A letter report issued by the Government Accountability Office with an abstract that begins "For most individuals with end-stage renal disease (ESRD), Medicare purchases a bundle of dialysis-related services using a single payment. In 2014, the Centers for Medicare & Medicaid Services (CMS) plans to include in this bundled payment "oral-only" ESRD drugs used to treat mineral and bone disorder. Currently, Medicare generally pays for these drugs only if the beneficiary has Part D prescription drug coverage. This report (1) describes the rationales for including oral-only ESRD drugs in the bundled payment, (2) examines dialysis organizations' recent experience providing oral-only ESRD drugs and their future ability to provide these drugs, (3) examines the data sources that CMS could use to account for oral-only ESRD drugs in the bundled payment, and (4) examines CMS's ability to monitor treatment of mineral and bone disorder. GAO interviewed CMS officials, experts in mineral and bone disorder, and representatives of 4 large and 16 small dialysis organizations. GAO also reviewed ESRD payment regulations, related reports, clinical guidelines, and state pharmacy licensure requirements in 10 selected states."

Correspondence issued by the Government Accountability Office with an abstract that begins "DISH is cooperating with the Special Master’s examination, which consists of examining DISH’s compliance with the royalty payment and household eligibility requirements of the license under Section 119. Since beginning his examination, the Special Master has been holding regular meetings with representatives of DISH and NAB, which represents the four major networks and their affiliates. The Special Master requested, and DISH provided, information on DISH’s royalty calculations and payments to the Copyright Office. The Special Master told us that he is satisfied with the information provided by DISH to date and is currently in the process of reviewing the methodology DISH used for its royalty payments. To determine whether any problems exist with DISH’s services to eligible subscribers, and whether a more detailed examination of DISH’s records may be needed, DISH and NAB are collaborating on a survey of all major network-affiliated television broadcast stations nationwide. According to the parties, the survey is to be distributed twice: once in February 2012 and again in May 2012, to ensure that affiliated stations are not having issues with DISH’s services. The Special Master has been kept apprised of the development …

A letter report issued by the Government Accountability Office with an abstract that begins "In 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, the Departments of Defense (DOD) and Veterans Affairs (VA) jointly developed the Federal Recovery Coordination Program (FRCP) to coordinate the clinical and nonclinical services needed by severely wounded, ill, and injured servicemembers and veterans. The FRCP, which continues to expand, is administered by VA, and the care coordinators, called Federal Recovery Coordinators (FRC), are VA employees. This report examines (1) whether servicemembers and veterans who need FRCP services are being identified and enrolled in the program, (2) staffing challenges confronting the FRCP, and (3) challenges facing the FRCP in its efforts to coordinate care for enrollees. GAO reviewed FRCP policies and procedures and conducted over 170 interviews of FRCP officials, FRCs, headquarters officials and staff of DOD and VA case management programs, and staff at medical facilities where FRCs are located."

A letter report issued by the Government Accountability Office with an abstract that begins "Federal efforts to support entrepreneurs are fragmented--including among 52 programs at the Department of Agriculture (USDA), Commerce, and Housing and Urban Development (HUD) and the Small Business Administration (SBA). All overlap with at least one other program in terms of the type of assistance they are authorized to offer, such as financial (grants and loans) and technical (training and counseling), and the type of entrepreneur they are authorized to serve. Some entrepreneurs struggle to navigate the fragmented programs that provide technical assistance. For example, some entrepreneurs and technical assistance providers GAO spoke with said the system can be confusing and that some entrepreneurs do not know where to go for assistance. Collaboration could reduce some negative effects of overlap and fragmentation, but field staff GAO spoke with did not consistently collaborate to provide training and counseling services to entrepreneurs. The agencies have taken initial steps to improve how they collaborate by entering into formal agreements, but they have not pursued a number of other good collaborative practices GAO has previously identified. For example, USDA and SBA entered into a formal agreement in 2010 to coordinate their …

A letter report issued by the Government Accountability Office with an abstract that begins "The nation's 4-year not-for-profit colleges and universities collectively held more than $400 billion in endowments in 2008. Some institutions' large endowments coupled with the high and growing cost of college have led to questions about institutions' use of endowments. This mandated report describes (1) the size and change in value of endowments over the last 20 years, (2) the extent and manner to which endowment funds are restricted for financial aid and other purposes, and (3) institutions' distribution of endowment assets. GAO obtained and analyzed data on college and university endowments from the Department of Education and other sources. Because industry-wide data were not available on endowment restrictions and distributions, GAO selected 10 colleges and universities for case studies. The case-study institutions were selected to include a mix of public, private, large, small, and minority-serving institutions. Information from these schools cannot be generalized to all U.S. colleges and universities."

A letter report issued by the Government Accountability Office with an abstract that begins "Congress has enacted laws to safeguard against former federal employees, including former trade officials, from using their access to influence government officials. These former officials' post-employment activities are restricted by a federal conflict of interest law, known as the "Revolving Door" law. Two other laws--the Foreign Agents Registration Act (FARA) and the Lobbying Disclosure Act (LDA)--are disclosure statutes that do not prohibit any activities per se, but require individuals conducting certain representation activities to publicly disclose them. FARA and LDA are not specific to former federal officials; they apply to all individuals. GAO was asked to provide a summary of the Revolving Door law, FARA, and LDA. GAO reviewed these laws, as well as guidance from the Office of Government Ethics (OGE). GAO interviewed ethics officials at three agencies whose missions focus on trade--the United States Trade Representative (USTR), the International Trade Administration (ITA), and the International Trade Commission (USITC)--and collected data on the number of senior officials who separated from these agencies from 2004 through 2009. In addition, GAO interviewed Department of Justice (Justice) officials concerning enforcement of these laws. GAO makes no recommendations in …

A letter report issued by the Government Accountability Office with an abstract that begins "Policymakers have raised questions about geoengineering--large-scale deliberate interventions in the earth's climate system to diminish climate change or its impacts--and its role in a broader strategy of mitigating and adapting to climate change. Most geoengineering proposals fall into two categories: carbon dioxide removal (CDR), which would remove carbon dioxide (CO2) from the atmosphere, and solar radiation management (SRM), which would offset temperature increases by reflecting sunlight back into space. GAO was asked to examine (1) the state of geoengineering science, (2) federal involvement in geoengineering, and (3) the views of experts and federal officials about the extent to which federal laws and international agreements apply to geoengineering, and any governance challenges. GAO examined relevant scientific and policy studies, relevant domestic laws and international agreements, analyzed agency data describing relevant research for fiscal years 2009 and 2010, and interviewed federal officials and selected recognized experts in the field."

A letter report issued by the Government Accountability Office with an abstract that begins "Bureau of Land Management (BLM) data indicate that BLM received about half as many applications for permit to drill (APD) for federal oil and gas resources in fiscal year 2012 as it had in fiscal year 2007. The decline in APDs since 2007 was driven by declines in natural gas and coalbed methane APDs on federal lands even while oil development on federal lands increased significantly. The reasons BLM officials and industry representatives cited for these changes in APDs include, among other things, a general industry move toward developing gas in shale formations using horizontal drilling and hydraulic fracturing; shale development has largely occurred on state and private lands, where shale resources are predominately located. However, the number of APDs has varied by BLM location, with 23 of 33 BLM offices seeing declines, 9 offices seeing increases, and 1 office seeing no change in APDs."

A letter report issued by the Government Accountability Office with an abstract that begins "On August 2, 2011, Congress and the President enacted the Budget Control Act of 2011, which established a process that increased the debt limit to its current level of $16.4 trillion through incremental increases effective on August 2, 2011; after close of business on September 21, 2011; and after close of business on January 27, 2012. Delays in raising the debt limit occurred prior to the August 2011 and January 2012 increases, with the Department of the Treasury (Treasury) deviating from its normal debt management operations and taking a number of actions, referred to by Treasury as extraordinary actions, to avoid exceeding the debt limit."

A letter report issued by the Government Accountability Office with an abstract that begins "The Office of Management and Budget (OMB), the General Services Administration (GSA), and selected agencies have taken steps to consider small businesses, including small disadvantaged businesses, in their strategic sourcing efforts. (Small disadvantaged businesses are those unconditionally owned and controlled by socially and economically disadvantaged individuals.) OMB and GSA have developed guidance on strategic sourcing that stresses the importance of including small businesses. GAO's review of documentation for three ongoing government-wide strategic sourcing initiatives showed that GSA considered the inclusion of small businesses in the strategic sourcing process. For example, when developing strategic sourcing initiatives for office supplies and print management, GSA identified the current market share of small businesses with these products and also set aside specific contracts for various categories of small businesses, such as service-disabled veteran-owned small businesses. In addition, GAO's review of agency-wide strategic sourcing initiatives at each of five agencies--Departments of Defense (DOD), specifically Army and the Defense Logistics Agency; Homeland Security (DHS); Housing and Urban Development (HUD); and the Interior and the National Aeronautics and Space Administration (NASA)--showed that the agencies generally considered the inclusion of small businesses."

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Export-Import Bank's (Ex-Im) methodology to calculate the number of U.S. jobs associated with the exports it helps finance has four key steps. First, Ex-Im determines the industry associated with each transaction it finances. Second, Ex-Im calculates the total value of exports it supports for each industry. Ex-Im implements these first two steps using its own data. Third, Ex-Im multiplies the export value for each industry by the Bureau of Labor Statistics (BLS) ratio of jobs needed to support $1 million in exports in that industry--a figure known as the "jobs ratio." Finally, Ex-Im aggregates across all industries to produce an overall estimate."

A letter report issued by the Government Accountability Office with an abstract that begins "While the Department of Defense (DOD) took steps to address previously identified weaknesses in updating and maintaining the Militarily Critical Technologies List (MCTL), the list remains outdated and updates have ceased. For example, DOD has solicited users' requirements and feedback on the MCTL, and added a search engine capability to improve navigation of the list and updated each technology section at least once. DOD also determined the list's purpose is to support export control decisions and in October 2008, issued an instruction that (1) recognized the list's usefulness for other DOD programs and activities and (2) outlined the roles, responsibilities, and procedures for updating and maintaining the list. However, in 2011, DOD cut funding for the program from $4 million in prior years to about $1.5 million and ceased MCTL content updates. Subsequently, DOD removed the public version of the list from the Internet, and officials posted a disclaimer for the restricted version noting that the list should only be used for informational purposes as it had not been updated. Similarly, the compendium of emerging technologies is outdated and two sections have not been updated since …

A letter report issued by the Government Accountability Office with an abstract that begins "In May 2012, 194 member states approved components of the World Health Organization's (WHO) reform agenda, encompassing three broad areas--priority-setting, governance, and management reforms--that generally address the challenges identified by stakeholders. According to WHO officials, member state representatives, and other stakeholders, some of the challenges facing WHO include its (1) lack of clear organizational priorities; (2) lack of predictable and flexible financing; and (3) highly decentralized organizational structure. In developing its reform agenda, WHO consulted with member states, employees, and other parties to gather their views and feedback. In addition, WHO has commissioned three ongoing evaluations to provide input into the reform process. The first stage of one of the planned evaluations was conducted by WHO's External Auditor, which concluded in March 2012 that WHO's reform proposals are comprehensive in addressing challenges faced by the organization. WHO continues to consult with member states on priority-setting and governance proposals, which generally require extensive deliberation and consensus from member states. In November 2011, the WHO Executive Board approved WHO's management reform proposals in several areas, and requested further development of proposals in other areas. In May 2012, WHO …

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2000, the annual number of new international parental child abduction cases reported to the Department of State--many of which likely involved air travel--has nearly tripled. Such abductions occur when a parent, family member, or person acting on behalf thereof, takes a child to another country in violation of the custodial parent's or guardian's rights. Once a child is abducted, the laws, policies, and procedures of the foreign country determine the child's return. Thus, preventing such abductions can help keep parents and children from being separated for a long period or indefinitely. As requested, this report addresses (1) the policies and measures airlines, federal agencies, and others have to prevent international parental child abductions on airline flights and (2) options federal agencies, airlines, and others could consider for helping prevent such abductions on airline flights, as well as the advantages and limitations of those options. To perform this work, GAO reviewed applicable laws and policies, interviewed government officials, and surveyed airlines and nonprofit associations."

A letter report issued by the Government Accountability Office with an abstract that begins "The 24 agencies participating in the Federal Data Center Consolidation Initiative (FDCCI) made progress towards the Office of Management and Budget's (OMB) goal to close 40 percent, or 1,253 of the 3,133 total federal data centers, by the end of 2015, but OMB has not measured agencies' progress against its other goal of $3 billion in cost savings by the end of 2015. Agencies closed 420 data centers by the end of December 2012, and have plans to close an additional 548 to reach 968 by December 2015--285 closures short of OMB's goal. OMB has not determined agencies' progress against its cost savings goal because, according to OMB staff, the agency has not determined a consistent and repeatable method for tracking cost savings. This lack of information makes it uncertain whether the $3 billion in savings is achievable by the end of 2015. Until OMB begins tracking and reporting on performance measures such as cost savings, it will be limited in its ability to oversee agencies' progress against key initiative goals. Additionally, extending the horizon for realizing planned cost savings could provide OMB and data center …

A letter report issued by the Government Accountability Office with an abstract that begins "Congress enacted the Electronic Government (E-Gov) Act in 2002 to promote better use of the Internet and other information technologies (IT), thereby improving government services for citizens, internal government operations, and opportunities for citizen participation in government. Among other things, the act established the E-Gov Fund to support projects that expand the government's ability to carry out its activities electronically. The act also created the Office of Electronic Government within the Office of Management and Budget (OMB). The Administrator of this office is to assist the OMB Director in approving projects to be supported by the E-Gov Fund. The General Services Administration (GSA) is responsible for administering the fund and notifying Congress of how the funds are to be allocated to projects approved by OMB. GAO was asked to (1) identify and describe the projects supported by the E-Gov Fund, including the distribution of fiscal year 2010 funds among the projects and their expected benefits; and (2) for selected projects, identify their progress against goals. To do this, GAO reviewed project and funding documentation, analyzed project goals, and interviewed agency officials.."

A publication issued by the Government Accountability Office with an abstract that begins "Environmental satellites provide critical data used in weather forecasting and measuring variations in climate over time. In February 2010, the White House's Office of Science and Technology Policy disbanded the National Polar-orbiting Operational Environmental Satellite System (NPOESS)--a tri-agency satellite acquisition that had encountered continuing cost, schedule, and management problems--and instructed the National Oceanic and Atmospheric Administration (NOAA) and the Department of Defense (DOD) to undertake separate acquisitions. Both agencies have begun planning their respective programs--the Joint Polar Satellite System (JPSS) and the Defense Weather Satellite System (DWSS)--including creating program offices and transitioning contracts. GAO was asked to summarize the status of ongoing work assessing (1) NOAA's and DOD's plans for their separate acquisitions and (2) the key risks in transitioning from NPOESS to these new programs. In preparing this statement, GAO relied on the work supporting previous reports, attended monthly program management meetings, reviewed documentation on both programs, and interviewed agency officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Following sweeping changes made to federal welfare policy in 1996 with the creation of the Temporary Assistance for Needy Families (TANF) program, the number of needy families who received cash assistance fell by more than half to 1.7 million in 2008. Poverty among children also fell from about 21 percent in 1995 to about 16 percent in 2000, rising again to 19 percent in 2008. The current recession deepened in 2008, raising questions about state TANF programs' response to increased needs. GAO was asked to provide Congress with information on the (1) factors contributing to the decline in the number of families receiving assistance; (2) characteristics of participating and nonparticipating eligible families; (3) impact of higher participation in TANF cash assistance on child poverty; and (4) changes states are experiencing in caseloads and spending in the current recession. GAO's methodologies included using microsimulation analyses; reviewing relevant research and federal laws; interviewing TANF officials in 21 selected states; analyzing state cash assistance data; and interviewing researchers, federal officials, and other experts."

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 "Since the Food Security Act of 1985, Congress has authorized monetization--the sale of U.S. food aid commodities in developing countries to fund development. In fiscal year 2010, more than $300 million was used to procure and ship 540,000 metric tons of commodities to be monetized by the U.S. Agency for International Development and the U.S. Department of Agriculture. Through analysis of agency data, interviews with agency officials, and fieldwork in three countries, this report (1) assesses the extent to which monetization proceeds cover commodity and other associated costs and (2) examines the extent to which U.S. agencies meet requirements to ensure that monetization does not cause adverse market impacts."

A statement of record issued by the Government Accountability Office with an abstract that begins "The current fiscal environment, ongoing deliberations for the next Farm Bill, and the public's expectations for a high-performing and efficient government underscore the need for the U.S. Department of Agriculture (USDA) to focus on program results and customer needs, work across organizational lines to help minimize any overlap and duplication, and build its internal capacity. USDA comprises 15 agencies in seven mission areas that are responsible for, among other things, assisting farmers and rural communities, overseeing meat and poultry safety, providing access to nutritious food for low-income families, and protecting the nation's forests. For fiscal year 2010, USDA estimated that its 15 agencies would have total outlays of $129 billion. This statement highlights examples from GAO's previous work that illustrate how USDA can address challenges it faces in three key areas: (1) the performance and accountability of USDA programs, (2) coordination within USDA and between USDA and other agencies to minimize duplication and overlap, and (3) the sufficiency of USDA management capacity. This statement is based on GAO's extensive body of work on USDA programs authorized under the Farm Bill and issued from September 2005 …

Other written product issued by the Government Accountability Office with an abstract that begins "This document is a listing of technical changes related to the 2011 Government Auditing Standards."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO identified 15 key aerostat and airship efforts that were underway or had been initiated since 2007, and the Department of Defense (DOD) had or has primary responsibility for all of these efforts. None of the civil agency efforts met GAO's criteria for a key effort. Most of the aerostat and airship efforts have been fielded or completed, and are intended to provide intelligence, surveillance, and reconnaissance (ISR) support. The estimated total funding of these efforts was almost $7 billion from fiscal years 2007 through 2012. However, funding estimates beyond fiscal year 2012 decline precipitously for aerostat and airship efforts under development, although there is an expectation that investment in the area will continue."

A publication issued by the Government Accountability Office with an abstract that begins "In 2007, the United States enacted a law incrementally raising the minimum wages in American Samoa and the Commonwealth of the Northern Mariana Islands (CNMI) until they equal the U.S. minimum wage. American Samoa's minimum wage increased by $.50 three times, and the CNMI's four times before legislation delayed the increases, providing for no increase in American Samoa in 2010 or 2011 and none in the CNMI in 2011. If further increases are implemented as scheduled, American Samoa's minimum wage will equal the current U.S. minimum wage of $7.25 in 2018, and the CNMI's will reach it in 2016. Recent economic declines in both areas reflect the closure of one of two tuna canneries in American Samoa and the departure of the garment industry in the CNMI. GAO is required to report in 2010, 2011, 2013, and biennially thereafter on the impact of the minimum wage increases. This testimony, requested by Congress, summarizes GAO's June 2011 report, which describes, since the increases began, (1) employment and earnings, and (2) the status of key industries. GAO reviewed federal and local information; collected data from employers through a questionnaire …