A letter report issued by the Government Accountability Office with an abstract that begins "Congress mandated in 2000 that the Centers for Medicare & Medicaid Services (CMS) conduct the Physician Group Practice (PGP) Demonstration to test a hybrid payment methodology for physician groups that combines Medicare fee-for-service payments with new incentive payments. The 10 participants, with 200 or more physicians each, may earn annual bonus incentive payments by achieving cost savings and meeting quality targets set by CMS in the demonstration that began in April 2005. In July 2007, CMS reported that in the first performance year (PY1), 2 participants earned combined bonuses of approximately $7.4 million, and all 10 achieved most of the quality targets. Congress mandated that GAO evaluate the demonstration. GAO examined, for PY1, the programs used, whether the design was reasonable, and the potential challenges in broadening the payment approach used in the demonstration to other physician groups. To do so, GAO reviewed CMS documents, surveyed all 10 groups, and conducted interviews and site visits."

Correspondence issued by the Government Accountability Office with an abstract that begins "About 75 percent of casualties in current combat operations in Iraq and Afghanistan are attributed to improvised explosive devices (IED). To mitigate the threat from these weapons, the Department of Defense (DOD) initiated the Mine Resistant Ambush Protected (MRAP) vehicle program, which uses a tailored acquisition approach to rapidly acquire and field the vehicles. In May 2007, the Secretary of Defense affirmed MRAP as DOD's single most important acquisition program. To date, more than $22 billion has been appropriated to acquire more than 15,000 MRAP vehicles, and about 6,600 of the vehicles have been fielded. In view of the importance of this program and the significant cost involved, Congress asked us to (1) describe DOD's approach for and progress in implementing its strategy for rapidly acquiring and fielding MRAP vehicles, and (2) identify the challenges remaining for the program."

A letter report issued by the Government Accountability Office with an abstract that begins "Medicare Advantage (MA) plans are an alternative to the original Medicare fee-for-service (FFS) program. Private fee-for-service (PFFS) plans--one type of MA plan--give beneficiaries an option that is more like Medicare FFS than other MA plans, with a wider choice of providers and less plan management of services and providers. PFFS enrollment increased from about 35,000 beneficiaries in June 2004 to about 2.3 million in June 2008. This report compares PFFS plans to other MA plans and Medicare FFS in three areas: (1) characteristics of beneficiaries, (2) financial risks for beneficiaries who do not contact their plans before receiving services, and (3) disenrollment rates. To do this work, GAO reviewed materials from a selected sample of nine PFFS plan sponsors, analyzed Medicare data, and interviewed officials from CMS, which administers the Medicare program, and other organizations."

A letter report issued by the Government Accountability Office with an abstract that begins "This report presents our opinion on the financial statements of the Congressional Award Foundation (the Foundation) for the fiscal years ended September 30, 2007, and 2006. These financial statements are the responsibility of the Foundation. This report also presents (1) our opinion on the effectiveness of the Foundation's related internal control as of September 30, 2007, and (2) the results of our tests of the Foundation's compliance in fiscal year 2007 with selected provisions of laws and regulations. We conducted our audit pursuant to section 107 of the Congressional Award Act, as amended (2 U.S.C. 807), and in accordance with U.S. generally accepted government auditing standards."

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 …

A letter report issued by the Government Accountability Office with an abstract that begins "In 1995, GAO first designated the Department of Defense's (DOD) business systems modernization program as "high risk," and GAO continues to do so today. To assist in addressing this high-risk area, the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 contains provisions that are consistent with prior GAO investment management and enterprise architecture-related recommendations, and requires the department to submit annual reports to its congressional committees on its compliance with these provisions. The act also directs GAO to review each annual report. In response, GAO assessed the actions taken by DOD to comply with requirements of the act. To do so, GAO leveraged its recent reports on various aspects of the department's modernization management controls, and it reviewed, for example, the latest version of its business enterprise architecture and the associated transition plan and architecture federation strategy. GAO also interviewed key officials."

Correspondence issued by the Government Accountability Office with an abstract that begins "In February 2006, we reported on significant internal control deficiencies related to contractor payments and property accountability associated with the development of the Federal Bureau of Investigation's (FBI) Trilogy information technology (IT) modernization project. In that audit, we found FBI's invoice review and approval process did not provide an adequate basis to verify that goods and services billed were actually received and that amounts billed were appropriate. We also found that FBI relied extensively on Trilogy contractors to purchase and account for Trilogy equipment without controls or data to verify the accuracy and completeness of the contractor records. Additionally, once FBI took possession of the Trilogy equipment, it did not have adequate controls to safeguard those assets. FBI is now acquiring and deploying a new automated case management system, known as Sentinel, to replace the case management system that was to be delivered as part of the Trilogy project. Sentinel is being developed in four phases at an estimated cost of $425 million and is scheduled to be completed in May 2010. Phase 1 of the project was completed in June 2007. In light of the problems we …

A letter report issued by the Government Accountability Office with an abstract that begins "Government and private-sector interest is growing in unmanned aircraft systems (UAS) for use in a variety of missions such as U.S. border protection, hurricane research, law enforcement, and real estate photography. However, UASs can fly only after the Federal Aviation Administration (FAA) conducts a case-by-case safety analysis. GAO's research questions included (1) What are the current and potential uses and benefits of UASs? (2) What challenges exist in operating UASs safely and routinely in the national airspace system? and (3) What is the federal government's response to these challenges? To address these questions, GAO reviewed the literature, interviewed agency officials and aviation stakeholders, and surveyed 23 UAS experts."

Correspondence issued by the Government Accountability Office with an abstract that begins "Recent operations in Iraq, Afghanistan, and other locations around the world have highlighted the need for U.S. forces to train as they intend to fight. Department of Defense (DOD) training ranges and operating areas are required to be managed and operated to support their long-term viability and utility to meet the national defense mission. The use of military training ranges enhances training by providing realistic, hands-on experience. Sustainable training range management focuses on the practices that allow the military to manage its ranges in a way that ensures their usefulness well into the future. Because the military faces obstacles in acquiring new training lands, the preservation and sustainable management of its current lands must be priorities. New advances in technology, coupled with a shift in force posture, mean that DOD needs to continually update and maintain its training ranges. Military training ranges vary in size from a few acres--for small arms training--to over a million acres for large maneuver exercises and weapons testing, and include broad open ocean areas for offshore training and testing. These ranges face ever increasing limitations and restrictions on land, water, and airspace as …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) established the Defense Critical Infrastructure Program (DCIP) to assure the availability of mission-critical infrastructure, including surface, sea, and air transportation assets to carry out its missions. GAO was asked to evaluate (1) the extent to which the U.S. Transportation Command (TRANSCOM) has identified, prioritized, and assessed critical transportation assets; (2) the extent to which DOD installation personnel have taken actions to help assure the availability of critical transportation assets, both within and independent of DCIP; and (3) how DOD is funding critical transportation asset assurance. GAO examined a nonprojectable sample of 22 critical transportation assets, reviewed relevant DOD guidance and documents, and interviewed cognizant officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Federal law requires commercial drivers to submit urine specimens for drug testing. The Federal Motor Carrier Safety Administration (FMCSA) is responsible for ensuring that motor carriers comply with these regulations. Recent reports have raised concerns that some drivers may not be tested, some may be tested but avoid detection, and some may test positive but continue to drive. GAO was asked to look at these challenges. This report reviews (1) the factors that contribute to challenges related to drug testing and (2) the various options that exist to address these challenges. GAO obtained information from a wide variety of stakeholders in the drug testing industry, and analyzed data from FMCSA and others to determine the potential effectiveness of various options."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) prepositions equipment at strategic locations around the world in order to field combat-ready forces in days, rather than the weeks it would take if equipment had to be moved from the United States to the locations of conflicts. DOD's prepositioned stock programs support the National Military Strategy and are an important part of its overall strategic mobility framework. Prepositioned materiel and equipment have played an important role in supporting ongoing operations in Iraq and Afghanistan. However, sustained continuing operations in Iraq and Afghanistan have taken a toll on the condition and readiness of military equipment. In April 2008 we testified that it was unclear when these critical reserve stocks would be reconstituted or how much the total cost would be. The Army and Marine Corps face a number of ongoing and long-term challenges that will affect both the timing and the cost of equipment repair and replacement--particularly to its prepositioned stocks. DOD has reported to Congress that the military services are committed to resetting prepositioned materiel but must balance its efforts within the priorities of reorganization of those prepositioned capabilities and changes in …

A letter report issued by the Government Accountability Office with an abstract that begins "Each year, criminal organizations transport hundreds of tons of illegal drugs from South America to the United States through a 6 million square mile "transit zone" including Central America, the Caribbean, the Gulf of Mexico, and the eastern Pacific Ocean. Since fiscal year 2003, the United States has provided over $950 million to support counternarcotics efforts in transit zone countries, which historically lacked the capacity to interdict drugs. GAO was asked to examine (1) how the United States has assisted transit zone countries in disrupting drug trafficking and (2) what factors have impeded these efforts. GAO analyzed relevant data, met with U.S. and foreign officials, and visited selected countries."

Testimony issued by the Government Accountability Office with an abstract that begins "The Implementing Recommendations of the 9/11 Commission Act of 2007 requires the Transportation Security Administration (TSA) to implement a system to physically screen 100 percent of cargo on passenger aircraft by August 2010. To fulfill these requirements, the Department of Homeland Security's (DHS) TSA is developing the Certified Cargo Screening Program (CCSP), which would allow the screening of cargo to occur prior to placement on an aircraft. This testimony addresses four challenges TSA may face in developing a system to screen 100 percent of cargo: (1) deploying effective technologies; (2) changing TSA air cargo screening exemptions; (3) allocating compliance inspection resources to oversee CCSP participants; and (4) securing cargo transported from a foreign nation to the United States. GAO's comments are based on GAO products issued from October 2005 through February 2008, including selected updates conducted in July 2008."

A letter report issued by the Government Accountability Office with an abstract that begins "Millions of taxpayers use paid tax return preparers and many of these paid preparers are not subject to any qualification requirements. Paid preparers in California and Oregon are exceptions in that these states have set paid preparer qualification standards. Additionally, two bills before Congress would require national paid preparer regulations. To help Congress better understand the potential costs and revenue effects of regulating paid preparers, GAO was asked to study (1) how IRS, California, Oregon, and other states regulate paid preparers, (2) how the accuracy of federal tax returns from California and Oregon compare to other returns, and (3) state-level costs and benefits of the California and Oregon programs and insights they provide for a possible national program. GAO analyzed IRS research data on tax return accuracy; interviewed IRS officials, state administrators, and preparer community representatives; and reviewed relevant documents."

A letter report issued by the Government Accountability Office with an abstract that begins "The outstanding amount of state and local government tax-exempt bonds has increased over the years. Congress is interested in whether the bonds are used for appropriate purposes since the federal government forgoes billions in tax revenues annually by excluding the bonds' interest from investors' federal gross income. Questions also exist over the bonds' borrowing costs as they can divert funds from the funded projects. This report (1) describes recent trends in tax exempt bonds, (2) provides information on the types of facilities financed with tax-exempt bonds, and (3) discusses borrowing costs considering the methods of selling bonds and compares issuance costs paid from bond proceeds for governmental and qualified private activity bonds. In addition to interviewing relevant officials, we analyzed IRS's Statistics of Income (SOI) data and data from Thomson Financial to address these objectives."

A letter report issued by the Government Accountability Office with an abstract that begins "The Visa Waiver Program, which enables citizens of participating countries to travel to the United States without first obtaining a visa, has many benefits, but it also has risks. In 2006, GAO found that the Department of Homeland Security (DHS) needed to improve efforts to assess and mitigate these risks. In August 2007, Congress passed the 9/11 Act, which provides DHS with the authority to consider expanding the program to countries whose short-term business and tourism visa refusal rates were between 3 and 10 percent in the prior fiscal year. Countries must also meet certain conditions, and DHS must complete actions to enhance the program's security. GAO has examined DHS's process for expanding the Visa Waiver Program and evaluated the extent to which DHS is assessing and mitigating program risks. GAO reviewed relevant laws and procedures and interviewed agency officials in Washington, D.C., and in U.S. embassies in eight aspiring and three Visa Waiver Program countries."

Correspondence issued by the Government Accountability Office with an abstract that begins "Since 2001, Congress has provided the Department of Defense (DOD) with about $808 billion in supplemental and annual appropriations, as of September 2008, primarily for military operations in support of the Global War on Terrorism (GWOT). DOD's reported annual obligations for GWOT have shown a steady increase from about $0.2 billion in fiscal year 2001 to about $162.4 billion in fiscal year 2008. The United States' commitments to GWOT will likely involve the continued investment of significant resources, requiring decision makers to consider difficult trade-offs as the nation faces an increasing fiscal challenge. The magnitude of future costs will depend on several direct and indirect cost variables and, in some cases, decisions that have not yet been made. DOD's future costs will likely be affected by the pace and duration of operations, the types of facilities needed to support troops overseas, redeployment plans, and the amount of equipment to be repaired or replaced. DOD compiles and reports monthly and cumulative incremental obligations incurred to support GWOT in a monthly Supplemental and Cost of War Execution Report. DOD leadership uses this report, along with other information, to advise Congress …

A letter report issued by the Government Accountability Office with an abstract that begins "On October 30, 2004, the Crime Victims' Rights Act (CVRA) was enacted, establishing eight rights for federal crime victims and two mechanisms to enforce those rights. The legislation also directed GAO to evaluate the implementation of the CVRA. To address this mandate, GAO reviewed: (1) efforts made to implement the CVRA, (2) mechanisms in place to ensure adherence to the CVRA, (3) methods the Department of Justice (DOJ) uses to monitor performance regarding the provision of CVRA rights, and (4) key issues that have arisen in the interpretation of the CVRA by the federal courts. To conduct its analysis, GAO reviewed guidance materials, victim complaints, and court rulings, and conducted surveys and interviews with criminal justice system participants. GAO cannot generalize its crime victim survey results due to a low response rate."

A letter report issued by the Government Accountability Office with an abstract that begins "The Social Security Administration (SSA) has been withholding Medicare premiums from beneficiaries' Social Security payments since the Supplementary Medical Insurance (Part B) program was first enacted in 1965. Beginning in 2006, premium withholding became a payment option for the Medicare Advantage program (Part C) and the new program for Prescription Drug Coverage (Part D). These changes were authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). Two federal agencies play critical roles in the premium withholding process: the Centers for Medicare & Medicaid Services (CMS) and SSA. The Department of the Treasury (Treasury) also plays an important role by disbursing the adjusted Social Security payments to beneficiaries. Premium withholding can make paying premiums easier for both beneficiaries and the insurance plans. However, following implementation of the premium withholding provisions under MMA in 2006, there were numerous reports of beneficiaries not having the correct Parts C and D premiums withheld. Also, about 231,000 beneficiaries had their premiums refunded erroneously because they were mistakenly identified as having paid excess premiums. As a result, you requested that we review efforts to ensure that the correct …

A letter report issued by the Government Accountability Office with an abstract that begins "Federal entities--agencies, corporations, and others--are growing users of credit and debit cards, as both "merchants" (receiving payments) and purchasers. Merchants accepting cards incur fees--called merchant discount fees--paid to banks to process the transactions. For Visa and MasterCard transactions, a large portion of these fees-- referred to as interchange--goes to the card-issuing banks. Some countries have acted to limit these fees. GAO was asked to examine (1) the benefits and costs associated with federal entities' acceptance of cards, (2) the effects of other countries' actions to limit interchange fees, and (3) the impact on federal entities of using cards to make purchases. Among other things, GAO analyzed fee data and information on the impact of accepting and using cards from the Department of the Treasury (Treasury) and the General Services Administration, reviewed literature, and interviewed officials of major card companies and three foreign governments."

A letter report issued by the Government Accountability Office with an abstract that begins "The President's New Way Forward in Iraq identified Iraq's inability to spend its resources to rebuild infrastructure and deliver essential services as a critical economic challenge to Iraq's self-reliance. Further, Iraq's ability to spend its $10.1 billion capital projects budget in 2007 was one of the 18 benchmarks used to assess U.S. progress in stabilizing and rebuilding Iraq. This report (1) examines data the U.S. embassy used to determine the extent to which the government of Iraq spent its 2007 capital projects budget, (2) identifies factors affecting the Iraqi government's ability to spend these funds, and (3) describes U.S. government efforts to assist the Iraqi government in spending its capital projects funds. For this effort, GAO reviewed Iraqi government budget data and information on provincial spending collected by the U.S. Provincial Reconstruction Teams. GAO also interviewed officials from the departments of the Treasury, Defense, State, and other agencies and organizations."

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter formally responds to section 371 of the National Defense Authorization Act for Fiscal Year 2008. The act requires GAO to provide an analysis of the Department of Defense's (DOD) budget submission for corrosion control and prevention and a DOD report that was to be submitted with defense budget materials to the congressional defense committees within 60 days after submission of the budget for a fiscal year. On April 3, 2008, we provided the briefing to staff of Congressional committees to satisfy the mandate and 60-day reporting requirement."

Correspondence issued by the Government Accountability Office with an abstract that begins "As of July 2008, the Department of Defense (DOD) reported that almost 33,000 servicemembers had been wounded in action as part of Operation Enduring Freedom or Operation Iraqi Freedom. Some of these servicemembers could have injuries that keep them from easily entering or returning to the workplace upon their exit from the military. For some service-disabled veterans, starting a business may be one option for entering or returning to the workforce. In the Veterans Entrepreneurship and Small Business Development Act of 1999 (P.L. 106-50), Congress stated that too little had been done to help veterans, particularly service-disabled veterans, in starting small businesses. This law established the framework for the Small Business Administration (SBA), the Department of Veterans Affairs (VA), the Department of Labor (DOL), DOD, and others to coordinate in providing entrepreneurial assistance to veterans and servicedisabled veterans. To improve coordination and enhance small business assistance to veterans, the law required that these agencies enter into memorandums of understanding (MOU) as specified in the 1999 Act (but not all of the agencies were required to participate in each of the MOUs); established the National Veterans Business Development Corporation …