Much of the debate over U.S. policy toward Iran has centered on the nature of the current regime; some believe that Iran, a country of about 70 million people, is a threat to U.S. interests because hardliners in Iran's regime dominate and set a policy direction intended to challenge U.S. influence and allies in the region. President George W. Bush, in his January 29, 2002, State of the Union message, labeled Iran part of an "axis of evil" along with Iraq and North Korea. This report discusses the political history of Iran, U.S. strategy in Iran, and the Obama Administration's policies for dealing with Iran, especially with regard to the previous administration's policies.

This report discusses the current political state of Iran and its relationship with the United States. This report emphasizes in particular the Iranian presidential elections that took place on June 12, 2009; current U.S. efforts under President Obama to forge diplomatic talks with Iran while at the same time urging aggressive action in the way of certain economic and trade sanctions; and how current U.S. efforts under the Obama Administration differ and/or are similar to efforts under the Bush Administration.

The United Nations Convention on the Law of the Sea (LOS Convention) was agreed to in 1982, but the United States never became a signatory nation. In the 111th Congress, Secretary of State Hillary Clinton, at her confirmation hearing before the Senate Committee on Foreign Affairs on January 13, 2009, acknowledged that U.S. accession to the LOS Convention would be an Obama Administration priority. This report describes provisions of the LOS Convention relating to living marine resources and discusses how these provisions comport with current U.S. marine policy.

This report provides a summary of some of the issues regarding the creation of a national land parcel database, or cadastre. The report identifies some of the perceived needs for a national cadastre, legislative and administrative options that could lead to a national land parcel database, and some of the challenges and concerns. The report also summarizes and briefly discusses recommendations in a 2007 National Research Council (NRC) report that concluded "...a national approach is necessary to provide a rational and accountable system of property records."

A letter report issued by the Government Accountability Office with an abstract that begins "The Emergency Economic Stabilization Act directed GAO to study the role of leverage in the current financial crisis and federal oversight of leverage. GAO's objectives were to review (1) how leveraging and deleveraging by financial institutions may have contributed to the crisis, (2) regulations adopted by federal financial regulators to limit leverage and how regulators oversee compliance with the regulations, and (3) any limitations the current crisis has revealed in regulatory approaches used to restrict leverage and regulatory proposals to address them. To meet these objectives, GAO built on its existing body of work, reviewed relevant laws and regulations and academic and other studies, and interviewed regulators and market participants."

Testimony issued by the Government Accountability Office with an abstract that begins "GAO's work over the past several years has demonstrated that improper payments are a long-standing, widespread, and significant problem in the federal government. The Improper Payments Information Act of 2002 (IPIA) has increased visibility over improper payments by requiring executive branch agency heads, using guidance from the Office of Management and Budget, to identify programs and activities susceptible to significant improper payments, estimate amounts improperly paid, and report on the amounts of improper payments and their actions to reduce them. This testimony addresses (1) progress made in agencies' implementation of IPIA for fiscal year 2008, and (2) several major challenges that continue to hinder full reporting of IPIA information. GAO was also asked to provide an overview of Medicare and Medicaid programs' implementation of IPIA. This testimony is based primarily on GAO products, Office of Inspector General (OIG) audit reports, and agencies' fiscal year 2008 reported improper payment information, including information reported by the Department of Health and Human Service's (HHS) Centers for Medicare and Medicaid Services (CMS). GAO also analyzed fiscal year 2008 governmentwide improper payment information to identify trends and reviewed Medicare and Medicaid programs' reported …

A letter report issued by the Government Accountability Office with an abstract that begins "The federal government is the world's largest and most complex entity, with about $3 trillion in outlays in fiscal year 2008 funding a broad array of programs and operations. GAO's biennial reports on high-risk areas, done since 1990, are meant to bring focus to specific areas needing added attention. Areas are identified, in some cases, as high risk due to their greater vulnerabilities to fraud, waste, abuse, and mismanagement. GAO also identifies high-risk areas needing broad-based transformation to address major economy, efficiency, or effectiveness challenges. In this 2009 update for the 111th Congress, GAO presents the status of high-risk areas listed in 2007 and identifies new high-risk areas warranting attention by Congress and the executive branch. Solutions to high-risk problems offer the potential to save billions of dollars, dramatically improve service to the public, strengthen confidence and trust in the performance and accountability of the U.S. government, and ensure the ability of government to deliver on its promises."

A letter report issued by the Government Accountability Office with an abstract that begins "Due to the federal government's role as guarantor, floods impose an enormous potential financial burden on the federal government. Consequently, decision makers at the Department of Homeland Security (DHS), the Federal Emergency Management Agency (FEMA), and the Congress need accurate and timely financial information to assess the effectiveness of the National Flood Insurance Program (NFIP). This report assesses whether controls in place during the 2005 to 2007 time frame were effective and whether actions to improve controls are likely to address identified weaknesses. The Government Accountability Office (GAO) reviewed and analyzed FEMA/NFIP guidance, data, and financial reports, reviewed prior audit reports, interviewed FEMA officials and contractors, and selected a sample of claim losses paid to determine whether claim files contained key documents."

A letter report issued by the Government Accountability Office with an abstract that begins "For more than two decades, the U.S. government has been broadcasting to Cuba to break the Cuban government's information blockade and promote democracy in Cuba. Over this period, questions have been raised regarding the quality and effectiveness of these broadcasts. GAO was asked to examine (1) the Office of Cuba Broadcasting's (OCB) broadcasting approach and what is known about its audience; (2) how the Broadcasting Board of Governors (BBG)--which oversees U.S. government broadcasting--and OCB ensure compliance with journalistic principles; (3) steps taken to ensure adherence to domestic and international broadcasting laws, agreements, and standards; and (4) steps BBG and OCB have taken to address management challenges. GAO analyzed documentation related to strategic planning, audience research, oversight, and operations and interviewed officials from BBG, BBG's International Broadcasting Bureau (IBB), OCB, State, and other agencies."

A letter report issued by the Government Accountability Office with an abstract that begins "Over the past decade, per capita consumption of bottled water in the United States has more than doubled. With this increase have come several concerns in recent years about the safety, quality, and environmental impacts of bottled water. The Food and Drug Administration (FDA) regulates bottled water under the Federal Food, Drug, and Cosmetic Act as a food and is responsible for ensuring that domestic and imported bottled water is safe and truthfully labeled. Among other things, GAO (1) evaluated the extent to which FDA regulates and ensures the quality and safety of bottled water; (2) evaluated the extent to which federal and state authorities regulate the accuracy of labels and claims regarding the purity and source of bottled water; and (3) identified the environmental and other impacts of bottled water. GAO reviewed FDA data, reports, and requirements for bottled water; conducted a state survey of all 50 states and the District of Columbia; reviewed bottled water labels; and interviewed FDA officials and key experts."

A letter report issued by the Government Accountability Office with an abstract that begins "Tens of thousands of women die each year from breast or cervical cancer. While screening and early detection through mammograms and Pap tests--followed by treatment--can improve survival, low-income, uninsured women are often not screened. In 1990, Congress authorized the Centers for Disease Control and Prevention (CDC) to fund screening and diagnostic services for such women, which led CDC to establish the National Breast and Cervical Cancer Early Detection Program. The Breast and Cervical Cancer Prevention and Treatment Act of 2000 was also enacted to allow states to extend Medicaid eligibility to women screened under the Early Detection Program and who need breast or cervical cancer treatment. Screened under the program is defined, at a minimum, as screening paid for with CDC funds. GAO examined the Early Detection Program's screening of eligible women, states' implementation of the Treatment Act, Medicaid enrollment and spending under the Treatment Act, and alternatives available to women ineligible for Medicaid under the Treatment Act. To do this, GAO compared CDC data on women screened by the Early Detection Program from 2002 to 2006 with federal estimates of the eligible population, surveyed program …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Indian Health Service (IHS), an agency in the Department of Health and Human Services (HHS), provides health care services to American Indians and Alaskan Natives. For fiscal year 2009, Congress appropriated approximately $3.6 billion for health care services to be made available through IHS. The agency provides direct medical care, including primary care services, ancillary services, and some specialty services, through its network of facilities, including hospitals, health centers, and clinics. IHS also provides funding to direct care facilities that are operated by tribes. IHS headquarters oversees 12 area offices that cover 161 service units in 35 states. The Indian Health Care Improvement Act of 1976, as amended, authorizes IHS to collect reimbursement for services provided at IHS facilities from third-party insurers, including Medicare, the federal health insurance program for elderly and disabled individuals; Medicaid, a joint federal and state health financing program for certain low-income families and individuals; and private health insurers. IHS is allowed to retain funds collected from these insurers without a corresponding offset against its appropriations, so that all revenue collected by a facility remains with that facility, supplementing its appropriations. For fiscal …

A letter report issued by the Government Accountability Office with an abstract that begins "Medicare covers dialysis--a process that removes excess fluids and toxins from the bloodstream--for most individuals with end-stage renal disease (ESRD), a condition of permanent kidney failure. Most patients with ESRD receive dialysis in a facility, while some patients with ESRD are trained to self-perform dialysis in their homes. The Centers for Medicare & Medicaid Services (CMS)--the agency that administers the Medicare program--has taken steps to encourage home dialysis and is in the process of changing the way it pays for dialysis services. Effective 2011, CMS will pay for dialysis services using an expanded bundled payment. The Tax Relief and Health Care Act of 2006 required GAO to report on the costs of home dialysis treatments and training. GAO examined (1) the extent to which the costs of home dialysis differ from the costs of dialysis received in a facility, and (2) CMS's plans to account for home dialysis costs in the expanded bundled payment. GAO obtained information from CMS, the U.S. Renal Data System, ESRD experts, and self-reported cost information from six dialysis providers."

Correspondence issued by the Government Accountability Office with an abstract that begins "In 2008, the Consumer Product Safety Commission (CPSC) announced that it had obtained the voluntary recall of 563 unsafe or potentially unsafe products by the companies that manufactured, imported, distributed, or sold the products--the largest number for the agency in the past 10 years. In the prior year, CPSC announced 472 recalls--which was also an increase from the previous year and included some high-profile recalls of lead-tainted toys--leading some consumer groups to call 2007 the "year of the recall." Consumer products can be recalled for a variety of reasons, including violations of safety standards, incidents of injuries that can occur from the design or manufacture of a product, or other conditions that present an imminent or substantial hazard to consumers. Since 1979 there have been few instances in which CPSC could not obtain cooperation from manufacturers or importers to conduct recalls, either because these companies did not have the financial resources to conduct a recall or because the companies refused to assume responsibility for a recall. This included troubled recalls involving more than 1.5 million imported cribs associated with multiple deaths of children. Another recall of imported tires, …

Correspondence issued by the Government Accountability Office with an abstract that begins "A growing number of states--35 as of June 2009--have created high-risk health insurance pools (HRPs) primarily to provide coverage to individuals whose health status limits their access to coverage in the private individual health insurance market. HRPs--typically state-run nonprofit associations--often contract with a private health insurance carrier to administer the pool and offer a range of health plan options to such individuals, who are commonly referred to as medically uninsurable. Plan options vary within pools and from state to state, and like the private individual market, HRPs typically impose waiting periods for coverage of preexisting conditions to discourage medically uninsurable individuals from foregoing health insurance until they require care. Because of the higher health care costs typically incurred by medically uninsurable individuals, all pools operate at a loss. Premiums for HRP health plans are higher than for plans offered to healthy individuals in the private health insurance market; however, these premiums are capped to limit enrollees' costs and are thus insufficient to cover the costs of enrollee health care claims. As a result, all HRPs supplement their revenues through various funding mechanisms, such as assessments on health insurance …

Correspondence issued by the Government Accountability Office with an abstract that begins "From fiscal years 2006 through 2008, the Office of Juvenile Justice and Delinquency Prevention (OJJDP) within the Department of Justice (DOJ) awarded $1.2 billion in funds through approximately 2,000 grants in support of its mission to help states and communities prevent and reduce juvenile delinquency and victimization and improve their juvenile justice systems. OJJDP awards grants to states, territories, localities, and organizations to address a variety of issues, such as reducing juvenile substance abuse, combating Internet crimes against children, preventing youth gang involvement, and providing youth mentoring services. The scope and administration of OJJDP grants also vary, ranging from private organization recipients that implement programs directly in a single community to states that administer grants by awarding the funds they receive to subgrantees to implement programs locally and statewide. Assessing the performance of these programs through grant monitoring is a key management tool to hold grantees accountable for implementing programs as agreed to in their awards, to verify they are making progress toward the objectives of their programs, and to ensure that grant funds are used in support of OJJDP's mission. DOJ's Office of Justice Programs (OJP) establishes …

A letter report issued by the Government Accountability Office with an abstract that begins "Until recently, ethics programs and practices of defense contractors were self-policed. Given the significant sums spent to acquire goods and services, the Federal Acquisition Regulation (FAR) was amended twice starting in December 2007 to first mandate and later amplify contractor ethics program rules. Before FAR changes were finalized in December 2008, Congress required GAO to report in 2009 on the ethics programs of major defense contractors. This report (1) describes the extent that contractors had ethics programs before the finalization of the FAR rules that included practices consistent with standards now required by the FAR and (2) assesses the impact the new FAR rules have on Department of Defense (DOD) oversight of contractor ethics programs. To do this work, in September 2008 GAO surveyed all 57 contractors--those receiving more than $500 million in 2006 DOD contract awards--and interviewed DOD contractor oversight agency officials on the impact of the new FAR rules on oversight."

A letter report issued by the Government Accountability Office with an abstract that begins "The growing cost of brand-name prescription drugs--FDA-approved drug products that typically have patent protection--is a concern for patients, payers, and providers of health care--particularly when price increases are large and occur suddenly. A 2008 congressional hearing by the Joint Economic Committee drew attention to some small market prescription drugs that had an extraordinary price increase--a price increase of 100 percent or more at a single point in time. GAO was asked to examine extraordinary price increases for brand-name prescription drugs. Specifically, GAO examined the: (1) frequency of extraordinary price increases for brand-name prescription drugs from 2000 to 2008, (2) characteristics of the brand-name prescription drugs that had extraordinary price increases, and (3) factors that contributed to the extraordinary price increases experienced by these brand-name prescription drugs. To determine the frequency and characteristics of the brand-name prescription drugs that experienced an extraordinary price increase, GAO reviewed drug pricing and other data from a pharmaceutical industry compendium. To illustrate the factors that may contribute to extraordinary price increases, GAO developed case studies of six brand-name prescription drugs identified from the analysis of drug pricing data. These brand-name prescription …

Testimony issued by the Government Accountability Office with an abstract that begins "Biosafety laboratories are primarily regulated by either the Department of Health and Human Services (HHS) or the U.S. Department of Agriculture (USDA), depending on whether the substances they handle pose a threat to the health of humans or plants, animals, and related products, respectively. Currently, all operational biosafety level 4 (BSL-4) labs are overseen by HHS's Centers for Disease Control and Prevention (CDC). BSL-4 labs handle the world's most dangerous agents and toxins that cause incurable and deadly diseases. This testimony summarizes GAO's previously issued reports on perimeter security at the nation's BSL-4 laboratories that were issued in September 2008 (GAO-08-1092) and July 2009 (GAO-09-851). Specifically, this testimony describes (1) the findings and recommendation on key perimeter security controls at five of the nation's operational BSL-4 labs, (2) CDC efforts to address our recommendation, (3) improvements that have been made to the perimeter security controls at the two labs found to be deficient, and (4) other observations about the BSL-4 labs GAO assessed."

Testimony issued by the Government Accountability Office with an abstract that begins "Federal agencies have identified billions of dollars in reinvestment requirements to maintain their aging facilities and bring them up to current standards. In addition, according to Department of Energy (DOE) estimates, federal agencies will need over a billion dollars annually through 2015 for projects needed to meet congressional energy efficiency goals. As the nation's single largest energy consumer, the federal government spent approximately $17 billion in fiscal year 2007 on energy use in buildings and vehicles. This total represents almost 1 percent of all federal expenditures for 2007, and these costs have risen in recent years. This testimony discusses the potential benefits that may accrue from infrastructure investment, including energy reductions within federal buildings, and principles that could help guide infrastructure investment. Our comments are based on our body of work on repair and maintenance and energy management issues associated with federal real property."

Testimony issued by the Government Accountability Office with an abstract that begins "The Deepwater Program is intended to recapitalize the Coast Guard's fleet and includes efforts to build or modernize five classes each of ships and aircraft, and procure other key capabilities. In 2002, the Coast Guard contracted with Integrated Coast Guard Systems (ICGS) to manage the acquisition as systems integrator. After the program experienced a series of failures, the Coast Guard announced in April 2007 that it would take over the lead role, with future work on individual assets to be potentially bid competitively outside of the existing contract. A program baseline of $24.2 billion was set as well. In June 2008, GAO reported on the new approach and concluded that while these steps were beneficial, continued oversight and improvement was necessary. The Coast Guard has taken actions to address the recommendations in that report. This testimony updates key issues from prior work: (1) Coast Guard program management at the overall Deepwater Program and asset levels; (2) how cost, schedules, and capabilities have changed from the 2007 baseline and how well costs are communicated to Congress; and (3) Coast Guard efforts to manage and build its acquisition workforce. GAO …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses our report to this committee on climate change adaptation and the role strategic federal planning could play in government decision making. Changes in the climate attributable to increased concentrations of greenhouse gases may have significant impacts in the United States and internationally. For example, climate change could threaten coastal areas with rising sea levels. In recent years, climate change adaptation--adjustments to natural or human systems in response to actual or expected climate change--has begun to receive more attention because the greenhouse gases already in the atmosphere are expected to continue altering the climate system into the future, regardless of efforts to control emissions. According to a recent report by the National Research Council (NRC), however, individuals and institutions whose futures will be affected by climate change are unprepared both conceptually and practically for meeting the challenges and opportunities it presents. In this context, adapting to climate change requires making policy and management decisions that cut across traditional economic sectors, jurisdictional boundaries, and levels of government. This testimony is based on our October 2009 report, which is being publicly released today, and addresses three issues: (1) …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses our work on the Troubled Asset Relief Program (TARP), under which the Department of the Treasury (Treasury), through the Office of Financial Stability (OFS), has the authority to purchase and insure almost $700 billion in troubled assets held by financial institutions. Treasury was granted this authority in response to the financial crisis that has threatened the stability of the U.S. banking system and the solvency of numerous financial institutions. The Emergency Economic Stabilization Act (the act) that authorized TARP on October 3, 2008, requires GAO to report at least every 60 days on findings resulting from our oversight of the status of actions taken under the program. This statement today is based on our fifth mandated report, issued on June 17, 2009, which follows up on the previous recommendations and covers the actions taken as part of TARP through June 12, 2009. Our oversight work under the act is ongoing, and our next report will be issued later this month, and will focus on TARP's loan modification program. Specifically, this statement focuses on (1) the nature and purpose of activities that have been initiated under …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses our report on a national strategy for high-containment laboratories that deal with dangerous--pathogens also known as biosafety level-3 (BSL-3) laboratories and biosafety level-4 (BSL-4) laboratories--in the United States, which was released yesterday. The number of high-containment laboratories that work with dangerous biological pathogens have proliferated in recent years. In 2007, we reported on several issues associated with the proliferation of high-containment laboratories in the United States, including risks posed by biosafety incidents that have occurred in the past. The Federal Bureau of Investigation's allegation in August 2008 that a scientist at the U.S. Army Medical Research Institute of Infectious Diseases was the sole perpetrator of the 2001 anthrax attacks raised additional concerns about the possibility of insider misuse of high-containment laboratory facilities, material, and technology. The public is concerned about these laboratories because the deliberate or accidental release of biological agents can have disastrous consequences by exposing workers and the public to dangerous pathogens. Highly publicized laboratory errors and controversies about where high-containment laboratories should be located have raised questions about whether the governing framework, oversight, and standards for biosafety and biosecurity measures are adequate. …