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 …

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 "Outpatient medical appointment wait times reported by the Veterans Health Administration (VHA), within the Department of Veterans Affairs (VA), are unreliable. Wait times for outpatient medical appointments--referred to as medical appointments--are calculated as the number of days elapsed from the desired date, which is defined as the date on which the patient or health care provider wants the patient to be seen. The reliability of reported wait time performance measures is dependent on the consistency with which schedulers record the desired date in the scheduling system in accordance with VHA's scheduling policy. However, VHA's scheduling policy and training documents for recording desired date are unclear and do not ensure consistent use of the desired date. Some schedulers at Veterans Affairs medical centers (VAMC) that GAO visited did not record the desired date correctly. For example, three schedulers changed the desired date based on appointment availability; this would have resulted in a reported wait time that was shorter than the patient actually experienced. VHA officials acknowledged limitations of measuring wait times based on desired date, and described additional information used to monitor veterans' access to medical appointments, …

A letter report issued by the Government Accountability Office with an abstract that begins "A number of factors—both external and internal to the Veterans Benefits Administration (VBA)—have contributed to the increase in processing timeframes and subsequent growth in the backlog of veterans’ disability compensation claims. As the population of new veterans has swelled in recent years, the annual number of claims received by VBA has gone up. Compared to the past, these claims have a higher number of disabling conditions, and some of these conditions, such as traumatic brain injuries, make their assessment complex. Moreover, due to new regulations that have established eligibility for benefits for new diseases associated with Agent Orange exposure, VBA adjudicated 260,000 previously denied and new claims. Beyond these external factors, issues with the design and implementation of the compensation program have contributed to timeliness challenges. For example, the law requires the Department of Veterans Affairs (VA) to assist veterans in obtaining records that support their claim. However, VBA officials said that lengthy timeframes in obtaining military records—particularly for members of the National Guard and Reserve—and Social Security Administration (SSA) medical records impact VA’s duty to assist, possibly delaying a decision on a veteran’s disability claim. …

A letter report issued by the Government Accountability Office with an abstract that begins "The Consumer Product Safety Commission (CPSC) has broad authority to identify, assess, and address product risks, but faces some challenges in identifying and responding to new risks in a timely manner. CPSC uses various means to stay informed about risks that may be associated with new or existing products. These methods include (1) market surveillance activities for imported products, retail stores, and Internet sales; and (2) formal agreements and various activities with other agencies. However, certain legal restrictions may hamper CPSC's ability to stay informed about new product hazards to public health and safety. Specifically, because of certain restrictions in the Consumer Product Safety Act (CPSA), CPSC cannot agree to allow foreign agencies to disclose nonpublic information they receive from CPSC. While the Consumer Product Safety Improvement Act (CPSIA) allows CPSC greater freedom to disclose information to U.S. courts, Congress, and state and local agencies, CPSC has been unable to complete information-sharing agreements with foreign counterparts as envisioned because it cannot offer its counterparts reciprocal terms on disclosure of nonpublic information. Due to the growing number of imported consumer products, this restriction on sharing information may …

A letter report issued by the Government Accountability Office with an abstract that begins "Agencies did not publish a notice of proposed rulemaking (NPRM), enabling the public to comment on a proposed rule, for about 35 percent of major rules and about 44 percent of nonmajor rules published during 2003 through 2010. A major rule has significant economic impact and may, for example, have an annual effect on the economy of $100 million or more. Agencies published a total of 568 major rules from 2003 through 2010. Agencies also published about 30,000 nonmajor rules during this period, which have less economic significance and can involve routine administrative issues."

Correspondence issued by the Government Accountability Office with an abstract that begins "A total of 22 of the 39 former high-ranking officials (admiral-level and SES officials) who separated from the Coast Guard from 2006 through 2010 were compensated at some point from 2006 through 2011 by contractors that received obligations from the Coast Guard in calendar year 2011. We found that 12 of these former officials were compensated in calendar year 2011 by major Coast Guard contractors--those contractors receiving more than $10 million in obligations during that calendar year. The responsibilities of these officials vary, but 9 of these 12 officials were assigned by major contractors to positions involving the development of new business."

Correspondence 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 "Of the 71 nonmajor projects that the Department of Energy's (DOE) Office of Environmental Management (EM) and National Nuclear Security Administration (NNSA) completed or had under way from fiscal years 2008 to 2012, 21 met or are expected to meet their performance targets for scope, cost, and completion date. These projects included a $22 million EM project to expand an existing waste disposal facility at the Oak Ridge Reservation in Tennessee and a $199 million NNSA project to equip a radiological laboratory and office building at the Los Alamos National Laboratory in New Mexico. Another 23 projects did not meet or were not expected to meet one or more of their three performance targets for scope, cost, and completion date. Among these, 13 projects met or are expected to meet two targets, including a $548 million NNSA project to shut down a nuclear reactor in Russia for nonproliferation purposes; 8 projects met or are expected to meet one target; 1 project did not meet any of its targets; and 1 project was cancelled. Of the remaining 27 projects, many had insufficiently documented performance targets for scope, …

A letter report issued by the Government Accountability Office with an abstract that begins "Agency officials told us that enhanced use leases (EUL) help them utilize their underutilized property better; commonly cited benefits include enhanced mission activities, cash rent revenue, and value received through in-kind consideration. However, some agencies we reviewed do not include all costs associated with their EULs when they assess the performance of their EUL programs. Guidance from the Office of Management and Budget (OMB) does not specify what costs agencies should include in their EUL evaluations, resulting in variance among agencies. For example, the Department of Veterans Affairs (VA) and the Department of State do not consistently attribute EUL-related costs of consultant staff who administer the leases, and VA does not attribute various administrative costs that offset EUL benefits. Without fully accounting for all EUL costs, agencies may overstate the net benefits of their EUL programs."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Energy (DOE) faces significant technical challenges in successfully constructing and operating the Waste Treatment and Immobilization Plant (WTP) project that is to treat millions of gallons of highly radioactive liquid waste resulting from the production of nuclear weapons. DOE and Bechtel National, Inc. identified hundreds of technical challenges that vary in significance and potential negative impact and have resolved many of them. Remaining challenges include (1) developing a viable technology to keep the waste mixed uniformly in WTP mix tanks to both avoid explosions and so that it can be properly prepared for further processing; (2) ensuring that the erosion and corrosion of components, such as tanks and piping systems, is effectively mitigated; (3) preventing the buildup of flammable hydrogen gas in tanks, vessels, and piping systems; and (4) understanding better the waste that will be processed at the WTP. Until these and other technical challenges are resolved, DOE will continue to be uncertain whether the WTP can be completed on schedule and whether it will operate safely and effectively."

A letter report issued by the Government Accountability Office with an abstract that begins "The Transportation Security Administration (TSA) has inconsistently overseen and enforced its rail security incident reporting requirement because it does not have guidance and its oversight mechanisms are limited, leading to considerable variation in the types and number of incidents reported. Though some variation is expected in the number and type of incidents reported because of differences in rail agency size, location, and ridership, local TSA inspection officials have provided rail agencies with inconsistent interpretations of the reporting requirement. For example, local TSA officials instructed one rail agency to report all incidents related to individuals struck by trains. However, local TSA officials responsible for another rail agency said these incidents would not need to be reported as they are most often suicides with no nexus to terrorism. Providing guidance to local TSA inspection officials and rail agencies on the types of incidents that are to be reported could improve consistency across different TSA field offices. GAO also found inconsistency in TSA compliance inspections and enforcement actions because TSA has not utilized limited headquarters-level mechanisms as intended for ensuring consistency in these activities. TSA's rail security inspection policies …

A letter report issued by the Government Accountability Office with an abstract that begins "While there have been efficiency gains and efforts to improve service, the Internal Revenue Service (IRS) faced challenges providing telephone service and responding to correspondence, continuing trends experienced in recent years. In 2012, 82 percent of individual taxpayers filed their returns electronically (e-filed), reducing IRS's processing costs. IRS also increased calls answered using automated service and added a variety of self service tools, which helped gain efficiencies. However, IRS's level of telephone service (the percentage of callers seeking live assistance who receive it) declined to 68 percent. In addition, of the 21 million pieces of paper correspondence IRS received, about 40 percent were considered overage (meaning that IRS did not respond within 45 days of receipt), an increase compared to last year. While IRS plans to continue to pursue efficiency gains, its strategy for future years does not specifically address how it plans to reverse these negative trends. Reversing the declines in telephone and correspondence services may require IRS to consider difficult tradeoffs, such as reassessing which phone calls IRS should answer with a live assistor and which it should not because automated services are available."

A letter report issued by the Government Accountability Office with an abstract that begins "To reduce the backlog of incurred cost audits, the Defense Contract Audit Agency (DCAA) implemented an initiative to focus its resources on auditing contractors' incurred costs that involve high dollar values or are otherwise determined to be high risk. Incurred cost audits are conducted on a contractor's annual proposal that includes all costs incurred on certain types of contracts in that fiscal year. Under the initiative, DCAA raised the dollar threshold that triggers an automatic audit on a contractor's incurred cost proposal from $15 million to $250 million, revised the criteria used to determine a proposal's risk level, and significantly reduced the number of low risk audits that will be randomly sampled. This initiative appears promising, and DCAA plans to track certain characteristics, such as the number of risk determinations made and audits completed. But DCAA has not fully developed the measures by which it will assess whether the initiative reduces the backlog in a manner that protects the taxpayers' interests. Specifically, DCAA does not have a plan for how it will determine whether key features of the initiative, such as the revised risk criteria and …

A letter report issued by the Government Accountability Office with an abstract that begins "Federal agencies conducted the regulatory analyses required by various federal statutes for all 54 regulations issued pursuant to the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) that GAO reviewed. As part of their analyses, the agencies generally considered, but typically did not quantify or monetize, the benefits and costs of these rules. Most of the federal financial regulators, as independent regulatory agencies, are not subject to executive orders that require comprehensive benefit-cost analysis in accordance with guidance issued by the Office of Management and Budget (OMB). Although most financial regulators are not required to follow OMB's guidance, they told GAO that they attempt to follow it in principle or spirit. GAO's review of selected rules found that regulators did not consistently follow key elements of the OMB guidance in their regulatory analyses. For example, while some regulators identified the benefits and costs of their chosen regulatory approach in proposed rules, they did not evaluate their chosen approach compared to the benefits and costs of alternative approaches. GAO previously recommended that regulators more fully incorporate the OMB guidance into their rulemaking policies, and the …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Justice's (DOJ) three grant-making components--the Office of Justice Programs (OJP), the Office of Community Oriented Policing Services (COPS), and the Office on Violence Against Women (OVW)--have partially met five of six leading practices, and fully met another, to ensure that the staffing models the contractor prepared for each of them to assess their workloads and workforce capacities are sound and reliable. These six leading practices are broad areas that represent a summary of the activities that should take place during the three stages of model design, development, and deployment. For example, the components partially met the leading practice for ensuring the credibility of data used in the models. This practice includes both verifying with staff that the models accurately depict the component's operations--an activity in which they fully engaged--and testing the models for logic and accuracy--an activity in which they partially engaged. Specifically, the components did not comprehensively check all of the models' formulas, and GAO found errors with all three components' models' retirement calculations. When left uncorrected, such errors have implications for workforce-related decisions and, ultimately, can affect the efficiency and effectiveness …

Correspondence issued by the Government Accountability Office with an abstract that begins "Exports of Haitian apparel to the United States under EIAP have increased substantially since we last reported in 2011. Although only three account holders are actively earning credits and two have begun to use them, in the 12-month period ending November 19, 2012, the number of credits OTEXA issued increased to about 42 million SMEs from approximately 8 million SMEs during the same period 1 year earlier. Similarly, over this period, the number of credits redeemed, or used by account holders increased to about 25 million SMEs from approximately million SMEs in 2011. In addition, exports of Haitian apparel to the United States under EIAP have grown faster than non-EIAP exports. Last year, we reported that about $350,000 in Haitian apparel had been exported to the United States under EIAP from January through August of 2011--about 0.07 percent of all Haitian apparel exported to the United States during that period. In contrast, from January through August of 2012, nearly $18 million in Haitian apparel was exported under EIAP--about 4 percent of Haitian apparel exported to the United States during this period. Increased use of the program may be …

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2011, the Departments of Justice (DOJ), Labor (Labor), and Health and Human Services (HHS) separately administered nine fragmented but minimally overlapping reentry grant programs with low risk of duplication. Specifically, GAO found that these grant programs are fragmented since more than one federal agency is involved in administering the programs. Further, GAO found that overlap across the nine programs was minimal because the programs varied in (1) their applicant eligibility criteria, (2) the extent to which their funds solely benefit the reentry population, and (3) their primary services funded. For example, Labor's reentry program limits eligibility to private, nonprofit organizations that will use the funds primarily to assist current or former inmates--residing in or released from any facility--with their employment needs. In contrast, one of DOJ's reentry programs limits eligibility to governmental entities that will use the funds primarily to assist current or former inmates--residing in or released from state, local, or tribal facilities--with their substance abuse treatment needs. Given the variance across eligible applicants, beneficiaries, and primary services, the overlap across the nine programs is minimal and the risk of duplication--when two …

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 Department of Defense (DOD) has taken steps to implement fundamental Weapon Systems Acquisition Reform Act of 2009 (Reform Act) provisions, including those for approving acquisition strategies and better monitoring weapon acquisition programs. DOD is also continuing to take additional steps to strengthen policies and capabilities. Some provisions, such as issuing guidance for estimating operating and support costs, are being implemented."

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 "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 Department of Defense (DOD) has recently created three new programs to help military spouses obtain employment: (1) the Military Spouse Career Advancement Accounts (MyCAA) tuition assistance program, (2) the Military Spouse Employment Partnership (MSEP), which connects military spouses with employers, (3) and the Military Spouse Career Center, consisting of a call center and a website for military spouses to obtain counseling and information. DOD's goals for these programs are to reduce unemployment among military spouses and close their wage gap with civilian spouses. Aside from these new programs, military spouses can also use employment assistance programs that the military services have long operated on DOD installations. However, GAO's site visits and interviews indicate that there may be gaps in coordination across the various programs that result in confusion for military spouses. Currently, DOD does not have guidance describing its overall strategy and how all of its programs should coordinate to help military spouses obtain employment, but DOD is in the process of developing such guidance."

A letter report issued by the Government Accountability Office with an abstract that begins "Incorporated under Alaska state law, regional Alaska Native corporations share fundamental characteristics, although they have chosen a variety of governance practices. Like other Alaska corporations, the regional corporations are subject to the state's corporate laws (with limited exceptions) and are run by an elected board of directors. Nevertheless, each regional corporation has chosen its own organization and governance approach in terms of board operations, executive and board compensation, board elections, and shareholder involvement."