A letter report issued by the Government Accountability Office with an abstract that begins "In 2009, the Department of Veterans Affairs (VA) spent nearly $4 billion on prescriptions for veterans. In general, VA provides drugs on its national formulary. However, all VA medical centers must have a nonformulary drug request process that is overseen by their regional Veterans Integrated Service Network (VISN). This report responds to a House Committee on Appropriations report directing GAO to review VA's formulary process and to an additional congressional request. Specifically, GAO reviewed (1) the process VA uses to review drugs for its national formulary, (2) the approaches VISNs and medical centers take to implementing the nonformulary drug request process, (3) the extent to which VA ensures the timely adjudication of nonformulary drug requests, and (4) the mechanisms VA has in place to obtain beneficiary input on the national formulary and make the drug review process transparent. GAO reviewed VA policy guidance and VA's pharmacy-related information technology (IT) initiatives, analyzed 2008 and 2009 drug review data and 2009 nonformulary drug request data, and interviewed VA officials from the national level, each VISN, and a judgmental sample of four medical centers."

A letter report issued by the Government Accountability Office with an abstract that begins "The need to better protect federal facilities, coupled with federal budget constraints and the increased scrutiny of homeland security funding and programs, has prompted the need for U.S. agencies to measure the performance of their facility protection efforts. In this environment, it is important for these agencies to ensure that investments in facility protection are providing adequate returns in terms of better protecting real property assets against terrorism. In addition, the U.S. government's national strategy, Presidential directive, and guidance on protecting critical infrastructures--including facilities--have identified the use of performance measurement as a key means of assessing the effectiveness of protection programs. Given that protection of critical infrastructures is an important issue for organizations outside of the federal government as well, it is beneficial to look to the experiences of these organizations to identify lessons learned. As such, our objectives for this review were (1) to identify examples of performance measures for facility protection being used by selected organizations outside of the federal government--including private-sector entities, state and local governments, and foreign governments, and (2) to determine the status of U.S. federal agencies' efforts to develop and …

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 "Over the past year, the overall size of DOD's major defense acquisition program portfolio decreased, from 85 programs to 80, while the estimated cost has increased by $14.1 billion. The average time to deliver initial capability to the warfighter also increased by 2 months. The slight cost increase can be attributed to the addition of one program, the Evolved Expendable Launch Vehicle. This furthers a trend for decreased portfolio size seen for the past three years. Although the overall cost of the 2013 portfolio increased, 50 of the 80 programs decreased costs, and 64 percent of programs increased their buying power. There are still some programs that have performed poorly, both over the past year and in the longer term. Fifty-five percent of the current portfolio funding has been appropriated, leaving approximately $682 billion needed for future funding. About forty-five percent of this remaining funding represents cost growth from initial estimates, a clear indicator that DOD needs to do more to control cost growth."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs' (VA) fee basis care spending increased from about $3.04 billion in fiscal year 2008 to about $4.48 billion in fiscal year 2012. The slight decrease in fiscal year 2012 spending from the fiscal year 2011 level was due to VA's adoption of Medicare rates as its primary payment method for fee basis providers. VA's fee basis care utilization also increased from about 821,000 veterans in fiscal year 2008 to about 976,000 veterans in fiscal year 2012."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of the Interior (Interior) continues to face challenges hiring and retaining staff with key skills needed to manage and oversee oil and gas operations on federal leases. Interior officials noted two major factors that contribute to challenges in hiring and retaining staff: lower salaries and a slow hiring process compared with similar positions in industry. In response to GAO's survey, officials from a majority of the offices in the three Interior bureaus that manage oil and gas activities--the Bureau of Land Management (BLM), the Bureau of Ocean Energy Management (BOEM), and the Bureau of Safety and Environmental Enforcement (BSEE)--reported ongoing difficulties filling vacancies, particularly for petroleum engineers and geologists. Many of these officials also reported that retention is an ongoing concern as staff leave for positions in industry. Bureau of Labor Statistics data confirm a wide gap between industry and federal salaries for petroleum engineers and geologists. According to Office of Personnel Management (OPM) data, the fiscal year 2012 attrition rate for petroleum engineers at BLM was over 20 percent, or more than double the average federal attrition rate of 9.1 percent. However, the …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on the quality of the 24 Chief Financial Officers (CFO) Act agencies' fiscal year (FY) 2000 performance plans and financial data."

Testimony issued by the Government Accountability Office with an abstract that begins "The Coast Guard, a component of the Department of Homeland Security (DHS), has made progress in developing its Common Operational Picture (COP) by increasing the information in the COP and increasing user access to this information. The Coast Guard has made progress by adding internal and external data sources that allow for better understanding of anything associated with the global maritime domain that could affect the United States. The COP has made information from these sources available to more COP users and decision makers throughout the Coast Guard. For example, in 2006, the ability to track the location of Coast Guard assets, including small boats and cutters, was added to the COP. This capability--also known as blue force tracking--allows COP users to locate Coast Guard vessels in real time and establish which vessels are in the best position to respond to mission needs. In addition to adding information to the COP, the Coast Guard has also made the information contained in the COP available on more computers and on more systems, which, in turn, has increased the number of users with access to the COP."

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed a court ruling that exempted certain medical residents from paying Federal Insurance Contributions Act taxes and Social Security coverage, focusing on: (1) how the Internal Revenue Service (IRS) and the Social Security Administration are proceeding since the court decision; and (2) what decisions IRS has made about refunding taxes for social security paid by medical residents and their employers and the effect of those decisions on the Social Security Trust Funds."

A letter report issued by the Government Accountability Office with an abstract that begins "In August 2005, Congress established the Safe Routes to School (SRTS) program primarily to encourage children to walk and bicycle to school. GAO was asked to determine (1) the steps the Federal Highway Administration (FHWA) and states have taken to implement the program, (2) the extent to which FHWA and states have evaluated the results of the program, and (3) how the program is related to other surface transportation programs and some considerations for future reauthorization. GAO reviewed statutes, regulations, and guidance; analyzed program obligation data and funds awarded by states; and interviewed officials with FHWA, state departments of transportation, and local grant recipients."

A letter report issued by the Government Accountability Office with an abstract that begins "The federal government plans to spend about $70 billion on information technology (IT) projects during fiscal year 2008. Consequently, it is important that projects be managed effectively to ensure that public resources are wisely invested. At times, a project's cost, schedule, and performance goals--known as its baseline--are modified to reflect changed development circumstances. These changes--called a rebaselining--can be done for valid reasons, but can also be used to mask cost overruns and schedule delays. GAO was asked to (1) determine the extent of and the primary reasons for IT project rebaselining and (2) determine whether federal agencies have sound policies for rebaselining projects. To do this, GAO surveyed the managers of a random sample of 180 projects selected from the 778 major IT projects the 24 major agencies plan to invest in during fiscal year 2008. GAO also compared agencies' rebaselining policies to best practices."

A letter report issued by the Government Accountability Office with an abstract that begins "In 1992 Congress authorized the U.S. Army Corps of Engineers (Corps) to implement the Delaware River deepening project, which would deepen the river's shipping channel from 40 to 45 feet. In 2002 GAO reviewed the Corps' economic analysis of the project, concluding that it contained significant limitations. GAO recommended that the Corps prepare a comprehensive economic reanalysis, which the Corps completed in 2004. GAO was asked to determine the extent to which (1) the reanalysis addressed the limitations GAO identified; (2) the reanalysis's benefit projections, as updated, reflect current and anticipated market and industry conditions; and (3) the Corps has accounted for other key issues that could affect the project. GAO reviewed Corps project documentation and interviewed federal officials along with representatives of affected states, firms, and environmental groups."

A letter report issued by the General Accounting Office with an abstract that begins "The fiscal year 2002 Conference Report for the Energy and Water Development Appropriations Act directed GAO to study the benefits and effects of the U.S. Army Corps of Engineers' (Corps) dredge fleet. GAO examined the characteristics and changing roles of the Corps and industry in hopper dredging; the effect of current restrictions on the Corps' hopper dredge fleet; and whether existing and proposed restrictions on the fleet, including the proposal to place the McFarland in ready reserve, are justified. In addition, GAO identified concerns related to the government cost estimates the Corps prepares to determine the reasonableness of industry bids."

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 effect of the Patient Protection and Affordable Care Act (PPACA), enacted in March 2010, on the long-term fiscal outlook depends largely on whether elements in PPACA designed to control cost growth are sustained. There was notable improvement in the longer-term outlook after the enactment of PPACA under GAO's Fall 2010 Baseline Extended simulation, which assumes both the expansion of health care coverage and the full implementation and effectiveness of the cost-containment provisions over the entire 75-year simulation period. However, the federal budget remains on an unsustainable path. Further, questions about the implementation and sustainability of these provisions have been raised by the Centers for Medicare & Medicaid Services' Office of the Actuary and others, due in part to challenges in sustaining increased health care productivity. The Fall 2010 Alternative simulation assumed cost containment mechanisms specified in PPACA were phased out over time while the additional costs associated with expanding federal health care coverage remained. Under these assumptions, the long-term outlook worsened slightly compared to the pre-PPACA January 2010 simulation."

Testimony issued by the Government Accountability Office with an abstract that begins "In 2004, Congress directed the Department of Defense (DOD) to establish a comprehensive policy to prevent and respond to sexual assaults involving servicemembers. Though not required to do so, the Coast Guard has established a similar program. This statement addresses the extent to which DOD and the Coast Guard (1) have developed and implemented policies and programs to prevent, respond to, and resolve sexual assault incidents involving servicemembers; (2) have visibility over reports of sexual assault; and (3) exercise oversight over reports of sexual assault. This statement draws on GAO's preliminary observations from an ongoing engagement examining DOD's and the Coast Guard's programs to prevent and respond to sexual assault. In conducting its ongoing work GAO reviewed legislative requirements and DOD and Coast Guard guidance, analyzed sexual assault incident data, and obtained through surveys and interviews the perspective on sexual assault matters of more than 3,900 servicemembers stationed in the United States and overseas. The results of GAO's survey and interviews provide insight into the implementation of the programs but are nongeneralizable. GAO expects to issue its final report in August 2008 and to make a number of …

A letter report issued by the General Accounting Office with an abstract that begins "GAO reviewed the National Aeronautics and Space Administration's (NASA) fiscal year 2000 performance report to assess the agency's progress in achieving selected key outcomes important to NASA's mission. The selected key outcomes are to (1) expand scientific knowledge of the Earth system, (2) expand the commercial development of space, and (3) deploy and operate the International Space Station safely and cost effectively. NASA reported mixed progress in achieving these key outcomes. In general, NASA's strategies for achieving unmet performance targets for theses outcomes are clear and reasonable. NASA achieved most targets related to expanding knowledge of the Earth system. However, its progress in other areas was more limited. NASA has made improvements in its fiscal year 2000 performance report in comparison to its fiscal year 1999 performance report. Specifically, NASA describes its verification and validation efforts and discloses its data sources for each performance target. NASA's report partially addressed the governmentwide high-risk area of strategic human capital management but not the area of information security. GAO has previously found that NASA lacks an effective agencywide security program. NASA's report only addressed two of the three critical …

A letter report issued by the Government Accountability Office with an abstract that begins "The Sentinel program is intended to replace and expand on the Federal Bureau of Investigation's (FBI) failed Virtual Case File (VCF) project and thereby meet the bureau's pressing need for a modern, automated capability to support its field agents and intelligence analysts' investigative case management and information sharing requirements. Because of the FBI's experience with VCF and the importance of Sentinel to the bureau's mission operations, GAO was asked to conduct a series of reviews on the FBI's management of Sentinel. This review focuses on the FBI's (1) use of effective practices for acquiring Sentinel and (2) basis for reliably estimating Sentinel's schedule and costs. To address its objectives, GAO researched relevant best practices, reviewed FBI policies and procedures, program plans and other program documents, and interviewed appropriate program officials."

A letter report issued by the Government Accountability Office with an abstract that begins "To prepare for potential attacks in the United States involving weapons of mass destruction (WMD), Congress approved the development of National Guard Civil Support Teams (CST) tasked to identify chemical, biological, radiological, nuclear, or high-yield explosive weapons; assess consequences; advise civil authorities on response measures; and assist with requests for additional support. Thus far, 36 of the 55 approved teams have been fully certified to conduct their mission. The National Guard Bureau (NGB) is in the process of establishing, certifying, and planning for the long-term sustainment of the CSTs. GAO was asked to address the extent to which (1) the CSTs are ready to conduct their mission and (2) effective administrative mechanisms are in place for the CSTs."

A letter report issued by the Government Accountability Office with an abstract that begins "Congress authorized the Mentor-Protege Program to boost the participation of small disadvantaged businesses as subcontractors and suppliers under Department of Defense (DOD) and other contracts. The program provides incentives to major defense contractors (mentors) to help small disadvantaged businesses (proteges) strengthen their ability to compete for contracts. GAO administered a Web-based survey to determine whether former proteges believe the program enhanced their business development; examined the accuracy of the Mentor-Protege Program Office's annual reporting to Congress; determined whether DOD reported on the progress of former proteges and their contributions to small business goals; and, identified how program funds have been obligated and used."

Testimony issued by the Government Accountability Office with an abstract that begins "Technological developments since the Privacy Act became law in 1974 have changed the way information is organized and shared among organizations and individuals. Such advances have rendered some of the provisions of the Privacy Act and the E-Government Act of 2002 inadequate to fully protect all personally identifiable information collected, used, and maintained by the federal government. For example, GAO has reported on challenges in protecting the privacy of personal information relative to agencies’ use of Web 2.0 and data-mining technologies."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Nanotechnology Initiative (NNI), administered by the Office of Science and Technology Policy (OSTP), is a multiagency effort intended to coordinate the nanotechnology-related activities of 25 federal agencies that fund nanoscale research or have a stake in the results. Nanotechnology is the ability to control matter at the scale of a nanometer--one billionth of a meter. A key research area funded by some federal agencies relates to potential environmental, health, and safety (EHS) risks that may result from exposure to nanoscale materials. Because of concerns about federal efforts to fund and prioritize EHS research, GAO was asked to determine (1) the extent to which selected agencies conducted such research in fiscal year 2006; (2) the reasonableness of the agencies' and the NNI's processes to identify and prioritize such federal research; and (3) the effectiveness of the agencies' and the NNI's process to coordinate this research. GAO reviewed quantitative and qualitative data from five federal agencies that provided 96 percent of fiscal year 2006 funding for EHS research."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) added a prescription drug benefit to the Medicare program, to become effective January 1, 2006. To assist Medicare beneficiaries with their prescription drug costs until the new benefit becomes available, the MMA also required the establishment of a temporary program, the Medicare Prescription Drug Discount Card and Transitional Assistance Program, which began in June 2004. The drug card program is designed to offer Medicare beneficiaries access to discounts off the retail price of prescription drugs. All Medicare beneficiaries, except those receiving Medicaid drug coverage, are eligible to enroll in the drug card program. Certain low-income beneficiaries without other drug coverage qualify for an additional benefit, a transitional assistance (TA) subsidy, that can be applied toward the cost of drugs covered under the drug card program. The Centers for Medicare & Medicaid Services (CMS)--the agency within the Department of Health and Human Services that administers the Medicare and Medicaid programs--administers and oversees the drug card program. The drug cards themselves are offered and managed by private organizations, known as drug card sponsors. There are different types of drug …

A letter report issued by the Government Accountability Office with an abstract that begins "Although the Department of Defense (DOD) pays active-duty servicemembers who do not live in military housing a Basic Allowance for Housing (BAH) to help them afford private market residences, expected growth at some military installations has raised concerns about whether nearby communities will have enough affordable rental housing for incoming personnel. In response to a congressional mandate, GAO assessed (1) how excluding BAH would affect servicemembers' eligibility to apply for federal rental housing programs and (2) factors that could affect their use of the programs in selected communities gaining military personnel. GAO compared servicemembers' eligibility for the programs as of December 2005 by including and excluding BAH from income determinations and examined factors affecting potential program use near four growing military installations."