Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the various schemes used to defraud the Medicare and Medicaid programs and private insurance companies and how the proposed legislation contained in H.R. 3461 and S.1231 could strenghten federal and state health care programs."

Testimony issued by the General Accounting Office with an abstract that begins "Management of Medicare has come under increasing scrutiny. The Health Care Financing Administration (HCFA) has had mixed success running the program. The agency has developed payment methods that have contained cost growth, and HCFA has paid fee-for-service claims quickly and at low administrative cost. However, HCFA has had difficulty ensuring that it paid claims appropriately. In addition, Medicare claims administration contractors have done a poor job of communicating with Medicare providers. HCFA has taken important steps to address some of these shortcomings, including strengthening payment safeguards, but several factors have hampered its efforts. Despite its growing responsibilities, HCFA suffers from staffing shortages. The agency also continues to rely on archaic computer systems. At the same time, HCFA has faltered in its attempts to adopt a results-based approach to agency management. Constraints on the agency's contracting authority have limited its use of full and open competition to select claims administration contractors and assign administrative tasks. Rising expectations among Medicare beneficiaries and providers are putting pressure on the Centers for Medicare and Medicaid Services to modernize and improve agency operations. Such improvements will require HCFA to begin a performance-based management …

Testimony issued by the General Accounting Office with an abstract that begins "This testimony summarizes previous GAO work that identified gaps in information needed to reconcile Individual Indian Moneys (IIM) trust accounts, and the rationale that led GAO to suggest that the Department of the Interior seek alternatives to reconciliation, such as a negotiated agreement. Congress established an Indian trust fund account reconciliation requirement in the Supplemental Appropriations Act of 1987 in response to tribal concerns that (1) Interior had not consistently provided them with statements on their account balances, (2) their trust fund accounts had never been reconciled, and (3) Interior planned to contract with a third party for management of trust fund accounts. There are many obstacles that will complicate Interior's ability to document the amount and source of funds deposited to, managed in, and disbursed from their IIM accounts. Interior's July 2002 report enumerates among those obstacles known discrepancies in the balances, at the trust fund level, reported by Treasury and Interior, as well as the potential for (1) errors in the electronic accounting system data, (2) missing paper transaction records, and (3) missing land ownership information and revenue instruments."

Testimony issued by the General Accounting Office with an abstract that begins "Congress faces critical decisions about the future of the National Railroad Passenger Corporation (Amtrak) and intercity passenger rail. In GAO's view, the goal of a national system, much like Amtrak's current system, and the goal of operational self-sufficiency appear to be incompatible. In fact, Amtrak was created because other railroads were unable to profitably provide passenger service. In addition, Amtrak needs more capital funding than has been historically provided in order to operate a safe, reliable system that can attract and retain customers. Developing a high-speed rail system is also costly, requiring additional tens of billions of dollars. If intercity passenger rail is to have a future in the nation's transportation system, Congress needs realistic assessments of the expected public benefits and the resulting costs of these investments as compared with investments in other modes of transportation. Such analyses would provide sound bases for congressional action in defining the national goals that will be pursued, the extent that Amtrak and other intercity passenger rail systems can contribute to meeting these goals, and whether federal and state money would be available to sustain such systems over the long term."

Testimony issued by the General Accounting Office with an abstract that begins "This testimony discusses the Department of Energy's (DOE) plan for external regulation of nuclear and worker safety at its facilities. DOE's position remains essentially unchanged since the 1999 congressional hearing, when the department decided not to move forward on external regulation until cost uncertainties and implementation issues were resolved. Past regulatory simulations and ongoing work by DOE and its potential regulators indicate that the external regulation of the science laboratories would not require prohibitively expensive facility upgrades to be licensable. Further, much of the expected "costs" would likely involve bringing facilities into compliance with DOE's own safety standards. DOE's response to the conference report directive is not a detailed implementation plan. Rather, it is a restatement of its previously stated call for further cost and benefit analyses before making a final decision on accepting external regulation."

Testimony issued by the General Accounting Office with an abstract that begins "As the nation's largest cash assistance program for the poor, the Supplemental Security Income (SSI) program SSI provided $33 billion in benefits to 6.8 million aged, blind, and disabled persons last year. In 2001, the outstanding SSI debt and newly detected overpayments totaled $4.7 billion. To deter and detect overpayments, the agency obtained legislative authority to use additional tools to verify recipients financial eligibility for benefits, enhanced its processes for monitoring and holding staff accountable for completing assigned SSI workloads, and improved its use of automation to strengthen its overpayment detection capabilities. However, because a number of initiatives are still in the planning or early implementation stages, it is too soon to assess their ultimate impact on SSI payment accuracy. In addition to improving its overpayment deterrence and detection capabilities, SSA has made recovery of overpaid benefits a high priority."

Testimony issued by the General Accounting Office with an abstract that begins "The National Infrastructure Protection Center (NIPC) is an important element of the U.S.' strategy to protect the nation's infrastructures from hostile attacks, especially computer-based attacks. This testimony discusses the key findings of a GAO report on NIPC's progress in developing national capabilities for analyzing cyber threats and vulnerability data and issuing warnings, enhancing its capabilities for responding to cyber attacks, and establishing information-sharing relationships with governments and private-sector entities. GAO found that progress in developing the analysis, warning, and information-sharing capabilities has been mixed. NIPC began various critical infrastructure protection efforts that have laid the foundation for future governmentwide efforts. NIPC has also provided valuable support and coordination related to investigating and otherwise responding to attacks on computers. However, the analytical and information-sharing capabilities that are needed to protect the nation's critical infrastructures have not yet been achieved, and NIPC has developed only limited warning capabilities. An underlying contributor to the slow progress is that the NIPC's roles and responsibilities have not been fully defined and are not consistently interpreted by other entities involved in the government's broader critical infrastructure protection strategy. This report summarized an April report …

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the roles of Fannie Mae and Freddie Mac in the U.S. housing finance system, focusing on: (1) the benefits and costs of the enterprises' housing finance activities; (2) federal efforts to ensure the enterprises' safety and soundness; and (3) federal efforts to ensure that the enterprises promote home ownership opportunities for all Americans."

Testimony issued by the General Accounting Office with an abstract that begins "Although the short-term outlook of Medicare's hospital insurance trust fund improved in the last year, Medicare's long-term prospects have worsened. The Medicare Trustee's latest projections, released in March, use more realistic assumptions about health care spending in the years ahead. These latest projections call into question the program's long-term financial health. The Congressional Budget Office also increased its long-term estimates of Medicare spending. The slowdown in Medicare spending growth in recent years appears to have ended. In the first eight months of fiscal year 2001, Medicare spending was 7.5 percent higher than a year earlier. This testimony discusses several fundamental challenges to Medicare reform. Without meaningful entitlement reform, GAO's long-term budget simulations show that an aging population and rising health care spending will eventually drive the country back into deficit and debt. The addition of a prescription drug benefits would boost spending projections even further. Properly structured reform to promote competition among health plans could make Medicare beneficiaries more cost conscious. The continued importance of traditional Medicare underscores the need to base adjustments to provider payments on hard evidence rather than on anecdotal information. Similarly, reforms in the …

Testimony issued by the General Accounting Office with an abstract that begins "Since September 11, the safety and security of the nation's civil aviation system have taken on greater urgency. GAO found that the newly created Transportation Security Administration (TSA) has assumed responsibility for aviation security and has focused on meeting congressionally mandated deadlines for strengthening aviation security. So far, TSA has developed plans and implemented procedures for using federal employees to conduct security screening at more than 400 commercial airports; hired and begun to train nearly 4,000 key security personnel; and undertaken more rigorous background checks of workers with access to secure areas at airports. TSA faces immediate challenges in assuming responsibility for security in other modes of transportation, improving the performance of screeners, and addressing aviation security issues not covered by the Aviation and Transportation Security Act's current-year deadlines. TSA also faces long-term organizational challenges, including strategically managing its workforce, controlling costs, and sharing threat information."

Testimony issued by the Government Accountability Office with an abstract that begins "In light of GAO's past three testimonies and two reports on problems with controls over excess DOD property, GAO was asked to perform follow-up investigations to determine if (1) unauthorized parties could obtain sensitive excess military equipment that requires demilitarization (destruction) when no longer needed by DOD and (2) system and process improvements are adequate to prevent sales of new, unused excess items that DOD continues to buy or that are in demand by the military services."

A letter report issued by the General Accounting Office with an abstract that begins "About 7,000 Peace Corps volunteers now serve in 70 countries, often living in areas with limited access to reliable communications, police, or medical services. Moreover, as Americans, they may be viewed as relatively wealthy and hence good targets for criminal activity. The Peace Corps has reported rising numbers of assaults against its volunteers since it began collecting data in 1990. However, the Peace Corps' record is mixed when it comes to developing safe and secure housing and worksites for volunteers, monitoring volunteers and responding to security concerns or criminal incidents, and preparing for emergencies. To reduce risks to its volunteers, the Peace Corps has adopted policies that address monitoring and disseminating information on the security environment; volunteer training; development of safe and secure housing and work sites for volunteers; monitoring volunteers and responding to incidents and concerns; and planning for emergencies, such as evacuations. Volunteer surveys and GAO visits to five overseas ports indicate that volunteers are generally satisfied with agency training programs and other efforts designed to emphasize safety and security awareness. The agency is not certain, but officials have stated that efforts to improve …

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the Army's acquisition of Category 2 weapons systems."

A letter report issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the Real Estate Assessment Center's (REAC) new physical inspection system for the Department of Housing and Urban Development's (HUD) public and multifamily housing properties, focusing on whether: (1) REAC's inspection system represents an improvement over HUD's prior inspection systems; and (2) REAC's inspections are reliable."

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony relates to the broader question: How should we deal with our nation's long-term fiscal challenge in order to help ensure that our future is better than our past? This testimony will start with our longer-term fiscal challenge. Then it will turn to the process question you present at this hearing: the reimposition of a statutory PAYGO rule(s) as a step toward dealing with this challenge. Finally it will talk about moving beyond caps and PAYGO to some ideas on how improved transparency and process changes can help in the effort to put us on a more prudent and sustainable long-term fiscal path. As widely reported earlier this month, the Administration now expects the deficit for fiscal year 2007 to be $205 billion, down from its February estimate of $244 billion and last year's deficit of $248 billion. However, because these numbers include the Social Security surpluses, they mask what GAO likes to call the "operating deficit" now estimated to be $385 billion for fiscal year 2007. Clearly lower short-term deficits are better than higher short-term deficits. However, our real challenge is not short-term deficits, rather it's …

Testimony issued by the Government Accountability Office with an abstract that begins "A 1994 Executive Order sought to ensure that minority and low-income populations are not subjected to disproportionately high levels of environmental risk. Studies have shown that these groups are indeed disproportionately exposed to air pollution and other environmental and health problems. The Order sought to address the problem by requiring EPA and other federal agencies to make achieving environmental justice part of their missions. In July 2005, GAO issued a report entitled, Environmental Justice: EPA Should Devote More Attention to Environmental Justice When Developing Clean Air Rules (GAO-05-289). Focusing on three specific rules for detailed study, the report identified a number of weaknesses in EPA's approach to ensuring that environmental justice is considered from the early stages of rule development through their issuance. The report made several recommendations, to which EPA replied in an August 24, 2006 letter. GAO also met recently with cognizant EPA staff to obtain updated information on the agency's responses to these recommendations. In this testimony, GAO (1) summarizes the key findings of its 2005 report, (2) outlines its recommendations to EPA and EPA's August 2006 responses, and (3) provides updated information on subsequent …

A letter report issued by the General Accounting Office with an abstract that begins "With annual obligations for goods and services totaling $1.7 billion, the Immigration and Naturalization Service (INS) is one of the largest of 23 entities coming into the Department of Homeland Security (DHS). INS's procurement organization will continue to acquire goods and services under DHS. GAO was asked to review INS's contracting processes to assess whether INS has an adequate infrastructure to manage its acquisitions and to determine whether INS is following sound contracting policies and procedures in awarding and managing individual contracts."

A letter report issued by the General Accounting Office with an abstract that begins "The U.S. government is one of the world's largest property owners, with a real estate portfolio of more than 400,000 defense and civilian buildings and more than one-half billion acres of land. Each year, the federal government spends billions of dollars to maintain its buildings. Even so, the General Services Administration (GSA) contends that it needs $4 billion, over and above these expenditures, to maintain its existing inventory. This report identifies the potential benefits to the federal government of entering into public-private partnerships on real property--an arrangement in which the federal government contributes real property and a private entity contributes financial capital and borrowing ability to redevelop or renovate the real property. GAO found that public-private partnership authority could be an important management tool to address problems in deteriorating federal buildings, but further study of how the tool would actually work and its benefits compared to other options is needed. Potential net benefits to the federal government of entering into these public-private partnerships include better space, lower operating costs, and increased revenue without up-front federal capital expenditures if further analysis shows that they would not be …

Testimony issued by the Government Accountability Office with an abstract that begins "The F-22A--the Air Force's next generation air superiority fighter aircraft--incorporates a low observable (stealth) and highly maneuverable airframe, advanced integrated avionics, and a new engine capable of sustained supersonic flight without the use of afterburners. The F-22A acquisition history is a case study in increased cost and schedule inefficiency. Since the program's inception in 1986, the Air Force has added new requirements, more than doubled the length of the acquisition schedule, cut purchase quantities by more than 75 percent, and increased total acquisition unit costs by more than 100 percent. The F-22A program's significant cost and schedule growth is illustrative of a number of systemic problems in the Department of Defense's (DOD) major weapon system acquisitions. Currently, DOD is proposing to buy the remaining 60 F-22As under a 3-year contract. At the Congress's request, GAO was asked for its views on DOD's latest plan to restructure the program and on the Air Force's request for authority to enter into a multiyear contract to implement this restructuring."

Testimony issued by the Government Accountability Office with an abstract that begins "In 2002, the system Medicare uses to determine annual changes to physician fees--the sustainable growth rate (SGR) system--reduced fees by almost 5 percent. Subsequent administrative and legislative actions averted fee declines in 2003 through 2006. Absent additional actions, fee reductions are projected for 2007 through 2015. Consequently, the appropriateness of the SGR system has been questioned. At the same time, there are concerns about the impact of increased physician services spending on the long-term fiscal sustainability of Medicare. GAO was asked to discuss the SGR system and Medicare physician payments. This statement addresses (1) how the SGR system is designed to moderate the growth in spending for physician services, (2) why physician fees are projected to decline under the SGR system, (3) trends in the use of services provided by physicians and spending for those services from 2000 through 2005, and (4) options for revising or replacing the SGR system. This statement is based on two GAO reports: Medicare Physician Services: Use of Services Increasing Nationwide and Relatively Few Beneficiaries Report Major Access Problems (GAO-06-704, July 21, 2006), and Medicare Physician Payments: Concerns about Spending Target System Prompt …

A letter report issued by the General Accounting Office with an abstract that begins "Capacity problems and other disruptions at the securities and options exchanges have caused processing delays within the U.S. securities markets in recent years. These exchanges and clearing organizations have also been concerned about unwarranted access by hackers and other unauthorized users. To address these issues, the securities and Exchange Commission (SEC) created its automation review policy program in 1989. The program calls for the exchanges and clearing organizations that act as self-regulatory organizations to voluntarily follow SEC guidance and submit to oversight of their information systems. The program includes two key policy statements that provide voluntary guidelines to these organizations, periodic on-site inspections by SEC staff, and independent reviews of systems by internal auditors or external organizations. In addition, self-regulatory organizations are expected to provide SEC with reports of system outages and notices of system modifications. This report reviews SEC's effectiveness in its oversight roles. GAO found that the program reasonably ensures that self-regulatory organizations address capacity, security, and other information systems issues. However, SEC could improve its program oversight by consolidating criteria used by program staff into a comprehensive guide. Overall, SEC's inspections addressed the …

Other written product issued by the General Accounting Office with an abstract that begins "Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) new rule on the Medicare Choice Program. GAO held that: (1) the final rule responds to comments on a June 26, 1998, interim final rule implementing the Medicare Choice program and revises the interim rule to reflect changes made to the program by the Balanced Budget Refinement Act of 1999; and (2) HCFA complied with applicable requirements in promulgating the rule."

A letter report issued by the General Accounting Office with an abstract that begins "Since September 11, 2001, concern has increased that terrorists could smuggle weapons of mass destruction in the 7 million ocean containers that arrive annually at U.S. seaports. In response to this concern, the U.S. Customs Service (Customs) implemented the Container Security Initiative (CSI) to screen for high-risk containers at overseas ports and Customs-Trade Partnership Against Terrorism (CTPAT) to improve global supply chain security in the private sector. GAO (1) describes the purpose and elements of these new programs, (2) examines Customs' implementation of CSI and C-TPAT during the first year, and (3) assesses the extent to which Customs has focused on factors critical to the programs' long-term success and accountability."

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) maintains a military force with unparalleled logistics capabilities, but it continues to confront decades-old supply chain management problems. The supply chain can be the critical link in determining whether our frontline military forces win or lose on the battlefield, and the investment of resources in the supply chain is substantial. Because of weaknesses in DOD's supply chain management, this program has been on GAO's list of high-risk areas needing urgent attention and transformation since 1990. Last year, DOD developed a plan to resolve its long-term supply chain problems in three focus areas: requirements forecasting, asset visibility, and materiel distribution. In October 2005, GAO testified that the plan was a good first step. GAO was asked to provide its views on DOD's progress toward (1) implementing the supply chain management improvement plan and (2) incorporating performance measures for tracking and demonstrating improvement, as well as to comment on the alignment of DOD's supply chain management improvement plan with other department logistics plans. This testimony is based on prior GAO reports and ongoing work in this area. It contains GAO's views on opportunities to improve …