A letter report issued by the Government Accountability Office with an abstract that begins "Medicare cost plans--managed care plans paid based on the reasonable costs of delivering Medicare-covered services--enroll a small number of beneficiaries compared to Medicare Advantage (MA), Medicare's managed care program in which the plans accept financial risk if their costs exceed fixed payments received for each enrolled beneficiary. Despite the small enrollment, industry representatives stated that cost plans provide a managed care option in areas that traditionally had few or no MA plans. Current law allows existing cost plans to continue operating unless specific MA plans of sufficient enrollment serve the same area. In such cases, the cost plan must discontinue serving that area beginning in 2011. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required the Government Accountability Office (GAO) to examine issues related to the conversion of Medicare cost plans to MA plans. In response, GAO (1) determined the MA options available to beneficiaries in cost plans, (2) described key differences for beneficiaries between cost plans, MA plans, and Medicare fee-for-service (FFS); (3) determined the extent to which organizations offering cost plans also offer MA plans; and (4) described concerns cost plans …

A letter report issued by the Government Accountability Office with an abstract that begins "The Federal Aviation Administration (FAA) predicts that the national airspace system will become increasingly congested over time, imposing costs of delay on passengers and regions. While transforming the current air-traffic control system to the Next Generation Air Transportation System (NextGen) may provide additional en route capacity, many airports will still face constraints at their runways and terminals. In light of these forecasts, the Government Accountability Office (GAO) was asked to evaluate regional airport planning in metropolitan regions with congested airports. GAO (1) identified which airports are currently or will be significantly congested and the potential benefits of regional airport planning, (2) assessed how regions with congested airports use regional airport planning in decision making, and (3) identified factors that hinder or aid in the development and implementation of regional airport plans. GAO reviewed studies; interviewed FAA, airport, and other aviation and transportation officials; and conducted case studies in selected regions."

A letter report issued by the Government Accountability Office with an abstract that begins "The growing cost of brand-name prescription drugs--FDA-approved drug products that typically have patent protection--is a concern for patients, payers, and providers of health care--particularly when price increases are large and occur suddenly. A 2008 congressional hearing by the Joint Economic Committee drew attention to some small market prescription drugs that had an extraordinary price increase--a price increase of 100 percent or more at a single point in time. GAO was asked to examine extraordinary price increases for brand-name prescription drugs. Specifically, GAO examined the: (1) frequency of extraordinary price increases for brand-name prescription drugs from 2000 to 2008, (2) characteristics of the brand-name prescription drugs that had extraordinary price increases, and (3) factors that contributed to the extraordinary price increases experienced by these brand-name prescription drugs. To determine the frequency and characteristics of the brand-name prescription drugs that experienced an extraordinary price increase, GAO reviewed drug pricing and other data from a pharmaceutical industry compendium. To illustrate the factors that may contribute to extraordinary price increases, GAO developed case studies of six brand-name prescription drugs identified from the analysis of drug pricing data. These brand-name prescription …

A letter report issued by the Government Accountability Office with an abstract that begins "Due to the federal government's role as guarantor, floods impose an enormous potential financial burden on the federal government. Consequently, decision makers at the Department of Homeland Security (DHS), the Federal Emergency Management Agency (FEMA), and the Congress need accurate and timely financial information to assess the effectiveness of the National Flood Insurance Program (NFIP). This report assesses whether controls in place during the 2005 to 2007 time frame were effective and whether actions to improve controls are likely to address identified weaknesses. The Government Accountability Office (GAO) reviewed and analyzed FEMA/NFIP guidance, data, and financial reports, reviewed prior audit reports, interviewed FEMA officials and contractors, and selected a sample of claim losses paid to determine whether claim files contained key documents."

A letter report issued by the Government Accountability Office with an abstract that begins "Recently, there has been an increased focus on developing the ability to provide early detection of and situational awareness during a disease outbreak. The Implementing Recommendations of the 9/11 Commission Act sought to enhance this capability, in part, by creating the National Biosurveillance Integration Center (NBIC) within the Department of Homeland Security. NBIC is to help provide early detection and situational awareness by integrating information and supporting an interagency biosurveillance community. The act directed the Government Accountability Office (GAO) to report on the state of biosurveillance and resource use in federal, state, local, and tribal governments. This report is one in a series responding to that mandate. This report focuses on the actions taken by NBIC to (1) acquire resources to accomplish its mission and (2) effectively collaborate with its federal partners. To conduct this work, GAO reviewed documents, such as NBIC's Concept of Operations, and interviewed officials at NBIC and 11 federal partners."

A letter report issued by the Government Accountability Office with an abstract that begins "Recent cases of corporate fraud and mismanagement heighten the Department of Justice's (DOJ) need to appropriately punish and deter corporate crime. Recently, DOJ has made more use of deferred prosecution and non-prosecution agreements (DPAs and NPAs), in which prosecutors may require company reform, among other things, in exchange for deferring prosecution. In June and November 2009, GAO testified on DOJ's use and oversight of DPAs and NPAs, and this report discusses additional findings, including (1) the extent to which DOJ has used DPAs and NPAs to address corporate misconduct and tracks use of these agreements, (2) the extent to which DOJ measures the effectiveness of DPAs and NPAs, and (3) the role of the court in the DPA and NPA process. GAO examined 152 DPAs and NPAs negotiated from 1993 through September 2009 and analyzed DOJ data on corporate prosecutions in fiscal years 2004 through 2009. GAO also interviewed DOJ officials, prosecutors from 13 DOJ offices, 20 company representatives, 11 monitors who oversee company compliance, and 12 federal judges. While not generalizable, these results provide insight into decisions about DPAs and NPAs."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) consumes about 60 percent of all energy used at federal government facilities. To encourage an increased use of energy from renewable sources, such as solar and wind power, (1) the Energy Policy Act of 2005 (the 2005 Act) directs DOD to consume at least 3 percent of its total electricity from renewable resources starting in fiscal year 2007; (2) Executive Order 13423 (the 2007 Executive Order) directs that an amount equal to half of the statutorily required renewable energy be generated by sources placed into service in 1999 or later; and (3) the 2007 Defense Authorization Act directed that at least 25 percent of electricity consumed by DOD come from renewable sources in fiscal year 2025. The Government Accountability Office (GAO) was asked to examine (1) DOD's progress toward these three key goals for consuming renewable energy in fiscal years 2007 and 2008, (2) challenges to DOD meeting those goals, and (3) DOD's plans to meet the goals. GAO reviewed relevant laws and DOD and Department of Energy (DOE) policy, plans, and data; interviewed agency officials; and visited DOD facilities."

Correspondence issued by the Government Accountability Office with an abstract that begins "The Veterans Benefits, Health Care, and Information Technology Act of 2006 authorizes the Secretary of Veterans Affairs to establish an educational assistance program for information security. The Information Security Education Assistance Program is envisioned as a means for the Department of Veterans Affairs (VA) to attract and retain individuals with advanced skills in information security. The legislation authorizes the agency to establish scholarships for qualified students who pursue doctoral degrees in computer science and electrical and computer engineering at accredited institutions and to offer educational debt reduction for VA employees who hold doctoral degrees in these fields. This letter responds to the act's requirement that we report on the scholarship and education debt reduction programs within 3 years of the act's December 22, 2006, enactment."

A letter report issued by the Government Accountability Office with an abstract that begins "Information is a crucial tool in securing the nation's borders against crimes and potential terrorist threats, with the Department of Homeland Security's (DHS) Border Patrol and Immigration and Customs Enforcement (ICE), and the FBI, having key information sharing roles. GAO was asked to assess the extent to which (1) local and tribal officials in border communities received useful information from their federal partners, (2) federal agencies supported state fusion centers'--where states collaborate with federal agencies to improve information sharing--efforts to develop border intelligence products, and (3) local and tribal agencies were aware of the suspicious activities they are to report. To conduct this work, GAO analyzed relevant laws, directives, policies, and procedures; contacted a nongeneralizable sample of 20 agencies in border communities and five fusion centers (based on geographic location and size); and interviewed DHS and FBI officials."

Correspondence issued by the Government Accountability Office with an abstract that begins "This report formally transmits the briefing on work performed under the authority of the Comptroller General to conduct evaluations on his own initiative."

A letter report issued by the Government Accountability Office with an abstract that begins "A serious problem for U.S. communities along the U.S.-Mexico border is the lack of access to safe drinking water and sanitation systems. Inadequate systems can pose risks to human health and the environment, including the risk of waterborne diseases. Numerous federal programs provide grants, loans, or other assistance to rural U.S. communities, including those in the border region, for drinking water and wastewater projects. The Government Accountability Office (GAO) was asked to determine (1) the amount of federal funding provided to rural U.S. communities in the border region for drinking water and wastewater systems and (2) the effectiveness of federal efforts to meet the water and wastewater needs in the region. GAO analyzed agency financial data; reviewed statutes, regulations, policies, and procedures; and interviewed federal, state, local, and private sector officials."

A letter report issued by the Government Accountability Office with an abstract that begins "In 2006, the United States and Canada signed the Softwood Lumber Agreement. The agreement, among other things, imposed export charges and quotas on Canadian lumber exports to the United States. To assist in monitoring compliance with the agreement, in 2008 Congress passed the Softwood Lumber Act, which imposed several data collection and analysis requirements on the Department of Homeland Security's U.S. Customs and Border Protection (CBP) and required two reports from GAO. This report discusses (1) CBP's processes for meeting the act's requirements and (2) how these requirements contribute to U.S. efforts to monitor compliance with the 2006 Softwood Lumber Agreement. GAO issued a report in June 2009 on U.S. agency efforts to monitor compliance with the 2006 agreement. This report includes an update on these efforts. GAO analyzed information from relevant U.S. agencies, interviewed knowledgeable officials, and discussed these issues with U.S. and Canadian industry representatives."

A letter report issued by the Government Accountability Office with an abstract that begins "Since 2001, Government Accountability Office (GAO) has designated strategic human capital management as a high-risk area because of the federal government's long-standing lack of a consistent approach to such management. In 2007, the Under Secretary of Defense for Intelligence (USD(I)) began developing a human capital system--called the Defense Civilian Intelligence Personnel System (DCIPS)--to manage Department of Defense (DOD) civilian intelligence personnel. In response to a congressional request, GAO examined the extent to which DOD has (1) incorporated internal safeguards into DCIPS and monitored the implementation of these safeguards and (2) developed mechanisms to identify employee perceptions about DCIPS. GAO analyzed guidance, interviewed appropriate officials, and conducted discussion groups with employees at select DOD components. At the end of GAO's review, legislation was enacted that impacts, among other things, how DCIPS employees will be paid."

A letter report issued by the Government Accountability Office with an abstract that begins "Rapid changes in the telecommunications industry, such as the development of broadband technologies, present new regulatory challenges for the Federal Communications Commission (FCC). Government Accountability Office (GAO) was asked to determine (1) the extent to which FCC's bureau structure presents challenges for the agency in adapting to an evolving marketplace; (2) the extent to which FCC's decision-making processes present challenges for FCC, and what opportunities, if any, exist for improvement; and (3) the extent to which FCC's personnel management and workforce planning efforts face challenges in ensuring that FCC has the workforce needed to achieve its mission. GAO reviewed FCC documents and data and conducted literature searches to identify proposed reforms, criteria, and internal control standards and compared them with FCC's practices. GAO also interviewed current and former FCC chairmen and commissioners, industry stakeholders, academic experts, and consumer representatives."

A letter report issued by the Government Accountability Office with an abstract that begins "State juvenile justice systems face critical problems when it comes to juvenile delinquency issues such as reentry--when offenders return home from incarceration--and substance abuse. GAO was asked to review juvenile reentry and substance abuse program research and efforts by the Department of Justice's (DOJ) Office of Juvenile Justice and Delinquency Prevention (OJJDP) to provide information on effective programs (i.e., whether a program achieves its intended goal) and cost-beneficial programs (i.e., whether the benefits of programs exceeded their costs). This report addresses (1) expert opinion and available research on these types of reentry and substance abuse programs, (2) the extent to which OJJDP assesses its efforts to disseminate information on effective programs, and (3) OJJDP's plans to accomplish its research and evaluation goals. GAO, among other things, reviewed academic literature, and OJJDP's dissemination efforts and research goals. GAO also interviewed OJJDP officials and a nonprobability sample of 26 juvenile justice experts selected based on their experience with juvenile reentry and substance abuse issues."

A letter report issued by the Government Accountability Office with an abstract that begins "Members of Congress and state agencies have raised questions about complaints that some Medicare Advantage (MA) organizations and their agents inappropriately marketed their health plans to Medicare beneficiaries. Inappropriate marketing may include activities such as providing inaccurate information about covered benefits and conducting prohibited marketing practices. The Centers for Medicare & Medicaid Services (CMS) is responsible for oversight of MA organizations and their plans. The Government Accountability Office (GAO) was asked to examine (1) the extent to which CMS has taken compliance and enforcement actions, (2) how CMS has helped beneficiaries affected by inappropriate marketing and the problems beneficiaries have encountered, and (3) information CMS has about the extent of inappropriate marketing. To do this work, GAO reviewed relevant laws and policies; analyzed Medicare data on beneficiary complaints, compliance actions and enforcement actions; and interviewed officials from CMS and selected state departments of insurance, state health insurance assistance programs, and MA organizations."

Correspondence issued by the Government Accountability Office with an abstract that begins "As GAO reported to Congress in July 2009, the number of nonprime mortgage originations (including subprime and Alt-A loans) grew rapidly from 2000 through 2006, a period during which average house prices appreciated dramatically. In dollar terms, the nonprime share of mortgage originations rose from about 12 percent ($125 billion) in 2000 to approximately 34 percent ($1 trillion) in 2006. These mortgages have been associated with what was subsequently recognized as a speculative housing bubble. As house prices subsequently fell, the subprime and Alt-A market segments contracted sharply, and very few nonprime originations were made after mid-2007. Borrowers who had obtained nonprime mortgages earlier in the decade increasingly fell behind on their mortgage payments, helping to push default and foreclosure rates to historical highs. Economic conditions and a weak housing market have contributed to the increase in troubled loans. In particular, falling house prices have left many borrowers in a negative equity position--that is, their mortgage balances exceed the current value of their homes. Negative equity makes borrowers more vulnerable to foreclosure by, among other factors, limiting their ability to sell or refinance their homes in the event …

Testimony issued by the Government Accountability Office with an abstract that begins "The Service-Disabled Veteran-Owned Small Business (SDVOSB) program is intended to provide federal contracting opportunities to qualified firms. In fiscal year 2008, the Small Business Administration (SBA) reported $6.5 billion in governmentwide sole-source, set-aside, and other SDVOSB contract awards. Given the amount of federal contract dollars being awarded to SDVOSB firms, GAO was asked to determine (1) whether cases of fraud and abuse exist within the SDVOSB program and (2) whether the program has effective fraud prevention controls in place. To identify whether cases exist, GAO reviewed SDVOSB contract awards and protests since 2003 and complaints sent to GAO's fraud hotline. GAO defined case-study firms as one or more affiliated firms that were awarded one or more SDVOSB contracts. To assess fraud prevention controls, GAO reviewed laws and regulations and conducted interviews with SBA and Department of Veterans Affairs (VA) officials. GAO did not attempt to project the extent of fraud and abuse in the program. In addition, GAO did not attempt to assess the overall effectiveness of VA's validation process to prevent or address fraud and abuse in VA SDVOSB contracts."

Correspondence issued by the Government Accountability Office with an abstract that begins "Section 502 of the Concurrent Resolution on the Budget for Fiscal Year 2010 required us to report to the appropriate congressional committees by December 31, 2009, regarding the Department of Defense's (DOD) progress in implementing GAO's audit recommendations. From fiscal years 2001 through 2008, we issued 743 reports to DOD or its components that included 3,099 recommendations. By law, agencies, including DOD, are required to submit written statements to Congress explaining actions taken in response to recommendations we have made. We follow up on the implementation status of each recommendation at least annually after report issuance to determine whether DOD has instituted sufficient corrective actions. This report, which responds to this mandate, contains the results of our analysis on the implementation status of the 3,099 recommendations."

Testimony issued by the Government Accountability Office with an abstract that begins "The recent financial crisis resulted in a wide-ranging federal response that included infusing capital into several major corporations. The Troubled Asset Relief Program (TARP) has been the primary vehicle for most of these actions. As a result of actions and others, the government is a shareholder in the American International Group (AIG), Citigroup Inc. (Citi), Chrysler Group LLC (Chrysler), and General Motors Company (GM), among others. As market conditions have become less volatile, the government has been considering how best to manage these investments and ultimately divest them. This testimony discusses (1) the government's approach to past crisis and challenges unique to the current crisis; (2) the principles guiding the Department of the Treasury's implementation of its authorities and mechanisms for managing its investments; and (3) preliminary views from GAO's ongoing work with the Special Inspector General for TARP on the federal government's monitoring and management of its investments. This statement builds on GAO's work since the 1970s on providing government assistance to large corporations and more recent work on oversight of the assistance and investments provided under TARP. In its November 2009 report, GAO recommended that Treasury …

Testimony issued by the Government Accountability Office with an abstract that begins "In September 2008, GAO reported internal control weaknesses over the Veterans Health Administration's (VHA) use of miscellaneous obligations to record estimates of obligations to be incurred at a future date. GAO was asked to testify on its previously reported findings that focused on (1) how VHA used miscellaneous obligations, and (2) the extent to which the Department of Veterans Affairs' (VA) related policies and procedures were adequately designed. GAO also obtained an update on the status of VA's activities to improve controls over its use of miscellaneous obligations. GAO's testimony is primarily a summary of its prior report (GAO-08-976), and also includes follow-up work to obtain information on the status of VA's efforts to implement our prior recommendations."

Testimony issued by the Government Accountability Office with an abstract that begins "Significant management challenges exist for the Department of Homeland Security (DHS) as it continues to integrate its varied management processes, policies, and systems in areas such as financial management and information technology. These activities are primarily led by the Under Secretary for Management (USM), department management chiefs, and management chiefs in DHS's seven components. This testimony summarizes a new GAO report (GAO-10-131) that examined (1) the extent to which DHS has developed a comprehensive strategy for management integration that includes the characteristics recommended in GAO's earlier 2005 report, (2) how DHS is implementing management integration, and (3) the extent to which the USM is holding the department and component management chiefs accountable for implementing management integration through reporting relationships. GAO reviewed DHS plans and interviewed DHS management officials."

A letter report issued by the Government Accountability Office with an abstract that begins "Many federal assistance programs are funded by formula grants that have historically relied at least in part on population data from the decennial census and related data to allocate funds. In June 2009, the Census Bureau reported that in fiscal year 2007 the federal government obligated over $446 billion through funding formulas that rely at least in part on census and related data. Funding for federal assistance programs continues to increase. Government Accountability Office (GAO) was asked to determine (1) how much the federal government obligates to the largest federal assistance programs based on the decennial census and related data, and how the Recovery Act changed that amount; and (2) what factors could affect the role of population in grant funding formulas. To answer these objectives, GAO identified the 10 largest federal assistance programs in each of the fiscal years 2008 and 2009 based on data from the President's fiscal year 2010 budget. GAO reviewed statutes, agency reports, and other sources to obtain illustrative examples of how different factors could affect the role of population data in grant funding."

A letter report issued by the Government Accountability Office with an abstract that begins "On May 7, 2009, the Government Printing Office (GPO) published a 266-page document on its Web site that provided detailed information on civilian nuclear sites, locations, facilities, and activities in the United States. At the request of the Speaker of the House, this report determines (1) which U.S. agencies were responsible for the public release of this information and why the disclosure occurred, and (2) what impact, if any, the release of the information has had on U.S. national security. In performing this work, the Government Accountability Office (GAO) analyzed policies, procedures, and guidance for safeguarding sensitive information and met with officials from four executive branch agencies involved in preparing the document, the White House, the House of Representatives, and GPO."