A letter report issued by the Government Accountability Office with an abstract that begins "Medicare claims are screened against enrollment information, using automated enrollment-related prepayment edits, in an effort to prevent improper payments to ineligible providers and suppliers—such as those that are no longer active in the Medicare program or are not properly licensed to provide the services for which they have submitted claims. Officials with the contractors we interviewed described the use of several types of prepayment edits to ensure that claims data are valid. For example, verification edits are intended to check the provider’s National Provider Identifier (NPI), which indicates whether the claim was submitted by an active provider or supplier. However, factors such as the frequency with which contractors have updated provider and supplier enrollment information and limitations of the data used may affect the timeliness and accuracy of data used to screen claims—in turn limiting the ability of the edits to prevent improper payments from occurring. For example, to update information maintained in the Provider Enrollment, Chain and Ownership System (PECOS)—CMS’s centralized database for Medicare enrollment information—the contractors have relied on a variety of data sources that vary in the frequency with which they are updated …

A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare and Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), and the four states GAO reviewed are implementing processes to verify whether providers met the Medicare and Medicaid EHR programs’ requirements and, therefore, qualified to receive incentive payments in the first year of the EHR programs. To receive such payments, providers must meet both (1) eligibility requirements that specify the types of providers eligible to participate in the programs and (2) reporting requirements that specify the information providers must report to CMS or the states, including measures that demonstrate meaningful use of an EHR system and measures of clinical quality. For the Medicare EHR program, CMS has implemented prepayment processes to verify whether providers have met all of the eligibility requirements and one of the reporting requirements. Beginning in 2012, the agency also has plans to implement a risk-based audit strategy to verify on a postpayment basis that a sample of providers met the remaining reporting requirements. For the Medicaid EHR Program, the four states GAO reviewed have implemented primarily prepayment processes to verify whether providers met …

A letter report issued by the Government Accountability Office with an abstract that begins "At the end of fiscal year 2011, GAO identified more than $794 million in funding remaining in expired grant accounts—accounts that were more than 3 months past the grant end date and had no activity for 9 months or more—in the Payment Management System (PMS). GAO found that undisbursed balances remained in some grant accounts several years past their expiration date: $110.9 million in undisbursed funding remained unspent more than 5 years past the grant end date, including $9.5 million that remained unspent for 10 years or more. GAO also found $126 million in grant accounts in the Automated Standard Application for Payments (ASAP) for which there had been no activity for 2 years or more, including $11 million that remained inactive for 5 years or more. However, data from these two systems are not comparable because, unlike PMS, ASAP accounts can include multiple grant agreements between a federal agency and a grantee, only some of which may be eligible for closeout."

A letter report issued by the Government Accountability Office with an abstract that begins "A majority of the initiatives GAO reviewed (26 of 30) met, or expected to meet, the Department of Defense’s (DOD) expectation for fielding a capability in response to joint urgent operational needs within 2 years. However, performance in meeting schedule estimates varied, and more than half of the initiatives experienced schedule delays."

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. agencies engaged in export controls use various compliance activities to prevent the diversion or misuse of exported items against U.S. interests or allies and reduce illicit transshipment risk. Compliance activities include (1) vetting transactions prior to export, (2) analyzing shipping data and monitoring the end use of items, and (3) educating companies and foreign governments about illicit transshipment risks. To vet transactions, agencies review license applications for the export of controlled items, consult multiple lists of entities known or suspected of violating export control laws or regulations, and screen foreign end users to determine their eligibility to receive items without a license. Agencies also review shipping records to identify patterns of abuse and to plan end-use checks—visiting foreign companies to verify the approved use and location of exported items on both licensed items and those eligible for export without a license. From 2008 to 2010, Commerce conducted 56 percent of its end-use checks on unlicensed exports. In the 13 transshipment countries, unlicensed exports accounted for about 94 percent of unfavorable end-use check determinations, which indicates that the end use or end user of an export …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has trained thousands of personnel on the use of biometrics since 2004, but biometrics training for leaders does not provide detailed instructions on how to effectively use and manage biometrics collection tools. The Office of the Secretary of Defense, the military services, and U.S. Central Command each has emphasized in key documents the importance of training. Additionally, the Army, Marine Corps, and U.S. Special Operations Command have trained personnel prior to deployment to Afghanistan in addition to offering training resources in Afghanistan. DOD’s draft instruction for biometrics emphasizes the importance of training leaders in the effective employment of biometrics collection, but existing training does not instruct military leaders on (1) the effective use of biometrics, (2) selecting the appropriate personnel for biometrics collection training, and (3) tracking personnel who have been trained in biometrics collection to effectively staff biometrics operations. Absent this training, military personnel are limited in their ability to collect high-quality biometrics data to better confirm the identity of enemy combatants."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) made a number of changes to improve the utility of the fiscal year 2010 inventory, such as centrally preparing contract data to provide greater consistency among DOD components and increasing the level of detail on the services provided. DOD, however, continued to rely primarily on the Federal Procurement Data System-Next Generation (FPDS-NG) for the inventory for most defense components other than the Army. As such, DOD acknowledged a number of factors that limited the utility, accuracy, and completeness of the inventory data. For example, FPDS-NG does not identify more than one type of service purchased for each contract action, provide the number of contractor full-time equivalent personnel, or identify the requiring activity. As before, the Army used its Contractor Manpower Reporting Application to compile its fiscal year 2010 inventory. This system collects data reported by contractors on services performed at the contract line item level, including information on labor hours and the function and mission performed. DOD officials noted that the Army’s current process complies with legislative requirements. In January 2011, GAO recommended that DOD develop a plan with time frames …

A letter report issued by the Government Accountability Office with an abstract that begins "The F-22A and legacy modernization programs GAO reviewed were rooted in different development strategies. The F-22A began as a single-step program and did not anticipate the need for future modernization, while the legacy programs each began with the expectation that their aircraft would be incrementally upgraded over time. F-22A modernization began in reaction to a major shift in the aircraft’s basic mission, which required the development of new capabilities that had not been planned for as part of the initial development program. In contrast, the legacy modernization programs made planned incremental improvements to existing mission capabilities. All of the modernization programs began at about the same time in development and procurement. The F-22A program is developing and retrofitting new capabilities onto a complex stealth aircraft, which is costly—currently estimated at $9.7 billion total. Legacy modernization programs were less complex, and thus less costly, and incorporated mature technologies onto new production aircraft. Accurately identifying and comparing the total cost of each modernization program is difficult. Each of the programs, including the F-22A, initially managed and funded modernization as a continuation of its baseline program, so modernization costs …

A letter report issued by the Government Accountability Office with an abstract that begins "In GAO’s opinion, the Federal Deposit Insurance Corporation (FDIC) fairly presented, in all material respects, the 2011 and 2010 financial statements for the two funds it administers—the Deposit Insurance Fund (DIF) and the Federal Savings and Loan Insurance Corporation (FSLIC) Resolution Fund (FRF). Also, in GAO’s opinion, although certain internal controls related to the DIF should be improved, FDIC maintained, in all material respects, effective internal control over financial reporting. Further, GAO did not find any reportable instances of noncompliance with provisions of the laws and regulations it tested."

A letter report issued by the Government Accountability Office with an abstract that begins "To prepare for its reporting obligations under the Telework Enhancement Act of 2010, the Office of Personnel Management (OPM) assembled the Interagency Telework Measurement Group, consisting of officials from several federal agencies, to assist in revising the telework data call—the survey OPM has used since 2002 to collect telework data from executive agencies. This group standardized key terms such as telework, employee, and eligibility to promote a common reporting methodology among the agencies. The revised telework data call also included changes to the time period for which OPM requested agencies report telework data, and included more extensive training for respondents."

A letter report issued by the Government Accountability Office with an abstract that begins "The Office of Management and Budget (OMB) and key federal agencies have made progress on action items in the Information Technology (IT) Reform Plan, but there are several areas where more remains to be done. Of the 10 key action items GAO reviewed, 3 were completed and 7 were partially completed by December 2011, in part because the initiatives are complex. OMB reported greater progress than GAO determined, stating that 7 of the 10 action items were completed and that 3 were partially completed. While OMB officials acknowledge that there is more to do in each of the topic areas, they consider the key action items to be completed because the IT Reform Plan has served its purpose as a catalyst for a set of broader initiatives. They explained that work will continue on all of the initiatives even after OMB declares that the related action items are completed under the IT Reform Plan. We disagree with this approach. In prematurely declaring the action items to be completed, OMB risks losing momentum on the progress it has made to date. Until OMB and the agencies complete …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has identified 11 initiatives aimed at slowing its rising health care costs, but has not fully applied results-oriented management practices in developing plans to implement and monitor its initiatives. Results-oriented management practices include developing plans that identify goals, activities, and performance measures; resources and investments; organization roles, responsibilities, and coordination; and key external factors that could affect goals, such as a decrease of funding to a program. At the conclusion of GAO’s review, DOD had completed and approved a detailed implementation plan, including a cost savings estimate, for just 1 of its 11 initiatives. Developing cost savings estimates is critical to successful management of the initiatives for achieving the 2010 Quadrennial Defense Review’s call for reduced growth in medical costs. DOD also has not completed the implementation of an overall process for monitoring progress across its portfolio of health care initiatives and has not completed the process of identifying accountable officials and their roles and responsibilities for all of its initiatives. Without comprehensive, results-oriented plans, a monitoring process, and clear leadership accountability, DOD may be hindered in its ability to achieve …

A letter report issued by the Government Accountability Office with an abstract that begins "Of the approximately 400 non-federally recognized tribes that GAO identified, 26 received funding from 24 federal programs during fiscal years 2007 through 2010. Most of the 26 non-federally recognized tribes were eligible to receive this funding either because of their status as nonprofit organizations or state-recognized tribes. Similarly, most of the 24 federal programs that awarded funding to non-federally recognized tribes during the 4-year period were authorized to fund nonprofit organizations or state-recognized tribes. In addition, some of these programs were authorized to fund other entities, such as tribal communities or community development financial institutions."

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

A letter report issued by the Government Accountability Office with an abstract that begins "Between 1981 and 2010, the time it took the Department of Labor’s Occupational Safety and Health Administration (OSHA) to develop and issue safety and health standards ranged widely, from 15 months to 19 years, and averaged more than 7 years. Experts and agency officials cited increased procedural requirements, shifting priorities, and a rigorous standard of judicial review as contributing to lengthy time frames for developing and issuing standards. For example, they said that a shift in OSHA’s priorities toward one standard took attention away from several other standards that previously had been a priority."

A letter report issued by the Government Accountability Office with an abstract that begins "Over the past 5 years, the U.S. Postal Service (USPS) has taken several actions to restructure its retail network through reducing its workforce and its footprint while expanding retail alternatives. USPS officials estimated that it had saved about $800 million from reducing the number of work hours dedicated to retail operations. USPS also closed 631 of its post offices, but it did not have cost-savings estimates for these closures. Most of the facilities closed (500) were in response to a postmaster vacancy or the suspension of operations due to an expired lease or irreparable damage following a natural disaster. Fewer closures (131) have resulted from nationwide reviews that USPS initiated in 2009 and 2011. USPS has also restructured its retail network by expanding alternatives through self-service options as well as partnerships with other retailers."

A letter report issued by the Government Accountability Office with an abstract that begins "Field employees have key roles in the U.S. Postal Service’s (USPS) efforts to reduce costs and generate revenue. For example, these employees evaluate the feasibility of closing or consolidating facilities, such as post offices and mail- processing facilities; carry out the closures and consolidations of these facilities; and evaluate and consolidate delivery routes. These roles support USPS’s plans to save, by 2016, about $9 billion annually by improving its operational efficiency and realigning its retail, mail processing, and delivery networks with declining mail use. These plans include evaluating about half of its approximately 31,000 post offices to identify cost-reduction opportunities, closing or reducing operations at about half of its 461 mail-processing facilities, and consolidating about 20,000 of its 144,000 city delivery routes. Area and district employees also have a significant role in USPS’s efforts to generate additional revenue by (1) promoting the value of mail to businesses, (2) maintaining and increasing its customer base through customer service, and (3) growing the package business."

A letter report issued by the Government Accountability Office with an abstract that begins "Over the years, the federal-aid highway program has expanded to encompass broader goals, more responsibilities, and a variety of approaches. As the program grew more complex, the Federal Highway Administration’s (FHWA) oversight role also expanded, while its resources have not kept pace. As GAO has reported, this growth occurred without a well-defined overall vision of evident national interests and the federal role in achieving them. GAO has recommended Congress consider restructuring federal surface transportation programs, and for this and other reasons, funding surface transportation remains on GAO’s high-risk list."

A letter report issued by the Government Accountability Office with an abstract that begins "Public housing agencies (PHA) that participate in the Moving to Work (MTW) program report annually on the performance of their activities, which include efforts to reduce administrative costs and encourage residents to work. But this performance information varies, and the Department of Housing and Urban Development’s (HUD) guidance does not specify that it be quantifiable and outcome oriented. Further, HUD has not identified the performance data that would be needed to assess the results of similar MTW activities or the program as a whole and has not established performance indicators for the program. The shortage of such analyses and indicators has hindered comprehensive evaluation efforts, although such evaluations are key to determining the success of any demonstration program. Further, while HUD has identified some lessons learned from the program, it has no systematic process to identify them and thus has relied primarily on ad hoc information. The absence of a systematic process for identifying lessons learned limits HUD’s ability to promote useful practices that could be more broadly implemented to address the purposes of the program."

A letter report issued by the Government Accountability Office with an abstract that begins "The Nuclear Regulatory Commission (NRC) and companies licensed to operate nuclear power reactors (or licensees) apply probabilistic risk assessment (PRA) to natural hazards at operating U.S. nuclear reactors to a limited extent. When the 104 operating reactors were originally licensed before 1997, NRC required licensees to assess natural hazards using deterministic analysis, which—informed by historical experience, test results, and expert judgment—considers a specific set of potential accidents and how the consequences of those accidents can be prevented and mitigated. Subsequent to most of these initial licenses being issued, NRC, through policy statements and other documents, has endorsed PRA—a systematic method for assessing what can go wrong, its likelihood, and its consequences, resulting in quantitative estimates of risk—as a means to enhance and extend traditional deterministic analysis. In 1991, NRC requested that licensees voluntarily examine their reactors’ vulnerability to natural hazards and suggested PRA as one of several possible methods for licensees to use in their examinations. However, most licensees opted to use other methods. According to NRC officials and nuclear power industry representatives—and reflected in data GAO obtained from five licensees that together operate 25 reactors—few …

A letter report issued by the Government Accountability Office with an abstract that begins "As with many other demographic groups, older workers’ unemployment overall and long-term unemployment rates have increased dramatically since the recession began in 2007. In December 2011, the unemployment rate for older workers was 6.0 percent, up from 3.1 at the start of the recession, but down from its peak of 7.6 percent in February 2010. In particular, long-term unemployment rose substantially, and at a greater rate for older than younger workers. By 2011, 55 percent of unemployed older workers had been actively seeking a job for more than half a year (27 weeks or more). Meanwhile, the long-term trend of rising labor force participation rates among older workers has continued, with the recession possibly amplifying this trend."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) has departmentwide policy and procedures for convening and conducting administrative investigation boards (AIB). The department’s procedures contain requirements for convening and conducting AIB investigations, but according to VA officials, they also provide the flexibility to tailor an investigation to effectively meet diverse informational needs. For example, the VA official convening an AIB investigation is required to select AIB members who are impartial and objective, but has flexibility to vary the number of members appointed to each AIB based on the matter being investigated. VA is currently updating its AIB policy and procedures, but officials said the department plans to maintain flexibility in its AIB process."

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

A letter report issued by the Government Accountability Office with an abstract that begins "Plan sponsors and participants paid a range of fees for services, though smaller plans typically paid higher fees as a percentage of plan assets. For example, the average amount sponsors of small plans reported paying for recordkeeping and administrative services was 1.33 percent of assets annually, compared with 0.15 percent paid by sponsors of large plans. Larger plans were more likely to pass recordkeeping fees along to participants, but when fees were passed along to participants in small plans, those in large plans paid lower fees than those in small plans. Participants also paid for investment and plan consulting fees—through fees deducted from their plan assets—in more instances than sponsors."