A letter report issued by the Government Accountability Office with an abstract that begins "VA has policies to ensure that physicians have appropriate qualifications and clinical abilities through the processes of credentialing, privileging, and continuous monitoring of performance. Results of a VA investigatory report in 2008 cited deficiencies in the Marion, Illinois, VA medical center's (VAMC) credentialing and privileging processes and oversight of its surgical program. This report examines VA's policies and guidance to help ensure that information about physician qualifications and performance is accurate and complete, VAMCs' compliance with selected VA credentialing and privileging policies, and their implementation of VA policies to continuously monitor performance. The Government Accountability Office (GAO) reviewed VA's policies, interviewed VA officials, and reviewed a judgmental sample of 30 credentialing and privileging files at each of six VAMCs that GAO visited. GAO selected the files to ensure inclusion of highly paid specialties, newly hired physicians, and other physician characteristics. GAO selected the judgmental sample of six VAMCs based on geographic balance and other factors."

This report discusses the current political climate in Tanzania, an important U.S. ally in Africa. The report also provides some general background information.

This report discusses the Uniformed and Overseas Citizens Absentee Voting Act (UOCAVA), under which members of the uniformed services and U.S. citizens who live abroad are eligible to register and vote absentee in federal elections. The report discusses recent improvements to UOCAVA, necessary as teh result of controversy surrounding ballots received in Florida from absentee voters in the 2000 presidential election. The report also discusses related legislation, such as the National Defense Authorization Act for FY2010, which provided for a major overhaul of UOCAVA.

A letter report issued by the Government Accountability Office with an abstract that begins "Over $81 billion has been committed under the Troubled Asset Relief Program (TARP) to improve the domestic auto industry's competitiveness and long-term viability. The bulk of this assistance has gone to General Motors (GM) and Chrysler, who sponsor some of the largest defined benefit pension plans insured by the federal Pension Benefit Guaranty Corporation (PBGC). As part of GAO's statutorily mandated oversight of TARP, this report examines: (1) the impact of restructuring on GM's and Chrysler's pension plans; (2) the impact of restructuring on auto supply sector pension plans; (3) the impacts on PBGC and plan participants should auto industry pension plans be terminated; and (4) how the federal government is dealing with the potential tensions of its multiple roles as pension regulator, shareholder, and creditor. To conduct this study, GAO interviewed officials at GM, Chrysler, a labor union, a supplier association, the Departments of the Treasury and Labor, and PBGC; and reviewed relevant statutes, reports, and documents concerning the automakers' restructuring and pension plan funding. Treasury and PBGC generally agreed with the report's findings. Their technical comments and the technical comments provided by GM, Chrysler, …

This report discusses the current political conditions of Kenya, which has long been an important ally of the United States. The report focuses particularly on the December 2007 elections, which many international observers have declared as rigged and deeply flawed. The report also discusses violence that erupted once election results were announced, as well as U.S. efforts to urge Kenya toward election reforms.

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2007, the Departments of Defense (DOD) and Veterans Affairs (VA) have been testing a new disability evaluation system designed to integrate their separate processes and thereby expedite veterans' benefits for wounded, ill, and injured servicemembers. Having piloted the integrated disability evaluation system (IDES) at 27 military facilities, they are now planning for its expansion military-wide. Part of the National Defense Authorization Act for Fiscal Year 2008 required GAO to report on DOD and VA's implementation of policies on disability evaluations. This report examines: (1) the results of the agencies' evaluation of the IDES pilot, (2) challenges in implementing the IDES pilot to date, and (3) whether DOD and VA's plans to expand the IDES adequately address potential future challenges. GAO analyzed data from DOD and VA, conducted site visits at 10 military facilities, and interviewed DOD and VA officials."

This report discusses the current political conditions of Uganda, which have long been ravaged by the Lord's Resistance Army (LRA), an armed rebel group backed by the government of Sudan. In particular, the report focuses on largely unsuccessful Ugandan efforts to resolve the conflict with the LRA, as well as talks with the U.S. under the Bush Administration and the recent suicide bombings in Kampala, Uganda, in July 2010.

The United States provides assistance to 47 African countries, and the United States Agency for International Development (USAID) has 23 missions in Africa. In recent years, U.S. assistance to Africa saw a major increase, especially in health-related programs. This report provides an overview of U.S. aid to Africa, including the strategic objectives that shape U.S. aid to Africa, information about specific aid programs and initiatives, and the Obama Administration's FY2011 foreign aid budget request.

This report provides an overview of the payment and other protections for subcontractors on certain federal prime contracts under the Miller Act, the 1988 amendments to the Prompt Payment Act, and the Small Business Act. Congress enacted these statutes to give subcontractors rights and remedies they would not otherwise have because of legal doctrines relating to sovereign immunity, privity of contract, and freedom to contract. The report also discusses legislation introduced in the 111th Congress that would provide additional protections for subcontractors.

This report discusses the November 7, 2010 parliamentary elections in Burma, which have long been controversial, mainly due to election fraud concerns. The report discusses debates about U.S. policy toward Burma, which has been sparked by the elections and the issues surrounding them.

According to the National Bureau of Economic Research (NBER), the U.S. economy was in a recession for 18 months from December 2007 to June 2009. It was the longest and deepest recession of the post-World War II era. This report provides information on the patterns found across past recessions since World War II to gauge whether and how this recession might be different.

Correspondence issued by the Government Accountability Office with an abstract that begins "Medicare funds health care services for more than 46 million beneficiaries. The Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--contracts with private organizations known as Quality Improvement Organizations (QIO) to, among other core functions, improve the quality of care for Medicare beneficiaries. CMS contracts with one QIO for each of the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. One of the QIOs' many responsibilities is to review quality of care concerns, raised by Medicare beneficiaries or others, to determine whether Medicare-financed medical services meet professionally recognized standards of health care. Quality of care reviews may address a range of issues, such as inappropriate treatment or hospital staff not administering medications on time; may involve a variety of health care services and settings; and may include a range of Medicare providers or practitioners. CMS enters into 3-year contracts with QIOs for a range of activities and reviews, including quality of care reviews. For each QIO contract, CMS establishes a budget reflecting the estimated costs of these activities and reviews. For the most recent contracts, which cover August 1, 2008, through …

A letter report issued by the Government Accountability Office with an abstract that begins "To address pervasive computer-based (cyber) attacks against the United States that posed potentially devastating impacts to systems and operations, the federal government has developed policies and strategies intended to combat these threats. A recent key development was in February 2009, when President Obama initiated a review of the government's overall strategy and supporting activities with the aim of assessing U.S. policies and structures for cybersecurity. The resulting policy review report--issued by the President in May 2009--provided 24 near- and mid-term recommendations to address these threats. GAO was asked to assess the implementation status of the 24 recommendations. In doing so, GAO, among other things, analyzed the policy review report and assessed agency documentation and interviewed agency officials."

This report discusses Washington-Harris Group, a protest filed with the Government Accountability Office (GAO) alleging, among other things, that an agency improperly awarded a "preference contract" to a service-disabled veteran-owned small business that proposed to subcontract a greater percentage of work on the contract than allowed under the Small Business Administration's limitations on subcontracting.

The American Recovery and Reinvestment Act of 2009 created an Emergency Contingency Fund (ECF) within the Temporary Assistance for Needy Families (TANF) block grant. The fund expired on September 30, 2010. It helped states, Indian tribes, and territories pay for additional costs of providing economic aid to families during the current economic downturn for FY2009 and FY2010. This report describes the TANF ECF as well as proposals offered in 2010 to extend and modify TANF emergency funding.

A letter report issued by the Government Accountability Office with an abstract that begins "For several decades, Congress and the Department of Defense (DOD) have explored ways to improve the acquisition of major weapon systems, yet program outcomes and their underlying causes have proven resistant to change. Last year, we reported that the cumulative cost growth in DOD's portfolio of major programs was $296 billion. The opportunity to achieve meaningful improvements may now be at hand with the recent introduction of major reforms to the acquisition process. In response to a mandate from this Committee, GAO has issued several reports about DOD's budget and requirements processes to support weapon program stability. This follow-on report focuses on (1) identifying weapon programs that are achieving good outcomes, (2) the factors that enable some programs to succeed, and (3) lessons to be learned from these programs to guide implementation of recent reforms. GAO analyzed DOD's portfolio of major defense programs and conducted case study reviews of five programs."

A letter report issued by the Government Accountability Office with an abstract that begins "To improve aviation safety, the Federal Aviation Administration (FAA) plans to have in place the initial capabilities of a risk-based approach to safety oversight, known as a safety management system (SMS), by the end of fiscal year 2010. FAA is also implementing new procedures and technologies to enhance the safety, capacity, and efficiency of the national airspace system. Data are central to SMS and FAA's ability to test the impact of these changes on safety. This congressionally requested report addresses FAA's (1) current and planned use of data to oversee aviation safety, (2) access to data for monitoring aviation safety and the safety performance of various industry sectors, and (3) efforts to help ensure data quality. To perform this work, GAO reviewed 13 databases that contain data on key aviation safety events, assessed data quality controls for the databases, and interviewed agency and industry officials, as well as 10 experts in aviation safety and data."

A letter report issued by the Government Accountability Office with an abstract that begins "To address challenges to the aviation industry's economic health and safety, the Federal Aviation Administration (FAA) is collaborating with the National Aeronautics and Space Administration (NASA) and other federal partners to plan and implement the Next Generation Air Transportation System (NextGen). NextGen will transform the current radar-based air traffic control system into a satellite-based system. Pilot and air traffic controller roles and responsibilities are expected to become more automated, thereby requiring an understanding of human factors, which studies how humans' abilities, characteristics, and limitations interact with the design of the equipment they use, environments in which they function, and jobs they perform. FAA and NASA are tasked with incorporating human factors issues into NextGen. As requested, this report discusses the extent to which FAA's and NASA's human factors research (1) is coordinated and (2) supports NextGen. To address these issues, GAO reviewed coordination mechanisms and planning documents and synthesized the views of nine aviation human factors experts."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Food, Conservation, and Energy Act of 2008 authorized appropriations of $10 million annually for the Housing Assistance Council (HAC) from fiscal years 2009 through 2011. Established in 1971, HAC is a nonprofit rural housing organization that aims to improve housing conditions for low-income rural residents, especially in high-need areas such as Indian country and Appalachia and among groups such as farmworkers. As part of its mission, HAC also offers technical assistance in developing affordable rural housing and capacity building to a variety of groups involved in rural housing. HAC signs agreements each year with the Department of Housing and Urban Development (HUD) detailing how it will use its appropriations. The 2008 act required GAO to report on HAC's use of appropriated funds over the last 7 years, from 2003 to 2009--a period when HAC received more than $20 million in appropriations. To respond to this mandate, our work had four objectives: to (1) describe HAC programs and activities, (2) identify the sources of HAC's funding and its use of the funds it receives, (3) discuss the results of HAC's programs and activities, and (4) determine what is …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) provides medical care to 9.6 million active duty service members, their families, and other eligible beneficiaries worldwide. DOD's Military Health System has long been engaged in efforts to acquire and deploy an electronic health record system. The latest version of this initiative--the Armed Forces Health Longitudinal Technology Application (AHLTA)--was expected to give health care providers real-time access to individual and military population health information and facilitate clinical support. However, the system's early performance was problematic, and DOD recently stated that it intended to acquire a new electronic health record system. GAO was asked to (1) determine the status of AHLTA, (2) determine DOD's plans for acquiring its new system, and (3) evaluate DOD's acquisition management of the initiative. To do this, GAO reviewed program plans, reports, and other documentation and interviewed DOD officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) included $10.4 billion in funding for the National Institutes of Health (NIH), an agency of the Department of Health and Human Services (HHS). Of the NIH Recovery Act funding, $8.2 billion was to be used to support additional scientific research and $400 million for comparative effectiveness research, including extramural research at universities and research institutions. NIH is comprised of the Office of the Director (OD) and 27 Institutes and Centers (IC), 24 of which make grant funding decisions. GAO was asked to report on how NIH awarded Recovery Act funds for scientific research and the information that NIH made available about the award of these funds. This report describes the (1) process and criteria NIH used to award extramural grants using Recovery Act funding, and (2) characteristics of Recovery Act extramural grants and the information made publicly available about these grants. GAO interviewed NIH officials in the OD and the three ICs that received the largest proportion of Recovery Act funds, and reviewed related documents, such as NIH guidance on awarding grants using Recovery Act funds. …

Correspondence issued by the Government Accountability Office with an abstract that begins "Since the September 11, 2001, terrorist attacks, the Department of Defense (DOD) has been engaged in domestic and overseas military operations in support of overseas contingency operations (OCO). These operations include Operation Iraqi Freedom, which focuses principally on Iraq, and Operation Enduring Freedom, which focuses principally on Afghanistan, but also include operations in the Horn of Africa, the Philippines, and elsewhere. Obtaining an accurate picture of OCO costs is of critical importance given the need to evaluate trade-offs and make more effective use of defense dollars in light of the nation's long-term fiscal challenges. In the past, the GAO has reported on the need for DOD to become more disciplined in its approach to developing plans and budgets, including building more OCO costs into the base defense budget. In February 2009, the Office of Management and Budget (OMB), in coordination with the Office of the Secretary of Defense (OSD), developed new guidance for use when constructing the initial fiscal year 2010 OCO funding request that more narrowly defined what should be considered an OCO funding need. The guidance remained in effect for building the fiscal year 2010 OCO …

A letter report issued by the Government Accountability Office with an abstract that begins "At the end of fiscal year 2009, the Environmental Protection Agency's (EPA) National Priorities List (NPL) included 1,111 of the most seriously contaminated nonfederal hazardous waste sites. Of these sites, EPA had identified 75 with unacceptable human exposure, 164 with unknown exposure, and 872 with controlled exposure that may need additional cleanup work. EPA may fund remedial actions--long-term cleanup--from its trust fund, and compel responsible parties to perform or reimburse costs of the cleanup. GAO was asked to determine (1) the cleanup and funding status at currently listed nonfederal NPL sites with unacceptable or unknown human exposure; (2) what is known about EPA's future cleanup costs at nonfederal NPL sites; (3) EPA's process for allocating remedial program funding; and (4) how many NPL sites some state and EPA officials expect to be added in the next 5 years, and their expected cleanup costs. GAO analyzed Superfund program data, surveyed and interviewed EPA officials, and interviewed state officials."

Testimony issued by the Government Accountability Office with an abstract that begins "Food imported from around the world constitutes a substantial and increasing percentage of the U.S. food supply. Ensuring the safety of imported food challenges the Food and Drug Administration (FDA) to better target its resources on the foods posing the greatest risks to public health and to coordinate efforts with the Department of Homeland Security's Customs and Border Protection (CBP) so that unsafe food does not enter U.S. commerce. This testimony focuses on (1) FDA's overseas inspections, (2) identified gaps in agencies' enforcement efforts to ensure the safety of imported food, and (3) statutory authorities that GAO has identified that could help FDA's oversight of food safety. This testimony is principally based on GAO's September 2009 report, Food Safety: Agencies Need to Address Gaps in Enforcement and Collaboration to Enhance Safety of Imported Food (GAO-09-873) and has been updated with information from FDA."