Correspondence issued by the Government Accountability Office with an abstract that begins "This report is in response to section 1899L of the American Recovery and Reinvestment Act of 2009. The statute required the Comptroller General to examine issues related to participation in and administrative costs associated with the Health Coverage Tax Credit program administered by the Internal Revenue Service (IRS) in the Department of the Treasury, and to provide the results to Congress by March 1, 2010."

Correspondence issued by the General Accounting Office with an abstract that begins "On February 25, 2004, Congress heard testimony at a hearing entitled "The Key to Homeland Security: The New Human Resources System." This report responds to additional questions posed by Senator Akaka and Senator Lautenberg."

Correspondence issued by the Government Accountability Office with an abstract that begins "CDC has administered and provided oversight of the CPPW program, which includes the monitoring of award recipients. CDC required recipients to use their CPPW funds to support efforts to improve nutrition, increase physical activity, or reduce tobacco use and exposure to secondhand smoke. In addition, CDC suggested possible strategies for achieving these results, such as working to establish smoke-free zones or to implement zoning changes that promote physical activity. CDC policy prohibited CPPW award recipients from using funds for specific types of activities, including lobbying, which generally meant certain activities designed to influence action in regard to a particular piece of pending legislation."

Correspondence issued by the Government Accountability Office with an abstract that begins "Improving collaboration and health resource sharing between the Department of Veterans Affairs (VA) and the Department of Defense (DOD) has been the focus of numerous efforts by Congress and the executive branch for more than two decades. In 1982, Congress passed the Veterans' Administration and Department of Defense Health Resources Sharing and Emergency Operations Act (Sharing Act), which authorized VA and DOD health care facilities to partner and enter into sharing agreements to buy, sell, and barter medical and support services. Since then, Congress has passed additional legislation to continue to promote VA and DOD health resource sharing. However, in previous work we have pointed out continuing barriers to such efforts, including incompatible computer systems that affect the exchange of patient health information, inconsistent reimbursement and budgeting policies, and burdensome processes for approving agreements between the departments. On May 28, 2001, the President established the 15-member President's Task Force to Improve Health Care Delivery for Our Nation's Veterans. The task force's mission was to identify ways to improve coordination and sharing between VA and DOD in order to improve health care for servicemembers and veterans. The task force …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the audit report covering the financial statements of the Retired Enlisted Association, Incorporated, for the fiscal years ended December 31, 1995, 1996, and 1997, focusing on whether the audit report complied with the financial reporting requirements of the law."

Correspondence issued by the Government Accountability Office with an abstract that begins "Recent increases in prescription drug costs have been fueled in part by the high and rising cost of specialty prescription drugs. Specialty prescription drugs are typically used to treat chronic or life-threatening conditions, such as multiple sclerosis and cancer, for which few other treatment options exist. The drugs typically have few competitors or generic alternatives and may require frequent dosage adjustment, special storage, patient education, or special methods of administration, such as by injection. Costs for specialty prescription drugs are usually high, typically ranging from $1,200 to $40,000 for a 30-day supply. Health plans--including those participating in the Federal Employees Health Benefits Program (FEHBP), which covers nearly 8 million federal employees, dependents, and retirees-- provide coverage for many specialty drugs. Enrollees may be required to pay a portion of specialty drug costs through a copayment--a flat dollar amount--or coinsurance--a percentage share of the drug's actual costs. To manage the high and rising costs of these drugs, some health plans have begun to require enrollees to contribute a greater share of their costs, such as by increasing the use of coinsurance. Congress asked us to examine the costs that …

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter responds to Congress's request for information on (1) selected federal expenditures, policies, and programs that affect the U.S. banking industry and (2) certain banking industry trends. These include the savings and loan industry crisis, trade finance, tax policies, and profits and executive compensation. Congress's letter also asked us for information on bank fees; as agreed with Congressional staff, we will discuss this topic in a separate report. On December 11, 2006, we briefed Congressional staff on information gathered during our preliminary work. This letter summarizes and updates the information presented at the briefing."

Correspondence issued by the Government Accountability Office with an abstract that begins "Since 1998, the Department of Defense (DOD) and the Department of Veterans Affairs (VA) have been working to electronically exchange patient health data, including outpatient pharmacy data, cross their electronic health information systems. Exchanging outpatient pharmacy data is important for DOD and VA because certain DOD and VA patients, known as shared patients, receive health care from both agencies. Clinicians' access to complete health information from both agencies' health information systems could assist clinicians in making more informed medical decisions and help prevent adverse medication reactions--which include detrimental or unintended reactions when multiple medications are taken together and allergic reactions to a medication. In March 2004, DOD and VA began collaborating on a long-term initiative to make their outpatient pharmacy data computable. Computable data refer to data that are in a format that a computer application can act on: for example, to provide automatic checks for adverse medication reactions or to plot graphs of changes in vital signs such as blood pressure. In reporting on this initiative in the past, GAO noted that the agencies have experienced delays in their efforts to begin exchanging computable outpatient pharmacy data. …

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) is facing the complex challenge of simultaneously supporting continuing operations in Iraq and Afghanistan and preparing its military forces to meet emerging threats of the new security environment. Congress appropriated $626 billion for DOD's fiscal year 2010 budget and to support current operations. As we have emphasized in previous reports, the federal government is facing serious long-term fiscal challenges, and DOD may confront increased competition over the next decade for federal discretionary funds. The 2010 Quadrennial Defense Review (QDR), the fourth since 1997 and the second since the start of operations in Afghanistan and Iraq, articulates DOD's strategic plan to rebalance capabilities in order to prevail in current operations and develop capabilities to meet future threats. The QDR acknowledged that the country faces fiscal challenges and that DOD must make difficult trade-offs where warranted. Also, the QDR results are intended to guide the services in making resource allocation decisions when developing future budgets. This letter provides our assessment of the degree to which DOD addressed each of these items in its 2010 report on the QDR and the supplemental information provided to the …

A statement of record issued by the General Accounting Office with an abstract that begins "This testimony discusses group purchasing organizations (GPO) for medical devices and supplies used in hospitals. By pooling the purchases of their member hospitals, these specialized firms negotiate lower prices from vendors. GAO found that a hospital's use of a GPO contract did not guarantee that the hospital saved money: GPOs' prices were not always lower and were often higher than prices paid by hospitals negotiating directly with vendors. GAO studied price savings with respect to: (1) whether hospitals using GPO contracts received better prices than hospitals that did their own contracting, (2) the size of the hospital, and (3) size of the GPO. This data raises questions about whether GPOs, specially large GPOs, achieve consistent price savings."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) leads detection and monitoring of aerial and maritime transit of illegal drugs into the United States in support of law enforcement agencies. Additionally, DOD's counternarcotics activities include sharing information with U.S. and foreign agencies, as well as helping foreign countries build their counternarcotics capacity. In support of these activities, Congress provided just over $6.1 billion to DOD's Counternarcotics Central Transfer Account from fiscal year 2005 through 2010. In November 2005, GAO recommended that DOD, in conjunction with other agencies performing counternarcotics activities, develop and coordinate counternarcotics performance measures. GAO has found that measuring performance allows organizations to track the progress they are making toward their goals and provides managers a basis for making key decisions to improve programs and results. In May 2007, the Office of National Drug Control Policy (ONDCP) released a circular that required agencies, including DOD, to submit a report on their performance-related information for counternarcotics activities, including how the agency's performance measures are used in the management of the program. The National Defense Authorization Act for Fiscal Year 2010 (Pub. L. No. 111-84, 1016) mandated that GAO report on …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO provided information on the Postal Service's Preliminary Performance Plan for fiscal year (FY) 2000."

Correspondence issued by the General Accounting Office with an abstract that begins "On March 3, 2004, the Subcommittee on Government Efficiency and Financial Management, House Committee on Government Reform, heard testimony on the U.S. government's consolidated financial statements for fiscal year 2003. This letter responds to questions related to the testimony and to subsequent questions from the Vice Chairman."

Correspondence issued by the General Accounting Office with an abstract that begins "The Department of Health and Human Service's (HHS) Office of Inspector General (OIG) plays a vital role in auditing and investigating allegations of fraud and abuse in federal health and welfare programs. Because it independently evaluates various programs, activities, and functions, the OIG must act with integrity at all times. In the fall of 2003, anonymous allegations charged that certain officials in the HHS OIG's Office of Evaluation and Inspections (OEI) sponsored training and management meetings for nonwork purposes and improperly renovated a regional office. The allegations primarily focused on the actions of the Acting OEI Deputy Inspector General in relation to specific events that took place from July through September 2003. The allegations charged that she (1) sponsored training at a Florida resort to facilitate vacation time for staff, (2) scheduled several follow-up training meetings as a way of providing staff with leisure time, and (3) held a managers' meeting in New York as a pretext for participants to attend a retirement celebration for one of OEI's managers. A fourth allegation charged that the Acting OEI Deputy Inspector General, along with an Acting OEI Regional Inspector General, …

Correspondence issued by the General Accounting Office with an abstract that begins "The electromagnetic radio frequency spectrum is critical to the development and operation of a variety of military systems such as radios, radars, and satellites. Due to the changing nature of warfighting, more and more military systems depend on the spectrum to guide precision weapons and obtain information superiority. In recent years, demand for the spectrum increased with advances in commercial technology. This demand has led to competition between government and nongovernment users, making spectrum management vital to prevent harmful interference and to promote spectrum efficiency. With these goals in mind, the Department of Defense (DOD) has long-standing policies and procedures that require system developers and acquirers to consider and deal with spectrum supportability knowledge early in the development and acquisition of systems. Early assessment of spectrum needs provides DOD the opportunity to identify, and therefore, better manage program and operational risks. DOD policy requires developers of spectrum dependent systems to obtain certification before assumption of contractual obligations for the full-scale development, production or procurement of those systems. Senate Report 107-151 and House Report 106-945 required us to assess DOD's spectrum management process. We focused our assessment on (1) …

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the audit report covering the financial statements of the Reserve Officers Association of the United States for the fiscal year ended March 31, 1998, focusing on whether the audit report complied with the financial reporting requirements of the law."

Correspondence issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO reviewed the audit report covering the financial statements of the National Ski Patrol System, Incorporated, for the fiscal year ended June 30, 1998, focusing on whether the audit report complied with the financial reporting requirements of the law."

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter formally transmits the summary of an oral briefing we gave in response to a mandate in the Consolidated Security, Disaster Assistance, and Continuing Appropriations Act, 2009, and subsequent agency comments. This mandate required the Department of Homeland Security (DHS) to prepare an expenditure plan that satisfied 12 specified conditions, and for the plan to be submitted to and approved by the House and Senate Appropriations Committees before the agency could obligate $400 million of the approximately $775 million appropriated for U.S. Customs and Border Protection (CBP) fencing, infrastructure, and technology. In response to this requirement, DHS submitted a plan on March 4, 2009, titled "U.S. Customs and Border Protection: Secure Border Initiative Border Security, Fencing, Infrastructure and Technology (BSFIT) Fiscal Year 2009 Expenditure Plan." As required by the act, we reviewed the plan and on March 12 and March 13, 2009, briefed staff of the Senate and House Appropriations Subcommittees, respectively, on the analysis of whether the plan satisfied the 12 specified legislative conditions."

Correspondence issued by the General Accounting Office with an abstract that begins "The enactment of the Homeland Security Act of 2002 led to the most substantial reorganization of the federal government since the 1940s by creating the Department of Homeland Security (DHS). Established in January 2003, DHS combined 29 program functions that were transferred from 10 agencies, referred to as the legacy agencies. In addition, legacy agencies transferred resources for support functions, such as offices of inspectors general and management and support. According to the President's proposal to create DHS, the reorganization was also designed to, among other things, achieve future savings through the elimination of redundancies among the transferred programs. Given the breadth and magnitude of the reorganization, questions have been raised among members of Congress and in the media about whether the creation of DHS would prompt increases in the size of the workforces at the agencies affected by the reorganization. This report responds to a request by the Chairman, House Committee on Transportation and Infrastructure, that we examine how the transfer of full-time equivalent (FTE) positions to DHS was conducted at the agencies involved in the transfer. Specifically, in this report, we (1) identify the budgetary resources …

Testimony issued by the Government Accountability Office with an abstract that begins "Since 1990, GAO has designated the Department of Defense's (DOD) management of its major weapon acquisitions as a high-risk area; however DOD's problems delivering weapon systems on time, at the estimated cost, in the planned amounts, and with the promised performance go back decades. Congress and DOD have continually explored ways to improve acquisition outcomes, yet problems persist. The committee asked GAO to testify on measures needed to reform the acquisition of major weapon systems and related legislative proposals. Specifically, this statement will describe the poor outcomes on weapon system investments that make reform imperative; attributes of the requirements, funding, and acquisition processes that will need to change for reform to be effective; and positive steps that Congress and DOD have taken to improve weapon program outcomes. The statement will also examine other factors that should be considered as the committee moves forward with its reform efforts. The testimony is drawn from GAO's body of work on DOD's requirements, funding, and acquisition processes. GAO has made numerous recommendations aimed at improving DOD's management of its major weapon acquisitions, but it is not making any new recommendations in this …

Testimony issued by the General Accounting Office with an abstract that begins "The Rail Passenger Service Act of 1970 created Amtrak to provide intercity passenger rail service because existing railroads found such service unprofitable. Amtrak operates a 22,000-mile network, primarily over freight railroad tracks, providing service to 46 states and the District of Columbia. Most of Amtrak's passengers travel on the Northeast Corridor, which runs between Boston, Massachusetts, and Washington, D.C. On some portions of the Corridor, Amtrak provides high-speed rail service (up to 150 miles per hour). Since its inception, Amtrak has struggled to earn revenues and run an efficient operation. Recent years have seen Amtrak continue to struggle financially. In February 2003, Amtrak reported that it would need several billion dollars from the federal government over the next few years to sustain operations. However, some have indicated that there needs to be a fundamental reassessment of how intercity passenger rail is structured and financed. Options raise questions about whether or not Amtrak should be purely an operating company, whether competition should be introduced for providing service, and if states should assume a greater financial role in the services that are provided."

Testimony issued by the General Accounting Office with an abstract that begins "The Veterans Equitable Resource Allocation (VERA) system allocated $17.8 billion of its $20.3 billion health care budget to 22 regional health care networks in fiscal year 2001. Before Vera resources were allocated to facilities on the basis of their historical expenditures. By aligning resources with workloads VERA shifted about$921 million among VA's networks in fiscal year 2001. VERA's design is reasonable for equitably allocating resources, but improvements could better allocate comparable resources for comparable workloads. VERA's allocations are based primarily on network workload, with adjustments made for factors beyond the control of network management. These include the health care needs of veterans and some local cost differences. VERA's design also protects patients from the effects of network budget shortfalls. However, GAO found that $200 million annually that could be reallocated to better align network resources with workloads. First, VERA's measurement of network workload is not accurate enough to determine each network's allocation because VERA excludes most veterans with higher incomes who do not have service-connected disabilities--about one-fifth of VA's workload. Second, VERA does not accurately adjust for cost differences among networks for differences in patients' health care needs …

Testimony issued by the General Accounting Office with an abstract that begins "Since 1997, federal spending on services has grown 11 percent and now represents more than 60 percent of contract spending governmentwide. Several significant changes in the government--including funding for homeland security--are expected to further increase spending on services. Adjusting to this new environment has proven difficult. Agencies need to improve in a number of areas: sustaining executive leadership, strengthening the acquisition workforce, and encouraging innovative contracting approaches. Improving these areas is a key goal of the proposed Services Acquisition Reform Act (SARA)."

Other written product issued by the Government Accountability Office with an abstract that begins "The new President, the new Congress, and the American people have been understandably focused on addressing problems with financial markets and responding to the economic downturn. However, the nation will need to apply the same level of intensity to the nation's long-term fiscal challenge. As shown in the figure below and the attached charts, GAO's updated simulations continue to show escalating and persistent debt that illustrates the long-term fiscal outlook is unsustainable. By 2025, debt held by the public under the Alternative simulation exceeds the historical high reached in the aftermath of World War II."