A letter report issued by the Government Accountability Office with an abstract that begins "Expiration of the Health Coverage Tax Credit (HCTC) and implementation of Patient Protection and Affordable Care Act (PPACA) premium tax credits, cost-sharing subsidies, and Medicaid expansion will affect HCTC participants' costs for health plans in multiple ways. Projections from GAO's analysis of 2010 Internal Revenue Service (IRS) data show that most HCTC participants in 2014 will likely be eligible for less generous tax credits under PPACA than the HCTC. Specifically, about 69 percent of HCTC participants will likely be ineligible for either a PPACA premium tax credit or Medicaid, or they will likely receive a PPACA premium tax credit less generous than the HCTC. On the other hand, GAO's analysis also found that at least 23 percent will likely be eligible for PPACA premium tax credits more generous than the HCTC. In addition to the PPACA premium tax credit, up to 28 percent of all HCTC participants will likely be eligible for PPACA cost-sharing subsidies--subsidies that will help them pay for deductibles and copays--depending in part on whether or not their state expands Medicaid under PPACA. For HCTC nonparticipants, the projections from GAO's analysis of 2010 …

Testimony issued by the Government Accountability Office with an abstract that begins "In recently completed work, we found that medical facilities (such as medical centers, clinics, and practices) and durable medical equipment suppliers were the most frequent subjects of criminal fraud cases in Medicare, Medicaid, and CHIP in 2010. Hospitals and medical facilities were the most frequent subjects of civil fraud cases, including cases that resulted in judgments or settlements. According to 2010 data, about one-quarter of the 7,848 subjects investigated in criminal health care fraud cases were medical facilities or were affiliated with these facilities. Additionally, about 16 percent of subjects were durable medical equipment suppliers. Among the subjects investigated in criminal fraud cases, a small percentage (approximately 3 percent) were individuals who were beneficiaries of health care programs. Hospitals constituted nearly 20 percent of the 2,339 subjects of civil fraud cases investigated in 2010, and other medical facilities accounted for about 18 percent of the subjects. Less than 1 percent of subjects involved in civil health care fraud cases were beneficiaries of health care programs. CMS has made progress in implementing strategies to prevent fraud, and recent legislation provided it with enhanced authority. However, CMS has not implemented …

Correspondence issued by the Government Accountability Office with an abstract that begins "DHS reported taking some steps to assess the realignment of its regional/field office structure. Since submitting an initial plan to Congress in 2004 that outlined regionalization, consolidation, and colocation opportunities, DHS officials said the agency considered the potential implementation of a unified regional field office structure through two major initiatives--the 2004 I-Staff review and the department's 2010 BUR. However, the I-Staff Regional Concept of Operations was not finalized or adopted, and in April 2012 a senior DHS official involved in the BUR effort stated that DHS no longer intends to implement the BUR recommendation related to regionalization because it is no longer the department's preferred approach. DHS had limited or no documentation related to either of these reviews, including the resulting key decisions from the efforts. As a result, we are unable to determine the extent to which DHS has fully considered the realignment of its regional/field office structure, including costs and benefits, since 2004. Standards for Internal Control in the Federal Government calls for clear documentation of significant events, which include assumptions and methods surrounding key decisions, and the standards also state that this documentation should be …

A letter report issued by the Government Accountability Office with an abstract that begins "Department of Homeland Security (DHS) employees reported having lower average morale than the average for the rest of the federal government, but morale varied across components and employee groups within the department. Data from the 2011 Office of Personnel Management (OPM) Federal Employee Viewpoint Survey (FEVS)--a tool that measures employees' perceptions of whether and to what extent conditions characterizing successful organizations are present in their agencies--showed that DHS employees had 4.5 percentage points lower job satisfaction and 7.0 percentage points lower engagement in their work overall. Engagement is the extent to which employees are immersed in their work and spending extra effort on job performance. Moreover, within most demographic groups available for comparison, DHS employees scored lower on average satisfaction and engagement than the average for the rest of the federal government. For example, within most pay categories DHS employees reported lower satisfaction and engagement than non-DHS employees in the same pay groups. Levels of satisfaction and engagement varied across components, with some components reporting scores above the non-DHS averages. Several components with lower morale, such as Transportation Security Administration (TSA) and Immigration and Customs Enforcement …

A letter report issued by the Government Accountability Office with an abstract that begins "We identified five major actions the Food and Drug Administration (FDA) is to complete under the FDA Food Safety Modernization Act (FSMA) to establish a reliable system that uses third-party audits conducted by foreign governments or other third parties to help ensure food safety. FDA officials and others report that each of these actions presents challenges that must be addressed. First, FDA is to develop new preventive controls and related guidance for all of the foods under its jurisdiction--such as produce, milk, cheese, spices, soft drinks, and processed foods--and will need to develop appropriate training, particularly for foreign producers and processors, which poses a challenge because FDA is responsible for a variety of food industries. Second, FDA is to establish a voluntary user fee program for importers that encourages the use of third-party certifications, and it faces a challenge in developing a program that encourages importers to participate. Third, FDA has to develop a system for recognizing accreditation bodies that can accredit third parties to certify foreign food facilities and is likely to face a challenge in addressing foreign governments' concerns about being evaluated by an …

A letter report issued by the Government Accountability Office with an abstract that begins "While their views varied to some degree, federal agency officials and advocacy groups GAO contacted identified a number of challenges that small, minority-owned businesses may face in pursuing federal government contracts. For example, officials and advocacy groups pointed to a lack of performance history and knowledge of the federal contracting process as significant barriers. Officials from advocacy groups cited additional challenges, such as difficulty gaining access to contracting officials and decreased contracting opportunities resulting from contract bundling—the consolidation of two or more contracts previously performed under smaller contracts, into a single contract. Officials from agencies that accounted for 70 percent of federal contracting with small, minority-owned businesses—(the Departments of Defense, Health and Human Services, and Homeland Security, and the General Services Administration) told GAO that they conducted outreach to help small, minority-owned businesses with these challenges. Their outreach efforts include one-on-one interviews between contracting office staff and businesses seeking federal contracts. Linguistic and cultural barriers were identified as a challenge on a limited basis."

A letter report issued by the Government Accountability Office with an abstract that begins "From 2004 through 2010, the number of self-referred and non-self-referred advanced imaging services--magnetic resonance imaging (MRI) and computed tomography (CT) services--both increased, with the larger increase among self-referred services. For example, the number of self-referred MRI services increased over this period by more than 80 percent, compared with an increase of 12 percent for non-self-referred MRI services. Likewise, the growth rate of expenditures for self-referred MRI and CT services was also higher than for non-self-referred MRI and CT services."

A letter report issued by the Government Accountability Office with an abstract that begins "As part of Medicare's Part D Coverage Gap Discount Program (Discount Program), the Centers for Medicare & Medicaid Services (CMS), located within the Department of Health and Human Services (HHS), oversees the provision of discounts by plan sponsors to eligible beneficiaries when they purchase brand-name drugs and monitors that discounts are paid for by drug manufacturers. CMS checks prescription drug data to verify that sponsors provide accurate discounts at the point-of-sale to eligible beneficiaries in the coverage gap. These checks include verifying whether a beneficiary has reached the coverage gap and that the plan sponsor has calculated the discount amount correctly. CMS also tracks that manufacturers pay plan sponsors for the discounts sponsors have provided to beneficiaries and has implemented a dispute resolution process for manufacturers disputing discount payment amounts. CMS also performs other activities such as monitoring beneficiary complaints related to the program."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Labor (Labor) was challenged to process the substantial increase in petitions filed for the Trade Adjustment Assistance (TAA) for Workers program after related legislation was enacted in 2009. Labor initially had insufficient capacity to handle this increased workload, leading to processing delays and data recording errors. For example, in the quarter after the 2009 legislation took effect, Labor took an average of 153 days to process a petition—nearly four times the statutory limit. Labor responded with corrective action, including hiring new staff and adding additional quality control steps for processing petitions. Partly as a result of these efforts, processing times fell substantially. Moreover, GAO found that Labor's petition investigation process, as of June 2012, generally conformed to best practices for internal controls."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Labor (Labor) designed and awarded the grants following its standard competitive award process by developing and publishing an announcement, screening applicants, and convening expert panels to score applications. It also collaborated with the Department of Education to develop the announcement and identify panelists. Though they varied in terms of target populations, as permitted by the grant, the applications GAO reviewed addressed trade impact, as required. However, the law’s requirement that every state receive a minimum amount of funding created challenges for Labor and certain grantees when applicants in 17 states scored below the cutoff score for grant awards. In these instances, Labor’s process stipulated that states designate an eligible institution. States, however, were given a 3-day deadline—over a weekend—to designate a grantee. As a result, these states had little time to identify an institution. The states that GAO contacted said that they found this process challenging or confusing and that they received no guidance from Labor. Moreover, state-designated grantees experienced delays in implementing their grants and required assistance from Labor to modify their original proposals and comply with grant requirements. Labor has identified …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs (VA) and Department of Defense (DOD) do not require that all collaboration sites--locations where the two departments share health care resources through hundreds of agreements and projects--develop and use performance measures to assess their effectiveness and efficiency. Officials cited several reasons for this, including not wanting to overburden sites with measures and monitoring requirements. Although VA and DOD require some limited performance information--such as the return on investment for pilot projects--without comprehensive performance measures, they lack information that could help decision makers assess collaboration sites' overall progress in meeting the departments' shared goals of improved health care access, quality, and costs; identify areas for improvement; and make informed decisions. Also, the departments cannot document the overall cost effectiveness of their collaboration efforts. In the absence of required measures for all sites, some have developed their own, but these fragmented efforts do not provide sufficient information about the overall results of collaborations."

A letter report issued by the Government Accountability Office with an abstract that begins "The military services have a degree of discretion regarding whether and how to apply Department of Defense (DOD) acquisition guidance for their uniform development and they varied in their usage of that guidance. As a result, the services had fragmented procedures for managing their uniform development programs, and did not consistently develop effective camouflage uniforms. GAO identified two key elements that are essential for producing successful outcomes in acquisitions: 1) using clear policies and procedures that are implemented consistently, and 2) obtaining effective information to make decisions, such as credible, reliable, and timely data. The Marine Corps followed these two key elements to produce a successful outcome, and developed a uniform that met its requirements. By contrast, two other services, the Army and Air Force, did not follow the two key elements; both services developed uniforms that did not meet mission requirements and had to replace them. Without additional guidance from DOD on the use of clear policies and procedures and a knowledge-based approach, the services may lack assurance that they have a disciplined approach to set requirements and develop new uniforms that meet operational needs."

Correspondence issued by the Government Accountability Office with an abstract that begins "While CRA should increase investor demand for LIHTCs, quantifying the extent of any effect of CRA on LIHTC equity contributions is difficult given data and methodological challenges. In part because of the qualitative nature of the CRA investment test, regulatory ratings cannot be systematically linked to banks' LIHTC investments. Although a bank's overall rating and the associated narrative of its CRA examination are publicly available, the performance evaluation report does not individually list qualified investments and how they were considered for that examination. Furthermore, quantifying potential bank demand for LIHTCs in specific geographic areas is complicated because not every bank assessment area is considered to the same degree in a CRA examination. Although one way to assess demand for LIHTCs is by examining how much equity investors are willing to contribute, the common LIHTC price measure--the ratio of investors' equity contribution to the total amount of LIHTCs in nominal dollars--is subject to misinterpretation. Specifically, an investor's equity contribution reflects the value of not just the LIHTCs, but also any other tax and regulatory benefits--such as higher CRA ratings--plus project risks. Such other tax benefits include deductions for depreciation …

A letter report issued by the Government Accountability Office with an abstract that begins "Case processing times under the Integrated Disability Evaluation System (IDES) have increased over time, and measures of servicemember satisfaction have shortcomings. Since 2008, annual average processing times for IDES cases have steadily climbed, while the percentage of cases meeting established timeliness goals declined. Average case processing times reached 394 and 420 days for active and reserve component members in fiscal year 2011--compared to goals of 295 and 305 days, respectively, and just 19 percent of active duty and 18 percent of guard or reserve servicemembers completed the process and received benefits within established goals. Of the four phases comprising IDES, the medical evaluation board phase increasingly fell short of timeliness goals, while the physical evaluation board phase, although meeting goals, was taking increasingly more time to complete. With respect to servicemember satisfaction with the IDES process, GAO found shortcomings in how these data are collected and reported, such as unduly limiting who is eligible to receive a survey and computing average satisfaction scores in a manner that may overstate them. Department of Defense (DOD) officials told GAO they are considering alternatives for gauging satisfaction with the …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) has taken steps to establish an approach for managing DOD’s overall fuel demand, but is still developing comprehensive guidance to address fuel demand management, including at forward-deployed locations in countries such as Afghanistan. In 2009, GAO reported that DOD lacked (1) visibility and accountability for achieving fuel reduction, (2) incentives and a viable funding mechanism to invest in the implementation of fuel demand reduction projects, and (3) guidance and policies that addressed fuel demand at forward-deployed locations. In response to GAO recommendations, DOD has taken steps since 2009 to increase its visibility and accountability for fuel demand management at forward-deployed locations, including those located in Afghanistan. In addition, with an increased focus on fuel demand management, DOD has also provided funding and incentives to implement fuel demand management projects. Further, DOD has issued some guidance on fuel demand management at forward-deployed locations since 2009 and is developing more comprehensive guidance on how DOD will incorporate energy efficiency considerations into operations, planning, and training decisions for current military operations in Afghanistan and for future military operations. DOD’s 2012 Operational Energy Strategy Implementation …

A letter report issued by the Government Accountability Office with an abstract that begins "In an effort to help the millions of homeowners struggling to keep their homes, a range of federal programs have offered relief in the form of loan modifications and refinancing into loans with lower interest rates, among other things. Under Treasury’s Home Affordable Modification Program (HAMP), initiated in early 2009, servicers have modified almost 1 million loans between 2009 and 2011. During the same period, servicers modified nearly 1 million additional loans under programs administered by the Departments of Agriculture (USDA) and Veterans Affairs (VA), Federal Housing Administration (FHA), and Fannie Mae and Freddie Mac (the enterprises). Servicers have also modified about 2.1 million loans under nonfederal loan modification programs resulting in a total of about 4 million modifications between 2009 and 2011. However, a large number of borrowers have sought assistance, but were unable to receive a modification. For example, approximately 2.8 million borrowers had their HAMP loan modification application denied or their trial loan modification canceled. Further, the volume of federal modifications has declined since 2010. Recent efforts have expanded refinancing programs. However, low participation rates in FHA’s program raise questions about the need …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Justice’s (Justice) website called FOIA.gov presents data from agencies’ annual Freedom of Information Act (FOIA) reports. Agencies submit their annual reports to Justice in print and in electronic form and Justice posts the electronic data onto the website. For fiscal year 2010, the data GAO reviewed on the website were generally consistent with the data in the agencies’ print versions. According to Justice officials, the department has taken steps to ensure accuracy and consistency of the data. These steps include providing annual training to agency personnel who are responsible for preparation of the FOIA annual reports and posting guidance for report completion and submission on the Office of Information Policy website. In addition, the department has implemented checks to ensure data consistency between the two report versions. Specifically, it has developed and provided agencies with a tool to be used in creating the electronic version for the website. The tool contains features that assist agencies in compiling their data and math checks to help ensure consistency. Further, Justice officials have a checklist they use as a guide for checking the consistency of the …

Testimony issued by the Government Accountability Office with an abstract that begins "The nation faces an evolving array of cyber-based threats arising from a variety of sources. These sources include criminal groups, hackers, terrorists, organization insiders, and foreign nations engaged in crime, political activism, or espionage and information warfare. These threat sources vary in terms of the capabilities of the actors, their willingness to act, and their motives, which can include monetary gain or political advantage, among others. Moreover, potential threat actors have a variety of attack techniques at their disposal, which can adversely affect an organization’s computers or networks and be used to intercept or steal valuable information. The magnitude of the threat is compounded by the ever-increasing sophistication of cyber attack techniques, such as attacks that may combine multiple techniques. Using these techniques, threat actors may target individuals and businesses, resulting in, among other things, loss of sensitive personal or proprietary information."

A letter report issued by the Government Accountability Office with an abstract that begins "The Internal Revenue Service (IRS) has made significant progress in improving its internal controls and financial management since its first financial statement audit in 1992, as evidenced by 12 consecutive years of clean audit opinions on its financial statements, the resolution of several material control deficiencies, and actions resulting in the closure of over 300 financial management recommendations. This progress has been the result of hard work throughout IRS and sustained commitment at the top levels of the agency. However, IRS still faces significant financial management challenges in (1) resolving its remaining material weaknesses and significant deficiency in internal control, (2) developing outcome-oriented performance metrics, and (3) correcting numerous other control deficiencies, especially those relating to safeguarding tax receipts and taxpayer information. At the beginning of GAO’s audit of IRS’s fiscal year 2011 financial statements, 77 recommendations from prior audits remained open because IRS had not fully addressed the underlying issues. During the fiscal year 2011 financial audit, IRS took actions that GAO considered sufficient to close 38 recommendations. At the same time, GAO identified additional control deficiencies resulting in 30 new recommendations. In total, 69 …

Testimony issued by the Government Accountability Office with an abstract that begins "The Departments of State (State) and Defense (DOD) planned for a civilian-led presence in Iraq consisting of more than 16,000 personnel at 14 sites in fiscal year 2012. As of May 2012, State and DOD were reassessing the Mission Iraq presence, and State had a plan to reduce the presence to 11,500 personnel at 11 sites by the end of fiscal year 2013. Even with the reductions, Mission Iraq would remain the largest U.S. diplomatic presence in the world. State and DOD allocated an estimated $4 billion for the civilian-led presence for fiscal year 2012, 93 percent of which was for security and support costs. In addition, State requested $1.9 billion in police and military assistance and $471 million in other foreign assistance for fiscal year 2012. State officials said they are lowering their fiscal year 2012 and 2013 budget estimates as a result of reducing the presence."

Testimony issued by the Government Accountability Office with an abstract that begins "Data GAO obtained from Fannie Mae and Freddie Mac (the enterprises) and five of the largest mortgage lenders indicate that appraisals—which provide an estimate of market value at a point in time—are the most commonly used valuation method for first-lien residential mortgage originations. Other methods, such as broker price opinions and automated valuation models, are quicker and less costly but are viewed as less reliable. As a result, they generally are not used for most purchase and refinance mortgage originations. Although the enterprises and lenders GAO spoke with did not capture data on the prevalence of approaches used to perform appraisals, the sales comparison approach—in which the value is based on recent sales of similar properties—is required by the enterprises and the Federal Housing Administration. This approach is reportedly used in nearly all appraisals."

Testimony issued by the Government Accountability Office with an abstract that begins "Federal agencies reported an estimated $115.3 billion in improper payments in fiscal year 2011, a decrease of $5.3 billion from the prior year reported estimate of $120.6 billion. According to the Office of Management and Budget (OMB), the $115.3 billion estimate was attributable to 79 programs spread among 17 agencies. Ten programs accounted for about $107 billion or 93 percent of the total estimated improper payments agencies reported. The reported decrease in fiscal year 2011 was primarily related to 3 programs—decreases in program outlays for the Unemployment Insurance program, and decreases in reported error rates for the Earned Income Tax Credit program and the Medicare Advantage program. Further, OMB reported that agencies recaptured $1.25 billion in improper payments to contractors and vendors."

Testimony issued by the Government Accountability Office with an abstract that begins "NASA plans to use international partner and new domestic commercial launch vehicles to access, utilize, and sustain the International Space Station from 2012 through 2020. However, the agency faces challenges in transporting cargo and crew to the ISS as well as ensuring the station is fully utilized. NASA’s decision to rely on the new commercial vehicles to transport cargo starting in 2012 and to transport crew starting in 2017 is inherently risky because the vehicles are not yet proven and are experiencing delays in development. Further, NASA does not have agreements in place for international partners to provide cargo services to the ISS beyond 2016. The agency will also face a decision regarding the need to purchase additional seats on the Russian Soyuz vehicle beyond 2016, likely before commercial vehicles have made significant progress in development, given the three-year lead time necessary for acquiring a seat. This decision is further complicated because restrictions prohibit NASA from making certain payments to Russia in connection with the ISS unless the President makes a determination. Further, NASA currently expects to transport all cargo needed by the ISS in 51 flights through …

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