A letter report issued by the Government Accountability Office with an abstract that begins "Spending on long-term care services--about $193 billion in 2004--is expected to rise. In 2000, Congress passed the Long-Term Care Security Act, requiring the federal government to offer long-term care insurance. To do so, the Office of Personnel Management (OPM) contracted with Long Term Care Partners LLC (Partners) to create the Federal Long Term Care Insurance Program. This is the second of two reports required by the act on the competitiveness of the federal program. GAO's March 31, 2006, report, Long-Term Care Insurance: Federal Program Compared Favorably with Other Products, and Analysis of Claims Trend Could Inform Future Decisions (GAO-06-401), found that the federal program's benefits and premiums compared favorably with other plans, but enrollment and claims experience--the amount and number of claims payments--were lower than Partners expected. In this report, GAO compared the federal program's profit structure and marketing efforts with those of other plans and updated its analysis of the program's claims experience. GAO reviewed the contract between OPM and Partners and interviewed OPM, Partners, and insurance carrier officials, as well as actuaries and industry experts. GAO also analyzed data on claim payments for the …

A letter report issued by the Government Accountability Office with an abstract that begins "Although recycling can generate environmental and economic benefits, the national recycling rate has increased only slightly since 2000, according to the Environmental Protection Agency (EPA). While local governments have the primary role in operating recycling programs, EPA and the Department of Commerce (Commerce) have some legal responsibilities for encouraging recycling. GAO was asked to (1) identify key practices cities are using to increase recycling, (2) describe what EPA and Commerce are doing to encourage recycling, and (3) identify federal policy options that could help increase recycling. GAO interviewed recycling coordinators in 11 large cities about key practices and 13 additional recycling stakeholders about policy options. GAO selected both groups based on geographic representation and recycling expertise, among other factors."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) provides health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through a managed care option that requires enrollment and the use of civilian provider networks, which are developed and managed by contractors. Beneficiaries who do not enroll may receive care through TRICARE Standard, a fee-for-service option, using nonnetwork civilian providers or through TRICARE Extra, a preferred provider organization option, using network civilian providers. Nonenrolled beneficiaries in some locations have reported difficulties finding civilian providers who will accept them as patients. The National Defense Authorization Act (NDAA) for fiscal year 2004 directed GAO to provide information on access to care for nonenrolled TRICARE beneficiaries. This report describes (1) how DOD and its contractors evaluate nonenrolled beneficiaries' access to care and the results of these evaluations; (2) impediments to civilian provider acceptance of nonenrolled beneficiaries, and how they are being addressed; and (3) how DOD has implemented the NDAA fiscal year 2004 requirements to take actions to ensure nonenrolled beneficiaries' access to care. To address these objectives, GAO examined DOD's survey results and DOD and contractor documents and interviewed DOD …

A letter report issued by the Government Accountability Office with an abstract that begins "Average health insurance premiums for plans participating in the Federal Employees Health Benefits Program (FEHBP) have risen each year since 1997. These growing premiums result in higher costs to the federal government and plan enrollees. The Office of Personnel Management (OPM) oversees FEHBP, negotiating benefits and premiums and administering reserve accounts that may be used to cover plans' unanticipated spending increases. GAO was asked to evaluate the nature and extent of premium increases. To do this, GAO examined (1) FEHBP premium trends compared with those of other purchasers, (2) factors contributing to average premium growth across all FEHBP plans, and (3) factors contributing to differing trends among selected FEHBP plans. GAO reviewed data provided by OPM relating to FEHBP premiums and factors contributing to premium growth. For comparison purposes, GAO also examined premium data from the California Public Employees' Retirement System (CalPERS) and surveys of other public and private employers. GAO also interviewed officials from OPM and eight FEHBP plans with premium growth that was higher than average, and six FEHBP plans with premium growth that was lower than average to discuss premium growth trends and …

A letter report issued by the Government Accountability Office with an abstract that begins "A key provision of the Cash Management Improvement Act (CMIA) of 1990 (P.L. 101-453), as amended, requires the federal government and the states to minimize the time between transfer of federal funds and payments made by states for federal grant program purposes. Concerns were expressed by representatives of local government subgrantees that more flexibility was needed in the receipt of federal funding for first responders. Congress exempted certain first responder grants from this CMIA provision in the Department of Homeland Security's (DHS) fiscal years 2005 and 2006 appropriations acts. Under the exemption, grantees can receive cash advance funding and hold such funds for extended periods of time prior to payment. GAO was asked to (1) assess whether this CMIA provision, prior to its exemption in fiscal year 2005, had prevented DHS grant recipients from receiving first responder grant funds when such funds were needed; and (2) identify any key fiscal and accountability implications of the exemption."

Correspondence issued by the Government Accountability Office with an abstract that begins "Spending on outpatient prescription drugs in Medicaid--the joint federal-state program that finances medical services for certain low-income adults and children--has accounted for a substantial and growing share of Medicaid expenditures. Medicaid's total spending on outpatient prescription drugs grew from $4.6 billion in fiscal year 1990 to $40 billion in fiscal year 2004--or from 7.0 to 14.2 percent of Medicaid's total expenditures for medical care. State Medicaid programs do not directly purchase prescription drugs; instead, they reimburse retail pharmacies for covered outpatient prescription drugs dispensed to Medicaid beneficiaries. For some outpatient multiple-source prescription drugs, state Medicaid programs may only receive federal matching funds for reimbursements up to a maximum amount known as a federal upper limit (FUL). Required by law as a cost-containment strategy, FULs are calculated as 150 percent of the lowest price for a drug, from among the prices published nationally in three drug pricing compendia. State Medicaid programs have the authority to determine their own reimbursements to retail pharmacies6 for covered outpatient multiple-source prescription drugs, as long as those reimbursements do not exceed established FULs in the aggregate. The Deficit Reduction Act of 2005 (DRA) included …

A letter report issued by the Government Accountability Office with an abstract that begins "During the evacuation of New Orleans in response to Hurricane Katrina in 2005, many of those who did not own a vehicle and could not evacuate were among the over 1,300 people who died. This raised questions about how well state and local governments, primarily responsible for disaster planning, integrate transportation-disadvantaged populations into such planning. GAO assessed the challenges and barriers state and local officials face; how prepared these governments are and steps they are taking to address challenges and barriers; and federal efforts to provide evacuation assistance. GAO reviewed evacuation plans; Department of Homeland Security (DHS), Department of Transportation (DOT), and other studies; and interviewed officials in five major city and four state governments."

A letter report issued by the Government Accountability Office with an abstract that begins "The Workforce Investment Act of 1998 (WIA) required that many federal workforce employment and training programs for low-income individuals, the unemployed, and other job seekers provide their services through a streamlined delivery system. WIA also promoted greater employer engagement in this delivery system by, among other things, calling for it to help meet employers' workforce needs with services provided through one-stop centers. In 2005, we found that about half of employers were aware of their local one-stop centers. However, questions remained about how employers use them. In this report, GAO addressed (1) the extent to which employers, both large and small, hire their employees through one-stops; (2) the extent to which these employers view one-stop services as useful; and (3) factors that may affect one-stop service to employers. To answer these questions we surveyed employers who had used the one-stop system, visited eight one-stops, and talked to one-stop and Labor officials."

Correspondence issued by the Government Accountability Office with an abstract that begins "On September 7, 2006, GAO testified before the Subcommittee on Defense, Committee on Appropriations, on recent trends in Department of Defense (DOD) contracting. Specifically, GAO testified about practices that undermine DOD's ability to establish sound business arrangements, particularly those involving the selection and oversight of DOD's contractors and their performance. This correspondence responds to a number of post-hearing questions relating to various issues, including measures that DOD can employ to ensure better contracting outcomes."

A letter report issued by the Government Accountability Office with an abstract that begins "Despite periodic price shocks and related energy crises, the United States is even more dependent on crude oil and natural gas than it was almost 30 years ago. And, without dramatic change, the nation will become ever more reliant on imported oil and natural gas with attendant threats to national security. The nation has also become concerned about global warming, which has been linked to carbon dioxide emissions from burning coal and oil. To address these concerns, the Department of Energy (DOE) has funded research and development (R&D) on advanced renewable, fossil, and nuclear energy technologies. GAO examined the (1) R&D funding trends and strategies for developing advanced energy technologies, (2) key barriers to developing and deploying advanced energy technologies, and (3) efforts of the states and six selected countries to develop and deploy advanced energy technologies. GAO reviewed DOE R&D budget data and strategic plans and interviewed DOE officials and scientists, U.S. industry executives, independent experts, and state and foreign government officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Each year, billions of dollars in dual-use items--items that have both commercial and military applications--as well as defense items are exported from the United States. To protect U.S. interests, the U.S. government controls the export of these items. A key function in the U.S. export control system is enforcement, which aims to prevent or deter the illegal export of controlled items. This report describes the roles, responsibilities, and authorities of export control enforcement agencies, identifies the challenges these agencies face, and determines if information on enforcement outcomes is provided to the export control agencies. GAO's findings are based on an examination of statutes, interagency agreements, and procedures; interviews with enforcement officials at selected field locations and headquarters; and an assessment of enforcement information."

A letter report issued by the Government Accountability Office with an abstract that begins "Law enforcement officers (LEOs) within the federal government play a key role in maintaining the safety and security of federal property, employees, and the general public. In this report, we describe the number of LEOs that federal civilian law enforcement components employed as of June 30, 2006; the federal job series classifications the components used to employ LEOs; and the sources of their primary legal authorities. To identify federal components that employ LEOs, we consulted, among other sources, the Federal Citizen Information Center's Cabinet Agencies and Independent Agencies and Commissions Directory; a list of organizations included in the Federal Law Enforcement Training Center (FLETC) 2004-2005 List of Agencies Trained at FLETC; and federal agencies listed in Federal Law Enforcement Officers, 2002, published by the Department of Justice's Bureau of Justice Statistics (BJS). We identified 104 federal civilian law enforcement components and administered two Web-based surveys to each--one survey on the primary authorities and the other survey on the job series classifications. We defined an LEO as an individual authorized to perform any of four specific functions: (1) conduct criminal investigations, (2) execute search warrants, (3) make …

A letter report issued by the Government Accountability Office with an abstract that begins "Rising oil prices, resulting from growth in energy consumption by rapidly developing Asian nations and by most industrialized nations, have increased concern about competition over oil and natural gas resources. In particular, Congress expressed interest in how the United States participates in energy cooperation through international forums. GAO was asked to review: (1) what are the key international energy forums in which the United States pursues energy cooperation, (2) what are some of the key emerging energy market issues that are important for international energy cooperation, and (3) how is the United States addressing these issues through its participation in these forums. GAO's work is based on contacts with agency officials and energy experts and review of documents."

Correspondence issued by the Government Accountability Office with an abstract that begins "On November 16, 2006, GAO testified before the Permanent Subcommittee on Investigations, Committee on Homeland Security and Governmental Affairs, on the results of our audit on the Defense Travel System (DTS). This letter responds to a question from Senator Coburn that we were asked to answer for the record. The question and our response follow."

A letter report issued by the Government Accountability Office with an abstract that begins "Prior GAO reports have identified problems with the Department of Defense's (DOD) management and oversight of contractors supporting deployed forces. GAO issued its first comprehensive report examining these problems in June 2003. Because of the broad congressional interest in U.S. military operations in Iraq and DOD's increasing use of contractors to support U.S. forces in Iraq, GAO initiated this follow-on review under the Comptroller General's statutory authority. Specifically, GAO's objective was to determine the extent to which DOD has improved its management and oversight of contractors supporting deployed forces since our 2003 report. GAO reviewed DOD policies and interviewed military and contractor officials both at deployed locations and in the United States."

A letter report issued by the Government Accountability Office with an abstract that begins "While tens of thousands of manufacturing workers have received services through the Trade Adjustment Assistance (TAA) program, until 2002, farmers and fishermen impacted by imports did not have access to similar assistance. The Trade Act of 2002 (Trade Act) established a new program, TAA for Farmers, administered by the U.S. Department of Agriculture (USDA) to provide technical assistance, a cash payment of up to $10,000 a year, and access to Department of Labor (Labor) training and reemployment services for farmers and fishermen who face significant price declines due to increased imports. The Trade Act provides for up to $90 million each year through fiscal year 2007 for the costs to carry out the program. Trade Act programs are due for reauthorization in 2007. To be eligible for benefits, farmers and fishermen--called producers--must complete a two-part process each year. First, a group of producers of a commodity must submit a petition to USDA on behalf of all producers in one or more states. The petition must demonstrate that the price of the commodity for the most recent marketing year declined by at least 20 percent from the …

A letter report issued by the Government Accountability Office with an abstract that begins "In 2005, over 16 million Bank Secrecy Act (BSA) reports were filed by more than 200,000 U.S. financial institutions. Enacted in 1970, BSA is the centerpiece of the nation's efforts to detect and deter criminal financial activities. Treasury's Financial Crimes Enforcement Network (FinCEN) and the Internal Revenue Service (IRS) play key roles in BSA compliance, enforcement, and data management. GAO was asked to describe FinCEN's and IRS's roles and assess their effectiveness at ensuring BSA compliance and efforts to reengineer BSA data management."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2003, the United States signed Compacts of Free Association with the Federated States of Micronesia (FSM) and the Republic of the Marshall Islands (RMI), amending a 1986 compact with the countries. The amended compacts provide the countries with a combined total of $3.6 billion from 2004 to 2023, with the annual grants declining gradually. The assistance, targeting six sectors, is aimed at assisting the countries' efforts to promote economic advancement and budgetary self-reliance. The Department of the Interior (Interior) administers and oversees the assistance. Complying with a legislative requirement, GAO examined, for fiscal years 2004 through 2006, (1) the FSM's and the RMI's use of compact funds, (2) their efforts to assess progress toward development goals, (3) their monitoring of sector grants and accountability for compact funds, and (4) Interior's administrative oversight of the assistance. GAO visited the FSM and the RMI; reviewed reports; and interviewed officials from the FSM, RMI, and U.S. governments."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) transient lodging programs were established to provide quality temporary facilities for authorized personnel, and reduce travel costs through lower rates than commercial hotels. DOD has approximately 82,000 temporary duty (TDY) and permanent-change-of-station (PCS) rooms worldwide, and reported that it cost about $860 million in appropriated and nonappropriated funds to operate them in fiscal year 2005. While the Army plans to privatize its lodging in the United States, there are concerns as to whether these plans are cost-effective, and how they relate to DOD-wide lodging efforts. GAO was asked to address (1) how each military service and DOD manages, funds, and assesses the performance of its lodging programs to meet short- and long- term needs, and (2) the effect that lodging privatization would have on the costs to the Army and the ability to maintain and recapitalize facilities. GAO is also providing information on DOD's actions to implement prior recommendations regarding the lodging program. GAO obtained data from the Office of the Secretary of Defense, the military services and visited nine military installations."

A letter report issued by the Government Accountability Office with an abstract that begins "Hospitals must meet certain conditions of participation established by the Centers for Medicare & Medicaid Services (CMS) in order to receive Medicare payments. In 2003, most hospitals--over 80 percent--demonstrated compliance with most of these conditions through accreditation from the Joint Commission on Accreditation of Healthcare Organizations (Joint Commission). Established in 1986, Joint Commission Resources, Inc. (JCR), a nonprofit affiliate of the Joint Commission, provides consultative technical assistance services to hospitals. Both organizations acknowledge the need to ensure that JCR's services do not--and are not perceived to--affect the independence of the Joint Commission's accreditation process. GAO was asked to provide information on the relationship between the Joint Commission and JCR. This report describes (1) their organizational relationship, and (2) the significant steps they have taken to prevent the improper sharing of information, obtained through their accreditation and consulting activities, respectively, since JCR was established. GAO reviewed pertinent documents, including conflict-of-interest policies and information about the organizations' financial relationship, and interviewed staff and board members from both organizations, JCR clients, and CMS officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Recognizing the importance of human capital to information technology (IT) and the need to improve the skills of federal IT workers, Congress created the Information Technology Exchange Program (ITEP) as part of the E-Government Act of 2002. ITEP aims to improve federal IT skills through exchanges of staff between the government and the private sector. The Office of Personnel Management (OPM) was required to issue implementing regulations, which it did in September 2005, and to report semiannually to the Congress. OPM's regulations require that each participating agency develop an ITEP plan before proceeding with exchanges. Agencies' opportunity to begin exchanges ends in December 2007. GAO is required to evaluate the program by December 2006. As agreed, GAO's objectives were to determine (1) the status of the program and (2) challenges facing agencies. To address these objectives, GAO analyzed key documents and interviewed OPM, participating agencies, and others."

A letter report issued by the Government Accountability Office with an abstract that begins "In August and September 2005, Hurricanes Katrina and Rita caused unprecedented destruction to property along the Gulf Coast, resulting in billions of dollars of damage claims to the National Flood Insurance Program (NFIP). This report, which we initiated under the authority of the Comptroller General, examines (1) the impact of Hurricanes Katrina and Rita on the NFIP and paid losses by location and property type; (2) the challenges the Federal Emergency Management Agency (FEMA) and others faced in addressing the needs of NFIP claimants and communities; (3) FEMA's methods of monitoring and overseeing claims adjustments; and (4) FEMA's efforts to meet the requirements of the Flood Insurance Reform Act of 2004 to establish policyholder coverage notifications, an appeals process for claimants, and education and training requirements for agents. To conduct these assessments, GAO interviewed FEMA and insurance officials, analyzed claims data, and examined a sample of reports done on the accuracy of claims adjustments."

Correspondence issued by the Government Accountability Office with an abstract that begins "Of the $18.4 billion that Congress appropriated for Iraq relief and reconstruction in fiscal year 2004, the Department of Defense (DOD) received the largest share--$13.5 billion. As of September 30, 2006, DOD had obligated about $13.1 billion and disbursed about $9.7 billion--$5.6 billion for construction, $3.6 billion for nonconstruction (e.g., engineering, procurement, and the delivery of equipment), and about $480 million for related overhead costs. Among the many contracts DOD uses in Iraq, DOD has obligated about $3.7 billion for 12 large-scale, multiple-year design-build contracts for major construction projects. The design-build contracting approach makes one award for both the design and construction of a project, thus eliminating the need for a separate bidding process for the construction phase. To help Congress monitor the current progress and costs of DOD's reconstruction activities in Iraq, this report discusses (1) the status of the current construction work and targeted completion dates and (2) the support costs incurred by the design-build contractors in DOD's construction program."

A letter report issued by the Government Accountability Office with an abstract that begins "In March 2006, the Smithsonian Institution (Smithsonian) announced that it had entered into a 30-year contract with Showtime Networks Inc., (Showtime) to create a digital on-demand television channel. Members of Congress and other interested parties, particularly filmmakers, raised issues about the contract's potential effects on public access to and use of the Smithsonian's collections, its confidential nature, and the process by which the Smithsonian negotiated it. This report discusses (1) the extent to which the Smithsonian followed its internal contracting guidelines, (2) what the Smithsonian gave up and received in return under the contract, (3) the Smithsonian's implementation of the contract, and (4) the contract's potential impact on outside parties. GAO reviewed the contract and pertinent documents, and interviewed Smithsonian and Showtime officials."