Testimony issued by the General Accounting Office with an abstract that begins "The Medicaid program served 33.4 million low-income families as well as elderly, blind, and disabled persons at a cost of $119 billion to the federal government and $88 billion to the states in fiscal year 2000. States are responsible for safeguarding Medicaid funds by making proper payments to providers, recovering misspent funds, and accurately reporting costs for federal reimbursement. At the federal level, the Centers for Medicare and Medicaid Services (CMS) is responsible for overseeing state financial activities and ensuring the propriety of expenditures reported for federal reimbursement. Audits of state Medicaid finances have identified millions of dollars of questionable or unallowable costs. In addition, annual financial statement audits have identified many internal control weaknesses in CMS oversight of state Medicaid operations. CMS has only recently begun to assess areas at greatest risk for improper payments. As a result, controls that focus on the highest risk areas and resources had not yet been deployed for areas of greatest risk. Since 1998, auditors have noted that CMS failed to institute an oversight process that effectively reduced the risk of inappropriate medical claims and payments. CMS attributed most of the …

Testimony issued by the General Accounting Office with an abstract that begins "This testimony discusses the results of security tests we performed in which agents of the Office of Special Investigations (OSI), acting in an undercover capacity, entered the United States from various countries in the Western Hemisphere using counterfeit documentation and fictitious identities. This work was initially undertaken at the request of the Senate Finance Committee and was continued at the request of the Subcommittee on Immigration, Border Security, and Claims, House Committee on the Judiciary. The purpose of our tests was to determine whether U.S. government officials conducting inspections at ports of entry would detect the counterfeit identification documents."

Testimony issued by the General Accounting Office with an abstract that begins "This testimony discusses findings from two GAO reports that relate to Maryland's pending legislation on pesticide reporting. To determine how the nation's information on pesticide illnesses could be improved, GAO has worked with two federal agencies--the National Institute for Occupational Safety and Health (NIOSH) and the National Center for Environmental Health. These agencies told GAO that establishing state pesticide illness reporting systems are key to improving the national information on acute pesticide illnesses. For example, according to NIOSH, state-based reporting systems are the best available data source for identifying epidemics, clusters of diseases, emerging pesticide problems, and populations at risk. Currently, about half of the states have some requirement that pesticide incidents be reported. However, only six states have a formal pesticide illness reporting and investigation system, and another three states have more limited systems. If Maryland decides to develop a formal pesticide illness reporting system, they may wish to consider these two important recommendations made by experts at federal agencies: (1) laws that require health care officials to report pesticide-related illness and injury. and (2) improving the training of health care professionals in pesticide incident handling."

Testimony issued by the General Accounting Office with an abstract that begins "This testimony discusses the implementation and management of the General Services Administration's (GSA) Metropolitan Area Acquisition (MAA) program, which encourages competition for telecommunication services in large cities. GAO found that as of June 2001, GSA had awarded 37 MAA contracts for 20 metropolitan areas. Existing GSA contracts were to become MAA contracts within nine months after contractors were authorized to begin work. This goal was met in only two of the 14 metropolitan areas in which authorization was given. GSA charges customer agencies two types of fees to recover the costs of their contract management and administration activities. Although GSA does not yet allow MAA contractors to offer FTS2001 services, it is taking steps to allow crossover between the two programs."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the efforts to reduce the future risk of catastrophic wildfires to human lives and property, focusing on (1) why conditions on federal forests and rangelands have reached the point that they pose a significant risk to nearby communities and to the ecological sustainability of lands and natural resources; (2) the history and status of efforts by the Forest Service and the Department of the Interior to reduce the risk; and (3) budget-related issues that should be addressed to better ensure that the agencies spend effectively and account accurately for funds appropriated to reduce hazardous fuels."

Testimony issued by the General Accounting Office with an abstract that begins "Easily concealed and transported, and virtually untraceable to their original source, diamonds are often used in lieu of currency in arms deals, money laundering, and other criminal activity. U.S. controls over diamond imports only require certification from the country of last import--and thus cannot identify diamonds from conflict sources. Although the United States bans diamonds documented as coming from the National Union for the Total Independence of Angola, the Revolutionary United Front in Sierra Leone, and Liberia--all of which are subject to U.N. sanctions--this does not prevent such diamonds from being shipped to a second country and mixed into parcels destined for the United States. GAO found that the Kimberley Process's proposal for international diamond certification incorporated some elements of accountability. However, it is not based on a risk assessment, and some high-risk activities are subject only to "recommended" controls. Also, from the time when rough diamonds enter the first foreign port until the final point of sale, there exists only a voluntary industry participation and self-regulated monitoring and enforcement system. These and other shortcomings significantly undermine efforts to deter trade in questionable diamonds."

Testimony issued by the General Accounting Office with an abstract that begins "The U.S. Postal Service continues to face financial and transformation challenges. Since GAO placed the Service's long-term outlook and transformation efforts on its high-risk list, the Service's financial situation has continued to decline, and its operational challenges have increased. The Service took a good first step when it issued its Transformation Plan. The plan provides information about the Service's challenges, identifies many actions the Service plans to take under its existing authority, and outlines steps that would require congressional action. The plan does not, however, adequately address some key issues or include an action plan with key milestones. The catastrophic events of September 11 and subsequent anthrax scares, coupled with the recent economic slowdown, have decreased mail volumes and revenues. However, the Service's financial difficulties are not just a cyclical phenomenon that will fade as the economy recovers. The Service's basic business model, which assumes that rising mail volume will cover rising costs and mitigate rate increases, is questionable as mail volumes stagnate or deteriorate in an increasingly competitive environment. The Service's Transformation Plan recognizes that postal costs are rising faster than revenues and identifies many actions that …

Testimony issued by the General Accounting Office with an abstract that begins "More than one in six nonelderly Americans are uninsured today. The lack of insurance coverage does not affect all Americans equally, varying widely among demographic groups as well as geographically. An estimated 42.1 million Americans were uninsured in 1999, which is down from 43.9 million in 1998. Although the decline in the number of uninsured is welcome news, it is too early to know whether this reflects a reversal in the trend. Recent expansions of public programs, such as the implementation of the State Children's Health Insurance Program, and the tight labor market likely contributed to the improved coverage. Even with these positive factors, the number of uninsured remains high, and any significant downturn in economic conditions could lead to a resumption in the growth of their numbers. The uninsured population is a diverse group, including individuals working in different industries and firms of all sizes as well as of different income levels, ages, races and ethnicities, and geographic locations. The heterogeneous nature of the 42 million uninsured Americans suggests that consideration of a combination of strategies must be appropriate in any efforts to expand health insurance coverage."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed companies in the chemical, agricultural, and brewing industries inspected under the Convention on the Prohibition of the Development, Production, Stockpiling and Use of Chemical Weapons and on Their Destruction (Chemical Weapons Convention), focusing on: (1) how companies protect proprietary information during inspections; (2) any adverse publicity for companies as a result of being inspected; and (3) the costs to companies of being inspected."

Testimony issued by the General Accounting Office with an abstract that begins "This testimony discusses GAO's follow-up on the audit of key internal controls over purchase card activity at two Navy units based in San Diego--the Space and Naval Warfare Systems Command (SPAWAR) Systems Center and the Navy Public Works Center (NPWC). A breakdown in internal controls over $68 million purchase card transactions in fiscal year 2000 left these two units vulnerable to fraudulent, improper, and abusive purchases and to theft and misuse of government property. Although both units improved the overall control environment, including reducing the number of cardholders, increasing the number of approving officials, and decreased purchase card usage, serious weaknesses persisted in three key control environment areas. First, SPAWAR Systems Center needs to ensure that all cardholders receive required training and that this training is documented. Second, SPAWAR Systems Center needs to more carefully implement internal review and oversight activities, which have been ineffective. Third, GAO identified a significant impairment of management "tone at the top" at SPAWAR Systems Center during the last quarter of fiscal year 2001. The two basic internal controls over the purchase card program that GAO tested remained ineffective during the last quarter …

Testimony issued by the General Accounting Office with an abstract that begins "In December 2001, GAO testified at a hearing, before the Subcommittee on Government Efficiency, Financial Management and Intergovernmental Relations, House Committee on Government Reform, that the Department of Agriculture, primarily the Rural Housing Service (RHS) and the Farm Service Agency (FSA), faced challenges in implementing key provisions of the Debt Collection Improvement Act of 1996 (DCIA). The testimony focused on RHS's and FSA's progress in referring delinquent debt for administrative offset and cross-servicing and Agriculture's implementation of administrative wage garnishment (AWG). During the hearing, Agriculture pledged to place a higher priority on delinquent debt collection and to substantially improve its implementation of DCIA by December 31, 2002. After the hearing, GAO made recommendations The Subcommittee requested GAO to review and provide an update on actions Agriculture has taken to resolve these problems. In addition, the Subcommittee requested that GAO report on the status of Treasury's implementation of a debt collection improvement account, a vehicle authorized by DCIA to give agencies financial incentives to improve their debt collection efforts."

Testimony issued by the General Accounting Office with an abstract that begins "The Subcommittee on Government Efficiency and Financial Management, House Committee on Government Reform asked GAO to testify on the Improper Payments Information Act (PL-107-300) and related draft guidance issued by the Office of Management and Budget (OMB), and on GAO recommendations to agencies on actions they can take to prevent or reduce improper payments."

Testimony issued by the General Accounting Office with an abstract that begins "The Department of Veterans Affairs (VA) has laid the groundwork for an integrated, departmentwide enterprise architecture--a blueprint for evolving its information systems and developing new systems to optimize their mission value. Crucial executive support is in place and the department has a strategy to define products and processes critical to its development. VA is now recruiting a chief architect to help implement and manage the enterprise architecture. VA has tried to strengthen its information security management program by mandating information security performance standards and greater management accountability for senior executives. It has also updated security policies, procedures, and standards to implement critical security measures. Despite these efforts, VA continues to report pervasive and serious information security weaknesses. The Veterans Benefits Administration is still far from launching a modernized system to replace its aging benefits delivery network. The Veterans Health Administration (VHA) has made good progress in expanding the use of its decision support system (DSS) for clinical and financial decision making. The use of DSS data for the fiscal year 2002 resource allocation process, and a requirement that veteran integrated service network directors better account for their use …

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the challenges the baby boom generation and society face in planning for and financing its future long-term care needs, and the role that private long-term care insurance may play in meeting those challenges, focusing on: (1) the increased demand the baby boom generation will likely create for long-term care; (2) an overview of current spending for long-term care of the elderly, including recent changes in Medicaid and Medicare financing of long-term care; and (3) the potential role of private long-term care insurance in helping finance this care, including who buys this insurance, its affordability, and the critical need for consumer information and protections."

Testimony issued by the General Accounting Office with an abstract that begins "Since 1998, the 34 democratic nations of the Western Hemisphere have been negotiating a Free Trade Area of the Americas agreement to eliminate tariffs and create common trade and investment rules for these nations. The United States will co-chair, with Brazil, the final phase of the negotiations, due to conclude in January 2005. GAO was asked to (1) review challenges that the United States faces as co-chair of the final negotiating phase and (2) discuss risks that the United States may encounter, as host, in Miami, of the November 2003 ministerial meeting."

Testimony issued by the General Accounting Office with an abstract that begins "This testimony focuses on the proposed Freedom to Manage legislation. First, in view of changing priorities and the need to improve the efficiency and effectiveness of government operations, a comprehensive review, reassessment, and reprioritization of what government does and how it conducts business is clearly warranted. Second, the Freedom to Manage proposal was motivated, in part, by a desire to eliminate wasteful, redundant, and inefficient reporting and other mandates. GAO has previously recommended a comprehensive and government-wide review in this area. However, the Freedom to Manage Act is very broad and contains several provisions that would significantly limit traditional congressional debate and involvement. Although Congress has adopted "fast track" approaches for specific areas in the past, this proposal would alter Congress' relative influence in addressing a broad range of federal management issues. Essentially, the act would limit Congress' ability to garner valuable input through hearings and other means. By requiring an expedited vote on presidential proposals without amendments, the act would change the role of Congress in the legislative process. Given the need to position our government to address new challenges and heightened public expectations, both Congress and …

Testimony issued by the General Accounting Office with an abstract that begins "A key element of the President's Management Agenda is the expansion of electronic government (e-government) to enhance access to information and services, particularly through the Internet. In response, the Office of Management and Budget (OMB) established a task force that selected a strategic set of initiatives to lead this expansion. GAO previously reviewed the completeness of the information used for choosing and overseeing these initiatives, including business cases and funding plans."

Testimony issued by the General Accounting Office with an abstract that begins "The over accumulation of vegetation is a serious problem, particularly in the interior West, where it is causing an increasing number of uncontrollable and destructive wildfires. The policy response to this was the development of the National Fire Plan--a long-term multibillion dollar effort to address wildland fire threats. GAO's work on wildland fires identified three needs: (1) a cohesive strategy to address growing threats to national forest resources and nearby communities from catastrophic wildfires, (2) clearly defined and effective leadership to carry out that strategy in a coordinated manner, and (3) accountability to ensure that progress is being made toward accomplishing the goals of the National Fire Plan. Two years ago, the Forest Service and the Department of the Interior developed strategies to address these problems, and recently established a leadership entity to respond to the need for greater contingency coordination. Whether the strategy and the council will serve as the framework and mechanism to effectively deal with the threat of a catastrophic wildland fire will depend on how well the National Fire Plan is implemented. To determine the effectiveness of this effort, a sound performance accountability framework …

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed the Department of Defense's (DOD) anthrax vaccine immunization program, focusing on: (1) vaccine supply; (2) medical records; and (3) efforts to educate servicemembers about the program."

Testimony issued by the General Accounting Office with an abstract that begins "The major network carriers dominate traffic at most of their large hubs and extensive evidence exists that fares in markets where competition is absent are consistently above competitive levels. GAO believes that the oversight scheme contemplated when the industry was deregulated--with antitrust enforcement by the Department of Justice (DOJ) and oversight of unfair trade practices by the Department of Transportation (DOT)--has not been entirely successful in preserving and ensuring competition. Although the current legislative scheme grants explicit authority for DOT to regulate unfair competitive practices, the legislation does give DOT substantial leeway on the scope of its action. Thus, with the range of competitive challenges confronting the industry and directly affecting consumers, especially in the face of unprecedented industry consolidation, GAO believes there is merit in the overall intent of the proposed Aviation Competition Restoration Act to direct DOT to actively monitor the state of competition in the industry and to institute remedial actions as appropriate."

Testimony issued by the General Accounting Office with an abstract that begins "The availability of child pornography has dramatically increased in recent years as it has migrated from printed material to the World Wide Web, becoming accessible through Web sites, chat rooms, newsgroups, and now the increasingly popular peer-to-peer file-sharing programs. These programs enable direct communication between users, allowing users to access each other's files and share digital music, images, and video. GAO was requested to determine the ease of access to child pornography on peer-to-peer networks; the risk of inadvertent exposure of juvenile users of peer-to-peer networks to pornography, including child pornography; and the extent of federal law enforcement resources available for combating child pornography on peer-to-peer networks. GAO's report on the results of this work (GAO-03-351) is being released today along with this testimony. Because child pornography cannot be accessed legally other than by law enforcement agencies, GAO worked with the Customs Cyber-Smuggling Center in performing searches: Customs downloaded and analyzed image files, and GAO performed analyses based on keywords and file names only."

Testimony issued by the General Accounting Office with an abstract that begins "Pursuant to a congressional request, GAO discussed how disability systems in the private sector and other countries encourage and facilitate return to work in three key areas: (1) the eligibility assessment process; (2) work incentives; and (3) staffing practices."

Testimony issued by the Government Accountability Office with an abstract that begins "The daunting challenges that face the nation in the 21st century establish the need for the transformation of government and demand fundamental changes in how federal agencies should meet these challenges by becoming flatter, more results-oriented, externally focused, partnership-oriented, and employee-enabling organizations. This testimony addresses how the long-term fiscal imbalance facing the United States, along with other significant trends and challenges, establish the case for change and the need to reexamine the base of the federal government; how federal agencies can transform into high-performing organizations; and how multiple approaches and selected initiatives can support the reexamination and transformation of the government and federal agencies to meet these 21st century challenges."

Testimony issued by the Government Accountability Office with an abstract that begins "The devastation and dislocation of individuals experienced throughout the Gulf Coast in Louisiana, Mississippi, Alabama, and Texas in the wake of Hurricanes Katrina and Rita has raised concern about both the charitable sector's and the government's abilities to effectively respond to such disasters. To strengthen future disaster response and recovery operations, the government needs to understand what went right and what went wrong, and to apply these lessons. The National Response Plan outlines the roles of federal agencies and charities in response to national disasters. Recognizing the historically large role of charities in responding to disasters, the plan included charities as signatories and gave them considerable responsibilities. In addition to carrying out the responsibilities outlined in the National Response Plan, charities served as partners to the federal government in providing both immediate and long-term assistance following Hurricanes Katrina and Rita. GAO was asked to provide an overview of lessons learned from charities' response to previous disasters as well as preliminary observations about the role of charities following the Gulf Coast hurricanes. As part of our ongoing work, GAO will continue to analyze federal and charitable efforts following the …