A letter report issued by the Government Accountability Office with an abstract that begins "Members of Congress and state agencies have raised questions about complaints that some Medicare Advantage (MA) organizations and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate information about covered benefits and conducting prohibited marketing practices. The Centers for Medicare & Medicaid Services (CMS) is responsible for oversight of MA organizations and their plans. The Government Accountability Office (GAO) was asked to examine (1) the extent to which CMS has taken compliance and enforcement actions, (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered, and (3) information CMS has about the extent of inappropriate marketing. To do this work, GAO reviewed relevant laws and policies; analyzed Medicare data on beneficiary complaints, compliance actions and enforcement actions; and interviewed officials from CMS and selected state departments of insurance, state health insurance assistance programs, and MA organizations."

A letter report issued by the Government Accountability Office with an abstract that begins "U.S. ports, waterways, and coastal approaches are part of a system handling more than $700 billion in merchandise annually. With the many possible threats--including transportation and detonation of weapons of mass destruction, suicide attacks against vessels, and others--in the maritime domain, awareness of such threats could give the Coast Guard advance notice to help detect, deter, interdict, and defeat them and protect the U.S. homeland and economy. GAO was asked to review the Coast Guard's efforts to achieve awareness about activity in the maritime domain. This report addresses: the extent to which the Coast Guard (1) has vessel tracking systems in place, (2) can use these systems to track vessels that may be threats, and (3) has coordinated the development and implementation of these systems. To answer these questions, GAO analyzed relevant statutes, regulations, and plans for vessel tracking systems, compared the roles of the planned systems, and interviewed appropriate officials."

A letter report issued by the Government Accountability Office with an abstract that begins "For the past 11 years, since GAO's first audit of the consolidated financial statements of the U.S. government (CFS), certain material weaknesses in internal control and in selected accounting and financial reporting practices have prevented GAO from expressing an opinion on the CFS. GAO has consistently reported that the U.S. government did not have adequate systems, controls, and procedures to properly prepare the CFS. GAO's December 2007 disclaimer of opinion on the fiscal year 2007 accrual basis consolidated financial statements included a discussion of continuing control deficiencies related to the preparation of the CFS. The purpose of this report is to (1) provide details of continuing material weaknesses, (2) recommend improvements, and (3) provide the status of corrective actions taken to address the 81 open recommendations related to the preparation of the CFS that GAO reported in July 2007."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO previously reported on how large information resellers like consumer reporting agencies obtain and use Social Security numbers (SSNs). Less is known about information resellers that offer services to the general public over the Internet. Because these resellers provide access to personal information, SSNs could be obtained over the Internet. GAO was asked to examine (1) the types of readily identifiable Internet resellers that have SSN-related services and characteristics of their businesses, (2) the extent to which these resellers sell SSNs, and (3) the applicability of federal privacy laws to Internet resellers."

A letter report issued by the Government Accountability Office with an abstract that begins "D.C. has a larger percentage of students in charter schools than any state. To help oversee D.C. charter schools, Congress established two authorizers--the Board of Education (BOE), which has an Office of Charter Schools responsible for oversight, and the independent Public Charter School Board (PCSB). Congress required the GAO to conduct a study of the authorizers. This report--which completes GAO's May 2005 study--examines the (1) authorizers' resources, (2) oversight practices, and (3) actions taken once charter schools close. GAO examined BOE and PCSB monitoring reports, revenue and expenditure documents, and closure procedures."

A letter report issued by the Government Accountability Office with an abstract that begins "Due to several simultaneous Department of Defense (DOD) force structure and basing initiatives, 20 installations are expecting a combined net growth of over 173,000 military and civilian personnel, not including family members and all contractors, over fiscal years 2006-2012. Although communities surrounding these installations can expect to realize economic benefits in the long term, DOD has identified these 20 to be substantially and seriously impacted in terms of being able to provide infrastructure to accommodate the growth. In response to the House report to the fiscal year 2007 defense appropriations bill, GAO (1) examined the extent to which communities affected by DOD's actions have identified their infrastructure needs, and (2) assessed DOD's efforts and those of other agencies to assist affected communities. GAO reviewed applicable directives and executive orders, surveyed the 20 growth communities, and met with community and agency officials to discuss growth issues."

A letter report issued by the Government Accountability Office with an abstract that begins "American Samoa, a U.S. territory, relies on federal funding to support government operations and deliver critical services. The Secretary of the Interior has administrative responsibility for coordinating federal policy in the territory. Under the Single Audit Act of 1996, American Samoa is required to perform a yearly single audit of federal grants and other awards to ensure accountability. To better understand the role of federal funds in American Samoa, GAO (1) examined the uses of 12 key grants in fiscal years 1999-2003, (2) identified local conditions that affected the grants, and (3) assessed accountability for the grants."

A letter report issued by the Government Accountability Office with an abstract that begins "The Nuclear Regulatory Commission (NRC) is responsible for licensing and inspecting the nation's nuclear power plants to ensure their safety and security. By 2010, about one third of NRC's workforce with mission-critical skills will be eligible to retire. At the same time, NRC's workforce needs to expand because NRC expects to receive at least 20 applications for 29 new nuclear power reactors beginning in October 2007. GAO assessed NRC's ability to meet its workforce needs by examining the extent to which NRC (1) has aligned its human capital planning framework with its strategic mission and programmatic goals; (2) is effectively recruiting, developing, and retaining critically skilled personnel; and (3) is addressing future uncertainties that could affect its overall workforce capacity. GAO examined strategic workforce planning and implementation documents, interviewed cognizant managers on NRC's human capital framework and activities, and surveyed these managers about NRC's human capital flexibilities and measures."

A letter report issued by the Government Accountability Office with an abstract that begins "While some progress has been made in recent years, agencies urgently need to strengthen basic management capabilities to successfully address current and emerging demands. The incoming administration will face challenges in implementing its policy and program agendas because of shortcomings in agencies' management capabilities. Building and developing the institutional capacity to meet these challenges will require appointing the right people to the right positions. It is vitally important that leadership and management skills, abilities, and experience be among the key criteria the new President uses to select his leadership teams in the agencies. The Senate's interest in leveraging its role in confirmation hearings will send a strong message that nominees should have the requisite skills to deal effectively with the broad array of complex management challenges they will face. This report includes questions for each of 28 major executive branch departments and agencies, and one for each of the following seven major governmentwide management areas: (1) acquisition management, (2) collaboration, (3) financial management, (4) human capital management, (5) information and technology management, (6) results-oriented decision making, and (7) real property management and security."

A letter report issued by the Government Accountability Office with an abstract that begins "Congress recognizes that the DOD needs some flexibility to adjust research and development program levels. A key mechanism--below threshold reprogramming (BTR)--enables DOD to adjust program funding levels without seeking prior congressional approval as long as a certain dollar amount or percentage threshold is not exceeded. In response to a mandate by the appropriations committees, this report addresses (1) the quality of the information available about DOD's use of BTRs and withheld funds in fiscal years 2002 and 2003 and (2) the amount and volume of BTRs and temporarily withheld funds for those years. The report also addresses recent congressional direction on providing information on funding adjustments. DOD disagreed that its recent reports to Congress provide BTR information of limited quality but noted that the issues GAO raised in this regard can be addressed and that DOD was open to suggestions and will gladly work with committee staff to satisfy their needs. DOD also offered suggestions to clarify language on certain issues and to put its use of BTRs more in context. DOD's willingness to work with Congress is a constructive response that can lead to reporting …

A letter report issued by the Government Accountability Office with an abstract that begins "Begun in 1998, the Job Access and Reverse Commute (JARC) program provides grants to states and localities for improving the mobility of low-income persons seeking work. The Federal Transit Administration (FTA) administers this program. In 2005, the Safe, Accountable, Flexible, Efficient Transportation Equity Act--A Legacy for Users (SAFETEA-LU) authorized $727 million for JARC for fiscal years 2005 through 2009, changed how these funds were to be awarded after fiscal year 2005, and required FTA to evaluate the program by August 2008. GAO examined (1) SAFETEA-LU's changes to JARC, (2) FTA's progress in implementing these changes, (3) states' and localities' efforts to respond and challenges they have encountered, and (4) FTA's proposed strategy for evaluation and oversight. GAO's work included analyzing program guidance as well as interviewing officials from FTA, industry groups, and more than 30 state and local agencies."

A letter report issued by the General Accounting Office with an abstract that begins "Colorectal cancer is the second leading cause of cancer deaths in the United States. Its mortality can be reduced through early detection and treatment. Four key tests are used to detect the cancer--fecal occult blood test (FOBT), flexible sigmoidoscopy, double-contrast barium enema (DCBE), and colonoscopy. Private health insurance plans generally cover these tests to diagnose cancer; however, the extent to which plans cover the tests for screening purposes--where no symptoms are evident--is less clear. Congress is considering legislation that would require coverage of the tests for screening purposes among all private health insurance plans. GAO was asked to (1) identify the state laws that require private health insurance coverage of these screening tests; and (2) determine the extent to which the tests are covered among small employer, individual, large employer, and federal employee health plans. GAO summarized state laws that require coverage of the tests. GAO examined test coverage among a sample of the largest 19 small employer and 14 individual plans in 10 states without laws requiring the coverage, and among 35 large employer plans nationally. The findings cannot be generalized beyond these plans. GAO …

A letter report issued by the Government Accountability Office with an abstract that begins "As part of its more than $24 billion Deepwater program to replace aging vessels and aircraft with new or upgraded assets, the Coast Guard is preparing the National Security Cutter (NSC) for service. GAO previously reported on Deepwater assets' deployment delays and the Coast Guard's management of the Deepwater program. GAO was legislatively directed to continue its oversight of the Deepwater program. As a result, this report addresses: (1) the operational effects, if any, of delays in the delivery of the NSC and its support assets of unmanned aircraft and small boats; (2) Coast Guard plans for mitigating any operational effects and any associated costs of these plans; and (3) the extent to which the Coast Guard has plans, to include cost estimates, for phasing in logistics support of the NSC while phasing out support for the High Endurance Cutter (HEC) it is replacing. GAO's work is based on analyses of the (1) operational capabilities and maintenance plans of the NSC and its support assets and (2) data on the HECs' condition; comparison of an NSC and HEC; and, interviews with Coast Guard officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of State (State) has designated about two-thirds of its 268 overseas posts as hardship posts. Staff working at such posts often encounter harsh conditions, including inadequate medical facilities and high crime. Many of these posts are vital to U.S. foreign policy objectives and need a full complement of staff with the right skills to carry out the department's priorities. As such, State offers staff at these posts a hardship differential--an additional adjustment to basic pay--to compensate officers for the conditions they encounter and as a recruitment and retention incentive. GAO was asked to assess (1) State's progress in addressing staffing gaps at hardship posts since 2006 and the effect of any remaining gaps, and (2) the extent to which State has used incentives to address staffing gaps at hardship posts. GAO analyzed State data; reviewed relevant documents; met with officials in Washington, D.C.; and conducted fieldwork in five hardship posts."

A letter report issued by the General Accounting Office with an abstract that begins "In 1967, the Congress created the National Park Foundation (Foundation)--a nonprofit organization with the sole purpose of providing private support to the National Park Service (Park Service). However, some Park Service officials have raised concerns that the Foundation's support is not meeting parks' priority needs. In this context, congressional requesters asked GAO to review the activities of the Foundation by determining the (1) Foundation's roles and responsibilities for raising funds to support the Park Service, (2) amount and kinds of donations the Foundation has raised between fiscal years 1999 and 2003, and (3) extent to which the contributions obtained by the Foundation assisted the Park Service in addressing park priorities."

A letter report issued by the Government Accountability Office with an abstract that begins "GAO's fifth report on the Troubled Asset Relief Program (TARP) follows up on prior recommendations. It also reviews (1) activities that had been initiated or completed under TARP as of June 12, 2009; (2) the Department of the Treasury's Office of Financial Stability's (OFS) hiring efforts and use of contractors; and (3) TARP performance indicators. To do this, GAO reviewed signed agreements and other relevant documentation and met with officials from OFS, contractors, and financial regulators."

A letter report issued by the Government Accountability Office with an abstract that begins "The Army and Marine Corps maintenance depots provide critical support to ongoing military operations in Iraq and Afghanistan and are heavily involved in efforts to reset the force. The Department of Defense (DOD) has an interest in ensuring that the depots remain operationally effective, efficient, and capable of meeting future maintenance requirements. In 2008, in response to direction by the Office of the Secretary of Defense (OSD), the Army and the Marine Corps each submitted a depot maintenance strategic plan. Our objective was to evaluate the extent to which these plans provide comprehensive strategies for meeting future depot maintenance requirements. GAO determined whether the plans were consistent with the criteria for developing a results-oriented management framework and fully addressed OSD's criteria."

A letter report issued by the General Accounting Office with an abstract that begins "The nation's roads, highways, and bridges are essential to mobility but can have negative effects on plants, animals, and the habitats that support them (collectively called ecosystems in this report). Federally funded transportation projects progress through three planning phases: long range (20 or more years), short range (3 to 5 years), and early project development, (collectively defined as planning in this report) before undergoing environmental review (which includes assessing air and water quality, ecosystems, and other impacts) required under the National Environmental Policy Act. Federal law requires planners to consider protecting and enhancing the environment in the first two phases, but does not specify how and does not require such consideration in the third phase. GAO reported on (1) the extent to which transportation planners consider ecosystem conservation in planning, (2) the effects of such consideration, and (3) the factors that encourage or discourage such consideration. GAO contacted 36 planning agencies (24 states and 12 of approximately 380 metropolitan planning organizations), as well as officials in 22 resource agencies that maintain ecological data and administer environmental laws. The Department of Transportation and U.S. Army Corps of …

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Aviation Administration (FAA) seeks to make the U.S. aviation system one of the safest in the world. However, a 2005 Department of Transportation Inspector General investigation found that FAA had issued medical certificates to a small percentage of pilots with disqualifying medical conditions, such as heart conditions, schizophrenia, and drug or alcohol addiction. In response to your request, our report addresses the following questions: (1) what procedures does FAA use to certify that pilot applicants meet medical standards and (2) how does FAA determine that medical certificates have been properly issued? In addressing these objectives, GAO researched FAA guidance and federal regulations; interviewed federal officials; analyzed FAA's application review procedures, quality assurance program, and its use of the National Driver Register; and conducted a data match between FAA's pilot registry and Social Security Administration's disability programs. The data match does not determine if pilots receiving disability benefits have medical conditions that would disqualify them from holding an FAA medical certificate. GAO is not making recommendations in this report. The Department of Transportation generally agreed with our findings. FAA and the Social Security Administration provided …

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2008, about 31 million children participated in the National School Lunch Program and more than 10 million children participated in the School Breakfast Program each school day. The U.S. Department of Agriculture's (USDA) Food and Nutrition Service (FNS) spent $11.7 billion on the school meal programs in that year. The majority of school meals are provided for free or at a reduced price to low-income students. Some states and school districts have chosen to implement programs that eliminate the reduced-price fee (known as ERP programs) and instead provide free meals to students eligible for the reduced fee. GAO was asked to provide information on (1) what is known about the states and districts that have eliminated the reduced-price fee for school meals, (2) the experiences of states and districts that have ERP programs with respect to participation, errors, and costs, and (3) the factors that may help or hinder the establishment or continuation of ERP programs. To obtain this information, GAO interviewed FNS officials, interviewed officials from state- and district-level programs, and conducted a Web-based survey of the 35 districts identified as having …

A letter report issued by the Government Accountability Office with an abstract that begins "It is estimated that over 10 million people in the United States suffer from jaw joint and muscle disorders. Artificial temporomandibular joint (TMJ) implants have been used to replace the jaw joint in some patients in an effort to decrease pain and increase jaw function. The safety and effectiveness of these implants, like other medical devices, is overseen by the Food and Drug Administration (FDA), an agency within the Department of Health and Human Services (HHS). Two implants used in the 1970s and 1980s that were later removed from the market caused severe side effects for some patients. In 1998, FDA began to require certain TMJ implant manufacturers sponsoring these devices to demonstrate the implants' safety and effectiveness before receiving approval. Since 1998, four TMJ implants from three sponsors were approved. In response to your request, GAO described (1) the types of concerns raised by FDA and how it addressed these concerns for the implants approved since 1998 and (2) how FDA has monitored sponsors' compliance with conditions of approval. GAO examined documentation related to the four TMJ implants approved by FDA since 1998 and sponsors' …

A letter report issued by the Government Accountability Office with an abstract that begins "The Homeland Security Act of 2002 mandated the merging of 22 federal agencies and organizations to create the Department of Homeland Security (DHS), whose mission, in part, is to protect our homeland from threats and attacks. DHS relies on a variety of computerized information systems to support its operations. GAO was asked to review DHS's information security program. In response, GAO determined whether DHS had developed, documented, and implemented a comprehensive, departmentwide information security program."

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."

A letter report issued by the General Accounting Office with an abstract that begins "GAO audited the financial statements of the Capitol Preservation Fund for fiscal years 2001 and 2000. GAO found that the financial statements (1) were presented fairly in conformity with U.S. generally accepted accounting principles, (2) contained no material weaknesses in internal control over financial reporting and compliance with laws and regulations, and (3) complied with the provisions of laws and regulations tested."