A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare and Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), and the four states GAO reviewed are implementing processes to verify whether providers met the Medicare and Medicaid EHR programs’ requirements and, therefore, qualified to receive incentive payments in the first year of the EHR programs. To receive such payments, providers must meet both (1) eligibility requirements that specify the types of providers eligible to participate in the programs and (2) reporting requirements that specify the information providers must report to CMS or the states, including measures that demonstrate meaningful use of an EHR system and measures of clinical quality. For the Medicare EHR program, CMS has implemented prepayment processes to verify whether providers have met all of the eligibility requirements and one of the reporting requirements. Beginning in 2012, the agency also has plans to implement a risk-based audit strategy to verify on a postpayment basis that a sample of providers met the remaining reporting requirements. For the Medicaid EHR Program, the four states GAO reviewed have implemented primarily prepayment processes to verify whether providers met …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) has departmentwide policy and procedures for convening and conducting administrative investigation boards (AIB). The department’s procedures contain requirements for convening and conducting AIB investigations, but according to VA officials, they also provide the flexibility to tailor an investigation to effectively meet diverse informational needs. For example, the VA official convening an AIB investigation is required to select AIB members who are impartial and objective, but has flexibility to vary the number of members appointed to each AIB based on the matter being investigated. VA is currently updating its AIB policy and procedures, but officials said the department plans to maintain flexibility in its AIB process."

A letter report issued by the Government Accountability Office with an abstract that begins "The Transportation Security Administration’s (TSA) Electronic Baggage Screening Program (EBSP) reports that 76 percent of the airports (337 of 446) the agency regulates for security have a mix of in-line and stand-alone baggage screening configurations that best meet airport needs (i.e., optimal systems). However, only 36 percent (10 of 28) of the nation’s larger airports—based on factors such as the total number of takeoffs and landings annually—have complete optimal systems. This is because the larger airports generally need more complex in-line systems and often require a significant amount of airport infrastructure modification and construction. In August 2011, TSA shifted its focus from installing optimal baggage screening systems to replacing aging machines (recapitalization). However, TSA plans to continue to optimize systems during many of its recapitalization projects."

Correspondence issued by the Government Accountability Office with an abstract that begins "The policies and procedures of the CDFI and NMTC Programs help ensure that awards and allocations generally are proportionate to the numbers of qualified applicants that serve metropolitan and nonmetropolitan areas. The CDFI Program’s authorizing legislation and regulations require that award recipients constitute a geographically diverse group, serving metropolitan and nonmetropolitan areas and Native communities from different U.S. regions. To meet this requirement, CDFI Program officials have used the application review process and established a goal of matching the proportion of awards to the proportion of qualified applicants that primarily serve nonmetropolitan areas. This proportion changed from year to year depending on the number of qualified applicants that served nonmetropolitan areas. According to officials, revisions to the award procedures in the fiscal year 2012 funding round will enhance the CDFI Program’s ability to achieve proportionality. In 2006, Congress, in the Tax Relief and Health Care Act of 2006, added a requirement for the NMTC Program that nonmetropolitan counties receive a proportional allocation of qualified equity investments. To meet this requirement, in 2008, the NMTC Program implemented two goals in its application review process. The first goal requires that …

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Emergency Management Agency (FEMA) is taking steps to integrate its workforce planning and training efforts across the agency consistent with critical success factors for strategic human capital management such as initiating working groups to coordinate related activities, but its efforts are in the early stages. Until recently FEMA’s efforts related to workforce planning have been independently conducted by various offices across the agency. In January 2012, FEMA human capital officials reported that they began integrating agencywide workforce planning initiatives underway by other program offices, such as FEMA’s Qualification System, which was developed to establish qualification requirements for FEMA’s workforce for deployment purposes, among other things. Additionally, FEMA’s Human Capital Office plans to release a directive that, according to officials, will address the need for integrating the agency’s training efforts consistent with critical success factors for strategic human capital management. Having integrated workforce planning and training could help FEMA ensure that it has the properly sized and skilled workforce to effectively meet its mission. However, the effectiveness of these integration efforts is dependent upon FEMA following through with its plans and it is, therefore, too …

Testimony issued by the Government Accountability Office with an abstract that begins "The federal government plays a wide-ranging role in promoting financial literacy. Efforts to improve financial literacy in the United States involve an array of public, nonprofit, and private participants, but among those participants, the federal government is distinctive for its size and reach and for the diversity of its components, which address a wide range of issues and populations. At forums of financial literacy experts that GAO held in 2004 and 2011, participants noted that the federal government can use its “bully pulpit,” convening power, and other tools to draw attention to the issue, and serve as an objective and unbiased source of information about the selection of financial products and services. In prior work, GAO cited a 2009 report by the RAND Corporation in which 20 federal agencies self-identified as having 56 federal financial literacy programs, but GAO’s subsequent analysis found substantial inconsistency in how different agencies defined and counted financial literacy programs. Based on a more consistent set of criteria, GAO identified 16 significant financial literacy programs or activities among 14 federal agencies, as well as 4 housing counseling programs among 3 federally supported entities, in …

A letter report issued by the Government Accountability Office with an abstract that begins "Over the years, the federal-aid highway program has expanded to encompass broader goals, more responsibilities, and a variety of approaches. As the program grew more complex, the Federal Highway Administration’s (FHWA) oversight role also expanded, while its resources have not kept pace. As GAO has reported, this growth occurred without a well-defined overall vision of evident national interests and the federal role in achieving them. GAO has recommended Congress consider restructuring federal surface transportation programs, and for this and other reasons, funding surface transportation remains on GAO’s high-risk list."

A letter report issued by the Government Accountability Office with an abstract that begins "The Office of Management and Budget (OMB) and key federal agencies have made progress on action items in the Information Technology (IT) Reform Plan, but there are several areas where more remains to be done. Of the 10 key action items GAO reviewed, 3 were completed and 7 were partially completed by December 2011, in part because the initiatives are complex. OMB reported greater progress than GAO determined, stating that 7 of the 10 action items were completed and that 3 were partially completed. While OMB officials acknowledge that there is more to do in each of the topic areas, they consider the key action items to be completed because the IT Reform Plan has served its purpose as a catalyst for a set of broader initiatives. They explained that work will continue on all of the initiatives even after OMB declares that the related action items are completed under the IT Reform Plan. We disagree with this approach. In prematurely declaring the action items to be completed, OMB risks losing momentum on the progress it has made to date. Until OMB and the agencies complete …

Testimony issued by the Government Accountability Office with an abstract that begins "The Internal Revenue Service (IRS) has made improvements in processing tax returns, and electronic filing (e-filing), which provides benefits to taxpayers including faster refunds, continues to increase. However, IRS’s performance in providing service over the phone and responding to paper correspondence has declined in recent years. For 2012, as with previous years, IRS officials attribute the lower performance to other funding priorities."

A letter report issued by the Government Accountability Office with an abstract that begins "The National Nuclear Security Administration (NNSA) and its M&O contractors have developed and implemented multifaceted strategies to recruit, develop, and retain both the federal and contractor workforces needed to preserve critical skills in the enterprise. NNSA’s recruiting and retention efforts for its federal staff focus on attracting early career hires with competitive pay and development opportunities. Its development efforts generally rely on two key programs to develop its critically skilled workforce––one that identifies needs and another that identifies the qualifications necessary to meet them. For strategic planning purposes, NNSA is also undertaking a comprehensive reassessment and analysis of staffing requirements to ascertain future federal workforce requirements. M&O contractors’ recruitment and retention strategies vary from site to site, but each site focuses on maintaining competitive compensation packages. Their development efforts vary in approach and scope and face some challenges––particularly in preserving underground nuclear testing skills."

A letter report issued by the Government Accountability Office with an abstract that begins "The Nuclear Regulatory Commission (NRC) and companies licensed to operate nuclear power reactors (or licensees) apply probabilistic risk assessment (PRA) to natural hazards at operating U.S. nuclear reactors to a limited extent. When the 104 operating reactors were originally licensed before 1997, NRC required licensees to assess natural hazards using deterministic analysis, which—informed by historical experience, test results, and expert judgment—considers a specific set of potential accidents and how the consequences of those accidents can be prevented and mitigated. Subsequent to most of these initial licenses being issued, NRC, through policy statements and other documents, has endorsed PRA—a systematic method for assessing what can go wrong, its likelihood, and its consequences, resulting in quantitative estimates of risk—as a means to enhance and extend traditional deterministic analysis. In 1991, NRC requested that licensees voluntarily examine their reactors’ vulnerability to natural hazards and suggested PRA as one of several possible methods for licensees to use in their examinations. However, most licensees opted to use other methods. According to NRC officials and nuclear power industry representatives—and reflected in data GAO obtained from five licensees that together operate 25 reactors—few …

A letter report issued by the Government Accountability Office with an abstract that begins "The Social Security Administration (SSA) has undertaken numerous modernization efforts, but it lacks effective measurement tools to determine progress. Since 2001, SSA has reported spending about $5 billion on the modernization of its systems. Specifically, the agency has undertaken hundreds of modernization projects each year from 2001 to 2011, and officials identified 120 such initiatives that they considered to be key investments in modernization. About two-thirds of these projects were for modernizing and enhancing existing systems, while other efforts were aimed at moving from manual to electronic processes and online access, and the development of new or redesigned system software. These efforts also enhanced work processes, automated notices to beneficiaries, and modified systems to accommodate legislation, among other things. Nonetheless, SSA still has major efforts under way to transition from its aging systems to a more modernized IT environment. Specifically, in order to help meet the agency’s key strategic goal of strengthening its infrastructure and further enhancing its online services, SSA intends to streamline its operations and reduce duplication in databases to allow for more efficient maintenance. The agency also intends to complete its conversion to …

A letter report issued by the Government Accountability Office with an abstract that begins "The F-22A and legacy modernization programs GAO reviewed were rooted in different development strategies. The F-22A began as a single-step program and did not anticipate the need for future modernization, while the legacy programs each began with the expectation that their aircraft would be incrementally upgraded over time. F-22A modernization began in reaction to a major shift in the aircraft’s basic mission, which required the development of new capabilities that had not been planned for as part of the initial development program. In contrast, the legacy modernization programs made planned incremental improvements to existing mission capabilities. All of the modernization programs began at about the same time in development and procurement. The F-22A program is developing and retrofitting new capabilities onto a complex stealth aircraft, which is costly—currently estimated at $9.7 billion total. Legacy modernization programs were less complex, and thus less costly, and incorporated mature technologies onto new production aircraft. Accurately identifying and comparing the total cost of each modernization program is difficult. Each of the programs, including the F-22A, initially managed and funded modernization as a continuation of its baseline program, so modernization costs …

Testimony issued by the Government Accountability Office with an abstract that begins "The Budget Control Act of 2011, amending the Balanced Budget and Emergency Deficit Control Act of 1985, establishes limits on discretionary spending for fiscal years 2012 through 2021. In addition, the Act specifies additional limits on discretionary spending and automatic reductions in direct spending because legislation was not enacted that would reduce projected deficits by at least $1.2 trillion by the end of fiscal year 2021. Among other things, the Budget Control Act requires the Office of Management and Budget (OMB) to calculate, and the President to order, a sequestration of discretionary and direct spending on January 2, 2013, to achieve reductions for that fiscal year."

Testimony issued by the Government Accountability Office with an abstract that begins "The Federal Aviation Administration (FAA) uses data reactively and proactively to prevent accidents and manage safety risks. For instance, since 1998, FAA has partnered with the airline industry to identify precursors and contributing factors, and ensure that efforts to improve safety focus on the most prevalent categories of accidents and formulate an intervention strategy designed to reduce recurrences. Although FAA plans to continue using data reactively to understand the causes of accidents and incidents, as part of its adoption of Safety Management Systems (SMS), it is shifting to a proactive approach in which it analyzes data to identify and mitigate risks before they result in accidents."

Testimony issued by the Government Accountability Office with an abstract that begins "Oversight of managed care rate-setting has been inconsistent. In August 2010, GAO reported that the Centers for Medicare & Medicaid Services (CMS) had not ensured that all states were complying with the managed care actuarial soundness requirements that rates be developed in accordance with actuarial principles, appropriate for the population and services, and certified by actuaries. For example, GAO found significant gaps in CMS’s oversight of 2 of the 26 states reviewed—CMS had not reviewed one state’s rates in multiple years and had not completed a full review of another state’s rates since the actuarial soundness requirements became effective. Variation in practices across CMS regional offices contributed to these gaps and other inconsistencies in the agency’s oversight of states’ rate setting. GAO’s previous work also found that CMS’s efforts to ensure the quality of the data used to set rates were generally limited to requiring assurances from states and health plans—efforts that did not provide the agency with enough information to ensure the quality of the data used. With limited information on data quality, CMS cannot ensure that states’ managed care rates are appropriate, which places billions of …

Testimony issued by the Government Accountability Office with an abstract that begins ""

Correspondence issued by the Government Accountability Office with an abstract that begins "To successfully manage AIA implementation, USPTO must consider a number of trade-offs as it sets and uses its over 340 fees, as well as maintain an effective fee review process. USPTO officials have stated that the agency’s limited fee-setting authority prior to the AIA and uncertainty about the extent to which its collections would be available contributed to a number of the agency’s operational challenges, such as the current backlog of over 640,000 patent applications and patent application processing time of over 30 months. They said fees that generated over 80 percent of USPTO’s revenues were set in statute, limiting the agency’s ability to ensure that total collections kept pace with total costs as its workload has grown. USPTO can only use its fee collections to the extent that Congress makes them available. In the past, Congress has in some years made available less than the total amount collected; there has been significant debate about the status and use of these fees collected in excess of amounts appropriated."

A letter report issued by the Government Accountability Office with an abstract that begins "Field employees have key roles in the U.S. Postal Service’s (USPS) efforts to reduce costs and generate revenue. For example, these employees evaluate the feasibility of closing or consolidating facilities, such as post offices and mail- processing facilities; carry out the closures and consolidations of these facilities; and evaluate and consolidate delivery routes. These roles support USPS’s plans to save, by 2016, about $9 billion annually by improving its operational efficiency and realigning its retail, mail processing, and delivery networks with declining mail use. These plans include evaluating about half of its approximately 31,000 post offices to identify cost-reduction opportunities, closing or reducing operations at about half of its 461 mail-processing facilities, and consolidating about 20,000 of its 144,000 city delivery routes. Area and district employees also have a significant role in USPS’s efforts to generate additional revenue by (1) promoting the value of mail to businesses, (2) maintaining and increasing its customer base through customer service, and (3) growing the package business."

A letter report issued by the Government Accountability Office with an abstract that begins "As with many other demographic groups, older workers’ unemployment overall and long-term unemployment rates have increased dramatically since the recession began in 2007. In December 2011, the unemployment rate for older workers was 6.0 percent, up from 3.1 at the start of the recession, but down from its peak of 7.6 percent in February 2010. In particular, long-term unemployment rose substantially, and at a greater rate for older than younger workers. By 2011, 55 percent of unemployed older workers had been actively seeking a job for more than half a year (27 weeks or more). Meanwhile, the long-term trend of rising labor force participation rates among older workers has continued, with the recession possibly amplifying this trend."

A letter report issued by the Government Accountability Office with an abstract that begins "Plan sponsors and participants paid a range of fees for services, though smaller plans typically paid higher fees as a percentage of plan assets. For example, the average amount sponsors of small plans reported paying for recordkeeping and administrative services was 1.33 percent of assets annually, compared with 0.15 percent paid by sponsors of large plans. Larger plans were more likely to pass recordkeeping fees along to participants, but when fees were passed along to participants in small plans, those in large plans paid lower fees than those in small plans. Participants also paid for investment and plan consulting fees—through fees deducted from their plan assets—in more instances than sponsors."

Testimony issued by the Government Accountability Office with an abstract that begins "The nation faces an evolving array of cyber-based threats arising from a variety of sources. These threats can be intentional or unintentional. Unintentional threats can be caused by software upgrades or defective equipment that inadvertently disrupt systems, and intentional threats can be both targeted and untargeted attacks from a variety of threat sources. Sources of threats include criminal groups, hackers, terrorists, organization insiders, and foreign nations engaged in crime, political activism, or espionage and information warfare. These threat sources vary in terms of the capabilities of the actors, their willingness to act, and their motives, which can include monetary gain or political advantage, among others. Moreover, potential threat actors have a variety of attack techniques at their disposal, which can adversely affect computers, software, a network, an organization’s operation, an industry, or the Internet itself. The nature of cyber attacks can vastly enhance their reach and impact due to the fact that attackers do not need to be physically close to their victims and can more easily remain anonymous, among other things. The magnitude of the threat is compounded by the ever-increasing sophistication of cyber attack techniques, such …

Other written product issued by the Government Accountability Office with an abstract that begins "The Government Accountability Office (GAO) and the U.S. Department of Agriculture’s Office of Inspector General (OIG) seek to enhance the efficiency, effectiveness, and accountability of the federal government. As Congress debates ways to address the federal government’s long-term fiscal imbalance, it becomes even more critical that we help with this challenge by identifying opportunities for cost-savings and for improving programs to ensure that every dollar counts."

Testimony issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS)—the agency that administers Medicare—has made progress in implementing several key strategies GAO identified in prior work as helpful in protecting Medicare from fraud; however, some actions that could help combat fraud remain incomplete."