Report that reviews the major facets of U.S.-India security relations with a focus on military-to-military contacts, counterterrorism and intelligence cooperation, and defense trade. It also discusses some of the many obstacles to deeper cooperation in each of these areas.

A letter report issued by the Government Accountability Office with an abstract that begins "The five studies GAO reviewed that used microsimulation models to estimate the effects of the Patient Protection and Affordable Care Act (PPACA) on employer-sponsored coverage generally predicted little change in prevalence in the near term, while results of employer surveys varied more widely. The five microsimulation study estimates ranged from a net decrease of 2.5 percent to a net increase of 2.7 percent in the total number of individuals with employer-sponsored coverage within the first 2 years of implementation of key PPACA provisions, affecting up to about 4 million individuals. Two of these studies also indicated that the majority of individuals losing employer-sponsored coverage would transition to other sources of coverage. In contrast to the microsimulation studies, which estimate the net effect on individuals, most employer surveys measure the percentage of employers that may drop coverage in response to PPACA. Among the 19 surveys, 16 reported estimates of employers dropping coverage for all employee types. Among these 16, 11 indicated that 10 percent or fewer employers were likely to drop coverage in the near term, but estimates ranged from 2 to 20 percent. Most surveys were …

A letter report issued by the Government Accountability Office with an abstract that begins "While the number of community banks and credit unions has declined in recent years, they have remained important lenders to small businesses and other local customers. From 1985 through 2010, the number of banks under $10 billion in assets and credit unions declined by over 50 percent to 7,551 and 7,339, respectively. The decline resulted largely from consolidations, which were facilitated by changes in federal law that made it easier for banks and credit unions to expand geographically. Another factor that may have contributed to consolidations is economies of scale, which refer to how an institution's size is related to its costs. Although the existence of economies of scale in banking has been subject to debate, some recent research suggests that banks can save costs by expanding. Despite the decline in their number, community banks and credit unions have maintained their relationship-banking model, relying on their relationships with customers and local knowledge to make loans. Such institutions can use their relationship-based information to make loans to small businesses and other borrowers that larger banks may not make because of their general reliance on more automated processes. …

A letter report issued by the Government Accountability Office with an abstract that begins "The Navy report addressed four of the five elements specified in House Report 112-78, while partially addressing one of the five elements. The Navy report addressed the potential for reducing maintenance and repair costs for the Navy’s small boat fleet by using advanced boat lifts, and it addressed recommendations regarding the potential establishment of improved boat corrosion control and prevention as key performance parameters. The Navy report partially addressed the committee’s direction to include an evaluation and business case analysis of the impact of advanced boat lifts for potential improvements to small boat acquisition costs and life-cycle sustainment. The report’s business case analysis evaluated potential improvements to life-cycle sustainment, focusing on potential maintenance cost savings associated with boat lifts. However, this business case analysis did not evaluate the impact of the use of advanced boat lifts on potential improvements to small boat acquisition costs. Navy officials told GAO that the use of advanced boat lifts would not significantly contribute to extending the service life of the boats or produce any other additional benefits that would lead to reduced small boat acquisition costs. This is primarily because …

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, 1,964 hospitals and 45,962 professionals were awarded a total of approximately $2.7 billion in Medicaid EHR incentive payments for 2011. These 1,964 hospitals, which represented 39 percent of the 5,013 eligible hospitals, were awarded a total of $1.7 billion in Medicaid EHR incentive payments for 2011. While the amount of Medicaid EHR incentive payments awarded to each hospital ranged from $7,528 to $7.2 million, the median payment amount was $613,512. Participation rates, as well as total payments, were higher for hospitals in the Medicaid EHR program when compared to the Medicare EHR program, though the median payment amount in the Medicaid EHR program was less than half as large. About 50 percent of hospitals accounted for about 80 percent of the total amount of Medicaid incentive payments awarded to hospitals. Among hospitals awarded a Medicaid EHR incentive payment for 2011, we found that"

A letter report issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins "The U.S. Army Corps of Engineers (Corps) and the Department of Transportation (DOT) use a variety of programs to maintain and improve Marine Transportation System (MTS) infrastructure. The Corps is the lead federal agency responsible for maintaining and improving navigable waterways. Corps data show that obligations for navigable waterways have decreased from over $3 billion in fiscal year 2009 to about $1.8 billion in fiscal year 2011. Most annual DOT funding is provided to states through formulas, and states determine which projects to fund. For example, in fiscal year 2011, the Surface Transportation Program provided $9.5 billion to states for a variety of transportation projects, which may have included port improvements. However, because DOT does not specifically track formula funding used to maintain or improve ports or port connectors, officials were unable to provide GAO the extent to which these funds were used for port improvements, although the officials stated that the number of port-specific projects was likely small. Several DOT grant and credit programs can also provide specific funding to ports, though ports are primarily responsible for maintaining and improving infrastructure on port property."

A letter report issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins "For fiscal years 2010 and 2011, the Department of Health and Human Services (HHS) allocated funds from the Prevention and Public Health Fund (PPHF) for 43 activities in five agencies. These activities—which include HHS programs and initiatives—were administered by HHS’s Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the Office of the Secretary (OS). Most of the $500 million available for fiscal year 2010 was allocated for activities administered by HRSA, and most of the $750 million available for fiscal year 2011 was allocated for activities administered by CDC (see fig.). HHS agencies funded individual projects with PPHF funds through grants, contracts, and interagency agreements."

A letter report issued by the Government Accountability Office with an abstract that begins "Mileage-based user fee initiatives in the United States and abroad show that such fees can lead to more equitable and efficient use of roadways by charging drivers based on their actual road use and by providing pricing incentives to reduce road use. Mileage fees for passenger vehicles, however, continue to face significant public concerns related to privacy as well as cost challenges. Privacy concerns are particularly acute when Global Positioning System (GPS) units are used to track the location of passenger vehicles. Reliable cost estimates for mileage fee systems are not available, but implementing a system to collect fees from 230 million U.S. passenger vehicles is likely to greatly exceed the costs of collecting fuel taxes. Commercial truck user fee systems in Germany and New Zealand have achieved substantial revenues and benefits such as reduced road damage and emissions with fewer privacy concerns, but ensuring compliance in a cost effective manner presents trade-offs. Few commercial truck mileage fee pilots have been conducted in the United States, but efforts in two states suggest such fees pose fewer privacy and cost challenges than passenger vehicle fees."

A letter report issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Protective Service (FPS) has not been effective as the lead agency for the government facilities sector, which includes facilities at the federal, state, local, tribal and territorial level. Under the National Infrastructure Protection Plan (NIPP) and the 2010 sector-specific plan, FPS is responsible for establishing a risk management approach and developing effective partnerships for the sector. However, FPS has not implemented a risk management approach. According to FPS, it has not identified or obtained data on facilities at the federal, state, local, tribal and territorial level, which are fundamental for employing a risk management approach. In addition, despite providing information on the principles of threat, vulnerability, and consequence, FPS has not coordinated or assessed risk across government facilities, another key element of risk management. FPS also lacks effective metrics and performance data to track progress toward implementing a risk management approach and for the overall resilience or protection of government facilities. Consequently, FPS does not have a risk management approach for prioritizing and safeguarding critical government facilities. Furthermore, FPS has not built effective partnerships across different levels of government. While FPS chairs the Government …

A letter report issued by the Government Accountability Office with an abstract that begins "DHS's and the Coast Guard did not meet the SAFE Port Act's requirement that IOCs be established at high-priority ports by October 2009, in part because the Coast Guard was not appropriated funds to establish the IOCs until 14 months after enactment of the law, and the definition of an IOC was evolving during this period. However, the Coast Guard plans to establish IOCs at all 35 of its sectors. According to the Coast Guard's analysis of sector status reports, none of its sectors have achieved IOCs with full operating capability. According to the Coast Guard’s Chief of IOC Implementation, as well as its Information Sharing Executive Agent, continued support is needed from DHS to increase port-partner participation and the success of the IOC initiative. DHS has recently begun to support efforts to increase port-partner participation and further IOC implementation, such as facilitating the review of an IOC management directive. It is too early to determine, though, if and when IOCs will achieve their intended goal of sharing information and coordinating operations with port partners."

A letter report issued by the Government Accountability Office with an abstract that begins "ARPA-E uses four selection criteria, such as the potential impact of the proposed technology relative to the state of the art, and other considerations in awarding funds. Other considerations include balancing a variety of technology approaches and the likelihood the technology would be brought to market. GAO identified 18 out of 121 award winners through ARPA-E’s first three funding rounds that had received some prior private sector investment, and ARPA-E took steps to identify and understand how this funding was related to proposed projects. Beginning with the third funding round, ARPA-E began requiring that applicants explain why private investors were not willing to fund proposed projects. However, ARPA-E did not provide applicants with guidance, such as a sample response, to assist them in completing this requirement, and responses were generally limited. Some applicants provided general information about prior research but did not specifically explain why private investors would not support their projects. When applicants provided little prior funding information, ARPA-E’s program directors spent time and resources to determine the extent of such funding for proposed ARPA-E projects. One applicant included a letter from its venture capital …

A letter report issued by the Government Accountability Office with an abstract that begins "GAO's analysis of Madoff account data shows that more than three-fourths of the firm's customers were individuals and families (individuals). The remaining accounts were held by institutions, such as pension funds and charities. A higher proportion of accounts held by an individual (60 percent) were "net winners" based on their net equity position--meaning they had withdrawn more from their accounts than they had deposited--compared to accounts held by institutions (50 percent). Correspondingly, 40 percent of institutional accounts were "net losers" that had deposited more into their accounts than they had withdrawn, compared to 29 percent of individuals' accounts that were net losers. However, individual and institutional accounts had similar deposit and withdrawal activity from 1981 through 2008, including increased withdrawals immediately before the firm's failure in December 2008."

A letter report issued by the Government Accountability Office with an abstract that begins "As GAO’s past work has shown, and other studies and specialists have confirmed, there are a number of key energy-water nexus issues that Congress and federal agencies need to consider when developing and implementing national policies for energy and water resources. Specifically:"

A letter report issued by the Government Accountability Office with an abstract that begins "Use of prepayment edits saved Medicare at least $1.76 billion in fiscal year 2010, but GAO found that savings could have been greater had prepayment edits been more widely used. GAO illustrated this point using analysis of a limited number of national policies and local coverage determinations (LCD), which are established by each Medicare administrative contractor (MAC) to specify coverage rules in its jurisdiction. GAO identified $14.7 million in payments in fiscal year 2010 that appeared to be inconsistent with four national policies and therefore improper. These payments could have been prevented through automated prepayment edits. GAO also found more than $100 million in payments that were inconsistent with three selected LCDs and that could have been identified using automated edits."

A letter report issued by the Government Accountability Office with an abstract that begins ""

A letter report issued by the Government Accountability Office with an abstract that begins "The Internal Revenue Service (IRS) has implemented one of GAO’s four recommendations from June 2011 to strengthen the Patient Protection and Affordable Care Act (PPACA) implementation efforts by scheduling the development of performance measures for the PPACA program. IRS has made varying degrees of progress on the other three recommendations:"

Testimony issued by the Government Accountability Office with an abstract that begins "The National Telecommunications and Information Administration (NTIA) is responsible for governmentwide federal spectrum management, but GAO reported in 2011 that NTIA’s efforts in this area had been limited. In 2003, the President directed NTIA to develop plans identifying federal and nonfederal spectrum needs, and in 2008, NTIA issued the federal plan. GAO found it did not identify governmentwide spectrum needs and did not contain key elements and conform to best practices for strategic planning. Furthermore, NTIA’s primary spectrum management operations do not focus on governmentwide needs. Instead, NTIA depends on agency self-evaluation of spectrum needs and focuses on mitigating interference among spectrum users, with limited emphasis on overall spectrum management. Additionally, NTIA’s data management system is antiquated and lacks internal controls to ensure the accuracy of agency-reported data, making it unclear if reliable data inform decisions about federal spectrum use. NTIA is developing a new data management system, but implementation is years away."

A letter report issued by the Government Accountability Office with an abstract that begins "The four Medicaid options for home- and community-based services (HCBS) included in the Patient Protection and Affordable Care Act (PPACA) provide states with new incentives and flexibilities to help increase the availability of services for Medicaid beneficiaries. Two of the options were newly created by PPACA, and the other two were existing options amended by the law. Three of the options provide states with financial incentives in the form of enhancements to the Medicaid matching rate that determines the federal share of the program’s costs."

A letter report issued by the Government Accountability Office with an abstract that begins "The design of the United Nations (UN) World Food Program's (WFP) internal controls related to delivery and monitoring of food assistance generally reflects principles for internal controls and enterprise risk management developed by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). WFP has developed an internal control framework that has, like the COSO internal control framework, five components: internal environment, risk management, control activities, information and communication, and monitoring. However, the design of some of WFP's controls has weaknesses that could expose WFP to risks such as waste, fraud, and abuse. For example, WFP's Executive Board oversight is limited, and it does not fully utilize the WFP Audit Committee to assist in overseeing the effectiveness of WFP's risk management and internal control processes. Also, WFP has designed risk management policies but has not developed detailed guidance to instruct staff in addressing risks, especially at the country level where WFP is most vulnerable. Additionally, as recommended by COSO, WFP has established control activities that address risks to its objectives--for example, policies and procedures designed to help ensure tracking of food assistance from delivery at the …

Testimony issued by the Government Accountability Office with an abstract that begins "The Department of Homeland Security (DHS) and the White House have acted to strengthen biosurveillance consistent with prior GAO recommendations made from December 2009 through October 2011.In August 2012, DHS issued a strategic plan for its National Biosurveillance Integration Center (NBIC) that officials say was written in coordination with federal partners and designed to respond to GAO’s December 2009 findings that NBIC did not have key resources to carry out its mission, in part due to collaboration issues it faced. In July 2012, the White House released the National Strategy for Biosurveillance, which describes guiding principles, core functions, and enablers for strengthening biosurveillance. In June 2010, GAO recommended a national biosurveillance strategy to provide a unifying framework for building and maintaining a national biosurveillance capability. In October 2011, GAO also recommended the strategy account for the need to leverage resources and respond to challenges while partnering with nonfederal entities. The July 2012 strategy partially responds to the issues GAO called for such a strategy to address, but does not fully address them, as discussed below. A strategic implementation plan is to be published within 120 days of strategy …