A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) and Congress have expressed concern with the frequency and length of time that volunteer reservists serve on active duty. In fiscal year 2006, DOD nearly doubled its fiscal year 2005 estimate for the total maximum levels of reservists volunteering to be on active duty for operational support. Congress required GAO to review the reasons behind the increases and expressed an interest in understanding which reservists were being included or excluded from these numbers. In this report, GAO (1) identified the factors that led to the increase in DOD's requests for the maximum number of volunteer reserve personnel authorized to be on active duty for operational support since DOD's initial request in fiscal year 2005 and (2) assessed the extent to which the reserve components have consistently reported the number of reservists serving in an operational support capacity since 2005. In conducting this review, GAO analyzed agency documents and interviewed DOD officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security (DHS) and its components--such as the U.S. Coast Guard and Customs and Border Protection (CBP)--have started or completed initiatives to address small vessel security risks, but DHS is not tracking the progress being made to address action items in the Small Vessel Security Strategy (SVSS) Implementation Plan. "Small vessels" are characterized as any watercraft--regardless of method of propulsion--less than 300 gross tons, and used for recreational or commercial purposes. DHS component officials GAO met with identified examples of key initiatives that they have completed or have under way to enhance small vessel security, including an initiative to help CBP better track small vessels arriving from foreign locations and another to assist the Coast Guard in assessing and monitoring small vessel launch sites. Although the SVSS Implementation Plan states that DHS is to assess and update the plan, DHS has not determined the progress its components and other relevant stakeholders--such as the Department of Defense--are making in completing the action items and has no current plans to do so. DHS officials stated that this is due, in part, to budget constraints that …

A letter report issued by the Government Accountability Office with an abstract that begins "The nation's critical infrastructure sectors--such as public health, energy, water, and transportation--rely on computerized information and systems to provide services to the public. To fulfill the requirement for a comprehensive plan, including cyber aspects, the Department of Homeland Security (DHS) issued a national plan in June 2006 for the sectors to use as a road map to enhance the protection of critical infrastructure. Lead federal agencies, referred to as sector-specific agencies, are responsible for coordinating critical infrastructure protection efforts, such as the development of plans that are specific to each sector. In this context, GAO was asked to determine if these sector-specific plans address key aspects of cyber security, including cyber assets, key vulnerabilities, vulnerability reduction efforts, and recovery plans. To accomplish this, GAO analyzed each sector-specific plan against criteria that were developed on the basis of DHS guidance."

A letter report issued by the Government Accountability Office with an abstract that begins "In 1995, GAO first designated the Department of Defense's (DOD) business systems modernization program as "high-risk," and continues to do so today. In 2004, Congress passed legislation reflecting prior GAO recommendations that DOD adopt a corporate approach to information technology (IT) business systems investment management, including tiered accountability for business systems at the department and component levels. To support GAO's legislative mandate to review DOD's efforts, GAO assessed whether the investment management approach of one of DOD's components--the Department of the Navy--is consistent with leading investment management best practices. In doing so, GAO applied its IT Investment Management (ITIM) framework and associated methodology, focusing on the stages related to the investment management provisions of the Clinger-Cohen Act of 1996."

A letter report issued by the Government Accountability Office with an abstract that begins "Once comprised of local, sole-proprietor ownership, the nation's for-profit institutions now range from small, privately owned schools to publicly traded corporations. Enrollment in such colleges has grown far faster than in traditional higher-education institutions. Moreover, during the 2009-2010 school year, for-profit colleges received almost $32 billion in grants and loans provided to students under federal student aid programs, as authorized under Title IV of the Higher Education Act of 1965, as amended. Because of interest in the student experience at for-profit colleges, GAO was asked to conduct undercover testing by enrolling in online classes under degree-granting programs. To conduct this testing, GAO selected 15 for-profit colleges using a selection process that included the 5 largest colleges and a random sample and attempted to enroll using fictitious identities. Once enrolled, each fictitious student engaged in behaviors consistent with substandard academic performance. Each fictitious identity enrolled for approximately one term, as defined by the college. The experience of each of GAO's undercover students is unique and cannot be generalized to other students taking courses offered by the for-profit colleges we tested or to other for-profit or nonprofit colleges. …

A letter report issued by the Government Accountability Office with an abstract that begins "Federal officials, Congress, and the public have long voiced concerns about safety at the nation's nuclear weapons laboratories: Lawrence Livermore, Los Alamos, and Sandia. The laboratories are overseen by the National Nuclear Security Administration (NNSA), while contractors carry out the majority of the work. A recent change to oversight policy would result in NNSA's relying more on contractors' own management controls, including those for assuring safety. This report discusses (1) the recent history of safety problems at the laboratories and contributing factors, (2) steps taken to improve safety, and (3) challenges that remain to effective management and oversight of safety. To address these objectives, GAO reviewed almost 100 reports and investigations and interviewed key federal and laboratory officials."

A letter report issued by the General Accounting Office with an abstract that begins "The LOCAL TV Act required that GAO perform an annual audit of the (1) administration of the provisions of the Act, and (2) financial position of each applicant who receives a loan guarantee under the Act, including the nature, amount, and purpose of investments made by the applicant. In fiscal year 2002, the LOCAL TV Program was funded; however, because it was not fully implemented in that year, there were no loan guarantee applicants for GAO to audit. Therefore, this report primarily addresses whether program administration during fiscal year 2002 satisfied the provisions of the Act."

A chapter report issued by the General Accounting Office with an abstract that begins "The federal government has been a key participant in the efforts to provide aid to the New York City area to help it respond to and recover from the September 11 terrorist attacks. The President pledged, and the Congress subsequently authorized, about $20 billion in federal aid. This federal aid was provided primarily through four sources: the Federal Emergency Management Agency (FEMA), the Department of Housing and Urban Development (HUD), the Department of Transportation (DOT), and the Liberty Zone tax benefits--a set of tax benefits targeted to lower Manhattan. These sources provided 96 percent, or $19.63 billion, of the committed federal aid to the New York City area. It has been over 2 years since the attacks occurred, and many efforts have been undertaken to aid the New York City area to cope with the disaster and its many impacts. GAO was asked to describe how much and what type of federal assistance was provided to the New York City area through these four sources and how the federal government's response to this disaster differed from previous disasters. We provided a draft of this report to …

A letter report issued by the General Accounting Office with an abstract that begins "Many small employers--those with 50 or fewer workers--do not offer health benefits to their employees. This is particularly true for employers with fewer than 10 workers. The families of workers employed by small employers are about twice as likely to be uninsured as households with a worker at a large employer. Despite efforts by Congress and the states to help small employers buy coverage, many small employers continue to cite cost as a major obstacle to providing coverage. Small and large employers purchasing health insurance generally had comparable premiums in 1998, but this comparison does not fully reflect the challenges facing small employers in providing health insurance for their employees. Although the premiums were similar, the health plans offered by small employers were slightly less generous on average--they had slightly higher average cost-sharing requirements for their employees and were somewhat less likely to offer some benefits, excluding, for example, mental health services and chiropractic care. Also, insurers' costs to administer employer-based health insurance and protect against potentially large health care costs result in a larger share of small employers' premium dollars being spent on these nonbenefit …

A letter report issued by the General Accounting Office with an abstract that begins "GAO was asked to review the Centers for Medicare & Medicaid Services (CMS) initiative to publicly report additional information on its "Nursing Home Compare" Web site intended to help consumers choose a nursing home. GAO examined CMS's development of the new nursing home quality indicators and efforts to verify the underlying data used to calculate them. GAO also reviewed the assistance CMS offered the public in interpreting and comparing indicators available in its six-state pilot program, launched in April 2002, and its own evaluation of the pilot. The new indicators are scheduled to be used nationally beginning in November 2002."

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 General Accounting Office with an abstract that begins "Medicare's physician fee schedule establishes payments for more than 7,000 different services, such as office visits, surgical procedures, and treatments. Before 1992, fees were based on charges physicians billed for these services. Since then, the Health Care Financing Administration (HCFA), which runs Medicare, has been phasing in a new fee schedule on the basis of the amount of resources used to provide that service relative to other services. The development of the resource-based practice expense component was a substantial undertaking. The implementation of the resource-based methodology has been the subject of considerable controversy, partly because of HCFA's adjustments to the underlying data and basic method and partly because payment changes were required to be budget-neutral--which means that total Medicare spending for physician services was to be the same under the new payment method as it was under the old one. As a result, Medicare payments to some specialties have increased while payments to other specialties have decreased. Oncologists claim that their practice expense payments are particularly inadequate for some office-based services, such as chemotherapy. Oncology practice expense payments in 2001 are eight percent higher than they …

A letter report issued by the Government Accountability Office with an abstract that begins "Questions about the financial status of the National Flood Insurance Program (NFIP) have increased since the 2005 hurricanes, which left the program with an unprecedented $17.4 billion deficit--a debt that resulted in GAO placing NFIP on its high-risk list in March 2006. Among the concerns are the subsidized rates NFIP must provide for about 25 percent of the policies, mostly for older buildings in high-risk flood zones. And although fully risk-based rates are supposed to reflect actual flood risk, concerns have been raised that they do not. This report evaluates (1) the Federal Emergency Management Agency's (FEMA) process for setting full-risk rates to determine whether it produces rates that accurately reflect the risk of flooding and (2) the process that FEMA uses to set subsidized rates and their effect on the financial condition of NFIP. To do this work, GAO evaluated the NFIP rate model, examined data from FEMA, surveyed relevant literature, and interviewed other relevant agencies and risk-modeling firms."

A letter report issued by the Government Accountability Office with an abstract that begins "Enrollment and spending in Medicare Advantage (MA) plans--the private plan alternative to the Medicare fee-for- service (FFS) program--have more than doubled since 2004. MA plans generally receive larger payments from Medicare than what these plans would require to provide the original Medicare FFS benefit package. Plans must use this additional money to reduce cost sharing, reduce premiums, and offer additional benefits. The Patient Protection and Affordable Care Act, enacted in 2010, required that the Centers for Medicare & Medicaid Services (CMS)--the agency within the Department of Health and Human Services (HHS) that administers Medicare--make changes in how Medicare pays MA plans. These changes, once fully implemented, are expected to reduce MA enrollment and payments, and lead to less generous benefit packages. GAO was asked to examine trends in MA from 2010 to 2011. This study assesses the extent to which the following changed from 2010 to 2011: (1) MA enrollment, (2) MA premiums and cost-sharing requirements, and (3) the additional benefits offered by MA plans. GAO analyzed data for the most common types of MA plans, accounting for about 71 percent of both the 11.1 million …

A letter report issued by the Government Accountability Office with an abstract that begins "For decades, the United States has tried to impede nuclear proliferation networks that provide equipment to nuclear weapons development programs in countries such as Pakistan and Iran. GAO was asked to examine U.S. efforts to counter nuclear proliferation networks, specifically the (1) status of U.S. efforts to strengthen multilateral controls, (2) impact of U.S. assistance to help other countries improve their legal and regulatory controls, and (3) impact of U.S. efforts to strengthen its enforcement activities. GAO's findings focused on seven countries where network activities reportedly occurred."

A letter report issued by the Government Accountability Office with an abstract that begins "As of August 2012, the National Nuclear Security Administration (NNSA) had completed 42 of 100 planned Megaports projects in 31 countries and, as of December 2011, NNSA had spent about $850 million on the Megaports Initiative (Initiative). NNSA’s Initiative has equipped these seaports with radiation detection equipment, established training programs for foreign personnel, and created a sustainability program to help countries operate and maintain the equipment. However, the administration’s fiscal year 2013 budget proposal would reduce the Initiative’s budget by about 85 percent, and NNSA plans to shift the Initiative’s focus from establishing new Megaports to sustaining existing ones. As a result, NNSA has suspended ongoing negotiations and cancelled planned deployments of equipment in five countries."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2004, the Department of Energy (DOE) disposed of more than 378,000 cubic meters of low-level radioactive waste (LLRW)--contaminated building rubble, soil, and debris. In 2002, DOE directed its sites to use life-cycle cost analysis to manage LLRW. Life-cycle cost analysis examines the total cost of various options to manage LLRW over its life, including its packaging, treatment, transport, and disposal, to identify the lowest-cost alternative. GAO determined whether (1) DOE sites use life-cycle cost analysis to evaluate LLRW management alternatives and (2) DOE has a strategy for cost-effectively managing LLRW departmentwide, including state actions that may affect this strategy."

A letter report issued by the Government Accountability Office with an abstract that begins "The Government National Mortgage Association, commonly known as Ginnie Mae, is a wholly owned government corporation that guarantees mortgage-backed securities (MBS) backed by pools of federally insured or guaranteed mortgage loans. The agency supports federal housing programs by facilitating the securitization of loans backed by the Federal Housing Administration (FHA), Department of Veterans Affairs (VA), Rural Housing Service, and the Office of Public and Indian Housing within the Department of Housing and Urban Development (HUD). Concerned that Ginnie Mae's share of the overall MBS market has declined significantly, Congress asked us to address (1) the state of Ginnie Mae's market share and guarantee volume, (2) the potential implications of changes in its share and volume, and (3) the challenges Ginnie Mae faces and steps it is taking and could take to address these challenges."

A letter report issued by the Government Accountability Office with an abstract that begins "The nation is at risk for a catastrophic biological event. The Implementing Recommendations of the 9/11 Commission Act directed GAO to report on biosurveillance--to help detect and respond to such events--at multiple jurisdictional levels. In June 2010, GAO recommended that the National Security Staff lead the development of a national biosurveillance strategy, which is now under development. This report focuses on nonfederal jurisdictions, which own many of the resources that support a national capability. It discusses (1) federal support for state and local biosurveillance; (2) state and local challenges; (3) federal support and challenges for tribal and insular areas and (4) federal assessments of nonfederal capabilities. To conduct this work, GAO interviewed select federal-agency, jurisdiction, and association officials and reviewed relevant documents. To collect information on federal efforts and challenges, we also sent standardized questionnaires to seven states and two cities."

A letter report issued by the General Accounting Office with an abstract that begins "Federal law enforcement and intelligence agencies are seeking to add new techniques to their arsenal of investigative tools. "Brain fingerprinting" measures brain wave responses to determine whether an individual recognizes certain details of an event or activity. Because the technique requires specific information about the event that would be known only to the perpetrator and the investigator, Brain Fingerprinting is not designed as a screening tool--a function that involves questioning a subject about events unknown to the investigator. Instead, an investigator would be able to use certain information as evidence for or against a subject. For example, the technique could be used to determine whether a subject has knowledge of details about a crime. Officials representing the Central Intelligence Agency, the Department of Defense, the Secret Service, and the Federal Bureau of Investigation do not forsee using the brain fingerprinting technique because of its limited use. Furthermore, given the technique's limitations, the research expenses, equipment, and training costs are perceived to exceed benefits."

A letter report issued by the General Accounting Office with an abstract that begins "In fiscal year 2001, the Federal Aviation Administration (FAA) spent more than $15 million to move air traffic controllers and their managers to new permanent duty locations. FAA classifies the funds that it spends for these moves as permanent change of station (PCS) benefits. In 1998, as part of a broader effort to reform its personnel policies, FAA changed its policies on PCS benefits. Instead of fully reimbursing the costs of all PCS moves and prohibiting unfunded PCS moves, as it once did, FAA now determines the amount of PCS benefits to be offered on a position-by-position basis and allows employees and managers to move at their own expense. Under its new polices, FAA can fully reimburse the costs of a move if it determines that he move is in the interest of the government, or it can offer partial fixed relocation benefits if it determines that the agency will derive some benefit from the move. FAA's policies on eligibility for PCS benefits are the same for air traffic controllers and their managers, but the amounts of the benefits vary. According to these policies, eligibility depends …

A letter report issued by the General Accounting Office with an abstract that begins "The federal government makes consolidation loans available to help borrowers manage their student loan debt. By combining loans into one and extending the repayment period, a consolidation loan reduces monthly repayments, which may lower default risk and, thereby, reduce federal costs of loan defaults. Consolidation loans also allow borrowers to lock in a fixed interest rate--an option not available for other student loans--and are available to borrowers regardless of financial need. GAO was asked to examine (1) how consolidation borrowers differ from nonconsolidation borrowers; (2) how federal costs have been affected by recent interest rate and loan volume changes; and (3) the extent to which repayment options--other than consolidation--are available to help simplify and reduce loan repayments."

A letter report issued by the Government Accountability Office with an abstract that begins "All 12 contracts GAO reviewed from the four Department of Veterans Affairs' (VA) medical centers (VAMC) visited contained performance requirements consistent with VA acquisition policy. However, the performance requirements lacked detail in six categories: type of provider or care; credentialing and privileging; clinical practice standards; medical record documentation; business processes; and access to care. GAO identified these categories from reviews of VA acquisition regulations, VA policies, and hospital accreditation standards; and VA officials verified that these six categories were an accurate reflection of performance requirements that should be in VA clinical contracts. GAO found, for example, one VAMC cardiothoracic contract that had detailed performance requirements while another VAMC's cardiothoracic contract did not contain a statement describing the contract provider's responsibilities for reporting and responding to adverse events and patient complaints. GAO also found that contracting officials lack tools, such as standard templates, that provide examples of the performance requirements that should be included in common types of clinical contracts. Such tools would help ensure consistency in requirements across contracts."

A letter report issued by the Government Accountability Office with an abstract that begins "In 1995, GAO first designated the Department of Defense's (DOD) business systems modernization program as "high-risk" and continues to do so today. In 2004, Congress passed legislation reflecting prior GAO recommendations that DOD adopt a corporate approach to information technology (IT) business systems investment management including tiered accountability for business systems at the department and component levels. To support GAO's legislative mandate to review DOD's efforts, GAO assessed whether the investment management approach of one of DOD's components--the Department of the Air Force (Air Force)--is consistent with leading investment management best practices. In doing so, GAO applied its IT Investment Management (ITIM) framework and associated methodology, focusing on the stages related to the investment management provisions of the Clinger-Cohen Act of 1996."