Testimony issued by the Government Accountability Office with an abstract that begins "To reduce spending on durable medical equipment (DME) and related items, under federal law the Centers for Medicare & Medicaid Services (CMS) is phasing in, with several rounds of bidding, a competitive bidding program (CBP) for certain DME and other items. Because of numerous concerns, the Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) terminated the CBP round 1 supplier contracts and required CMS to repeat the CBP round 1, the rebid that began in 2009. In November 2009, GAO issued the report Medicare: CMS Working to Address Problems from Round 1 of the Durable Medical Equipment Competitive Bidding Program (GAO-10-27) that documented problems in CMS's implementation of CBP round 1. This statement discusses some of the problems GAO identified and how CMS has or plans to address them in the ongoing CBP rebid bidding process, particularly (1) the bid submission information provided to suppliers, (2) the electronic bid submission system, and (3) the bid disqualification notification process. For the 2009 report, GAO reviewed data provided by CMS and relevant laws and regulations, and interviewed CMS officials. For this statement, GAO also obtained select information on …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses the U.S. Government Accountability Office's (GAO) budget request for fiscal year 2011. In fiscal year 2009, GAO supported congressional decision making and oversight on a range of critical issues, including the government's efforts to help stabilize financial markets and address the most severe recession since World War II. In addition to providing oversight for the 2008 Economic Stabilization Act and the American Recovery and Reinvestment Act of 2009 (Recovery Act), we continued to provide the Congress updates on programs that are at high risk for waste, fraud, abuse, and mismanagement or are in need of broad reform, and delivered advice and analyses on a broad array of pressing domestic and international issues that demand urgent attention and continuing oversight. These include modernizing the regulatory structure for financial institutions and markets to meet 21st century demands; controlling escalating health care costs and providing more effective oversight of medical products; restructuring the U.S. Postal Service to ensure its financial stability; and improving the Department of Defense's management approaches to issues ranging from weapons system acquisitions to accounting for weapons provided to Afghan security forces. Overall, we responded …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses the Department of Defense's (DOD) separation requirements for enlisted servicemembers diagnosed with personality disorders and the military services' compliance with these requirements. DOD requires that all enlisted servicemembers, including those serving in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), be physically and psychologically suitable for military service. Enlisted servicemembers who fail to meet this standard may be involuntarily separated from the military. One psychological condition that can render an enlisted servicemember unsuitable for military service is a personality disorder, which is defined as a long-standing, inflexible pattern of behavior that deviates markedly from expected behavior, has an onset in adolescence or early adulthood, and leads to distress or impairment. Although a personality disorder by itself does not make enlisted servicemembers unsuitable for military service, DOD policy allows for involuntary separation from the military if a servicemember's disorder is severe enough that it interferes with his or her ability to function in the military. DOD data show that from November 1, 2001, through June 30, 2007, about 26,000 enlisted servicemembers were separated from the military because of a personality disorder. Of these …

Other written product issued by the Government Accountability Office with an abstract that begins "Since 1992, GAO has published long-term fiscal simulations showing federal deficits and debt levels under both "Baseline Extended" and an "Alternative" set of assumptions. GAO has regularly updated these twice a year. GAO developed its long-term model in response to a bipartisan request from Members of Congress concerned about the long-term effects of fiscal policy. GAO's simulations provide a broad context for consideration of policy options by illustrating both the importance of taking action and the magnitude of the steps necessary to change the path. They are not intended to suggest particular policy choices that are the prerogative of elected officials but rather to help facilitate a dialog on this important issue. As in the past, GAO shows two simulations: "Baseline Extended" and an "Alternative." Each is run using two different projections for Social Security and the major health entitlements--CBO's baseline and alternative assumptions and the Social Security and Medicare Trustees' (Trustees) intermediate assumptions and projections based on the Centers for Medicare & Medicaid Services Office of the Actuary (CMS Actuary) alternative assumptions. "Baseline Extended" follows the Congressional Budget Office's (CBO) August 2010 baseline estimates for …

Testimony issued by the Government Accountability Office with an abstract that begins "U.S. insular areas face serious economic and fiscal challenges and rely on federal funding to support their governments and deliver critical services. The Department of the Interior, through its Office of Insular Affairs (OIA), provides about $70 million in grants annually, including technical assistance grants, to increase insular area self-sufficiency. In the past, GAO and others have raised concerns regarding insular areas' internal control weaknesses, which increase the risk of grant fund mismanagement, fraud, and abuse. In March 2010, GAO reported on insular area grants (GAO-10-347); this testimony summarizes that report and focuses on (1) whether previously reported internal control weaknesses have been addressed and, if not, to what extent they are prevalent among OIA grant projects, including technical assistance grant projects, as of March 2010; and (2) the extent to which OIA has taken action to improve the implementation and management grant projects, as of March 2010. For the March 2010 report, GAO reviewed a random sample of 173 OIA grant project files and interviewed OIA and insular area officials. For this testimony, GAO conducted additional analysis for the 49 technical assistance grant projects included in the …

Testimony issued by the Government Accountability Office with an abstract that begins "Since 2003, the Future Combat System (FCS) program has been the centerpiece of the Army's efforts to transition to a lighter, more agile, and more capable combat force. In 2009, however, concerns over the program's performance led to the Secretary of Defense's decision to significantly restructure and ultimately cancel the acquisition program. As a result, the Army is outlining a new approach to ground force modernization. This statement outlines the Army's preliminary post-FCS actions and identifies the challenges the Department of Defense (DOD) and the Army must address as they proceed. This testimony is based on GAO's report on the Army's Ground Force Modernization effort released on March 15, 2010. It emphasizes the December 2009 decision to begin low-rate initial production for Increment 1 of the Brigade Combat Team Modernization."

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses oversight of U.S. assistance programs in Afghanistan. Strengthening the Afghan economy through development assistance efforts is critical to the counterinsurgency strategy and a key part of the U.S Integrated Civilian-Military Campaign Plan for Afghanistan. Since fiscal year 2002, the U.S. Agency for International Development (USAID) has awarded over $11.5 billion in support of development assistance programs in Afghanistan. Since 2003, GAO has issued several reports and testimonies related to U.S. security, governance, and development efforts in Afghanistan. In addition to reviewing program planning and implementation, we have focused on efforts to ensure proper management and oversight of the U.S. investment, which are essential to reducing waste, fraud, and abuse. Over the course of this work, we have identified improvements that were needed, as well as many obstacles that have affected success and should be considered in program management and oversight. While drawing on past work relating to U.S. development efforts in Afghanistan, this testimony focuses on findings in our most recent report released yesterday on the USAID's management and oversight of its agricultural programs in Afghanistan. It will address (1) the challenges the United States …

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security's (DHS) Domestic Nuclear Detection Office (DNDO) is charged with developing and acquiring equipment to detect nuclear and radiological materials to support federal efforts to combat nuclear smuggling. Also within DHS, Customs and Border Protection (CBP) has the lead for operating systems to detect nuclear and radiological materials entering the country at U.S. ports of entry. In 2005, DNDO began working on the cargo advanced automated radiography system (CAARS) intending that it be used by CBP to detect certain nuclear materials in vehicles and containers at U.S. ports of entry. However, in 2007 DNDO decided to cancel the acquisition phase of the program and convert it to a research and development program. GAO was asked to examine events that led to DNDO's decision to cancel the acquisition phase of the program and provide lessons learned from DNDO's experience. This statement is based on prior GAO reports from March 2006 through July 2010 and ongoing work reviewing DHS efforts to develop radiography technology. For ongoing work, GAO reviewed CAARS planning documents and interviewed DHS, DNDO, and CBP officials. GAO provided a draft of the information …

Testimony issued by the Government Accountability Office with an abstract that begins "Millions of people rely on the services of Social Security Administration (SSA) field offices. In fiscal year 2009, SSA's approximately 1,300 field offices provided service to a record 45.1 million customers. People visit field offices to apply for Social Security cards, apply for retirement and disability benefits, request replacement benefit checks, and a host of other services. Over the last several years, growing workloads have challenged field offices' ability to manage work while continuing to deliver quality customer service. The Subcommittee asked GAO to discuss our January 2009 report on SSA field office service delivery challenges. Specifically, this testimony will discuss (1) the state of SSA field office operations, and (2) the status of SSA's efforts to develop a plan to address future service delivery challenges. To respond to the request, GAO relied primarily on the January 2009 report titled Social Security Administration: Service Delivery Plan Needed to Address Baby Boom Retirement Challenges (GAO-09-24, Jan. 2009), and updated it with additional information provided by SSA. In that report, GAO recommended that SSA develop a service delivery plan that explains how it will deliver quality service while managing growing …

Other written product issued by the Government Accountability Office with an abstract that begins "Presented is GAO's performance and accountability report for fiscal year 2010. In the spirit of the Government Performance and Results Act, this annual report informs the Congress and the American people about what we have achieved on their behalf. The financial information and the data measuring GAO's performance contained in this report are complete and reliable."

Testimony issued by the Government Accountability Office with an abstract that begins "GAO has designated Medicare as a high-risk program since 1990, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable business or medical practices. Waste, which includes inaccurate payments for services, also occurs in the Medicare program. Fraud, waste, and abuse all can lead to improper payments, overpayments and underpayments that should not have been made or that were made in an incorrect amount. In 2009, the Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--estimated billions of dollars in improper payments in the Medicare program. This statement, will focus on challenges facing CMS and selected key strategies that are particularly important to helping prevent fraud, waste, and abuse, and ultimately to reducing improper payments, including challenges that CMS continues to face. It is based on nine GAO products issued from September 2005 through March 2010 using a variety of methodologies, including analysis of claims, review of relevant policies and procedures, stakeholder interviews, and …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses preventing and addressing government payment errors in the Medicare program. Medicare, which provides health insurance for those aged 65 and older and certain disabled persons, is susceptible to improper payments due to its size and complexity. Because the Medicare program has paid billions of dollars in error each year, the Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--conducts a number of activities to reduce improper payments. CMS administers the Medicare program with the help of Medicare claims administration contractors, which are not only responsible for processing and paying approximately 4.5 million claims per day, but for also conducting pre-payment reviews of claims to prevent improper payments before claims are paid, as well as post-payment reviews of claims potentially paid in error. To supplement these and other program integrity efforts, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 directed CMS to conduct a 3-year demonstration project on the use of a new type of contractors---recovery audit contractors (RAC)---in identifying underpayments and overpayments, and recouping overpayments in the Medicare program. The RAC demonstration program began in 2005. Subsequently, the Tax Relief and …

Testimony issued by the Government Accountability Office with an abstract that begins "The U.S. Postal Service's (USPS) financial condition and outlook deteriorated significantly during fiscal years 2007 through 2009. USPS was not able to cut costs fast enough to offset declines in mail volumes and revenues resulting from the economic recession and changes in the use of mail, such as electronic bill payment. In July 2009, GAO added USPS's financial condition to its high-risk list and reported that USPS urgently needed to restructure to improve its financial viability. The Postal Accountability and Enhancement Act (PAEA) of 2006 required GAO to evaluate strategies and options for USPS's long-term structural and operational reform and report by December 2011. Because of USPS's financial crisis and the need for urgent action, GAO accelerated its work and issued a report (GAO-10-455) on April 12, 2010. This testimony provides (1) information on USPS's financial condition and outlook and (2) GAO's perspective on the actions that are needed to facilitate progress toward USPS's financial viability. This testimony is based on GAO's recently issued report and recent testimonies on USPS's financial condition and outlook."

A letter report issued by the Government Accountability Office with an abstract that begins "Pervasive and sustained computer-based attacks pose a potentially devastating impact to systems and operations and the critical infrastructures they support. Addressing these threats depends on effective partnerships between the government and private sector owners and operators of critical infrastructure. Federal policy, including the Department of Homeland Security's (DHS) National Infrastructure Protection Plan, calls for a partnership model that includes public and private councils to coordinate policy and information sharing and analysis centers to gather and disseminate information on threats to physical and cyber-related infrastructure. GAO was asked to determine (1) private sector stakeholders' expectations for cyber-related, public-private partnerships and to what extent these expectations are being met and (2) public sector stakeholders' expectations for cyber-related, public-private partnerships and to what extent these expectations are being met. To do this, GAO conducted surveys and interviews of public and private sector officials and analyzed relevant policies and other documents."

A letter report issued by the Government Accountability Office with an abstract that begins "Pakistan's Federally Administered Tribal Areas (FATA) has been a recognized safe haven for al Qaeda leadership and a base for the Taliban to launch cross-border attacks into Afghanistan. The United States, in an effort to assist Pakistan in addressing this threat, pledged $750 million between 2007 and 2011 to support development activities in the FATA region. This report focuses on (1) the extent U.S. development objectives align with U.S. national security goals and Pakistan's objectives, (2) U.S. efforts to track the pledge, (3) U.S. efforts to measure program performance in the FATA, and (4) efforts to monitor assistance in the FATA. GAO reviewed U.S. and Pakistani documents and interviewed U.S. and Pakistani officials in Washington, D.C., and Pakistan. GAO has prepared this report under the Comptroller General's authority to conduct evaluations on his own initiative."

A letter report issued by the Government Accountability Office with an abstract that begins "Originally established in 2002 to fight terrorism, the Combined Joint Task Force-Horn of Africa (CJTF-HOA), based at Camp Lemonnier, Djibouti, is the military's main operational presence in Africa. The U.S. Africa Command (AFRICOM), created in 2007 to focus on stability in Africa, has been assessing existing activities--as well as CJTF-HOA--against its mission of sustained security engagement in Africa. This report discusses: (1) AFRICOM's decisions on CJTF-HOA's future and whether CJTF-HOA's activities align with the command's mission, and (2) benefits of the task force and challenges it faces. For its review, GAO analyzed AFRICOM and CJTF-HOA guidance, conducted interviews at the command's and task force's headquarters, and obtained perspectives from U.S. embassies in the region."

A letter report issued by the Government Accountability Office with an abstract that begins "Before the passage of federal environmental legislation in the 1970s and 1980s, Department of Defense (DOD) activities contaminated millions of acres of soil and water on and near DOD sites. The Environmental Protection Agency (EPA) has certain oversight authorities for cleaning up contaminants on federal property, and has placed 1,620 of the most contaminated sites--including 141 DOD installations--on its National Priorities List (NPL). As of February 2009, after 10 or more years on the NPL, 11 DOD installations had not signed the required interagency agreements (IAG) to guide cleanup with EPA. GAO was asked to examine (1) the status of DOD cleanup of hazardous substances at selected installations that lacked IAGs, and (2) obstacles, if any, to cleanup at these installations. GAO selected and visited three installations, reviewed relevant statutes and agency documents, and interviewed agency officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Traffic crashes kill or injure millions of people each year. High-quality traffic safety data is vital to allocate resources and target programs as the Department of Transportation's (DOT) National Highway Traffic Safety Administration (NHTSA) and states work to improve traffic safety through data-driven approaches. To qualify for federal funding, states must submit plans which include fatality and crash data analyses to identify areas for improvement. This requested report provides information on (1) the extent to which state traffic safety data systems meet NHTSA performance measures for assessing the quality of data systems, and (2) progress states have made in improving traffic safety data systems, and related challenges. To conduct this work, GAO analyzed state traffic records assessments, visited eight states, and interviewed federal officials and other traffic safety experts."

A letter report issued by the Government Accountability Office with an abstract that begins "Adaptive housing assistance grants help eligible service members or veterans adapt or modify a residence to accommodate disabilities sustained through military service. The Veterans' Housing Opportunity and Benefits Improvement Act of 2006 authorized the Department of Veterans Affairs (VA) to expand its existing adaptive housing assistance grants to include eligible individuals temporarily living in a home owned by a family member, known as Temporary Residence Adaptation (TRA) grants. The act also mandated GAO to issue interim and final reports on VA's implementation of TRA. This final report examines (1) the characteristics of TRA grants and grantees and (2) what accounts for low utilization of the program and how to ensure that the program serves its intended recipients. To address these objectives, GAO analyzed VA data and documents and interviewed service members and veterans who both had and had not used the TRA grant."

A letter report issued by the Government Accountability Office with an abstract that begins "The Housing and Economic Recovery Act of 2008 (HERA) created the Federal Housing Finance Agency (FHFA) and gave it responsibility for, among other things, the supervision and oversight of the housing-related government-sponsored enterprises (GSE): Fannie Mae, Freddie Mac, and the 12 federal home loan banks. Specifically, FHFA was assigned responsibility for ensuring that each of the regulated entities operates in a fiscally safe and sound manner, including maintenance of adequate capital and internal controls, and carries out its housing and community development finance mission. HERA also requires FHFA to annually prepare financial statements, and further requires GAO to audit these statements. Pursuant to HERA's requirement, GAO audited FHFA's fiscal years 2010 and 2009 financial statements to determine whether (1) the financial statements were fairly stated, and (2) FHFA management maintained effective internal control over financial reporting. GAO also tested FHFA's compliance with selected laws and regulations. GAO is not making any recommendations in this report. In commenting on a draft of this report, FHFA stated that it was pleased with the results of the audit, and it would continue to work to enhance its internal controls …

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2003, the Future Combat System (FCS) program has been the centerpiece of the Army's efforts to transition to a lighter, more agile, and more capable combat force. In 2009, however, concerns over the program's performance led to the Secretary of Defense's decision to significantly restructure and ultimately cancel the program. As a result, the Army has outlined a new approach to ground force modernization. This report (1) outlines the Army's preliminary post-FCS plans and (2) identifies the challenges and opportunities the Department of Defense (DOD) and the Army must address as they proceed with Army ground force modernization efforts. To meet these objectives, GAO reviewed key documents, performed analyses, visited test facilities where the Army evaluated FCS equipment, and interviewed DOD and Army officials."

A letter report issued by the Government Accountability Office with an abstract that begins "This report responds to two mandates for GAO under the American Recovery and Reinvestment Act of 2009 (Recovery Act). First, it is the latest report on the uses of and accountability for Recovery Act funds in selected states and localities. Second, it comments on recipients' reports of the jobs created and retained. The Recovery Act provided $2.1 billion for Head Start and Early Head Start, primarily to expand services. GAO addressed four questions: (1) How have Head Start and Early Head Start grantees used Recovery Act funds, including for expanding enrollment? (2) What challenges have grantees encountered in spending Recovery Act funds? (3) How has the Office of Head Start (OHS) monitored the use of Recovery Act funds? (4) How has the quality of jobs data reported by Recovery Act recipients, particularly Head Start grantees, changed over time? In this report, GAO also updates the status of open recommendations from previous bimonthly and recipient reporting reviews. To address these questions, GAO interviewed grantees, analyzed federal agency and recipient reported data, and interviewed officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Through the statewide transportation planning process, states decide how to spend federal transportation funds--almost $46 billion in fiscal year 2009. Draft legislation to reauthorize federal surface transportation legislation would, among other things, revise planning requirements to recognize states' use of rural planning organizations (RPO) and require performance measurement. As requested, GAO examined (1) states' planning activities and RPOs' satisfaction that rural needs are considered, (2) states' planning challenges, (3) the U.S. Department of Transportation's (USDOT) approach to overseeing statewide planning, and (4) states' use of performance measurement and opportunities to make statewide planning more performance based. GAO analyzed planning documents; surveyed departments of transportation in 50 states, Puerto Rico, and Washington, D.C., and 569 RPOs; interviewed officials in 6 states; and held an expert panel on performance-based planning."

A letter report issued by the Government Accountability Office with an abstract that begins "The Global Positioning System (GPS) provides positioning, navigation, and timing (PNT) data to users worldwide. The U.S. Air Force, which is responsible for GPS acquisition, is in the process of modernizing the system. Last year GAO reported that it was uncertain whether the Air Force could acquire new satellites in time to maintain GPS service without interruption. GAO was asked to assess (1) the status of Air Force efforts to develop and deliver new GPS satellites, the availability of the GPS constellation, and the potential impacts on users if the constellation availability diminishes below its committed level of performance; (2) efforts to acquire the GPS ground control and user equipment necessary to leverage GPS satellite capabilities; (3) the GPS interagency requirements process; and (4) coordination of GPS efforts with the international PNT community. To do this, GAO analyzed program documentation and Air Force data on the GPS constellation, and interviewed officials from DOD and other agencies."