Correspondence issued by the General Accounting Office with an abstract that begins "Specialty hospitals represent a small but growing segment of the health care industry. These hospitals specialize in providing care for certain conditions, such as cardiac care, or performing certain procedures, such as orthopedic surgery. Specialty hospitals are not an entirely new phenomenon, as children's and other types of specialty hospitals have existed for decades. Consequently, it is challenging to distinguish between the old and new types of specialty hospitals. One aspect that sets apart the newer genre of specialty hospitals is that many are owned, in part, by the physicians who work in them. Advocates contend that, because of their focused mission, specialty hospitals can provide high-quality specialty services more efficiently than general hospitals. Because specialty hospitals can tailor their facilities and resources to best fit the needs of certain types of patients, individuals treated in such hospitals may enjoy relatively greater convenience and comfort. Specialty hospitals may also offer physicians financial and work environment advantages. Advocates have stated that the focused mission and dedicated resources of specialty hospitals allow physicians to treat more patients than they could in general hospitals. Physicians may gain financially from this increased …

Correspondence issued by the General Accounting Office with an abstract that begins "In October 2002, we reported the results of our audit of selected internal control activities at three military treatment facilities: Eisenhower Army Medical Center, Augusta, Georgia; Naval Medical Center-Portsmouth, Portsmouth, Virginia; and Wilford Hall Air Force Medical Center, San Antonio, Texas. As part of our work for that report, we requested data files of all patients who had been admitted, treated as outpatients, or received pharmaceutical benefits during fiscal year 2001. Despite considerable effort by the three facilities, only Wilford Hall Air Force Medical Center was able to provide a file of beneficiaries who received pharmaceuticals during the year. We compared this file to data in the Social Security Administration's (SSA) Death Master File as a technique to identify instances of potential fraud or abuse. For Wilford Hall, we identified 41 cases in which a prescription was ordered for an individual after the date of his or her death as recorded in the SSA Death Master File. Congress requested that we determine whether individuals fraudulently obtained pharmaceuticals or other health benefits by assuming the identity of a dead person, and, if so, to identify the specific breakdowns in …

Correspondence issued by the General Accounting Office with an abstract that begins "In response to a Congressional request, we issued a report in March 2003 on the Department of Defense's (DOD) strategic planning efforts for civilian personnel at DOD and selected defense components, including the four military services and two defense agencies. In that report we made recommendations to the Secretary of Defense to strengthen civilian human capital planning, including integration with military personnel and sourcing initiatives. DOD's response to our March 2003 report and recommendations were received too late to be included in that report. To provide our perspective on DOD's comments, we briefly summarize our March 2003 report's objectives, results, and recommendations and DOD's comments, along with our evaluation of the comments. DOD's civilian employees play key roles in such areas as defense policy, intelligence, finance, acquisitions, and weapon systems maintenance. Although downsized 38 percent between fiscal years 1989 and 2002, this workforce has taken on greater roles as a result of DOD's restructuring and transformation. Responding to congressional concerns about the quality and quantity of, and the strategic planning for, the civilian workforce, we determined the following for DOD, the military services, and selected defense agencies (the …

Correspondence issued by the General Accounting Office with an abstract that begins "Our June 2000 report Securities Arbitration: Actions Needed to Address Problem of Unpaid Awards revealed that, although investors had won a majority of awards against brokers, a high proportion of those awards had not been paid. Nearly all of the unpaid awards involved cases decided in the National Association of Securities Dealer's (NASD) arbitration program and most involved brokers that had left the securities industry. A year later we reported on limited data suggesting that the rate of unpaid awards had declined. However, we noted that given the short time period that the data covered, regulators needed to continue monitoring the payment of the awards to determine whether additional steps need to be taken. Arbitration attorneys and claimants have also expressed concern about the timeliness of NASD's updating of arbitrator disclosure information, which can be used by the parties in arbitration to judge the competence and objectivity of arbitrators, and with NASD's ability to remove arbitrators from cases if conflicts arise. In addition, arbitration attorneys also expressed concern about the use of motions to dismiss and motions for summary judgment to terminate NASD-administered arbitration cases. This report responds …

A statement of record issued by the General Accounting Office with an abstract that begins "Floods have been, and continue to be, the most destructive natural hazard in terms of economic loss to the nation. The National Flood Insurance Program is a key component of the federal government's efforts to minimize the damage and financial impact of floods. The program identifies flood-prone areas of the country, makes flood insurance available in the nearly 20,000 communities that participate in the program, and encourages flood-plain management efforts. Since its inception in 1969, the National Flood Insurance has provided $12 billion in insurance claims to owners of flood-damaged properties, and its building standards are estimated to save $1 billion annually. The program has been managed by the Federal Emergency Management Agency, but along with other activities of the agency, it was recently placed into the Department of Homeland Security. GAO has issued a number of reports on the flood insurance program and was asked to discuss the current challenges to the widespread success of the program."

Correspondence issued by the General Accounting Office with an abstract that begins "The U.S. Marshal Service was created by the first Congress in the Judiciary Act of 1789. U.S. Marshals were placed in each federal judicial district and were given broad authority to support the federal courts and to carry out all lawful orders issued by judges, Congress, and the President. Early duties of U.S. Marshals included taking the census, distributing presidential proclamations, protecting the borders, and making arrests. Beginning in the late nineteenth century, some responsibilities of U.S. Marshals were transferred to newly created federal agencies, including the U.S. Census Bureau, Immigration and Naturalization Service, and Federal Bureau of Investigation. Today, the primary responsibilities of U.S. Marshals include protecting federal judges and witnesses, transporting federal prisoners, apprehending federal fugitives, and managing assets seized from criminal enterprises. We obtained information on the (1) U.S. Marshals' appointment process and, for comparison, the processes used by the Bureau of Alcohol, Tobacco, and Firearms (ATF); Drug Enforcement Administration (DEA); and Internal Revenue Service-Criminal Investigation (IRS-CI) to select senior field supervisors; (2) experience, education and diversity of U.S. Marshalls and senior field supervisors at the ATF, DEA, and IRS-CI; (3) authority of the Director …

Correspondence issued by the General Accounting Office with an abstract that begins "The electromagnetic radio frequency spectrum is critical to the development and operation of a variety of military systems such as radios, radars, and satellites. Due to the changing nature of warfighting, more and more military systems depend on the spectrum to guide precision weapons and obtain information superiority. In recent years, demand for the spectrum increased with advances in commercial technology. This demand has led to competition between government and nongovernment users, making spectrum management vital to prevent harmful interference and to promote spectrum efficiency. With these goals in mind, the Department of Defense (DOD) has long-standing policies and procedures that require system developers and acquirers to consider and deal with spectrum supportability knowledge early in the development and acquisition of systems. Early assessment of spectrum needs provides DOD the opportunity to identify, and therefore, better manage program and operational risks. DOD policy requires developers of spectrum dependent systems to obtain certification before assumption of contractual obligations for the full-scale development, production or procurement of those systems. Senate Report 107-151 and House Report 106-945 required us to assess DOD's spectrum management process. We focused our assessment on (1) …

Correspondence issued by the General Accounting Office with an abstract that begins "Weaknesses in the Department of Housing and Urban Development's (HUD) financial management systems have been a long-standing challenge for the department and have contributed to our designating two of its major programs areas as high-risk and the financial management information systems in particular as a major management challenge. While some progress has been made, both GAO and the HUD Office of the Inspector General (IG) have reported extensively on weaknesses related to HUD's financial management systems. In audits of HUD's consolidated financial statements, the IG has consistently identified several material internal control weaknesses resulting from inadequate financial management systems. In recent audit reports, the HUD OIG also noted that the completion of the development of adequate financial management systems is the most critical need faced by HUD in improving its financial management control environment. Responsive financial management systems are particularly critical to HUD's ability to meet its mission, deliver key services, and establish sufficient management control over its operations. In light of these issues, Congress asked that we (1) summarize HUD's past efforts to implement an integrated financial management system, (2) identify the challenges HUD faces with its …

Guidance issued by the General Accounting Office with an abstract that begins "This publication is superseded by GAO-10-846G, Organizational Transformation: A Framework for Assessing and Improving Enterprise Architecture Management (Version 2.0), August 2010. Effective use of enterprise architectures is a recognized hallmark of successful public and private organizations. For over a decade, GAO has promoted the use of architectures, recognizing them as a crucial means to a challenging goal: agency operational structures that are optimally defined, in both business and technological environments. The alternative, as GAO's work has shown, is perpetuation of the kinds of operational environments that saddle most agencies today, in which lack of integration among business operations and supporting information technology (IT) resources leads to inefficiencies and duplication. Why are enterprise architectures so important? Metaphorically, an enterprise architecture is to an organization's operations and systems as a set of blue prints is to a building. That is, building blueprints provide those who own, construct, and maintain the building with a clear and understandable picture of the building's uses, features, functions, and supporting systems, including relevant building standards. Further, the building blueprints capture the relationships among building components and govern the construction process. Enterprise architectures provide to people …

Guidance issued by the General Accounting Office with an abstract that begins "In July 2001, the U.S. General Accounting Office (GAO) and the President's Council on Integrity and Efficiency (PCIE) issued the GAO/PCIE Financial Audit Manual (FAM). The FAM provides guidance for financial audits conducted by the Inspector General community, GAO, and their contractors. The FAM is a key part in enhancing accountability over taxpayer-provided resources. GAO and the PCIE are committed to keeping the FAM current and intend to prepare updates as needed. With this goal in mind, a GAO/PCIE task force prepared this update to volume II of the FAM, which provides tools to assist the auditor in complying with audit standards ."

Testimony issued by the General Accounting Office with an abstract that begins "We are pleased to be here today as Congress examines Medicare's financial health and consider the budgetary and economic challenges presented by an aging society. The Comptroller General has been particularly attentive to the sustainability challenges faced by the nation's two largest entitlement programs--Medicare and Social Security--for more than a decade since he served as a public trustee for these programs in the early 1990s. The recent publication of the 2003 Trustees' annual report reminds us, once again, that the status quo is not an option for Medicare. If the program stays on its present course, in 10 years Hospital Insurance (HI) Trust Fund outlays will begin to exceed tax receipts, and by 2026 the HI trust fund will be exhausted. It is important to note that trust fund insolvency does not mean the program will cease to exist; program tax revenues will continue to cover a portion of projected expenditures.1 However, Medicare is only part of the broader health care financing problem that confronts both public programs and private payers. The unrelenting growth in health care spending is producing a health care sector that continues to claim …

Testimony issued by the General Accounting Office with an abstract that begins "The Federal Financial Assistance Management Improvement Act of 1999 is one of the most recent in a series of efforts to reform the federal grants management system. The act seeks to improve the effectiveness and performance of Federal financial assistance programs; simplify application and reporting requirements; improve delivery of services to the public; and facilitate greater coordination among those responsible for delivering such services. GAO has a responsibility to evaluate the implementation of this Act by 2005 and will soon begin developing an approach and methodology for the study. This testimony describes the problems fostered by proliferation and fragmentation, which the Act addresses indirectly."

Testimony issued by the General Accounting Office with an abstract that begins "DOD faces growing challenges in carrying out realistic training at installations and training ranges--land, air, and sea--because of encroachment by outside factors. These include urban growth, competition for radio frequencies or airspace, air or noise pollution, unexploded ordnance and munition components, endangered species habitat, and protected marine resources. Building on work reported on in 2002, GAO assessed (1) the impact of encroachment on training ranges, (2) DOD's efforts to document the effect on readiness and cost, and (3) DOD's progress in addressing encroachment."

Testimony issued by the General Accounting Office with an abstract that begins "In response to concerns that some children were languishing in temporary foster care, Congress enacted the Adoption and Safe Families Act of 1997 (ASFA) to help states move children in foster care more quickly to safe and permanent homes. ASFA contained two key provisions: (1) the "fast track" provision allows states to bypass efforts to reunify families in certain egregious situations and (2) the "15 of 22" provision requires states, with a few exceptions, to file a petition to terminate parental rights (TPR) when a child has been in foster care for 15 of the most recent 22 months. Representative Wally Herger, Chairman of the House Ways and Means Subcommittee on Human Resources asked GAO to review (1) changes in outcomes for children in foster care since ASFA was enacted, (2) states' implementation of ASFA's fast track and 15 of 22 provisions, (3) states' use of two new adoption related funds provided by ASFA, and (4) states' initiatives to address barriers to achieving permanency"

Testimony issued by the General Accounting Office with an abstract that begins "GAO is a key source of objective information and analyses and, as such, plays a crucial role in supporting congressional decision-making and helping improve government for the benefit of the American people. This testimony focuses on GAO's (1) fiscal year 2002 performance and results, (2) efforts to maximize our effectiveness, responsiveness and value, and (3) our budget request for fiscal year 2004 to support the Congress and serve the American public."

Testimony issued by the General Accounting Office with an abstract that begins "The Rail Passenger Service Act of 1970 created Amtrak to provide intercity passenger rail service because existing railroads found such service unprofitable. Amtrak operates a 22,000-mile network, primarily over freight railroad tracks, providing service to 46 states and the District of Columbia. Most of Amtrak's passengers travel on the Northeast Corridor, which runs between Boston, Massachusetts, and Washington, D.C. On some portions of the Corridor, Amtrak provides high-speed rail service (up to 150 miles per hour). Since its inception, Amtrak has struggled to earn revenues and run an efficient operation. Recent years have seen Amtrak continue to struggle financially. In February 2003, Amtrak reported that it would need several billion dollars from the federal government over the next few years to sustain operations. However, some have indicated that there needs to be a fundamental reassessment of how intercity passenger rail is structured and financed. Options raise questions about whether or not Amtrak should be purely an operating company, whether competition should be introduced for providing service, and if states should assume a greater financial role in the services that are provided."

Testimony issued by the General Accounting Office with an abstract that begins "Improvement and innovation based on highway research have long been important to the highway system. The Federal Highway Administration (FHWA) is the primary federal agency involved in highway research. Throughout the past decade, FHWA received hundreds of millions of dollars for its surface transportation research program, including nearly half of the Department of Transportation's approximate $1 billion budget for research in fiscal year 2002. Given the expectations of highway research and the level of resources dedicated to it, it is important to know that FHWA is conducting high quality research that is relevant and useful. In May 2002, GAO issued a report on these issues and made recommendations to FHWA, which the agency agreed with, aimed at improving its processes for setting research agendas and evaluating its research efforts. GAO was asked to testify on (1) best practices for developing research agendas and evaluating research outcomes for federal research programs; (2) how FHWA's processes for developing research agendas align with these best practices; and (3) how FHWA's processes for evaluating research outcomes align with these best practices."

Testimony issued by the General Accounting Office with an abstract that begins "Department of Homeland Security's (DHS) Immigration Interior Enforcement Strategy's implementation is now the responsibility of the Bureau of Immigration and Customs Enforcement (BICE). This strategy was originally created by the Immigration and Naturalization Service (INS). In the 1990s, INS developed a strategy to control illegal immigration across the U.S. border and a strategy to address enforcement priorities within the country's interior. In 1994, INS's Border Patrol issued a strategy to deter illegal entry. The strategy called for "prevention through deterrence"; that is, to raise the risk of being apprehended for illegal aliens to a point where they would consider it futile to try to enter. The plan called for targeting resources in a phased approach, starting first with the areas of greatest illegal activity. In 1999, the INS issued its interior enforcement strategy designed to deter illegal immigration, prevent immigration-related crimes, and remove those illegally in the United States. Historically, Congress and INS have devoted over five times more resources in terms of staff and budget on border enforcement than on interior enforcement."

Testimony issued by the General Accounting Office with an abstract that begins "There is widespread agreement that the basic approach to federal pay is broken and that it needs to be more market- and performance-based. Doing so will be essential if the federal government is to maximize its performance and assure accountability for the benefit of the American people. While there will be debate and disagreement about the merits of individual reform proposals, all should be able to agree that a performance management system with adequate safeguards, including reasonable transparency and appropriate accountability mechanisms in place, must serve as the fundamental underpinning of any fair, effective, and appropriate pay reform. At the request of the Subcommittee on Civil Service and Agency Organization, House Committee on Government Reform, GAO discussed the key practices for effective performance management that federal agencies should consider as they develop and implement performance management systems as part of any pay reform."

Testimony issued by the General Accounting Office with an abstract that begins "Since the Government Performance and Results Act (GPRA) was enacted in 1993, federal agencies increasingly have been expected to link strategic plans and budget structures with program results. The current administration has taken several steps to strengthen and further the performance-resource linkage by making budget and performance integration one of its five management initiatives included in the President's Management Agenda. GAO has reported and testified numerous times on agencies' progress in making clearer connections between resources and results and how this information can inform budget deliberations. The administration's use of the Program Assessment Rating Tool (PART) for the fiscal year 2004 President's budget and further efforts in fiscal year 2005 to make these connections more explicit, have prompted our examination of what can and cannot be expected from performance budgeting."

Testimony issued by the General Accounting Office with an abstract that begins "Recently, the Small Business Administration's (SBA) auditors withdrew their unqualified audit opinions on SBA's fiscal year 2000 and 2001 financial statements and issued disclaimers of opinion. The auditors also issued a disclaimer of opinion on SBA's fiscal year 2002 financial statements. This turn of events was primarily due to flaws in the way SBA accounted for its loan sales and for the remaining portfolio. There were also several other issues affecting SBA's fiscal year 2002 audit, including key internal control weaknesses and systems that did not substantially comply with the Federal Financial Management Improvement Act. The information GAO presents in this testimony, which is discussed in greater detail in our January 2003 report, Small Business Administration: Accounting Anomalies and Limited Operational Data Make Results of Loan Sales Uncertain (GAO-03-87), is intended to assist Congress in assessing the current status of financial accountability at SBA."

Testimony issued by the General Accounting Office with an abstract that begins "Since 1997, federal spending on services has grown 11 percent and now represents more than 60 percent of contract spending governmentwide. Several significant changes in the government--including funding for homeland security--are expected to further increase spending on services. Adjusting to this new environment has proven difficult. Agencies need to improve in a number of areas: sustaining executive leadership, strengthening the acquisition workforce, and encouraging innovative contracting approaches. Improving these areas is a key goal of the proposed Services Acquisition Reform Act (SARA)."

Testimony issued by the General Accounting Office with an abstract that begins "The Air Force is developing the F/A-22 aircraft to replace its fleet of F-15 air superiority aircraft. The F/A-22 is designed to be superior to the F-15 by being capable of flying at higher speeds for longer distances, less detectable, and able to provide the pilot with substantially improved awareness of the surrounding situation. The National Defense Authorization Act for Fiscal Year 1998 requires us to annually assess the F/A-22 development program and determine whether the program is meeting key performance, schedule, and cost goals. We have issued six of these annual reports to Congress. We have also reported on F/A-22 production program costs over the last 3 years. Most recently, we reported on F/A-22 production and development in February and March 2003 respectively. This testimony summarizes our work on the F/A-22 program, covering performance, cost, and scheduling issues."

Testimony issued by the General Accounting Office with an abstract that begins "GAO is required by law to audit the consolidated financial statements of the U.S. government. Timely, accurate, and useful financial information is essential for making informed operating decisions day to day, managing the federal government's operations more efficiently and effectively, meeting the goals of federal financial management reform legislation, supporting results-oriented management approaches, and ensuring accountability on an ongoing basis. The importance of such information is heightened by the unprecedented demographic challenge of an aging population. Federal spending on the elderly, health care, and new homeland security and defense commitments increases the need to look at competing claims on the budget and at new priorities. Over the past year, the Principals of the Joint Financial Management Improvement Program continued efforts to accelerate progress in financial management reform. Also, President Bush has implemented the President's Management Agenda to provide direction to, and closely monitor, management reform across government, which encompasses improved financial management performance. To effectively implement federal financial management reform, sustained leadership and oversight are essential."