nearly 4 million businesses in 2006. However, long-standing problems with S corporation compliance produce revenue losses in individual income taxes and employment taxes. GAO was asked to (1) describe the reasons businesses choose to become S corporations, (2) analyze types of S corporation noncompliance, what IRS has done to address noncompliance, and options to improve compliance, and (3) further analyze the extent of shareholder compensation noncompliance and identify options for improving compliance. GAO analyzed IRS research and examination data; interviewed IRS officials, examiners and other knowledgeable stakeholders; and reviewed relevant literature."

A letter report issued by the Government Accountability Office with an abstract that begins "Following September 11, 2001, the number of international students coming to the United States dropped for the first time in over 30 years. While enrollments have rebounded, the U.S. image has declined in the Muslim world and elsewhere. To improve global attitudes toward America, the U.S. government funds higher education for international students to facilitate exchanges, promote understanding among peoples in different countries, and build capacity in developing nations. To provide insight on how higher education is used to advance public diplomacy and development assistance goals, we examined (1) the objectives the United States and selected peer governments seek to advance through higher education for international students and the approaches they employ to attract international students, and (2) the characteristics of major U.S. and peer government programs that fund higher education for international students to support public diplomacy and development goals. GAO collected information from the United States, Australia, China, the European Commission, Germany, and the United Kingdom."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security, through the Federal Emergency Management Agency (FEMA), awards grants to fire departments and other organizations for equipment, staffing, and other needs. As of July 2009, FEMA had received about 25,000 and 22,000 applications for its fiscal years 2007 and 2008 fire grant programs, respectively, and had awarded more than 5,000 grants in both years. GAO was congressionally directed to review the application and award process for these grants. This report addresses the (1) extent to which FEMA has met statutory and program requirements for distributing the grant funds; (2) actions FEMA has taken to provide assistance to grant applicants and involve the fire service community in the grant process; and (3) extent to which FEMA has ensured that its grant process is accessible, clear, and consistent with requirements, including its grant guidance. GAO analyzed relevant laws and interviewed 36 randomly selected grant applicants to obtain their views, but the results are not generalizable."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Justice's (DOJ) Federal Bureau of Prisons (BOP) is responsible for the custody and care of about 209,000 federal inmates--a population which has grown by 44 percent over the last decade. In fiscal years 2008 and 2009, the President requested additional funding for BOP because costs for key operations were at risk of exceeding appropriated funding levels. Government Accountability Office (GAO) was congressionally directed to examine (1) how BOP estimates costs when developing its annual budget request to DOJ; (2) the extent to which BOP's methods for estimating costs follow established best practices; and (3) the extent to which BOP's costs for key operations exceeded requested funding levels identified in the President's budget in recent years, and how this has affected BOP's ability to manage its growing inmate population. In conducting our work, GAO analyzed BOP budget documents, interviewed BOP and DOJ officials, and compared BOP's cost estimation documentation to criteria in GAO's Cost Estimating and Assessment Guide."

A letter report issued by the Government Accountability Office with an abstract that begins "Concerns over unsuitable insurance products and inappropriate sales practices directed at servicemembers have prompted legislative and regulatory changes to address these concerns. Congress asked GAO to assess oversight efforts by the Department of Defense (DOD), the National Association of Insurance Commissioners (NAIC), and state insurance regulators. In this report, GAO (1) describes actions to improve oversight of life insurance sales to servicemembers and the extent to which they have been completed, and (2) identifies and analyzes factors that contribute to apparent ongoing inappropriate insurance sales. To complete this work, GAO visited five military facilities, analyzed DOD pay records, reviewed DOD and state enforcement actions, and spoke with DOD, state regulatory, and insurance industry officials."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2004, the U.S. Consumer Product Safety Commission (CPSC) estimated that 29,400 deaths in the United States were related to consumer products. As required under Section 107 of the Consumer Product Safety Improvement Act of 2008, this study reviews what is known about the relative incidence of preventable injuries and deaths among minority children associated with products intended for children's use and also examines what actions CPSC has taken through its public information and education initiatives to minimize these injuries and deaths. To address these issues, we assessed injury and death data sources used by CPSC, compared CPSC's consumer education efforts with key practices, and interviewed federal officials and groups representing the health and consumer interests of minority populations."

A letter report issued by the Government Accountability Office with an abstract that begins "Medicaid, a federal-state program that finances health care for certain low-income populations, can play a critical role in the provision of preventive services, which help prevent, diagnose, and manage health conditions. GAO examined available data to assess (1) the extent to which Medicaid children and adults have certain health conditions and receive certain preventive services, (2) for Medicaid children, state monitoring and promotion of the provision of preventive services, (3) for Medicaid adults, state coverage of preventive services, and (4) federal oversight by the Centers for Medicare & Medicaid Services (CMS). GAO analyzed data from nationally representative surveys: the National Health and Nutrition Examination Survey (NHANES), which includes physical examinations of participants, and the Medical Expenditure Panel Survey (MEPS). GAO also surveyed state Medicaid directors and interviewed federal officials."

A letter report issued by the Government Accountability Office with an abstract that begins "As part of a broad congestion relief initiative, the Department of Transportation awarded about $848 million from 10 grant programs to five cities (Miami, Minneapolis, New York, San Francisco, and Seattle) in 2007 as part of the Urban Partnership Agreements (UPA) initiative. The UPA initiative is intended to demonstrate the feasibility and benefits of comprehensive, integrated, and innovative approaches to relieving congestion, including the use of tolling (congestion pricing), transit, technology, and telecommuting (4Ts). Congestion pricing involves charging drivers a fee that varies with the density of traffic. This report addresses congressional interest in (1) how well the department communicated UPA selection criteria, (2) whether it had discretion to allocate grant funds to UPA recipients and consider congestion pricing as a priority selection factor, and (3) how it is ensuring that UPA award conditions are met and results are assessed. GAO reviewed departmental documents, statutes and case law, and interviewed department officials and UPA applicants."

A letter report issued by the Government Accountability Office with an abstract that begins "Protecting federal workers essential to ensuring the continuity of the country's critical operations will involve new challenges in the event of a pandemic influenza outbreak. This requested report discusses (1) the extent to which agencies have made pandemic plans to protect workers who cannot work remotely and are not first responders, (2) the pandemic plans selected agencies have for certain occupations performing essential functions other than first response, and (3) the opportunities to improve agencies' workforce pandemic plans. GAO surveyed pandemic coordinators from 24 agencies and selected three case study occupations for review: federal correctional workers, staff disbursing Treasury checks, and air traffic controllers."