A letter report issued by the Government Accountability Office with an abstract that begins "DOD’s Arctic Report, submitted May 31, 2011, addressed three and partially addressed two of the elements specified in the House Report."

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 …

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 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 ""

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, according to FMS officials, FMS considers both TOP and the cross-servicing program to be fully mature in that all key elements of the programs have been implemented. As such, FMS's current and future efforts will focus on enhancements that will (1) for TOP, facilitate its ability to increase federal nontax debt collections through additional offsets and (2) for the cross-servicing program, enable it to collect such debt more efficiently and effectively. Further, FMS is considering a number of initiatives intended to improve centralized collection of delinquent federal nontax debt. These initiatives primarily involve increasing the amount of debt subject to collection by FMS, bolstering FMS's set of debt collection tools, and enhancing FMS's internal operations and interactions with referring federal agencies. Several of FMS's initiatives, which are in the early stages of development, could, if approved and effectively implemented, address long-standing concerns about FMS's centralized debt collection program."

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

Correspondence issued by the Government Accountability Office with an abstract that begins "The Navy follows the five basic guiding principles for managing risk at the strategic, environmental, and operational levels before making decisions about the placement and operation of its force structure—including the placement of nuclear-powered aircraft carriers on the East Coast of the United States. The Navy does not conduct any unique risk assessment for its nuclear-powered aircraft carriers at naval installations; rather, nuclear-powered aircraft carriers are high-value assets that are included in the Navy’s overall risk management process. At the strategic level, Office of the Secretary of the Navy and Office of the Chief of Naval Operations headquarters staff have identified and analyzed risks, such as emerging threats from hostile nation-states, which could make demands on homeland defense capabilities. Since 2004, according to Navy officials, the Navy has been using its strategic laydown and dispersal methodology in dividing its force structure and assets between the Atlantic and Pacific Fleets. In addition, officials stated that there may be adjustments to the Navy’s current split of assets between the Atlantic and Pacific Fleets based on direction from the President that is reflected in DOD’s January 2012 defense strategic guidance, which …

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 …

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 "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:"

Correspondence issued by the Government Accountability Office with an abstract that begins "USAID obligated and expended most of the ESF assistance to the West Bank and Gaza appropriated for fiscal years 2010 and 2011. Of the total $789 million provided for West Bank and Gaza assistance over the 2 years, USAID had obligated 96 percent and expended 70 percent by the end of April 2012. USAID obligated about $410 million for 26 development projects and $350 million in budget support to the PA over the 2 fiscal years. USAID provided the most assistance to the water resources and infrastructure sector, about 56 percent of total project obligations."

A letter report issued by the Government Accountability Office with an abstract that begins "NQF has made progress on projects under its contract activities, as of August 2011. Specifically, NQF has completed or made progress on 60 of 63 projects. For example, NQF has completed projects to endorse measures related to various topics, including nursing homes. However, for more than half of the projects, NQF did not meet or did not expect to meet the initial time frames approved by HHS. For example, NQF completed one project to retool measures—that is, convert previously endorsed quality measures to an electronic format. While the retooling project was expected to be completed by September 2010, its completion was delayed by 3 months. NQF and HHS officials identified various reasons that contributed to this delay, including an expansion of the project’s scope and complexity. As a result of the delay, HHS did not have all the retooled measures it expected to include in its Electronic Health Records (EHR) Incentive Program. The delay of this project was also a contributing factor to NQF exceeding its estimated cost for its entire contract activity related to EHR by about $560,000 in the second contract year— January 14, …

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 "The U.S. tactical wheeled vehicle (TWV) industrial base includes seven manufacturers that utilize common suppliers of major subsystems, such as engines and armor. Four of these manufacturers reported that their reliance on sales to the Department of Defense (DOD) varies, in part, as they also produce commercial vehicles or parts. Collectively, the seven manufacturers supplied DOD with over 158,000 TWVs to meet wartime needs from fiscal years 2007 through 2011. DOD, however, plans to return to pre-war purchasing levels, buying about 8,000 TWVs over the next several years, in part, due to fewer requirements."

Correspondence issued by the Government Accountability Office with an abstract that begins "During fiscal year 2011, OFS addressed several of the internal control issues related to the significant deficiency we reported for fiscal year 2010 concerning its accounting and financial reporting processes. However, remaining uncorrected control deficiencies along with other control deficiencies that we identified in this area in fiscal year 2011 collectively represented a continuing significant deficiency in OFS’s internal control over its accounting and financial reporting processes. Specifically, while OFS improved its review and approval process for preparing its financial statements, notes, and Management Discussion and Analysis (MD&A) for TARP for fiscal year 2011, we continued to identify incorrect amounts and inconsistent disclosures in OFS’s draft financial statements, notes, and MD&A that were significant, but not material, and that were not detected by OFS. For fiscal year 2011, we also identified deficiencies in other OFS accounting and financial reporting procedures related to: (1) recording of noncash transactions, (2) recording of warrant adjustments, and (3) accounting for Public-Private Investment Fund (PPIF) equity distributions."

Correspondence issued by the Government Accountability Office with an abstract that begins "In our audit of SEC’s fiscal years 2011 and 2010 financial statements, we identified four significant deficiencies in internal control as of September 30, 2011. These significant internal control deficiencies represent continuing deficiencies concerning controls over (1) information systems, (2) financial reporting and accounting processes, (3) budgetary resources, and (4) registrant deposits and filing fees. These significant control deficiencies may adversely affect the accuracy and completeness of information used and reported by SEC’s management. We are making a total of 10 new recommendations to address these continuing significant internal control deficiencies."

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 "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 "The Medicaid Integrity Group's (MIG) hiring of separate review and audit contractors for its National Medicaid Audit Program (NMAP) was inefficient and led to duplication because key functions were performed by both entities. Review contractors analyze state claims data to identify aberrant claims or billing anomalies while audit contractors conduct postpayment audits to determine if payments to providers were improper. Because both types of contractors had to assess whether payments were improper under state Medicaid policies, having separate contractors doubled states' burden in ensuring that state policies were being correctly applied. Also, poor coordination and communication between the two types of contractors resulted in duplicative data analysis. In turn, these inefficiencies added to the length of audits, which on average took almost 23 months to complete. By contrast, the average duration of six audits using a more collaborative and coordinated approach was 16 months, and the amount of identified overpayments increased significantly."

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 ""

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 "About 9 million of Medicare's over 48 million beneficiaries are also eligible for Medicaid because they meet income and other criteria. These dual-eligible beneficiaries have greater health care challenges than other Medicare beneficiaries, increasing their need for care coordination across the two programs. In addition to meeting all the requirements of other MA plans, D-SNPs are required by CMS to provide specialized services targeted to the needs of dual-eligible beneficiaries as well as integrate benefits or coordinate care with Medicaid services. GAO was asked to examine D-SNPs' specialized services to dual-eligible beneficiaries. GAO (1) analyzed the characteristics of dual-eligible beneficiaries in D-SNPs and other MA plans, (2) reviewed differences in specialized services between D-SNPs and other MA plans, and (3) reviewed how D-SNPs work with state Medicaid agencies to enhance benefit integration and care coordination. GAO analyzed CMS enrollment, plan benefit package, projected revenue, and beneficiary health status data; reviewed 15 D-SNP models of care and 2012 contracts with states; and interviewed representatives from 15 D-SNPs and Medicaid agency officials in 5 states."