A letter report issued by the Government Accountability Office with an abstract that begins "Commercial U.S. Arctic maritime activities are expected to be limited for the next 10 years, according to industry representatives, due to a variety of factors. Interviews with industry representatives highlighted a variety of general challenges related to operating in the Arctic, such as geography, extreme weather, and hard-to-predict ice floes. Industry-specific factors were also cited as contributing to limited commercial activity. For example, shipping companies noted higher costs with Arctic transit; cruise industry groups noted a lack of demand for Arctic cruises from the mainstream cruise-consumer base, and oil companies last drilled offshore exploratory wells in the U.S. Arctic in 2012."

A letter report issued by the Government Accountability Office with an abstract that begins "The Occupational Safety and Health Administration (OSHA) has taken steps to include auto industry employees in its Whistleblower Protection Program and has coordinated with the Department of Transportation (DOT) on whistleblower issues, but interagency collaborative mechanisms could be strengthened. Among other steps, OSHA is developing procedures for how it will investigate claims from auto employees and estimates most of its efforts will be completed in 2014. OSHA documents its collaboration with DOT's component agencies on whistleblower protections by developing memorandums of agreements (MOA), and currently MOAs cover aviation and rail employees; the agencies are considering developing MOAs to cover other transportation sectors such as commercial motor-carrier employees. Officials from both OSHA and DOT believe it is important to identify or refer potential claims of retaliation and safety violations to each other. In September 2012, GAO concluded that collaboration is critical when meaningful results that the federal government seeks to achieve require the coordinated efforts of more than one federal agency. Among others, key practices of effective collaboration include clearly delineating roles and responsibilities and monitoring progress. OSHA and DOT officials agree that following GAO's key practices …

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2009, states spent nearly a third (31.6 percent) of all Medicaid expenditures on the most expensive Medicaid-only beneficiaries, who were 4.3 percent of total Medicaid beneficiaries. States spent another third (33.1 percent) on all other Medicaid-only beneficiaries, who represented 81.2 percent of total Medicaid beneficiaries. Among dual eligible beneficiaries, a similar pattern existed, with a small proportion of the population accounting for a disproportionate share of expenditures."

A letter report issued by the Government Accountability Office with an abstract that begins "To develop a national benchmark for retail pharmacy acquisition costs of Medicaid covered outpatient prescription drugs--known as the National Average Drug Acquisition Cost (NADAC)--the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) surveys each month randomly selected retail community pharmacies for invoice data on their actual drug acquisition costs. CMS then calculates an average acquisition cost for each drug based on invoice data received from about 500 to 600 pharmacies. CMS officials expressed confidence in their current process, but noted that some limitations may exist. For example, CMS officials stated the extent to which NADACs reflect rebates and discounts is limited because most occur off-invoice or are not tied to a specific drug purchase. CMS has developed and published more than 5,000 NADACs, which CMS has estimated apply to more than 90 percent of the drug claims reimbursed by Medicaid."

A letter report issued by the Government Accountability Office with an abstract that begins "Medicare Advantage (MA) organizations' actual medical expenses, nonmedical expenses (such as marketing, sales, and administration) and profits as a percentage of total revenue were, on average, similar to projected values for plans available to all beneficiaries in 2011, the most recent year for which data were available at the time of the request for this work. MA organizations' actual medical expenses, nonmedical expenses, and profits were 86.3 percent, 9.1 percent, and 4.5 percent of total revenue, respectively. As a percentage of revenue, all three categories were within 0.3 percentage points of what MA organizations had projected. In addition, MA organizations received, on average, $9,893 in total revenue per beneficiary, slightly higher than the projected amount of $9,635."

A letter report issued by the Government Accountability Office with an abstract that begins "The Navy has experienced significant quality problems with several ship classes over the past several years. It has focused on reducing the number of serious deficiencies at the time of delivery, and GAO's analysis shows that the number of deficiencies--particularly "starred" deficiencies designated as the most serious for operational or safety reasons--has generally dropped. Nonetheless, the Navy continues to accept ships with large numbers of open deficiencies. Accepting ships with large numbers of uncorrected deficiencies is a standard practice and GAO found that there are varying interpretations of Navy policy with regard to when the defects should be resolved. In 2009, the Navy organization that oversees ship construction launched the Back to Basics initiative to improve Navy oversight of ship construction. However, a key output of the initiative promoting consistent and adequate quality requirements in Navy contracts has yet to be implemented."

A letter report issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins "The General Services Administration's (GSA) 218 high-value leases GAO reviewed represented only about 3 percent of the total number of GSA leases, yet made up about one-third of its leased portfolio in terms of cost and size. GSA has reduced the costs of its high-value leases in line with the administration's goal to reduce real property costs. GSA's efforts include helping agencies improve space utilization. However, for leases nearing expiration, GSA and tenant agencies have faced challenges in funding space renovations and moving costs. This lack of funds has contributed to delays and some cases in which GSA continues to occupy space after the lease expires."

A letter report issued by the Government Accountability Office with an abstract that begins "Little is known about lithium-7 production in China and Russia and whether their supplies can meet future domestic demand. According to industry representatives, China and Russia produce enough lithium-7 to meet demand from U.S. pressurized water reactors, a type of commercial nuclear power reactor that requires lithium-7 for safe operation. However, China's continued supply may be reduced by its own growing demand, according to an expert that is familiar with China's plans. Specifically, China is building several pressurized water reactors and developing a new type of reactor that will require 1,000s of kilograms of lithium-7 to operate, rather than the 300 kilograms needed annually for all 65 U.S. pressurized water reactors. Relying on two producers of lithium-7 leaves U.S. pressurized water reactors vulnerable to lithium-7 supply disruptions."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO's analysis of the Centers for Medicare & Medicaid Services' 2010 Medicare Current Beneficiary Survey (MCBS) showed that estimated average total health care expenditures were higher for beneficiaries with Medigap or employer-sponsored coverage than for beneficiaries with traditional fee-for-service (FFS) Medicare only. While estimated average expenditures were lower for beneficiaries with Medicare FFS-only, those who were enrolled in Medicare's Part D prescription drug program had higher average health care expenditures than those without Part D. Although some research has found similar patterns of higher health care expenditures for those with supplemental coverage, other studies have found that certain characteristics, such as health status and age, may influence the decision to purchase supplemental coverage, which could provide a partial explanation of the differences in expenditures. Furthermore, some studies suggest that increasing cost-sharing for those with supplemental coverage could decrease the utilization of (and associated health care expenditures for) certain types of health care such as physician visits, but increase the utilization of (and expenditures for) other types of health care such as inpatient hospitalizations."

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal years 2008-2012, $52.4 billion was appropriated out of the $62.2 billion authorized under the America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education, and Science Act of 2007 (COMPETES 2007) and the America COMPETES Reauthorization Act of 2010 (COMPETES 2010). Almost all of these funds went to the entire budgets of three existing research entities--the National Science Foundation (NSF), the National Institute of Standards and Technology (NIST), and the Department of Energy's (DOE) Office of Science (Science)--including all of the programs and activities the entities carry out. Appropriations for NSF, NIST, and Science generally increased under the acts but did not reach levels authorized by the acts. In addition to authorizing the budgets of these entities, COMPETES 2007 and COMPETES 2010 specifically authorized funding for 40 individual programs, including some programs within and some outside of these entities. Among those 40 programs, the 12 programs that existed before COMPETES 2007 received appropriations and continue to operate. Six of 28 newly authorized programs were also funded. Of these 6 programs, 1--DOE's Advanced Research Projects Agency-Energy, set up to develop new energy technologies--is continuing operations, …

A letter report issued by the Government Accountability Office with an abstract that begins "In GAO's opinion, the financial statements of the American Battle Monuments Commission (the Commission) as of September 30, 2012 and 2011, and for the fiscal years then ended, are presented fairly, in all material respects, in conformity with U.S. generally accepted accounting principles. However, GAO found two material weaknesses that resulted in ineffective internal control over financial reporting. GAO also found one area of noncompliance with laws and regulations it tested."

A letter report issued by the Government Accountability Office with an abstract that begins "The number of Medicare prostate cancer-related intensity-modulated radiation therapy (IMRT) services performed by self-referring groups increased rapidly, while declining for non-self-referring groups from 2006 to 2010. Over this period, the number of prostate cancer-related IMRT services performed by self-referring groups increased from about 80,000 to 366,000. Consistent with that growth, expenditures associated with these services and the number of self-referring groups also increased. The growth in services performed by self-referring groups was due entirely to limited-specialty groups--groups comprised of urologists and a small number of other specialties--rather than multispecialty groups."

A letter report issued by the Government Accountability Office with an abstract that begins "The Transportation Security Administration's (TSA) Adjudication Center performance data show mixed results, and the center's performance measurement practices have limitations. The Adjudication Center relies on contractors to adjudicate security threat assessments and uses three primary measures to evaluate their performance--timeliness for completing adjudication, adjudication accuracy, and caseload status. GAO found that the Adjudication Center contractor met its timeliness and accuracy measures, but faced challenges in meeting its caseload measure. The Adjudication Center's timeliness and accuracy measures did not capture key data. According to TSA officials, the Adjudication Center's accuracy rate is based on a review of all cases where adjudicators had disqualified an applicant. However, this calculation generally does not include the accuracy rate for those applicants adjudicators had approved--which account for roughly 90 percent of the Adjudication Center's caseload. In this way, the accuracy rate provides a limited assessment of adjudicator performance. By developing an accuracy rate that includes data on both incorrectly disqualified and incorrectly approved applicants, TSA can better identify and addresses performance issues among its workforce."

A letter report issued by the Government Accountability Office with an abstract that begins "Reducing the cap to the President's salary ($400,000) or the Vice President's salary ($230,700) would have substantially increased the number of employees with compensation costs exceeding the cap in 2010-2012."

A letter report issued by the Government Accountability Office with an abstract that begins "Of the $595 million identified by Labor as having been appropriated or allocated specifically for green jobs activities since 2009, approximately $501 million went toward efforts with training and support services as their primary objective, with much of that funding provided by the American Recovery and Reinvestment Act of 2009 (Recovery Act). Because the Recovery Act directed federal agencies to spend funds quickly and prudently, Labor implemented a number of high-investment green jobs efforts simultaneously. As a result, in some cases, Recovery Act training programs were initiated prior to a full assessment of the demand for green jobs, which presented challenges for grantees. While Labor's internal agencies initially communicated with each other and with other federal agencies after the Recovery Act was passed, most Recovery Act grants have ended or are winding down."

A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS) will operate a health insurance exchange in the 34 states that will not operate a state-based exchange for 2014. Of these 34 federally facilitated exchanges (FFE), 15 are in states expected to assist CMS in carrying out certain FFE functions. However, the activities that CMS plans to carry out in these 15 exchanges, as well as in the state-based exchanges, have evolved and may continue to change. For example, CMS approved states' exchange arrangements on the condition that they ultimately complete activities necessary for exchange implementation. CMS indicated that it would carry out more exchange functions if any state did not adequately progress towards implementation of all required activities."

A letter report issued by the Government Accountability Office with an abstract that begins "For 2014, the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS) granted conditional approval to 18 states to establish state-based Small Business Health Options Programs, or SHOPs, and to 17 states to operate health insurance exchanges for individuals. CMS is required to operate a federally facilitated SHOP (FF-SHOP) and a federally facilitated exchange for individuals (FFE) in the remaining states. Of the 33 states with FF-SHOPs and 34 states with FFEs, 15 states are expected to assist CMS to carry out certain functions of the exchange. However, the activities that CMS plans to complete in these 15 exchanges have evolved, and CMS activities in these and other exchanges may continue to change. For example, CMS approved state roles in SHOPs and individual exchanges on the condition that they ultimately complete key activities for exchange establishment. CMS indicated that it would assume more responsibilities in these exchanges if any state did not adequately progress towards completion of all required activities."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Army Corps of Engineers (Corps) uses a multistep process to build overhead costs into projects. At the foundation of this process, Corps policy establishes two categories of costs to calculate overhead--general and administrative overhead expenses associated with district administrative offices, such as resource management, and technical overhead expenses associated with district technical offices, such as engineering. Using these two categories as a starting point, the Corps next calculates overhead rates as part of its annual budget process. Specifically, each district administrative and technical office develops operating budgets with overhead estimates, which are then consolidated and routed through district and division management, resulting in a final division-wide operating budget and overhead rates. The Corps then bills projects for overhead costs based on the number of hours its staff charge to projects. Overhead charges are not applied to hours worked by contracted labor, which represent a substantial amount of work. The Corps reports that it contracts out most of its design work and all of its construction work to private sector entities, such as architectural and engineering firms and construction companies. Finally, the Corps periodically monitors …

A letter report issued by the Government Accountability Office with an abstract that begins "For 102 agency priority goals (APGs) for 2012 to 2013 that GAO reviewed, agencies implemented three GPRA Modernization Act of 2010 (the act) requirements. Agencies identified (1) a target level of performance within a 2-year time frame; (2) how their APGs contribute to their strategic goals; and (3) an agency official responsible for achieving each APG. These represent important accomplishments, but information about other requirements is incomplete:"

A letter report issued by the Government Accountability Office with an abstract that begins "When GAO compared prices paid by the Department of Defense (DOD) and the Department of Veterans Affairs (VA) for a sample of 83 drugs purchased in the first calendar quarter of 2012, DOD's average unit price for the entire sample was 31.8 percent ($0.11 per unit) higher than VA's average price, and DOD's average unit price for the subset of 40 generic drugs was 66.6 percent ($0.04 per unit) higher than VA's average price. However, VA's average unit price for the subset of 43 brand-name drugs was 136.9 percent ($1.01 per unit) higher than DOD's average price. These results were consistent with each agency obtaining better prices on the type of drugs that made up the majority of its utilization: generic drugs accounted for 83 percent of VA's utilization of the sample drugs and brand-name drugs accounted for 54 percent of DOD's utilization of the sample drugs. DOD officials told GAO that in certain circumstances they are able to obtain competitive prices for brand-name drugs--even below the prices for generic equivalents--and therefore will often preferentially purchase brand-name drugs."

A letter report issued by the Government Accountability Office with an abstract that begins "The United States has kept strategic goals for Lebanon constant since 2007 and adjusted security assistance in response to political and security conditions. Since 2007, U.S. strategic goals for Lebanon have been to support the nation as a stable, secure, and independent democracy. According to U.S. officials, U.S. policy priorities include supporting the Government of Lebanon in establishing stability and security against internal threats from militant extremists and the influence of Iran and Syria. U.S. programs to help achieve these priorities include Foreign Military Financing, International Military Education and Training (IMET), International Narcotics Control and Law Enforcement (INCLE), Antiterrorism Assistance, Counterterrorism Financing, Export Control and Related Border Security, and Section 1206 and 1207 authorities. While strategic goals have not changed, program implementation has changed to meet conditions on the ground, according to U.S. officials. For example, the Department of State (State) delayed committing Foreign Military Financing funds to Lebanon for 3 months in 2010, following an exchange of fire between the Lebanese Armed Forces and Israeli forces."

A letter report issued by the Government Accountability Office with an abstract that begins "Of the 71 nonmajor projects that the Department of Energy's (DOE) Office of Environmental Management (EM) and National Nuclear Security Administration (NNSA) completed or had under way from fiscal years 2008 to 2012, 21 met or are expected to meet their performance targets for scope, cost, and completion date. These projects included a $22 million EM project to expand an existing waste disposal facility at the Oak Ridge Reservation in Tennessee and a $199 million NNSA project to equip a radiological laboratory and office building at the Los Alamos National Laboratory in New Mexico. Another 23 projects did not meet or were not expected to meet one or more of their three performance targets for scope, cost, and completion date. Among these, 13 projects met or are expected to meet two targets, including a $548 million NNSA project to shut down a nuclear reactor in Russia for nonproliferation purposes; 8 projects met or are expected to meet one target; 1 project did not meet any of its targets; and 1 project was cancelled. Of the remaining 27 projects, many had insufficiently documented performance targets for scope, …

A letter report issued by the Government Accountability Office with an abstract that begins "Agency officials told us that enhanced use leases (EUL) help them utilize their underutilized property better; commonly cited benefits include enhanced mission activities, cash rent revenue, and value received through in-kind consideration. However, some agencies we reviewed do not include all costs associated with their EULs when they assess the performance of their EUL programs. Guidance from the Office of Management and Budget (OMB) does not specify what costs agencies should include in their EUL evaluations, resulting in variance among agencies. For example, the Department of Veterans Affairs (VA) and the Department of State do not consistently attribute EUL-related costs of consultant staff who administer the leases, and VA does not attribute various administrative costs that offset EUL benefits. Without fully accounting for all EUL costs, agencies may overstate the net benefits of their EUL programs."