A letter report issued by the Government Accountability Office with an abstract that begins "The Workforce Investment Act of 1998 (WIA) required that many federal workforce employment and training programs for low-income individuals, the unemployed, and other job seekers provide their services through a streamlined delivery system. WIA also promoted greater employer engagement in this delivery system by, among other things, calling for it to help meet employers' workforce needs with services provided through one-stop centers. In 2005, we found that about half of employers were aware of their local one-stop centers. However, questions remained about how employers use them. In this report, GAO addressed (1) the extent to which employers, both large and small, hire their employees through one-stops; (2) the extent to which these employers view one-stop services as useful; and (3) factors that may affect one-stop service to employers. To answer these questions we surveyed employers who had used the one-stop system, visited eight one-stops, and talked to one-stop and Labor officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Average health insurance premiums for plans participating in the Federal Employees Health Benefits Program (FEHBP) have risen each year since 1997. These growing premiums result in higher costs to the federal government and plan enrollees. The Office of Personnel Management (OPM) oversees FEHBP, negotiating benefits and premiums and administering reserve accounts that may be used to cover plans' unanticipated spending increases. GAO was asked to evaluate the nature and extent of premium increases. To do this, GAO examined (1) FEHBP premium trends compared with those of other purchasers, (2) factors contributing to average premium growth across all FEHBP plans, and (3) factors contributing to differing trends among selected FEHBP plans. GAO reviewed data provided by OPM relating to FEHBP premiums and factors contributing to premium growth. For comparison purposes, GAO also examined premium data from the California Public Employees' Retirement System (CalPERS) and surveys of other public and private employers. GAO also interviewed officials from OPM and eight FEHBP plans with premium growth that was higher than average, and six FEHBP plans with premium growth that was lower than average to discuss premium growth trends and …

A letter report issued by the Government Accountability Office with an abstract that begins "CBP revised its training program for newly hired CBP officers in accordance with its own training development standards. Consistent with these standards, CBP convened a team of subject-matter experts to identify and rank the tasks that new CBP officers are expected to perform. As a result, the new curriculum was designed to produce a professional law enforcement officer capable of protecting the homeland from terrorist, criminal, biological and agricultural threats. In addition, the curriculum stated that the CBP officer is to draw conclusions and take appropriate action to identify behavioral indicators displayed by criminals, effectively interview travelers to identify potential threats, identify fraudulent documents, and use technology in support of the inspection process."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Secretary of Treasury, in coordination with the Director of the Office of Management and Budget (OMB), is required to annually prepare and submit audited financial statements of the U.S. government to the President and Congress. We are required to audit these consolidated financial statements (CFS) and report on the results of our work. An issue meriting concern and close scrutiny that emerged during our fiscal year 2004 CFS audit was the growing number of Chief Financial Officers (CFO) Act agencies that restated certain of their financial statements for fiscal year 2003 to correct errors. Errors in financial statements can result from mathematical mistakes, mistakes in the application of accounting principles, or oversight or misuse of facts that existed at the time the financial statements were prepared. Frequent restatements to correct errors can undermine public trust and confidence in both the entity and all responsible parties. Further, when restatements do occur, it is important that financial statements clearly communicate, and readers of the restated financial statements understand, that the financial statements originally issued by management in the previous year and the opinion thereon should no longer be relied …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) provides health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through a managed care option that requires enrollment and the use of civilian provider networks, which are developed and managed by contractors. Beneficiaries who do not enroll may receive care through TRICARE Standard, a fee-for-service option, using nonnetwork civilian providers or through TRICARE Extra, a preferred provider organization option, using network civilian providers. Nonenrolled beneficiaries in some locations have reported difficulties finding civilian providers who will accept them as patients. The National Defense Authorization Act (NDAA) for fiscal year 2004 directed GAO to provide information on access to care for nonenrolled TRICARE beneficiaries. This report describes (1) how DOD and its contractors evaluate nonenrolled beneficiaries' access to care and the results of these evaluations; (2) impediments to civilian provider acceptance of nonenrolled beneficiaries, and how they are being addressed; and (3) how DOD has implemented the NDAA fiscal year 2004 requirements to take actions to ensure nonenrolled beneficiaries' access to care. To address these objectives, GAO examined DOD's survey results and DOD and contractor documents and interviewed DOD …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information regarding work done on the Union Station Redevelopment Project by Park Woodworking, Inc., focusing on the: (1) extent of the government's liability, if any, for costs incurred for which Park was not compensated; (2) extent to which Park was not compensated for the work it did; and (3) actions taken by the Secretary of Transportation and the Department of Transportation (DOT) Inspector General (IG) in response to complaints received from Park."

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."

Correspondence issued by the Government Accountability Office with an abstract that begins "Natural hazards adversely affect hundreds of thousands of people worldwide each year and cause extensive property damage. In 2007, a year that was not considered an exceptional one for natural hazards, natural hazards caused an estimated 14,600 deaths and $70 billion in property losses. For that year, the insurance industry covered $23.3 billion in losses. In catastrophic loss years, such as 2005--the year that saw Hurricane Katrina--losses can be far greater. Scientific assessments indicate that climate change is expected to alter the frequency and severity of natural hazard events, and as a result, losses can be expected to climb. Given this scenario, examining policies that are used in other countries to reduce the loss of life and property caused by natural hazard events and examining insurance approaches that provide coverage for natural hazard losses can help identify practices in both areas that could benefit the United States. Similarly, given the ongoing challenges facing the United States, international cooperative efforts may provide instructive examples of risk management and disaster reduction. Because of Congressional interest in these areas, GAO was asked to (1) identify policies used by other countries to …

A letter report issued by the Government Accountability Office with an abstract that begins "Key measures of prescription pain reliever abuse and misuse increased from 2003 to 2009. The largest increases were in measures of adverse health consequences such as emergency department visits, substance abuse treatment admissions, and unintentional overdose deaths, though increases were not consistent across all measures. Federal officials suggested that increasing availability of prescription pain relievers and high-risk behaviors by those who abuse or misuse the drugs, such as combining prescription pain relievers with other drugs or alcohol, likely contributed to the rise in adverse health consequences, though data about the reasons for the increases are limited."

A letter report issued by the Government Accountability Office with an abstract that begins "A key provision of the Cash Management Improvement Act (CMIA) of 1990 (P.L. 101-453), as amended, requires the federal government and the states to minimize the time between transfer of federal funds and payments made by states for federal grant program purposes. Concerns were expressed by representatives of local government subgrantees that more flexibility was needed in the receipt of federal funding for first responders. Congress exempted certain first responder grants from this CMIA provision in the Department of Homeland Security's (DHS) fiscal years 2005 and 2006 appropriations acts. Under the exemption, grantees can receive cash advance funding and hold such funds for extended periods of time prior to payment. GAO was asked to (1) assess whether this CMIA provision, prior to its exemption in fiscal year 2005, had prevented DHS grant recipients from receiving first responder grant funds when such funds were needed; and (2) identify any key fiscal and accountability implications of the exemption."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security's (DHS) Science and Technology (S&T) Directorate was established to focus on areas such as addressing countermeasures for biological threats. To do this, it hired experts from the national laboratories under the authority of the Intergovernmental Personnel Act (IPA). The Directorate is organized into portfolios, led by portfolio managers. Questions have been raised about potential conflicts of interest for these individuals, since a portion of the Directorate's research funds have gone to the national laboratories. GAO was asked to examine (1) the management controls established within the Directorate to help guard against conflicts of interest for IPA portfolio managers; and (2) the role of the IPA portfolio managers, particularly those from national laboratories, in determining where research and development projects were directed."

Correspondence issued by the General Accounting Office with an abstract that begins "Third party payments represent blank-form financial instruments that government employees use to pay for expenses when traditional payments are not feasible or possible. GAO surveyed government entities on their use of third party payments. Forty of the 86 entities that responded to GAO's survey reported that they had used third party payment instruments at some time during fiscal years 1997 through 1999. Although the number of reported payment transactions declined 3.7 percent for these 40 entities during this period, the reported total dollar amount associated with these transactions rose 13.4 percent. On the basis of the transaction data reported, the average dollar value of each payment rose 17.6 percent. Among the 40 entities, the most common reasons cited for using third party payment instruments were (1) to pay for small purchases of supplies and services; (2) to pay contractors that either could not or would not accept government checks, electronic funds transfers, or credit card payments; (3) to make emergency payments; (4) to provide immediate reimbursement for out-of-pocket expenses; or (5) as an alternative to disbursing a cash advance. In response to questions about whether entities used internal …

Correspondence issued by the Government Accountability Office with an abstract that begins "Spending on outpatient prescription drugs in Medicaid--the joint federal-state program that finances medical services for certain low-income adults and children--has accounted for a substantial and growing share of Medicaid expenditures. Medicaid's total spending on outpatient prescription drugs grew from $4.6 billion in fiscal year 1990 to $40 billion in fiscal year 2004--or from 7.0 to 14.2 percent of Medicaid's total expenditures for medical care. State Medicaid programs do not directly purchase prescription drugs; instead, they reimburse retail pharmacies for covered outpatient prescription drugs dispensed to Medicaid beneficiaries. For some outpatient multiple-source prescription drugs, state Medicaid programs may only receive federal matching funds for reimbursements up to a maximum amount known as a federal upper limit (FUL). Required by law as a cost-containment strategy, FULs are calculated as 150 percent of the lowest price for a drug, from among the prices published nationally in three drug pricing compendia. State Medicaid programs have the authority to determine their own reimbursements to retail pharmacies6 for covered outpatient multiple-source prescription drugs, as long as those reimbursements do not exceed established FULs in the aggregate. The Deficit Reduction Act of 2005 (DRA) included …

A letter report issued by the Government Accountability Office with an abstract that begins "During the evacuation of New Orleans in response to Hurricane Katrina in 2005, many of those who did not own a vehicle and could not evacuate were among the over 1,300 people who died. This raised questions about how well state and local governments, primarily responsible for disaster planning, integrate transportation-disadvantaged populations into such planning. GAO assessed the challenges and barriers state and local officials face; how prepared these governments are and steps they are taking to address challenges and barriers; and federal efforts to provide evacuation assistance. GAO reviewed evacuation plans; Department of Homeland Security (DHS), Department of Transportation (DOT), and other studies; and interviewed officials in five major city and four state governments."

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 …

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the Adoption and Safe Families Act of 1997 (ASFA), focusing on: (1) how states have responded to ASFA regarding legal, administrative, and other changes that social workers may need to make in their day-to-day practice of handling child welfare cases; (2) the status of states' implementation of the two provisions related to making timely permanency decisions for those foster children who are unable to safely return home; and (3) the actions the Department of Health and Human Services (HHS) has taken to assist states and monitor the implementation of these two provisions."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed challenges facing the Department of Health and Human Services' (HHS) Vaccine Injury Compensation Program (VICP), focusing on: (1) how long it takes to process a claim through VICP; (2) the extent to which recent changes to the program's injury table have made it easier or more difficult for petitioners to obtain compensation for vaccine-related injuries; and (3) why the trust fund continues to grow, and what budgetary effect proposed options for addressing the growing trust fund balance would have."

Other written product issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO reviewed the Securities and Exchange Commission (SEC) new rule on amending the Intermarket Trading System Plan. GAO noted that: (1) the final rule amends the plan governing the operation of the Intermarket Trading System; and (2) SEC complied with the applicable requirements in promulgating the rule."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has three military exchanges--the Army and Air Force Exchange Service, the Navy Exchange, and the Marine Corps Exchange--that operate retail and other specialty stores. During fiscal years 2000 through 2004, the three exchanges provided more than $300 million annually, an average of 55 to 70 percent of their profits, in the form of a dividend to support the military services' morale, welfare, and recreation programs. DOD, through the Defense Commissary Agency (DeCA), also operates commissaries that sell groceries and authorized household products at the lowest practical price, charging patrons only for the cost of goods sold plus a 5 percent surcharge. The funds generated by the surcharge are used to construct new and modernize existing commissaries. The Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 authorized the Secretary of Defense to conduct a pilot project involving the sale of film, one-time use cameras, and telephone cards in not less than 10 commissary stores for a period selected by the Secretary, but not less than 6 months. Previously, these items had only been sold by the exchanges. Concerns were expressed by …

A letter report issued by the General Accounting Office with an abstract that begins "GAO reviewed the Internal Revenue Service's (IRS) performance during the 2000 tax filing season. Except for a few relatively minor glitches, which were not unexpected given the enormity of the IRS processing task, the processing systems worked well. On the other hand, although taxpayers had an easier time reaching IRS by telephone compared to 1999, IRS' performance was still well below the level achieved in 1998. GAO identified several opportunities for improvement. In some areas, such as with the volunteer assistance programs and the assistance provided by IRS' walk-in sites and area distribution centers, the opportunities centered around performance measures. In those areas, it was not easy to assess the agency's performance because either IRS lacked good measures or there were problems with the data behind the measures. Other improvement opportunities centered around management oversight-the kind of oversight that would enhance the level of service provided by better ensuring that (1) training materials and computer equipment were delivered to the volunteer assistance sites on time and in working condition and (2) data being entered on the website by various IRS offices are current and consistent."