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Physician Services: Concierge Care Characteristics and Considerations for Medicare
A letter report issued by the Government Accountability Office with an abstract that begins "Concierge care is an approach to medical practice in which physicians charge their patients a membership fee in return for enhanced services or amenities. The recent emergence of concierge care has prompted federal concern about how the approach might affect beneficiaries of Medicare, the federal health insurance program for the aged and some disabled individuals. Concerns include the potential that membership fees may constitute additional charges for services that Medicare already pays physicians for and that concierge care may affect Medicare beneficiaries' access to physician services. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 directed GAO to study concierge care and its relationship to Medicare. Using a variety of methods, including a nationwide literature search and telephone interviews, GAO identified 146 concierge physicians and surveyed concierge physicians in fall 2004. GAO analyzed responses from 112 concierge physicians. GAO also reviewed relevant laws, policies, and available data on access to physician services and interviewed officials at the Department of Health and Human Services (HHS) and representatives of Medicare beneficiary advocacy groups."
Date:
August 12, 2005
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Consumer Product Safety Commission: Better Data Collection and Assessment of Consumer Information Efforts Could Help Protect Minority Children
A letter report issued by the Government Accountability Office with an abstract that begins "In 2004, the U.S. Consumer Product Safety Commission (CPSC) estimated that 29,400 deaths in the United States were related to consumer products. As required under Section 107 of the Consumer Product Safety Improvement Act of 2008, this study reviews what is known about the relative incidence of preventable injuries and deaths among minority children associated with products intended for children's use and also examines what actions CPSC has taken through its public information and education initiatives to minimize these injuries and deaths. To address these issues, we assessed injury and death data sources used by CPSC, compared CPSC's consumer education efforts with key practices, and interviewed federal officials and groups representing the health and consumer interests of minority populations."
Date:
August 5, 2009
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Medicaid Preventive Services: Concerted Efforts Needed to Ensure Beneficiaries Receive Services
A letter report issued by the Government Accountability Office with an abstract that begins "Medicaid, a federal-state program that finances health care for certain low-income populations, can play a critical role in the provision of preventive services, which help prevent, diagnose, and manage health conditions. GAO examined available data to assess (1) the extent to which Medicaid children and adults have certain health conditions and receive certain preventive services, (2) for Medicaid children, state monitoring and promotion of the provision of preventive services, (3) for Medicaid adults, state coverage of preventive services, and (4) federal oversight by the Centers for Medicare & Medicaid Services (CMS). GAO analyzed data from nationally representative surveys: the National Health and Nutrition Examination Survey (NHANES), which includes physical examinations of participants, and the Medical Expenditure Panel Survey (MEPS). GAO also surveyed state Medicaid directors and interviewed federal officials."
Date:
August 14, 2009
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Information Security: Progress Made, but Federal Aviation Administration Needs to Improve Controls over Air Traffic Control Systems
A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Aviation Administration (FAA) performs critical functions that contribute to ensuring safe, orderly, and efficient air travel in the national airspace system. To that end, it operates and relies extensively on an array of interconnected automated information systems and networks that comprise the nation's air traffic control systems. These systems provide information to air traffic controllers and aircraft flight crews to help ensure the safe and expeditious movement of aircraft. Interruptions of service by these systems could have a significant adverse impact on air traffic nationwide. Effective information security controls are essential for ensuring that the nation's air traffic control systems are adequately protected from inadvertent or deliberate misuse, disruption, or destruction. Accordingly, GAO was asked to evaluate the extent to which FAA has implemented information security controls for these systems."
Date:
August 26, 2005
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Legal Services Corporation: Governance and Accountability Practices Need to Be Modernized and Strengthened
A letter report issued by the Government Accountability Office with an abstract that begins "The Legal Services Corporation (LSC) was federally created as a private nonprofit corporation to support legal assistance for low-income people to resolve their civil matters and relies heavily on federal appropriations. Due to its unique status, its governance and accountability requirements differ from those of federal entities and nonprofits. This report responds to a congressional request that GAO review LSC board oversight of LSC's operations and whether LSC has sufficient governance and accountability. GAO's report objectives are to (1) compare LSC's framework for corporate governance and accountability to others', (2) evaluate LSC's governance practices, and (3) evaluate LSC's internal control and financial reporting practices. We reviewed the LSC Act, legislative history, relevant standards and requirements, and LSC documentation and accountability requirements and interviewed board and staff."
Date:
August 15, 2007
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Federal Law Enforcement: Survey of Federal Civilian Law Enforcement Mandatory Basic Training
A letter report issued by the Government Accountability Office with an abstract that begins "Federal law enforcement officers (LEO) are required to complete mandatory basic training in order to exercise their law enforcement authorities. GAO was asked to identify federal mandatory law enforcement basic training programs. This report builds on GAO's prior work surveying federal civilian law enforcement components regarding their functions and authorities (see GAO-07-121, December 2006). GAO defined an LEO as an individual authorized to perform any of four functions: conduct criminal investigations, execute search warrants, make arrests, or carry firearms. In this report GAO describes (1) the mandatory basic law enforcement training that the components reported requiring their LEOs to complete and the federal law enforcement job series classifications for which basic training programs are mandatory; and (2) a breakdown of the delivery of the of basic training programs, by type of organization providing the training and location. To conduct this work, GAO administered a Web-based survey to 105 federal civilian law enforcement components. Each was requested to self-report on, required basic training programs for LEOs, the organizations conducting the training, training locations, and the job series for which programs are mandatory. GAO is not making recommendations."
Date:
August 10, 2007
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
United States Merchant Marine Academy: Internal Control Weaknesses Resulted in Improper Sources and Uses of Funds; Some Corrective Actions Are Under Way
A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Merchant Marine Academy (Academy), a component of the Department of Transportation's Maritime Administration (MARAD), is one of five U.S. service academies. The Academy is affiliated with 14 non-appropriated fund instrumentalities (NAFI) and two foundations. GAO was asked to determine whether there (1) were any potentially improper or questionable sources and uses of funds by the Academy, including transactions with its affiliated organizations; (2) was an effective control environment with key controls in place over the Academy's sources and uses of funds; and (3) were any actions taken, under way, or planned to improve controls and accountability. GAO analyzed selected transactions from fiscal years 2006, 2007, and 2008 to identify improper or questionable sources and uses of funds and reviewed documents and interviewed cognizant officials to assess the Academy's internal controls, and identify corrective actions to improve controls."
Date:
August 10, 2009
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Defined Benefit Pension Plans: Guidance Needed to Better Inform Plans of the Challenges and Risks of Investing in Hedge Funds and Private Equity
A letter report issued by the Government Accountability Office with an abstract that begins "Millions of retired Americans rely on defined benefit pension plans for their financial well-being. Recent reports have noted that some plans are investing in 'alternative' investments such as hedge funds and private equity funds. This has raised concerns, given that these two types of investments have qualified for exemptions from federal regulations, and could present more risk to retirement assets than traditional investments. To better understand this trend and its implications, GAO was asked to examine (1) the extent to which plans invest in hedge funds and private equity; (2) the potential benefits and challenges of hedge fund investments; (3) the potential benefits and challenges of private equity investments; and (4) what mechanisms regulate and monitor pension plan investments in hedge funds and private equity. To answer these questions GAO interviewed relevant federal agencies, public and private pension plans, industry groups and investment professionals, and analyzed available survey data."
Date:
August 14, 2008
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Workplace Safety and Health: OSHA's Oversight of Its Civil Penalty Determination and Violation Abatement Processes Has Limitations
A letter report issued by the Government Accountability Office with an abstract that begins "This report presents the findings of our study of the Department of Labor's Occupational Safety and Health Administration's (OSHA) determination of civil penalties and abatement of violations. The objective of the study was to assess the extent of OSHA's oversight of the civil penalty determination and the violation abatement processes. In addition, we developed a statistical model, known as a multivariate analysis, to better understand factors that influenced variation in penalty amounts. On July 7, 2004, we briefed Labor officials on the results of our study. This letter report formally conveys the information we presented at that briefing. To assess the extent of OSHA's oversight of the civil penalty determination and violation abatement processes, we (1) reviewed 2002 and 2003 regional audits from the five regions with the most inspections, (2) visited one of these regional offices and one area office within this region to interview officials and review documents and procedures, (3) conducted telephone interviews with the four remaining regional offices and one area office within each of those regions, (4) interviewed OSHA officials to identify relevant policies and procedures, and (5) reviewed relevant policies …
Date:
August 13, 2004
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Nuclear Waste: DOE's Efforts to Protect the Columbia River from Contamination Could Be Further Strengthened
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy's (DOE) Hanford site in Washington State is one of the most contaminated nuclear waste sites in North America. The Columbia River flows through about 50 miles of the site. Radioactive and hazardous contamination from decades of producing nuclear materials for the nation's defense have migrated through the soil into the groundwater, which generally flows toward the river. In November 2005, GAO reported on the potential for the Hanford site to contaminate the Columbia River. To address continuing concerns, GAO reviewed the status of DOE's efforts to (1) understand the risk to the Columbia River from Hanford site contamination and to deploy effective technologies to address contamination near the river and (2) strengthen the management of its river protection program. To assess DOE's efforts, GAO reviewed numerous reports by DOE and others, and discussed the problem with federal and state regulators and DOE officials."
Date:
August 28, 2006
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Supply Chain Security: CBP Works with International Entities to Promote Global Customs Security Standards and Initiatives, but Challenges Remain
A letter report issued by the Government Accountability Office with an abstract that begins "Oceangoing cargo containers play a vital role in global trade but can also pose a risk of terrorist exploitation. U.S. Customs and Border Protection (CBP), part of the Department of Homeland Security (DHS), oversees security of the supply chain--the flow of goods from manufacturer to retailer. CBP anticipates that adoption of uniform, international customs security standards could eventually lead to a system of mutual recognition whereby the customs security-related practices and programs taken by one customs administration are recognized and accepted by another administration. In response to congressional requesters, GAO determined (1) actions CBP has taken to develop and implement international supply chain security standards, (2) actions CBP has taken with international partners to achieve mutual recognition of customs security practices, and (3) issues CBP and foreign customs administrations anticipate in implementing 100 percent scanning of U.S.-bound container cargo. To conduct its work, GAO analyzed CBP documents on supply chain security programs and international cooperation initiatives and met with CBP officials and foreign customs officials from various trading partner nations. Also, GAO drew upon its related reports and testimony on supply chain security issued earlier this …
Date:
August 15, 2008
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Military Training: Management Actions Needed to Enhance DOD's Investment in the Joint National Training Capability
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) established its Training Transformation Program to ensure combatant commanders that forces deploying to their theaters have had experience operating jointly. The centerpiece of this effort is the Joint National Training Capability (JNTC) initiative, which accounts for 84 percent of the $2 billion the department plans to invest by 2011 to provide a persistent global network that will increase the level of joint training. GAO assessed the extent to which (1) JNTC has improved the ability of the services and combatant commands to train jointly, (2) the reserve components are benefiting from the JNTC initiative, and (3) the Joint Forces Command has developed an accreditation process to facilitate program goals. To address these objectives, GAO obtained and analyzed key DOD and JNTC documents. GAO also reviewed and analyzed 5 of 16 events selected in 2005 as JNTC training events, and observed 2 of those events firsthand."
Date:
August 11, 2006
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Flood Insurance: Opportunities Exist to Improve Oversight of the WYO Program
A letter report issued by the Government Accountability Office with an abstract that begins "Since 2004, private insurance companies participating in the Federal Emergency Management Agency's (FEMA) Write-Your-Own (WYO) program have collected an average of $2.3 billion in premiums annually and, of this amount, have been paid or allowed to retain an average of $1 billion per year. Questions have been raised about FEMA's oversight of the program in light of the debts FEMA has incurred since the 2005 hurricanes. GAO placed NFIP on its high-risk list and issued several reports addressing the challenges the program faces. This report addresses the methods FEMA uses for determining the rates at which WYOs are paid, its marketing bonus system for WYOs, its adherence to financial control requirements for the WYO program, and alternatives to the current system. To do this work, we reviewed and analyzed FEMA's data and policies and procedures and obtained the views of select WYOs and flood insurance experts."
Date:
August 21, 2009
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Defense Acquisitions: Navy Faces Challenges Constructing the Aircraft Carrier Gerald R. Ford within Budget
A letter report issued by the Government Accountability Office with an abstract that begins "The Navy is investing over $3 billion to develop technologies for a new type of aircraft carrier--the Ford class--and it expects to spend almost $11 billion to design and construct the USS Gerald R. Ford (CVN 78)--the lead ship of the class. New technologies are to improve the carrier's performance and reduce crew size. The Navy requested authorization of CVN 78 in its fiscal year 2008 budget. GAO was asked to assess the Navy's ability to meet its goals for developing the new carrier. Specifically, this report assesses (1) the extent to which technology development could affect the capability and construction of CVN 78, (2) the status of efforts to achieve design stability, and (3) the challenges to building CVN 78 within budget. To accomplish this, our work includes analysis of test reports, development schedules, and ship progress reviews; interviews with Navy and other officials; and examinations of cost estimates and our own past work."
Date:
August 23, 2007
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Transportation Research: Opportunities for Improving the Oversight of DOT's Research Programs and User Satisfaction with Transportation Statistics
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Transportation's (DOT) research, development, and technology (RD&T) budget totaled $1.1 billion in fiscal year 2005. DOT's Research and Innovative Technology Administration (RITA)--which includes the Bureau of Transportation Statistics (BTS)--oversees DOT's RD&T activities. GAO examined (1) how RITA's responsibilities for overseeing DOT's RD&T activities differ from those of its predecessor, the Research and Special Programs Administration (RSPA); (2) RITA's practices for coordinating, facilitating, and reviewing RD&T activities; (3) the progress DOT has made in implementing GAO's 2003 recommendations on how to improve the coordination and evaluation of RD&T activities; and (4) how BTS identifies and monitors how well it serves its users. To address these issues, GAO reviewed relevant documentation and interviewed officials from RITA, BTS, and three operating administrations."
Date:
August 15, 2006
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
DOD Business Transformation: Air Force's Current Approach Increases Risk That Asset Visibility Goals and Transformation Priorities Will Not Be Achieved
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) established a goal to achieve total asset visibility over 30 years ago. This initiative aims to provide timely, accurate information on the location, movement, status, and identity of equipment and supplies. To date, the effort has been unsuccessful. GAO was requested to determine (1) the implementation status of the Air Force's business system initiatives to achieve total asset visibility, and whether the Air Force has implemented related best practices, and (2) whether the Air Force's business transformation efforts to achieve total asset visibility are aligned within the Air Force and with DOD's broader business transformation priorities. GAO interviewed Air Force officials and reviewed Air Force documentation to obtain an understanding of the Air Force's system initiatives and strategy for achieving total asset visibility and to identify areas for improvement."
Date:
August 8, 2008
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Executive Office For Immigration Review: Caseload Performance Reporting Needs Improvement
A letter report issued by the Government Accountability Office with an abstract that begins "Within the Department of Justice's (DOJ) Executive Office for Immigration Review (EOIR), the Office of the Chief Immigration Judge (OCIJ) is responsible for managing the 53 immigration courts located throughout the United States where over 200 immigration judges adjudicate individual cases involving alleged immigration law violations. This report addresses: (1) in recent years, what has been the trend in immigration courts' caseload; (2) how does OCIJ assign and manage the immigration court caseload; and (3) how does EOIR/OCIJ evaluate the immigration courts' performance? To address these issues, GAO interviewed EOIR officials; reviewed information on caseload trends, caseload management, and court evaluations; and analyzed caseload data, case completion goal data, and OCIJ court evaluation reports."
Date:
August 11, 2006
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Financial Management: Long-standing Financial Systems Weaknesses Present a Formidable Challenge
A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Financial Management Improvement Act of 1996 (FFMIA) requires the 24 Chief Financial Officers (CFO) Act agencies to implement and maintain financial management systems that comply substantially with (1) federal financial management systems requirements, (2) federal accounting standards, and (3) the U.S. Government Standard General Ledger (SGL). FFMIA also requires GAO to report annually on the implementation of the act. This report, primarily based on GAO and inspectors general reports, discusses (1) the problems that continued to affect agencies systems' FFMIA compliance in fiscal year 2006 and (2) the initiatives under way to help move federal financial management toward FFMIA compliance."
Date:
August 3, 2007
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
International Marriage Broker Regulation Act of 2005: Agencies Have Implemented Some, but Not All of the Act's Requirements
A letter report issued by the Government Accountability Office with an abstract that begins "The International Marriage Broker Regulation Act of 2005 (IMBRA) was enacted to address issues of domestic violence and abuse against noncitizens (beneficiaries) married or engaged to U.S. citizens (petitioners) who have petitioned for them to immigrate to the U.S., including those who met through an international marriage broker (IMB). IMBRA mandated that GAO study the act's impact on the visa process for noncitizen spouses and fiance(e)s. This report addresses the extent to which the U.S. Citizenship and Immigration Services (USCIS), a component of the Department of Homeland Security (DHS); the Department of State (DOS); and the Department of Justice (DOJ) have implemented IMBRA, and the extent to which USCIS and DOS have collected and maintained data for this GAO report as required by IMBRA. To address these objectives, GAO reviewed the act and related legislation, analyzed IMBRA implementation guidance and available data on applications filed, and interviewed officials at USCIS, DOS, and DOJ."
Date:
August 8, 2008
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Registered Apprenticeship Programs: Labor Can Better Use Data to Target Oversight
A letter report issued by the Government Accountability Office with an abstract that begins "Between 2002 and 2012 nearly 850,000 jobs will open in the construction industry; experts predict that there will not be enough skilled workers to fill them. This has heightened concerns about program outcomes and program quality in the nation's apprenticeship system and the U.S. Department of Labor's oversight of it. GAO assessed (1) the extent to which Labor monitors registered apprenticeship programs in the states where it has direct oversight, (2) its oversight activities in states that do their own monitoring, and (3) the outcomes for construction apprentices in programs sponsored by employers and unions in relation to programs sponsored by employers alone."
Date:
August 29, 2005
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Enterprise Architecture: Leadership Remains Key to Establishing and Leveraging Architectures for Organizational Transformation
A letter report issued by the Government Accountability Office with an abstract that begins "A well-defined enterprise architecture is an essential tool for leveraging information technology (IT) to transform business and mission operations. GAO's experience has shown that attempting to modernize and evolve IT environments without an architecture to guide and constrain investments results in operations and systems that are duplicative, not well integrated, costly to maintain, and ineffective in supporting mission goals. In light of the importance of enterprise architectures, GAO developed a five stage architecture management maturity framework that defines what needs to be done to effectively manage an architecture program. Under GAO's framework, a fully mature architecture program is one that satisfies all elements of all stages of the framework. As agreed, GAO's objective was to determine the status of major federal department and agency enterprise architecture efforts."
Date:
August 14, 2006
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Electronic Records Archives: The National Archives and Records Administration's Fiscal Year 2006 Expenditure Plan
A letter report issued by the Government Accountability Office with an abstract that begins "Since 2001, the National Archives and Records Administration (NARA) has been working to acquire the Electronic Records Archives (ERA) system, which is intended to address critical issues in the creation, management, and use of federal electronic records. As required by law, the agency submitted its fiscal year 2006 expenditure plan to the congressional appropriations committees, seeking the release of about $22 million for the development of the system. GAO's objectives in reviewing the expenditure plan were to (1) determine the extent to which the expenditure plan satisfied the legislative conditions specified in the appropriations act; (2) determine the extent to which NARA has implemented GAO's prior recommendations; and (3) provide any other observations about the expenditure plan and the ERA acquisition. We reviewed the expenditure plan and analyzed it against the legislative conditions and assessed NARA's progress in addressing prior recommendations."
Date:
August 18, 2006
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
NASA: Constellation Program Cost and Schedule Will Remain Uncertain Until a Sound Business Case Is Established
A letter report issued by the Government Accountability Office with an abstract that begins "NASA's Constellation program is developing the Ares I Crew Launch Vehicle and the Orion Crew Exploration Vehicle as the agency's first major efforts in a plan to return to the moon and eventually send humans to Mars. GAO has issued a number of reports and testimonies on various aspects of this program, and made several recommendations. GAO was asked to assess NASA's progress in implementing GAO's recommendations for the Ares I and Orion projects, and identify risks the program faces. GAO analyzed NASA plans and schedules, risk mitigation information, and contract performance data relative to knowledge-based acquisition practices identified in prior GAO reports, and interviewed government officials and contractors."
Date:
August 26, 2009
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library
Pension Benefit Guaranty Corporation: More Strategic Approach Needed for Processing Complex Plans Prone to Delays and Overpayments
A letter report issued by the Government Accountability Office with an abstract that begins "As the insurer of over 29,000 private sector defined benefit plans, the Pension Benefit Guaranty Corporation (PBGC) may be required to assume responsibility for the plans of a growing number of companies filing bankruptcy due to the recession. Concerns about PBGC's benefit determination process, reductions in benefits due to guarantee limits, and workers' retirement security overall led the chairmen and ranking members of the Senate Health, Education, Labor, and Pensions Committee and the Senate Finance Committee, among others, to ask GAO to study: (1) how long it takes PBGC to make benefit determinations; (2) the extent of overpayments on retirees' benefits; (3) how well PBGC communicates with participants; and (4) the timeliness and accessibility of the appeals process. To conduct this study, GAO reviewed PBGC policies and procedures, analyzed automated data and case files, and interviewed PBGC officials and certain associations, participants, and their representatives from among those most affected by the process."
Date:
August 17, 2009
Creator:
United States. Government Accountability Office.
System:
The UNT Digital Library