A letter report issued by the Government Accountability Office with an abstract that begins "The Centers for Medicare & Medicaid Services (CMS)--an agency within the Department of Health and Human Services (HHS)--and the Congress, through the Deficit Reduction Act of 2005 (DRA), recently acted to constrain spending on imaging services, one of the fastest growing set of services under Medicare Part B, which covers physician and other outpatient services. GAO was asked to provide information to help the Congress evaluate imaging services in Medicare. In this report, GAO provides information on (1) trends in Medicare spending on imaging services from 2000 through 2006, (2) the relationship between spending growth and the provision of imaging services in physicians' offices, and (3) imaging management practices used by private payers that may have lessons for Medicare. To do this work, GAO analyzed Medicare claims data from 2000 through 2006, interviewed private health care plans, and reviewed health services literature."

A letter report issued by the Government Accountability Office with an abstract that begins "The General Services Administration (GSA) is responsible for ensuring that federal agencies have access to the telecommunications needed to meet mission requirements. GSA's current telecommunications program, called FTS2001, has contracts in place that will expire by June 2010. Thus, agencies face the difficult task of transitioning their services to a successor program, known as Networx. GAO was asked to determine (1) the extent to which agencies are following sound transition planning practices and (2) the actions GSA is taking to identify and resolve common transition challenges affecting agencies. In performing this work, GAO selected six agencies based on, among other things, their FTS2001 charges; reviewed transition planning at these agencies and GSA; and analyzed GSA documentation of actions to address transition challenges."

A letter report issued by the Government Accountability Office with an abstract that begins "The increasing need for warfighters for the Global War on Terrorism has meant longer and multiple deployments for soldiers. Medical readiness is essential to their performing needed duties, and an impairment that limits a soldier's capacities represents risk to the soldier, the unit, and the mission. Asked to review the Army's compliance with its guidance, GAO examined the extent to which the Army is (1) adhering to its medical and deployment requirements regarding decisions to send soldiers with medical conditions to Iraq and Afghanistan, and (2) deploying soldiers with medical conditions requiring duty limitations, and assigning them to duties suitable for their limitations. GAO reviewed Army guidance, and medical records for those preparing to deploy between April 2006 and March 2007; interviewed Army officials and commanders at Forts Benning, Stewart, and Drum, selected for their high deployment rates; and surveyed deployed soldiers with medical limitations."

A letter report issued by the Government Accountability Office with an abstract that begins "For the past 11 years, since GAO's first audit of the consolidated financial statements of the U.S. government (CFS), certain material weaknesses in internal control and in selected accounting and financial reporting practices have prevented GAO from expressing an opinion on the CFS. GAO has consistently reported that the U.S. government did not have adequate systems, controls, and procedures to properly prepare the CFS. GAO's December 2007 disclaimer of opinion on the fiscal year 2007 accrual basis consolidated financial statements included a discussion of continuing control deficiencies related to the preparation of the CFS. The purpose of this report is to (1) provide details of continuing material weaknesses, (2) recommend improvements, and (3) provide the status of corrective actions taken to address the 81 open recommendations related to the preparation of the CFS that GAO reported in July 2007."

A letter report issued by the Government Accountability Office with an abstract that begins "Due to several simultaneous Department of Defense (DOD) force structure and basing initiatives, 20 installations are expecting a combined net growth of over 173,000 military and civilian personnel, not including family members and all contractors, over fiscal years 2006-2012. Although communities surrounding these installations can expect to realize economic benefits in the long term, DOD has identified these 20 to be substantially and seriously impacted in terms of being able to provide infrastructure to accommodate the growth. In response to the House report to the fiscal year 2007 defense appropriations bill, GAO (1) examined the extent to which communities affected by DOD's actions have identified their infrastructure needs, and (2) assessed DOD's efforts and those of other agencies to assist affected communities. GAO reviewed applicable directives and executive orders, surveyed the 20 growth communities, and met with community and agency officials to discuss growth issues."

A letter report issued by the Government Accountability Office with an abstract that begins "The Coast Guard's 110-foot patrol boats are used for a number of missions, such as enforcement of fisheries laws, and the interdiction of migrants and illicit drugs. As part of the Coast Guard's initial plans to replace many of its vessels, it intended to convert its 110-foot patrol boats into 123-foot patrol boats with increased capabilities until the replacement vessel, the Fast Response Cutter (FRC), became operational. However, structural problems on the eight converted 123-foot boats led the Coast Guard to remove these boats from service. Faced with a loss of operational hours, especially in the Coast Guard's Florida-based District 7 where these boats operated, the Coast Guard implemented mitigation strategies to recover lost operational hours. This report provides information on Coast Guard patrol boat operations and, in particular, addresses: (1) operational challenges created by the removal from service of the 123-foot patrol boats and the Coast Guard's strategies for mitigating their loss; (2) effects these mitigation strategies have had on overall Coast Guard operational hours, as well as operating and maintenance costs, patrol boat crews, and mission performance; and (3) issues that could affect the …

A letter report issued by the Government Accountability Office with an abstract that begins "Technological advances have led to an increasing convergence of previously separate networks used to transmit voice and data communications. While the benefits of this convergence are enormous, such interconnectivity also poses significant challenges to our nation's ability to respond to major disruptions. Two operations centers--managed by the Department of Homeland Security's (DHS) National Communications System and National Cyber Security Division--plan for and monitor disruptions on voice and data networks. In September 2007, a DHS expert task force made three recommendations toward establishing an integrated operations center that the department agreed to adopt. To determine the status of efforts to establish an integrated center, GAO reviewed documentation, interviewed relevant DHS and private sector officials, and reviewed laws and policies to identify DHS's responsibilities in addressing convergence."

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2002, the United States has worked to develop the Afghan National Security Forces (ANSF). The Department of Defense (Defense), through its Combined Security Transition Command-Afghanistan (CSTC-A), directs U.S. efforts to develop the Afghan National Army (ANA) and, in conjunction with the Department of State (State), the Afghan National Police (ANP). To follow up on recommendations from GAO's 2005 report on the ANSF, GAO analyzed the extent to which U.S. plans for the ANSF contain criteria we recommended. GAO also examined progress made and challenges faced in developing the ANA and ANP. To address these objectives, GAO reviewed Defense, State, and contractor documents and met with cognizant officials. GAO has prepared this report under the Comptroller General's authority to conduct evaluations on his own initiative."

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Reserve Board's (FRB) Regulation B, which implements the Equal Credit Opportunity Act of 1974 (ECOA), generally prohibits lenders from collecting certain data from loan applicants, such as their race or gender, for nonmortgage loans (e.g., small business loans). FRB has stated that this provision of Regulation B minimizes the chances that lenders would use such data in an unlawful and discriminatory manner. However, others argue that the prohibition limits the capacity of researchers and regulators to identify possible discrimination in nonmortgage lending. This report analyzes (1) studies on possible discrimination in nonmortgage lending and the data used in them, (2) FRB's 2003 decision to retain the prohibition of voluntary data collection, and (3) the benefits and costs of a data collection and reporting requirement. GAO conducted a literature review; reviewed FRB documents; analyzed issues involving the Home Mortgage Disclosure Act (HMDA), which requires lenders to collect and publicly report data on personal characteristics for mortgage loan applicants; and interviewed FRB and other regulatory officials, researchers, banks, and consumer groups. FRB did not take a position on this report's analysis. In addition to restating its …

A letter report issued by the Government Accountability Office with an abstract that begins "The Implementation Plan for the National Strategy for Pandemic Influenza states that in an influenza pandemic, the primary response will come from states and localities. To assist them with pandemic planning and exercising, Congress has provided $600 million to states and certain localities. The Department of Homeland Security (DHS) established five federal influenza pandemic regions to work with states to coordinate planning and response efforts. GAO was asked to (1) describe how selected states and localities are planning for an influenza pandemic and who they involved, (2) describe the extent to which selected states and localities conducted exercises to test their influenza pandemic planning and incorporated lessons learned as a result, and (3) identify how the federal government can facilitate or help improve state and local efforts to plan and exercise for an influenza pandemic. GAO conducted site visits to five states and 10 localities."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy (DOE) manages more than 56 million gallons of radioactive and hazardous waste stored in 149 single-shell and 28 double-shell underground tanks at its Hanford Site in Washington State. Many of these aging tanks have already leaked waste into the soil. Meanwhile, DOE's planned process for emptying the tanks and treating the waste--mixing it with molten glass and solidifying it in canisters for storage--has experienced delays, lengthening the time the tanks will store waste and intensifying concerns about the tanks' viability during a long cleanup process. This report addresses (1) the condition, contents, and long-term viability of Hanford's underground tanks; (2) DOE's strategy for managing the tanks; and (3) the extent to which DOE has weighed the risks and benefits of its tank management strategy against the growing costs of that strategy. GAO analyzed numerous studies and reports on the tanks and interviewed DOE officials and other experts on relevant issues."

A letter report issued by the Government Accountability Office with an abstract that begins "The attacks on 9/11 underscored the federal government's need to facilitate terrorism-related information sharing among government, private sector, and foreign stakeholders. In response, the Intelligence Reform and Terrorism Prevention Act of 2004 mandated the creation of the Information Sharing Environment (ISE), which is described as an approach for the sharing of terrorism-related information. A presidentially appointed Program Manager oversees ISE development with assistance from the Information Sharing Council (ISC), a forum for 16 information sharing officials from federal agencies and departments. GAO was asked to report on (1) what actions have been taken to guide the design and implementation of the ISE and (2) what efforts have been made to report on progress in implementing the ISE. To perform this work, GAO reviewed related laws, directives, guidance, and ISE planning and reporting documents and interviewed officials from the Program Manager's office and key agencies who serve on the ISC."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA), through its Veterans Health Administration (VHA), provides health care for more than 5 million veterans each year. In 2001, VHA began an initiative, HealtheVet, to modernize its current medical information system. GAO's objectives were to determine the status of the modernization, VA's overall plan for completing it, and how VA is providing oversight to ensure the success of the initiative. To conduct this review, GAO analyzed project documentation and interviewed officials responsible for the development and implementation of the new system."

A letter report issued by the Government Accountability Office with an abstract that begins "Federal agencies are increasingly using electronic mail (e-mail) for essential communication. In doing so, they are potentially creating messages that have the status of federal records, which must be managed and preserved in accordance with the Federal Records Act. Under the act, both the National Archives and Records Administration (NARA) and federal agencies have responsibilities for managing federal records, including e-mail records. In view of the importance that e-mail plays in documenting government activities, GAO was asked, among other things, to review the extent to which NARA provides oversight of federal records management, describe selected agencies' processes for managing e-mail records, and assess these agencies' e-mail policies and key practices. To do so, GAO examined NARA guidance, regulations, and oversight activities, as well as e-mail policies at four agencies (of contrasting sizes and structures) and the practices of selected officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The Equal Employment Opportunity Commission (EEOC), created by title VII of the Civil Rights Act of 1964, promotes equal opportunity in the workplace and enforces federal laws that prohibit employment discrimination on the basis of race, sex, color, religion, national origin, age, and disability. As the nation's primary enforcer of civil rights employment laws, EEOC investigates charges of employment discrimination from the public, litigates major cases, and reaches out to federal agencies and the public to educate and prevent discrimination. EEOC serves every industry, every segment of the population, and every part of the country. While its core mission has not changed since the agency was established more than 40 years ago, EEOC continues to face a range of new challenges in the 21st century, including long-term fiscal constraints, changing demographics, and rapid advances in technology. The federal government overall faces significant human capital challenges, including a retirement wave that will lead to the loss of leadership and institutional knowledge at all levels. EEOC is not immune from this trend. EEOC estimates that within 4 years, all of its current senior executives and senior managers will …

A letter report issued by the Government Accountability Office with an abstract that begins "Under the Medicare program, the Centers for Medicare & Medicaid Services (CMS) and its contractors paid over $400 billion in Medicare benefits in calendar year 2006. GAO was asked to determine if Medicare providers have unpaid federal taxes and, if so, to (1) determine the magnitude of such debts, (2) identify examples of Medicare providers that have engaged in abusive or potentially criminal activities, and (3) determine whether CMS prevents delinquent taxpayers from enrolling in Medicare or levies payments to pay taxes. To determine amount of unpaid taxes owed by Medicare providers, GAO compared claim payment data from CMS and tax debt data from the Internal Revenue Service (IRS). In addition, GAO reviewed policies, procedures, and regulations related to Medicare. GAO also performed additional investigative activities."

A letter report issued by the Government Accountability Office with an abstract that begins "Concerns have grown that terrorists could use radioactive materials and sealed sources (materials sealed in a capsule) to build a "dirty bomb"-- a device using conventional explosives to disperse radioactive material. In 2003, GAO found weaknesses in the Nuclear Regulatory Commission's (NRC) radioactive materials licensing process and made recommendations for improvement. For this report, GAO assesses (1) the progress NRC has made in implementing the 2003 recommendations, (2) other steps NRC has taken to improve its ability to track radioactive materials, (3) Customs and Border Protection's (CBP) ability to detect radioactive materials at land ports of entry, and (4) CBP's ability to verify that such materials are appropriately licensed prior to entering the United States. To perform this work, GAO assessed documents and interviewed NRC and CBP officials in headquarters and in several field locations."

A letter report issued by the Government Accountability Office with an abstract that begins "After a 1975 fire at the Browns Ferry nuclear plant in Alabama threatened the unit's ability to shut down safely, the Nuclear Regulatory Commission (NRC) issued prescriptive fire safety rules for commercial nuclear units. However, nuclear units with different designs and different ages have had difficulty meeting these rules and have sought exemptions to them. In 2004, NRC began to encourage the nation's 104 nuclear units to transition to a less prescriptive, risk-informed approach that will analyze the fire risks of individual nuclear units. GAO was asked to examine (1) the number and causes of fire incidents at nuclear units since 1995, (2) compliance with NRC fire safety regulations, and (3) the transition to the new approach. GAO visited 10 of the 65 nuclear sites nationwide, reviewed NRC reports and related documentation about fire events at nuclear units, and interviewed NRC and industry officials to examine compliance with existing fire protection rules and the transition to the new approach."

A letter report issued by the Government Accountability Office with an abstract that begins "First responders are responsible for responding to terrorist-related and accidental releases of CBRN materials in urban areas. Two primary tools for identifying agents released and their dispersion and effect are equipment to detect and identify CBRN agents in the environment and plume models to track the dispersion of airborne releases of these agents. GAO reports on the limitations of the CBRN detection equipment, its performance standards and capabilities testing, plume models available for tracking urban dispersion of CBRN materials, and information for determining how exposure to CBRN materials affects urban populations. To assess the limitations of CBRN detection equipment and urban plume modeling for first responders' use, GAO met with and obtained data from agency officials and first responders in three states."

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal and District of Columbia Government Real Property Act of 2006 (Public Law 109-396) mandated GAO's review of the property exchange between the District and the federal government. None of the conveyances had occurred by the beginning of GAO's audit phase. After consulting with the congressional committees specified in the law, GAO developed research questions that reflect an assessment of property exchanges and development progress to date. GAO's objectives were to determine (1) the status of the conveyances and transfers of the properties identified in the law; (2) what steps the District and the federal government have taken toward completing the conveyances, what factors have affected their completion, and what additional steps remain; (3)what preliminary development has occurred on the properties exchanged between the District and the federal government, and what are the current plans for use of these properties; and (4)what development challenges the District and federal government face going forward. GAO analyzed planning and property documents; conducted site visits; and interviewed senior officials from the District and the Department of the Interior (DOI) among others. DOI and the General Services Administration agreed with …

A letter report issued by the Government Accountability Office with an abstract that begins "Hurricane Katrina illustrated that effective preparation and response to a catastrophe requires a joint effort between federal, state, and local government. The Department of Homeland Security (DHS), through the Federal Emergency Management Agency (FEMA), is responsible for heading the joint effort. In January 2008, DHS released the National Response Framework (NRF), a revision of the 2004 National Response Plan (2004 Plan), the national preparation plan for all hazards. In response to the explanatory statement to the Consolidated Appropriations Act of 2008 and as discussed with congressional committees, this report evaluates the extent to which (1) DHS collaborated with non-federal stakeholders in revising and updating the 2004 Plan into the 2008 NRF and (2) FEMA has developed policies and procedures for managing future NRF revisions. To accomplish these objectives, GAO reviewed DHS and FEMA documents related to the revision process, analyzed the relevant statutes, and interviewed federal and non-federal officials who held key positions in the revision process."

A letter report issued by the Government Accountability Office with an abstract that begins "The No Child Left Behind Act (NCLBA) requires states and the Department of the Interior's Bureau of Indian Education (BIE) to define and determine whether schools are making adequate yearly progress (AYP) toward meeting the goal of 100 percent academic proficiency. To address tribes' needs for cultural preservation, NCLBA allows tribal groups to waive all or part of BIE's definition of AYP and propose an alternative, with technical assistance from BIE and the Department of Education, if requested. GAO is providing information on the extent of (1) BIE schools' adoption of BIE's definition of AYP; (2) tribal groups' pursuit of alternatives and their reasons as well as reasons other tribal groups have not done so; and (3) federal assistance to tribal groups developing alternatives. To obtain this information, GAO interviewed tribal groups, federal officials, and state education officials; conducted site visits to BIE schools; and reviewed laws, regulations, and other relevant documents."

A letter report issued by the Government Accountability Office with an abstract that begins "Over the past decade, average college tuition and fees increased between 20 and 38 percent, depending on the type of institution. This rising cost of college affects all students--both veteran and nonveteran students--who rely on a mix of family resources, grants, scholarships, loans, and work-study to finance their education. Students may face particular hardships when the cost of attendance outpaces students' available resources. For example, some lenders recently have tightened the eligibility criteria for obtaining student loans in response to problems in financial markets. In fiscal year 2007, the Department of Education (Education) provided $82 billion in financial aid in the form of grants, loans, and work-study programs under Title IV of the Higher Education Act of 1965, as amended, to 11 million students and their families. The primary Title IV aid programs include Pell Grants, Stafford Loans, and campus-based aid programs. Veterans also may be eligible for federal financial aid from the Department of Veterans Affairs (VA). VA awarded about $2 billion in Chapter 30 education benefits under the Montgomery GI Bill1 (Chapter 30 GI benefits) to more than 300,000 veteran students in fiscal year …

A letter report issued by the Government Accountability Office with an abstract that begins "The United States has reimbursed Pakistan, a key ally in the global war on terror, about $5.56 billion in Coalition Support Funds (CSF) for its efforts to combat terrorism along its border with Afghanistan. The Department of Defense (Defense) provides CSF to 27 coalition partners for costs incurred in direct support of U.S. military operations. Pakistan is the largest recipient of CSF, receiving 81 percent of CSF reimbursements as of May 2008. This report focuses on (1) the extent to which Defense has consistently applied its guidance to validate the reimbursements claimed by Pakistan and (2) how the Office of the Defense Representative to Pakistan's (ODRP) role has changed over time. To address these objectives, GAO reviewed CSF oversight procedures, examined CSF documents, and interviewed Defense officials in Washington, D.C., U.S. Central Command in Florida, and Pakistan."