A letter report issued by the Government Accountability Office with an abstract that begins "Clinical data registries (CDR) have demonstrated a particular strength in assessing physician performance through their capacity to track and interpret trends in health care quality over time. Studies examining results reported by several long-established CDRs demonstrate the utility of CDR data sets for analyzing trends in both outcomes and treatments. CDR efforts to improve outcomes typically involve a combination of performance improvement activities including feedback reports to participating physicians, benchmarking physician performance relative to that of their peers, and related educational activities designed to stimulate changes in clinical practice. Studies GAO reviewed provided less insight on ways to improve the efficiency of care."

Testimony 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 "As pass-through grant funds flow to subrecipients, they are subject to government-wide and program-specific policies, two of which are particularly relevant to disbursement issues for states as they pass funds on to subrecipients. Pass-through grants are typically first awarded to states, local governments, or other entities and then further awarded to subrecipients. The Cash Management Improvement Act governs the exchange of funds between the federal government and the states and is applicable to timeliness in the grant disbursement process. In addition, the Office of Management and Budget's (OMB) Circular No. A-133, Audits of States, Local Governments, and Non-Profit Organizations, provides general guidance on the roles and responsibilities of the federal awarding agencies and primary recipients of government funds regarding audit requirements of grantees. Specific program policies can provide additional requirements for individual grant programs related to disbursement of funds. For example, as with the programs we reviewed, authorizing legislation may contain statutory limits on the amount of funds that states and local governments can withhold from the grant awards for their own administrative expenses. To ensure states comply with federal requirements and agency regulations for disbursing …

Testimony issued by the Government Accountability Office with an abstract that begins "GAO's 2013 annual report identifies 31 new areas where agencies may be able to achieve greater efficiency or effectiveness. Seventeen areas involve fragmentation, overlap, or duplication. For example, GAO reported that the Department of Defense could realize up to $82 million in cost savings and ensure equivalent levels of performance and protection by taking action to address its fragmented approach to developing and acquiring combat uniforms. Additionally, GAO reported that a total of 31 federal departments and agencies collect, maintain, and use geospatial information. Better planning and implementation could help reduce duplicative investments and save of millions of dollars."

A letter report issued by the Government Accountability Office with an abstract that begins "The military departments' Corrosion Control and Prevention Executives (Corrosion Executives) coordinated with the Department of Defense's (DOD) Corrosion Policy and Oversight Office (Corrosion Office) on reviews of their respective strategic plans. GAO's prior work has found that linking the goals of component organizations to departmental strategic goals is a practice that, if consistently applied, should improve the usefulness of plans to decision makers. However, the military departments varied in the extent that their strategic plans show clear linkage to the 10 goals and objectives included in the DOD Corrosion Prevention and Mitigation Strategic Plan. The Army's strategic plan showed clear linkage to all 10 of the goals and objectives. The Air Force's plan clearly linked to half of the goals and objectives and the Navy's plan clearly linked to 3 of the goals and objectives. GAO's review of the military departments' strategic plans found no inconsistencies with DOD Instruction 5000.67, which establishes policy, assigns responsibilities, and provides guidance for managing programs to prevent or mitigate corrosion. Without consistency or a clear linkage between the strategic plans of the military departments and the overarching goals and objectives …

Correspondence issued by the Government Accountability Office with an abstract that begins "During fiscal years 2009 through 2011, four administrations within DOT obligated about $144 billion from the HTF. FHWA obligated the largest share--about 81 percent--of this total, specifically:"

Correspondence issued by the Government Accountability Office with an abstract that begins "According to our nationwide survey of state testing directors, all states reported that their policies and procedures included 50 percent or more of the leading practices to prevent test irregularities in the following five areas—security plans, security training, security breaches, test administration and protecting secure materials. Additionally, of the 28 states that administered computer-based assessments, the majority reported including half or more of the leading practices in computer-based testing. However, states varied in the extent to which they incorporated elements of certain categories of leading practices. For example, 22 states reported having all of the leading practices for security training, but four states reported having none of the practices in this category. Although state officials reported having a variety of security policies and procedures in place, many reported feeling vulnerable to cheating at some point during the testing process."

Correspondence issued by the Government Accountability Office with an abstract that begins "In its fiscal year 2012 report, the Army included information that responded to some of the statutory reporting requirements, but did not include required information on the risks associated with, and mitigation strategies for, any shortfalls in key enabler personnel and equipment and a schedule for meeting personnel and equipment needs. The report included, among other things, an assessment of the status of key enabler personnel and equipment and information on assessments of modular force capabilities. However, the Army did not present the information it included in a way that clearly demonstrated the extent of progress toward meeting modular force requirements. While not explicitly required by law, there were also a number of ways in which the Army could have presented the information to better demonstrate the extent of progress toward meeting modularity requirements. For example, the Army could have provided more explicit comparisons with prior years to demonstrate the trend toward meeting key enabler equipment and personnel requirements, but instead presented limited data for only one year. Army officials agreed that some of the required information was omitted and that some of the information could have been …

Testimony 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 "Deferral: Both deferral tax expenditures confer the benefit of effectively reducing taxes by delaying the taxation of certain income of foreign subsidiaries of U.S. corporations until it is repatriated to the U.S. parent as dividends."

Testimony issued by the Government Accountability Office with an abstract that begins "About 14 percent of small employers sponsor some type of plan for their employees to save for retirement and these employers in general can face numerous challenges establishing and maintaining a plan. GAO's March 2012 report found that many of the small employers who were contacted said they felt overwhelmed by the number of plan options, plan administration requirements, and fiduciary responsibilities. For example, some small employers found it challenging to select investment funds for their plans. Small employers also cited other challenges in sponsoring a plan, including a lack of financial resources, time, and personnel. GAO's April 2012 review of select 401(k) plans--the most common type of plan sponsored by small employers--found that some smaller plan sponsors did not know about or fully understand fees they and their participants were charged, such as fees associated with group annuity contracts. In addition to these fees, participants in small plans often pay higher recordkeeping and investment management fees than participants in larger plans. GAO's work demonstrates the need for plan sponsors, particularly small sponsors, to understand fees in order to help participants secure adequate retirement savings. Any fees paid …

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO found (1) the Federal Housing Finance Agency's (FHFA) financial statements as of and for the fiscal years ended September 30, 2013, and 2012, are presented fairly, in all material respects, in accordance with U.S. generally accepted accounting principles; (2) FHFA maintained, in all material respects, effective internal control over financial reporting as of September 30, 2013; and (3) no reportable noncompliance for fiscal year 2013 with provisions of applicable laws, regulations, contracts, and grant agreements GAO tested. In commenting on a draft of this report, the acting Director of FHFA stated that he accepted the audit conclusions and commented that the agency would continue to work to enhance its internal control and ensure the reliability of its financial reporting, its soundness of operations, and public confidence in its mission."

A letter report issued by the Government Accountability Office with an abstract that begins "State-run programs face several challenges that primarily relate to staffing, and include having constrained budgets, according to OSHA and state officials. States have difficulty filling vacant inspector positions, obtaining training for inspectors, and retaining qualified inspectors. Recruiting inspectors is difficult due to the shortage of qualified candidates, relatively low state salaries, and hiring freezes. Although OSHA has taken steps to make its courses more accessible to states, obtaining inspector training continues to be difficult. According to an agency official, OSHA's Training Institute faces several challenges in delivering training, including recruiting and retaining instructors, difficulty accommodating the demand for training, and limitations in taking some courses to the field due to the need for special equipment and facilities. These challenges are further exacerbated by states' lack of travel funds, which limit state inspectors' access to OSHA training. Retaining qualified inspectors is another challenge among states. Officials noted that, once state inspectors are trained, they often leave for higher paying positions in the private sector or federal government. GAO's survey of the 22 state-run programs that cover private and public sector workplaces showed that turnover was more prevalent …

Correspondence issued by the Government Accountability Office with an abstract that begins "GAO found (1) the United States Securities and Exchange Commission's (SEC) and its Investor Protection Fund's (IPF) financial statements are presented fairly, in all material respects, in accordance with U.S. generally accepted accounting principles; (2) SEC maintained, in all material respects, effective internal control over financial reporting as of September 30, 2013, although internal control deficiencies exist that merit attention by those charged with governance; and (3) no reportable noncompliance in fiscal year 2013 with provisions of applicable laws, regulations, contracts, and grant agreements GAO tested. In commenting on a draft of this report, SEC's Chair expressed her pleasure that GAO found that SEC had successfully remediated the two significant deficiencies identified in 2012. The Chair added that SEC will focus on the significant deficiency GAO reported in 2013 in the area of information security."

A letter report issued by the Government Accountability Office with an abstract that begins "The 2007-2009 financial crisis has been associated with large economic losses and increased fiscal challenges. Studies estimating the losses of financial crises based on lost output (value of goods and services not produced) suggest losses associated with the recent crisis could range from a few trillion dollars to over $10 trillion. Also associated with the crisis were large declines in employment, household wealth, and other economic indicators. Some studies suggest the crisis could have long-lasting effects: for example, high unemployment, if persistent, could lead to skill erosion and lower future earnings for those affected. Finally, since the crisis began, federal, state, and local governments have faced greater fiscal challenges, in part because of reduced tax revenues from lower economic activity and increased spending to mitigate the impact of the recession."

A letter report issued by the Government Accountability Office with an abstract that begins "The Internal Revenue Service’s (IRS) existing online services are limited when compared to many other government and private sector organizations. Static web pages make up the majority of www.IRS.gov; however, IRS highlights 18 basic interactive tools from its homepage. IRS does not offer dynamic account access to taxpayers. Other federal and state taxing authorities provide a broader range of online services to their customers, including interactive account access."

Correspondence issued by the Government Accountability Office with an abstract that begins "DOD officials stated that their policy is to accommodate children with special needs unless those accommodations fundamentally alter the nature of the program. However, DOD does not centrally collect or maintain data on accommodation decisions; instead they are kept at the installation level. Two services--Army and Air Force--have begun or plan to collect specific data at the service level to monitor and track services to children with special needs across their installations by 2013. Further, the services have different definitions of special needs, although officials told us DOD is working on a standard definition. According to OSD officials, each service has established an assessment process to determine how to accommodate children with special needs in DOD's child care programs. This assessment process is the primary means through which parents can address concerns related to finding appropriate child care for their children with special needs, as well as to help identify support and outreach programs for the family. The National Defense Authorization Act for Fiscal Year 2010 created the Office of Special Needs, which is responsible for enhancing and improving support for families of children with special needs. Although …

A letter report issued by the Government Accountability Office with an abstract that begins "Department of Homeland Security (DHS) components have developed models to assess the risks of foreign ports and cargo, but not all components have applied risk management principles to assess whether maritime security programs cover the riskiest ports. The U.S. Coast Guard uses its risk model to inform operational decisions for its International Port Security (IPS) program and annually updates its assessment. In contrast, U.S. Customs and Border Protection (CBP) has not regularly assessed ports for risks to cargo under its Container Security Initiative (CSI) program. CBP's selection of the initial 23 CSI ports was primarily based on the volume of U.S.-bound containers, but beginning in 2003, CBP considered more threat information when it expanded the number of CSI ports. CBP has not assessed the risk posed by foreign ports that ship cargo to the United States for its CSI program since 2005. In 2009, CBP developed a model that ranked 356 potential expansion ports for a related program on the basis of risk, but it was never implemented because of budget cuts. By applying CBP's risk model to fiscal year 2012 cargo shipment data, GAO found …

A letter report issued by the Government Accountability Office with an abstract that begins "The International Atomic Energy Agency (IAEA) has taken several steps to strengthen its safeguards program since GAO's 2005 report, including increasing the number of countries that are subject to a broader range of safeguards measures, upgrading its analytical laboratories, and producing its first long-term strategic plan. However, the agency faces two critical challenges in further improving the effectiveness and efficiency of the safeguards program. First, several countries have raised concerns about IAEA's plans to expand implementation of what it calls the "state-level concept" to all countries with safeguards agreements by 2014. The state-level concept is an approach in which the agency considers a broad range of information about a country's nuclear capabilities and tailors its safeguards activities in each country accordingly. IAEA officials told GAO that broader implementation of this approach would allow the agency to better allocate resources by reducing safeguards activities where there is no indication of undeclared nuclear activities and to focus its efforts on any issues of safeguards concern. However, IAEA has not clearly defined and communicated how it will implement the state-level concept. As a result, several countries are concerned that …

A letter report issued by the Government Accountability Office with an abstract that begins "To install positive train control (PTC)--a communications-based system designed to prevent certain types of train accidents caused by human factors-- almost all railroads are overlaying their existing infrastructure with PTC components; nonetheless, most railroads report they will miss the December 31, 2015, implementation deadline. Both the Association of American Railroads (AAR) and the Federal Railroad Administration (FRA) have reported that most railroads will not have PTC fully implemented by the deadline. Of the four major freight railroads included in GAO's review, only one expects to meet the 2015 deadline. The other three freight railroads report that they expect to have PTC implemented by 2017 or later. Commuter railroads generally must wait until freight railroads and Amtrak equip the rail lines they operate on, and most of the seven commuter railroads included in this review reported that they do not expect to meet the 2015 deadline. To implement PTC systems that meet the requirements of the Rail Safety Improvement Act of 2008 (RSIA), railroads are developing more than 20 major components that are currently in various stages of development, integrating them, and installing them across the rail …

A letter report issued by the Government Accountability Office with an abstract that begins "Management-level representation of minorities and women in the financial services industry and among federal financial agencies and Federal Reserve Banks (Reserve Banks) has not changed substantially from 2007 through 2011. Industry representation of minorities in 2011 was higher in lower-level management positions--about 20 percent--compared to about 11 percent of senior-level manager positions. Industry representation of women at the overall management level remained at about 45 percent. Agency representation of minorities at the senior management level in 2011 ranged from 6 percent to 17 percent and from 0 percent to 44 percent at the Reserve Banks. Women's representation ranged from 31 to 47 percent at the agencies and from 15 to 58 percent at the Reserve Banks. Officials said the main challenge to improving diversity was identifying candidates, noting that minorities and women are often underrepresented in both internal and external candidate pools."

Correspondence 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 "The designation of senior-level officials to key performance management roles with responsibilities under the Government Performance and Results Act Modernization Act of 2010 (GPRAMA) has helped elevate accountability for performance management within federal agencies and ensure high-level involvement, according to officials GAO interviewed. The 24 Chief Financial Officers (CFO) Act agencies have all assigned officials to the key management roles--chief operating officer, performance improvement officer (PIO), and goal leader--required under GPRAMA, according to the Office of Management and Budget (OMB) and the results of GAO's PIO survey. PIOs GAO surveyed reported that most key officials were greatly involved in central aspects of performance management, such as agency quarterly performance reviews. PIOs GAO surveyed, and priority goal leaders GAO interviewed at the Department of Health and Human Services (HHS) and the National Science Foundation (NSF), reported they were supported in their responsibilities by their deputies and other staff. PIOs generally reported that their staff had competencies identified as relevant by the Office of Personnel Management (OPM), such as reasoning, to a large extent, although PIOs reported that the competencies were not as widespread among their staff as …

Testimony issued by the Government Accountability Office with an abstract that begins "The Federal Aviation Administration (FAA) is responsible for approving the design and airworthiness of new aircraft and equipment before they are introduced into service. FAA approves changes to aircraft and equipment based on evaluation of industry submissions against standards set forth in federal aviation regulations and related guidance documents. In September 2011, we reported that, overall, FAA did a good job following its certification processes in assessing the composite fuselage and wings of Boeing's 787 against its airworthiness standards. However, the approval process--referred to as certification--presents challenges for FAA in terms of resources and maintaining up-to-date knowledge of industry practices, two issues that may hinder FAA's efforts to conduct certifications in an efficient and timely manner. FAA is currently assessing its certification process and identifying opportunities to streamline it."