Testimony issued by the Government Accountability Office with an abstract that begins "As GAO and others have reported, the use of information technology (IT) has enormous potential to help improve the quality of health care and is important for improving the performance of the U.S. health care system. Given its role in providing health care, the federal government has been urged to take a leadership role to improve the quality and effectiveness of health care, and it has been working to promote the nationwide use of health IT for a number of years. However, achieving widespread adoption and implementation of health IT has proven challenging, and the best way to accomplish this transition remains subject to much debate. At the committee's request, this testimony discusses important issues identified by GAO's work that have broad relevance to the successful implementation of health IT to improve the quality of health care. To develop this testimony, GAO relied largely on its previous work on federal health IT activities."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Missouri River reservoir system is a critical national resource that provides a variety of benefits, including navigation, flood control, irrigation, hydropower, municipal and industrial water supply, recreation, and fish and wildlife habitat. The U.S. Army Corps of Engineers (Corps) is responsible for operating the Missouri River system to serve these congressionally authorized purposes. Between 1933 and 1964, the Corps built six dams on the Missouri River to serve the water resource needs within the Missouri River basin. The resulting reservoirs form a series of lakes from Montana to the South Dakota-Nebraska border. The Corps manages the system of dams and reservoirs according to the water control plan presented in its Missouri River Mainstem Reservoir System Master Water Control Manual, which was first published in 1960 and most recently revised in 2006. The master manual provides water control criteria for the reservoir system for a spectrum of anticipated runoff conditions. Annual operating plans based on these criteria provide detailed reservoir regulation for each operating year. Four states, Iowa, Nebraska, Kansas, and Missouri, are adjacent to the Missouri River and are served by barge and other vessel traffic along …

A letter report issued by the General Accounting Office with an abstract that begins "Social Security is an important social insurance program affecting virtually every American family. It represents a foundation of the nation's retirement income system and provides millions of Americans with disability insurance and survivors' benefits. Over the long term, as the baby boom generation retires, Social Security's financing shortfall presents a major solvency and sustainability challenge. Numerous reform proposals have been put forward in recent years, and in December 2001 a commission appointed by the President presented three possible reform models. Senator Breaux, Chairman of the Senate Special Committee on Aging, asked GAO to use its analytic framework to evaluate the Commission's models. This framework consists of three criteria: (1) the extent to which a proposal achieves sustainable solvency and how it would affect the economy and the federal budget; (2) the balance struck between the twin goals of income adequacy and individual equity; and (3) how readily such changes could be implemented, administered, and explained to the public."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on: (1) the status of the proposed alliances to be formed by the six largest U.S. airlines; (2) the potential beneficial and harmful effects on consumers; and (3) the authority of the Department of Justice (DOJ) and the Department of Transportation (DOT) to review these alliances and the status of their reviews."

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO investigated: (1) the Indian Health Service (IHS) award of Indian Health Professions Scholarships (graduate scholarships) pursuant to 25 U.S.C. section 1613a of the Indian Health Care Improvement Act."

A letter report issued by the General Accounting Office with an abstract that begins "The federal government is dramatically changing the way it purchases goods and services by relying more on judgment and initiative versus rigid rules for making purchasing decisions. Congress has enacted a series of reforms to help the government adapt to this environment. GAO was asked to assess strategies agencies are using to ensure that their acquisition workforces are receiving the training needed to operate in a changing business environment. In doing so, GAO looked at the General Services Administration (GSA), the National Aeronautics and Space Administration (NASA), and the Department of Defense (DOD). GAO also looked at the Federal Aviation Administration (FAA) because it is exempt from federal acquisition laws, giving it greater flexibility and discretion."

Correspondence issued by the General Accounting Office with an abstract that begins "This report contains information on (1) the results of evaluations on the long-term effectiveness of the Drug Abuse Resistance Education program (DARE) elementary school curriculum in preventing illicit drug use among children and (2) federal efforts to identify programs that are effective in preventing illicit drug use among children."

A letter report issued by the Government Accountability Office with an abstract that begins "Over the last 50 years, the composition and work patterns of the American household have changed dramatically. During this period, the proportion of unmarried and never-married individuals in the population increased steadily as couples chose to marry at later ages and live together prior to marriage. At the same time, the proportion of single-parent households more than doubled. These trends were more pronounced for individuals with lower levels of income and education and for certain racial and ethnic groups. Over the same period, labor force participation among married women nearly doubled."

A letter report issued by the Government Accountability Office with an abstract that begins "The Food and Drug Administration (FDA) within the Department of Health and Human Services (HHS) is responsible for oversight of medical devices sold in the United States. Regulations place devices into three classes, with class III including those with the greatest risk to patients. Unless exempt by regulation, new devices must clear FDA premarket review via either the 510(k) premarket notification process, which determines if a new device is substantially equivalent to another legally marketed device, or the more stringent premarket approval (PMA) process, which requires the manufacturer to supply evidence providing reasonable assurance that the device is safe and effective. Class III devices must generally obtain an approved PMA, but until FDA issues regulations requiring submission of PMAs, certain types of class III devices may be cleared via the 510(k) process. The FDA Amendments Act of 2007 mandated that GAO study the 510(k) process. GAO examined which premarket review process--510(k) or PMA--FDA used to review selected types of device submissions in fiscal years 2003 through 2007. GAO reviewed FDA data and regulations, and interviewed FDA officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The President's New Way Forward in Iraq identified Iraq's inability to spend its resources to rebuild infrastructure and deliver essential services as a critical economic challenge to Iraq's self-reliance. Further, Iraq's ability to spend its $10.1 billion capital projects budget in 2007 was one of the 18 benchmarks used to assess U.S. progress in stabilizing and rebuilding Iraq. This report (1) examines data the U.S. embassy used to determine the extent to which the government of Iraq spent its 2007 capital projects budget, (2) identifies factors affecting the Iraqi government's ability to spend these funds, and (3) describes U.S. government efforts to assist the Iraqi government in spending its capital projects funds. For this effort, GAO reviewed Iraqi government budget data and information on provincial spending collected by the U.S. Provincial Reconstruction Teams. GAO also interviewed officials from the departments of the Treasury, Defense, State, and other agencies and organizations."

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

Testimony issued by the Government Accountability Office with an abstract that begins "GAO's work at four VAMCs found that these VAMCs did not always follow VHA requirements for documenting open-market purchases of surgical implants. Specifically:"

A letter report issued by the Government Accountability Office with an abstract that begins "The Administrative Procedure Act established unique conditions for administrative law judges' (ALJ) hiring and employment to protect their decisional independence. However, the potential for a wave of retirements and other events have focused attention on how ALJs are hired and managed. In response to the Consolidated Appropriations Act of 2008, this report examines, among other things, (1) the process for hiring ALJs and selected agencies' observations of the process; (2) ALJs' retirement eligibility and retirement issues; (3) and agency managers' reported ALJ performance management practices and stakeholders' views of these practices. To address these objectives GAO reviewed relevant statutes, regulations, Office of Personnel Management (OPM) retirement-related data, and other program-related documents, and interviewed officials from OPM, ALJ professional associations, and the two largest federal agencies employing ALJs--the Social Security Administration (SSA) and the Department of Health and Human Services (HHS)."

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Emergency Management Agency (FEMA) has made progress in improving its processes for monitoring NFIP contracts since GAO last reported on these issues in 2008 and 2011. For example, GAO recommended in 2011 that FEMA complete the development and implementation of its revised acquisition process to be consistent with a Department of Homeland Security (DHS) directive. FEMA updated its contract management guidance and revised its handbook for contracting officer's representatives to be consistent with DHS directives. The updated handbook also contained many of the elements identified in a federal guide to best practices for contract administration. Furthermore, the FEMA division that manages the National Flood Insurance Program (NFIP) developed a contract management reference guide that followed FEMA's handbook and federal best practices guidance."

A letter report issued by the General Accounting Office with an abstract that begins "The Social Security Administration's (SSA) Disability Insurance (DI) program paid $50 billion in cash benefits to more than five million disabled workers in 2000. Eligibility for DI benefits is based on whether a person with a severe physical or mental impairment has earnings that exceed the Substantial Gainful Activity (SGA) level. SSA terminates monthly cash benefit payments for beneficiaries who return to work and have earnings that exceed the SGA level--$1,300 per month for blind beneficiaries and $780 per month for all other beneficiaries. GAO found that the SGA level affects the work patterns of only a small proportion of DI beneficiaries. However, GAO also found that the SGA may affect the earnings of some beneficiaries. About 13 percent of those beneficiaries with earnings near the SGA level in 1985 still had earnings near the SGA level in 1995, even though the level was increased during that period. The absence of key information identifying the monthly earnings of beneficiaries, their trial work period status, and whether they are blind limited GAO's ability to definitively identify a relationship between SGA levels and beneficiaries' work patterns. Data limitations …

A letter report issued by the General Accounting Office with an abstract that begins "The Title I program spends $8 billion each year on elementary and secondary education. Although state and local funds account for more than 90 percent of national education expenditures, Title I has been an important source of funding for many poor school districts and schools since 1965. In the 1999-2000 school year, Title I funds were targeted on the basis of numbers and percentages of poor children, but the complex allocation process resulted in differences in actual funding per poor child. When the numbers of children from low-income families shift among states, Title I allocations adjust, but not completely, and a state whose share of the nation's poor children changed from year to year would not necessarily see a corresponding change in its Title I allocation amount. The following two factors account for this: lack of current poverty data and various hold-harmless provisions. GAO found no monetary, statutory, or regulatory incentives for states to target their own funds to children from low-income families. Several policy options could increase Title I funds allocated to states and school districts with high numbers and percentages of poor children. These …

A letter report issued by the General Accounting Office with an abstract that begins "The key to a successful census is meticulous planning as it helps ensure greater cost-effectiveness. However, the 2000 and previous censuses have been marked by poor planning, which unnecessarily raised the costs and risks of those efforts. GAO was asked to (1) review the U.S. Census Bureau's (Bureau) current plans for 2010 and whether they might address shortcomings of the 2000 Census, (2) analyze the Bureau's cost estimates, and (3) review the rigor of the Bureau's 2010 planning process."

Testimony issued by the General Accounting Office with an abstract that begins "Social Security not only represents the foundation of our retirement income system; it also provides millions of Americans with disability insurance and survivors' benefits. As a result, Social Security provides benefits that are critical to the current and future well-being of tens of millions of Americans. However, the system faces both solvency and sustainability challenges in the longer term. In their 2002 report, the Trustees emphasized that while the program's near-term financial condition has improved slightly, Social Security faces a substantial financial challenge in the not-too-distant future that needs to be addressed soon. In essence, the program's long-term outlook remains unchanged. Without reform, Social Security, Medicare, and Medicaid are unsustainable, and the long-term impact of these entitlement programs on the federal budget and the economy will be dramatic. Over the past few years, a wide array of proposals has been put forth to restore Social Security's long-term solvency, and a commission established by the President has presented three models for modifying the current program. The Commission's final report called for a period of discussion lasting at least a year before legislative action is taken to strengthen and restore …

A letter report issued by the General Accounting Office with an abstract that begins "Employers are required to withhold amounts from their employees' salary to cover individual federal income tax, Social Security, and Medicare taxes; match the amounts for Social Security and Medicare taxes; and deposit these amounts with the U.S. Treasury. In fiscal year 2000, the Internal Revenue Service (IRS) collected $1.3 trillion in this manner. Most employers withhold and deposit these taxes as required; however, the amount of unpaid employment taxes, penalty, and interest has grown significantly. IRS data show that in 1997, 1998, 1999, and 2000, delinquent employers owed about $3.2, $3.5, $4.4, and $5 billion, respectively, in unpaid employment taxes, penalties, and interest. The time IRS takes to notify employers of delinquent payment of employment taxes varies. On average, IRS takes about five weeks to initially notify employers regarding employment tax delinquencies after the Form 941 return is received. When employers fail to file Form 941 returns, IRS normally takes from 14 to 28 weeks to notify them of this delinquency. Aside from its usual efforts to educate and inform taxpayers of their responsibilities, IRS has four programs to prevent or reduce employers' tax delinquencies. Two …

A chapter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO examined: (1) the risk of lead poisoning faced by young children served by federal health care programs; (2) the extent to which children served by these programs have been screened for this condition; (3) key reasons why screenings may not be occurring; and (4) problems that federal health care programs face in ensuring that children who have harmful lead levels in their blood receive timely follow-up treatment and other services."

Other written product issued by the Government Accountability Office with an abstract that begins "This report presents the highlights of GAO's fiscal year 2008 Performance and Accountability Report. The Government Accountability Office, the audit, evaluation, and investigative arm of the Congress, exists to support the Congress in meeting its constitutional responsibilities and to help improve the performance and accountability of the federal government for the American people. GAO examines the use of public funds; evaluates federal programs and policies; and provides analyses, recommendations, and other assistance to help the Congress make informed oversight, policy, and funding decisions. To fulfill its mission, GAO organizes and manages its resources to support four broad strategic goals. These include helping to address challenges to the well being and economic security of the American people, U.S. national and homeland security efforts, and modernizing government to meet current and emerging issues. Strategic goal 4 is an internal goal that focuses on enhancing GAO's business and administrative processes through investments in human capital, financial management, information technology, and various processes and systems needed to support the agency and the Congress. GAO maintains a workforce of highly trained professionals across a breadth of academic and scientific disciplines. About …

A letter report issued by the General Accounting Office with an abstract that begins "Lockbox banks are commercial banks that process certain taxpayer receipts on behalf of the Internal Revenue Service (IRS). Following an incident at a lockbox site during 2001, which involved the loss and destruction of about 78,000 tax receipts totaling more than $1.2 billion, the Senate Committee on Finance asked GAO to examine whether (1) provisions of the contracts under which lockbox banks operate address previously identified problems or might contribute to mishandling of tax receipts, (2) oversight of lockbox banks is adequate, (3) internal controls are sufficient, and (4) IRS and Treasury's Financial Management Service (FMS) had considered the costs and benefits of contracting out the functions performed by lockbox banks."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO determined: (1) whether the demand for recalled magistrate and bankruptcy judges has exceeded the number of judges available to serve in recalled positions; (2) whether the courts that recalled judges had judgeship vacancies or higher than average weighted case filings; and (3) the approximate 1-year cost savings associated with using a recalled judge rather than filling a full-time judgeship position."

A letter report issued by the General Accounting Office with an abstract that begins "Trade ministers from 146 members of the World Trade Organization (WTO), representing 93 percent of global commerce, convened in Cancun, Mexico, in September 2003. Their goal was to provide direction for ongoing trade negotiations involving a broad set of issues that included agriculture, nonagricultural market access, services, and special treatment for developing countries. These negotiations, part of the global round of trade liberalizing talks launched in November 2001 at Doha, Qatar, are an important means of providing impetus to the world's economy. The round was supposed to be completed by January 1, 2005. However, the Cancun Ministerial Conference ultimately collapsed without ministers reaching agreement on any of the key issues. GAO was asked to analyze (1) the divisions on key issues for the Cancun Ministerial Conference and how they were dealt with at Cancun and (2) the factors that influenced the outcome of the Cancun Ministerial Conference."