Testimony issued by the Government Accountability Office with an abstract that begins "Since the Government Accountability Office (GAO) reported on the commercial space launch industry in 2006, the industry has evolved and moved further toward space tourism. Commercial space tourism promises to make human space travel available to the public for the first time. The Federal Aviation Administration (FAA) oversees the safety of commercial space launches, licensing and monitoring the safety of such launches and of spaceports (sites for launching spacecraft), and FAA promotes the industry. FAA is also responsible for overseeing the safety of space tourism, but it may not regulate crew and passenger safety before 2012 except in response to high-risk incidents, serious injuries, or fatalities. This testimony addresses (1) recent trends in the commercial space launch industry, (2) challenges that FAA faces in overseeing the industry, and (3) emerging issues that will affect the federal role. This statement is based on GAO's October 2006 report on commercial space launches, updated with information GAO gathered from FAA, the Department of Commerce, and industry experts in November 2009 on industry trends and recent FAA actions. In past work, GAO recommended that FAA take several actions to improve its oversight …

Testimony issued by the Government Accountability Office with an abstract that begins "As a result of the damage caused by Hurricanes Katrina and Rita in 2005, the federal government funded several disaster case management programs. These programs help victims access services for disaster-related needs. This testimony addresses the following questions: 1) How did the federal government support disaster case management programs after Hurricanes Katrina and Rita, and how did federal agencies coordinate their efforts?; 2) What challenges did disaster case management agencies experience in delivering services under federally funded programs?; and 3) How will previous or existing federally funded programs be used to inform the development of a federal case management program for future disasters? This testimony is based on a July 2009 report (GAO-09-561). To complete this report GAO reviewed federal laws, regulations, and guidance, obtained data from two programs, conducted site visits to Louisiana and Mississippi, and interviewed case management providers and federal and state officials. For this testimony, GAO updated certain information."

A statement of record issued by the Government Accountability Office with an abstract that begins "Securing the nation's transportation and information systems is a primary responsibility of the Department of Homeland Security (DHS). Within DHS, the Transportation Security Administration (TSA) is responsible for securing all transportation modes; U.S. Customs and Border Protection (CBP) is responsible for cargo container security; the U.S. Coast Guard is responsible for protecting the maritime environment; and the National Protection and Programs Directorate is responsible for the cybersecurity of critical infrastructure. This statement focuses on the progress and challenges DHS faces in key areas of maritime, aviation, and cybersecurity. It is based on GAO products issued from June 2004 through November 2009, as well as ongoing work on air cargo security. GAO reviewed relevant documents; interviewed cognizant agency officials; and observed operations at 12 airports, chosen by size and other factors. The results are not generalizable to all airports."

A letter report issued by the Government Accountability Office with an abstract that begins "Voting is fundamental to the U.S. democratic system and federal law provides broad protections for people with disabilities, including older voters. Many long-term care facility residents, who often have physical or cognitive impairments, vote by absentee or early ballot. Concerns have been raised about the extent to which states and localities are helping the increasing number of facility residents exercise their right to vote, especially those requiring voting assistance, who may be subject to undue influence or unauthorized completion of their ballot by facility staff or relatives. Given these concerns, GAO was asked to identify the actions taken to facilitate and protect voting for long-term care facility residents at (1) the state level and (2) the local level. To address these objectives, GAO interviewed federal officials, national organizations, and researchers; reviewed Election Assistance Commission (EAC) guidance on voting in long-term care facilities; surveyed state and local election officials; and visited seven localities in the weeks prior to the November 2008 federal election to observe the voting process in long-term care facilities."

A letter report issued by the Government Accountability Office with an abstract that begins "In response to concerns about the nation's energy dependence on imported oil, climate change, and other issues, the federal government has encouraged the use of biofuels. Water plays a crucial role in all stages of biofuel production--from cultivation of feedstock through its conversion into biofuel. As demand for water from various sectors increases and places additional stress on already constrained supplies, the effects of expanded biofuel production may need to be considered. To understand these potential effects, GAO was asked to examine (1) the known water resource effects of biofuel production in the United States; (2) agricultural conservation practices and technological innovations that could address these effects and any barriers to their adoption; and (3) key research needs regarding the effects of water resources on biofuel production. To address these issues, GAO reviewed scientific studies, interviewed experts and federal and state officials, and selected five states to study their programs and plans related to biofuel production. GAO is not making any recommendations in this report. A draft of this report was provided to the Departments of Agriculture (USDA), Energy (DOE), and the Interior (DOI); and the …

Correspondence issued by the Government Accountability Office with an abstract that begins "Medicaid--the joint federal-state program that finances medical services for certain low-income adults and children--spent $15.0 billion on outpatient prescription drugs in fiscal year 2007. Instead of directly purchasing drugs, state Medicaid programs reimburse retail pharmacies for dispensing them to Medicaid beneficiaries. The federal government provides matching funds to states to help cover the costs of their Medicaid programs, and states must pay the remaining costs to qualify for these federal funds. For certain outpatient prescription drugs, state Medicaid programs may only receive federal matching funds for reimbursements up to a maximum amount known as a federal upper limit (FUL). Designed to control drug spending, FULs are currently calculated as 150 percent of a drug's lowest published price in three national drug pricing compendia. State Medicaid programs can determine reimbursements to retail pharmacies for each drug, but the federal government will only provide matching funds to the extent that reimbursements for all drugs subject to FULs do not exceed established FULs in the aggregate. A 2005 report by the Department of Health and Human Services' (HHS) Office of Inspector General (OIG) found that FULs were ineffective at controlling outpatient …

Correspondence issued by the Government Accountability Office with an abstract that begins "The American Recovery and Reinvestment Act of 2009 (Recovery Act) was enacted on February 17, 2009, to help stimulate the United States economy by creating new jobs, as well as saving existing ones, and investing in projects that will provide long-term economic benefits. Estimates show that the Recovery Act's combined spending and tax provisions will cost $787 billion over 10 years--about $207 billion in tax reductions plus about $580 billion in additional federal spending. These funds are being provided directly to federal agencies and also distributed to states, localities, other entities, and individuals through a combination of formula and competitive grants and direct assistance. About $280 billion of the funds will be administered through state and local governments. The Recovery Act delineates an important set of responsibilities for the accountability community. The inspectors general across government are expected to audit the programs, grants, and projects funded under the Recovery Act, both within their particular agency or department and collectively. To address the collective oversight at the federal level, the Recovery Act established the Recovery Accountability and Transparency Board to help prevent waste, fraud, and abuse. In addition, the …

A letter report issued by the Government Accountability Office with an abstract that begins "To help prevent the substitution of federal funds for state, local, or private funds, the American Recovery and Reinvestment Act of 2009 (Recovery Act) contains maintenance of effort and similar provisions requiring that recipients maintain certain levels of spending for selected programs. This report provides information on selected programs in the Recovery Act with maintenance of effort or similar provisions, the guidance federal agencies have issued to implement these requirements, and how responsible federal agencies are determining whether recipients meet these requirements. To conduct this work, GAO identified eight programs in the Recovery Act that contain a new maintenance of effort or similar provision; account for at least $4 billion in appropriations by agency; and collectively account for about $100.5 billion of the $106.8 billion in Recovery Act appropriations with these provisions. The eight programs with maintenance of effort or similar provisions span the areas of education, highway, housing, rail, telecommunications, and transit. The specifics of each provision vary by responsible agency, such as whether a state must certify the amount of funding it will maintain, whether waivers are allowed, and the consequences (if any) of …

A letter report issued by the Government Accountability Office with an abstract that begins "Accounting standards require governments to account for the costs of other postemployment benefits (OPEB)--the largest of which is typically retiree health benefits--when an employee earns the benefit. As such, governments are reporting their OPEB liabilities--the amount of the obligation to employees who have earned OPEB. As state and local governments have historically not funded retiree health benefits when the benefits are earned, much of their OPEB liability may be unfunded. Amid fiscal pressures facing governments, this has raised concerns about the actions the governments can take to address their OPEB liabilities. The Government Accountability Office (GAO) was asked to provide information on governments' retiree health liabilities. GAO described (1) what has been reported in state and local governments' comprehensive annual financial reports (CAFR) regarding OPEB liabilities, (2) actions state and local governments have taken to address retiree health liabilities, and (3) the overall fiscal pressures these governments face. GAO reviewed the CAFRs for 50 states and the 39 local governments with at least $2 billion in total revenue. GAO also reviewed the actions taken to address retiree health liabilities by 10 state and local governments, selected …

Correspondence issued by the Government Accountability Office with an abstract that begins "Growing congestion on our nation's roads results in wasted time and fuel, which adversely affects the economy and the environment. State and local government agencies and private companies disseminate real-time traffic information to help travelers decide whether to use alternative, less congested routes. Legislation enacted in 2005 required the U.S. Department of Transportation (DOT) to establish the Real-Time System Management Information Program, in order to provide states the capability to monitor traffic and travel conditions on major highways and share that information. As requested, this GAO report addresses, among other things, (1) how the public and private sectors disseminate real-time traffic information to the public, (2) actions DOT has taken to establish the Real-Time System Management Information Program, and (3) experts' views on the need for a nationwide real-time traffic information system and its potential characteristics. To conduct this study, GAO visited sites in California and Florida, which have well-developed traffic information systems; reviewed and analyzed DOT reports and data; and interviewed transportation officials, experts, and other stakeholders. GAO is not making any recommendations at this time because DOT has not finalized the proposed rule it issued in …

A letter report issued by the Government Accountability Office with an abstract that begins "In times of economic uncertainty as well as in times of stability, policymakers and the public rely on labor force statistics, such as the unemployment rate, to provide important information on the current state of the economy. These statistics, published by the Department of Labor's Bureau of Labor Statistics (BLS), include key figures that are based on data obtained from the Current Population Survey (CPS). The CPS, a household interview survey administered by the Department of Commerce's U.S. Census Bureau, is designed to represent the entire United States civilian noninstitutional population. However, certain U.S. residents--specifically, foreign-born persons who are not authorized to live here, to whom the Government Accountability Office (GAO) refers as unauthorized residents in this report--may not be represented in CPS data to the same extent as the general population. Little research has been done on whether potential underrepresentation of the unauthorized population might noticeably affect labor statistics, but policy efforts that depend on valid and reliable labor force statistics would benefit from such information. GAO agreed with the Bureau of Labor Statistics to examine issues concerning unauthorized residents' impact on labor force statistics. …

A letter report issued by the Government Accountability Office with an abstract that begins "In 2010, after about 25 years of work and the expenditure of billions of dollars, the International Space Station (ISS) will be completed. According to the National Aeronautics and Space Administration (NASA), the ISS crew will then be able to redirect its efforts from assembling the station to conducting research. In 2005, Congress designated the ISS as a national laboratory; in addition, the NASA Authorization Act of 2008 required NASA to provide a research management plan for the ISS National Laboratory. In light of these developments, the Government Accountability Office (GAO) was asked to review the research use of the ISS. Specifically, GAO (1) identified how the ISS is being used for research and how it is expected to be used once completed, (2) identified challenges to maximizing ISS research; and (3) identified common management practices at other national laboratories and large science programs that could be applicable to the management of the ISS. To accomplish this, GAO interviewed NASA officials and reviewed key documents related to the ISS. GAO also studied two ground-based national laboratories and several large science institutions."

A letter report issued by the Government Accountability Office with an abstract that begins "The current H1N1 pandemic highlights the threat posed to our nation by an influenza pandemic. The previous administration's Homeland Security Council (HSC) issued the Implementation Plan for the National Strategy for Pandemic Influenza (Plan) in May 2006 to help address a pandemic. The Government Accountability Office (GAO) was asked to (1) determine how the HSC and responsible federal agencies monitor the progress and completion of the Plan's action items; and (2) assess the extent to which selected action items have been completed. To do this, GAO interviewed officials from the HSC and the six federal agencies responsible for implementing most of the Plan, and analyzed a random sample of 60 action items. While this report does not assess the response efforts for the H1N1 pandemic, GAO continues to monitor the outbreak and the federal response."

A letter report issued by the Government Accountability Office with an abstract that begins "Under contract with the Centers for Medicare and Medicaid Services (CMS), states conduct surveys at nursing homes to help ensure compliance with federal quality standards. Over the past decade, the Government Accountability Office (GAO) has reported on inconsistencies in states' assessment of nursing homes' quality of care, including understatement--that is, when state surveys fail to cite serious deficiencies or cite them at too low a level. In 2008, GAO reported that 9 states had high and 10 had low understatement based on CMS data for fiscal years 2002 through 2007. This report examines the effect on nursing home deficiency understatement of CMS's survey process, workforce shortages and training, supervisory reviews of surveys, and state agency practices. GAO primarily collected data through two Web-based questionnaires sent to all eligible nursing home surveyors and state agency directors, achieving 61 and 98 percent response rates, respectively."

A letter report issued by the Government Accountability Office with an abstract that begins "Recent congressional initiatives seek to focus funds for certain federal social programs on interventions for which randomized experiments show sizable, sustained benefits to participants or society. The private, nonprofit Coalition for Evidence-Based Policy undertook the Top Tier Evidence initiative to help federal programs identify interventions that meet this standard. The Government Accountability Office (GAO) was asked to examine (1) the validity and transparency of the Coalition's process, (2) how its process compared to that of six federally supported efforts to identify effective interventions, (3) the types of interventions best suited for assessment with randomized experiments, and (4) alternative rigorous methods used to assess effectiveness. GAO reviewed documents, observed the Coalition's advisory panel deliberate on interventions meeting its top tier standard, and reviewed other documents describing the processes the federally supported efforts had used. GAO reviewed the literature on evaluation methods and consulted experts on the use of randomized experiments. The Coalition generally agreed with the findings. The Departments of Education and Health and Human Services provided technical comments on a draft of this report. The Department of Justice provided no comments."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of the Treasury's Financial Management Service (FMS) collections program provides services to agencies to collect, deposit, and account for collections through a variety of methods. Electronic collection methods can reduce government borrowing costs and agency administrative costs, while improving compliance and security. The Government Accountability Office (GAO) was asked to identify (1) the extent to which agencies other than the Internal Revenue Service (IRS) use various collection methods, (2) ways to maximize the benefits of and overcome any barriers to agency use of the various collection methods, and (3) issues that FMS should consider in its plans to improve the efficiency and security of collections. GAO analyzed collections data, plans, and documents from FMS and five case-study agencies in the Departments of the Interior and Commerce that use a variety of collection methods, observed fee collection methods, and interviewed FMS and case-study agency officials. GAO also interviewed selected payer groups for case study agencies."

A letter report issued by the Government Accountability Office with an abstract that begins "In fiscal year 2008, the Department of Defense (DOD) obligated $200 billion on services contracts, including $42 billion for professional and management services. The Government Accountability Office (GAO) previously identified weaknesses in DOD's management and oversight of services contracts, contributing to DOD contract management being on GAO's high-risk list. For selected professional and management support contracts, GAO was asked to examine (1) the extent to which DOD considered the risks of contractors closely supporting inherently governmental functions at key decision points, (2) how DOD implemented performance-based practices, (3) the extent to which DOD designated trained surveillance personnel, and (4) whether a new review process may improve DOD's management of such contracts. GAO reviewed federal regulations, agency policies and guidance, and analyzed seven acquisitions approved from 2004 to 2007 and 64 related task orders for services."

A letter report 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. The Government Accountability Office (GAO) was asked to examine: (1) the extent to which DHS has developed a comprehensive strategy for management integration that includes the characteristics recommended in GAO's 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 management officials in DHS's headquarters and in all components."

A letter report issued by the Government Accountability Office with an abstract that begins "In addition to standard Medicaid payments, hospitals receive supplemental payments for uncompensated costs of care provided to uninsured and Medicaid patients. These supplemental payments are referred to as disproportionate share hospital (DSH) payments. Hospitals may also receive non-DSH supplemental payments. In fiscal year 2006, DSH payments totaled about $17 billion and non-DSH supplemental payments exceeded $6 billion. Hospitals' DSH payments are limited to their uncompensated care costs, that is, their costs for covered care less Medicaid and other payments. Concerns have been raised about the accuracy of DSH payment limits, particularly as states may estimate limits using data that are not audited or up to date. The Government Accountability Office (GAO) was asked to examine (1) how state DSH payments in 2006 compared to DSH payment limits, and (2) certain aspects of states' calculations of 2006 DSH payment limits. In selected states, GAO analyzed state Medicaid payment data and interviewed officials from the states and from the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid."

Correspondence issued by the Government Accountability Office with an abstract that begins "The nation's 1.4 million nursing home residents are a highly vulnerable population of elderly and disabled individuals for whom remaining at home is no longer feasible. The federal government plays a key role in ensuring that nursing home residents receive appropriate care by setting quality requirements that nursing homes must meet to participate in the Medicare and Medicaid programs and by contracting with states to conduct routine inspections--called standard surveys--and complaint investigations. To encourage compliance with quality requirements, Congress has authorized certain enforcement actions, known as sanctions, such as civil money penalties or termination from participating in the Medicare and Medicaid programs. The Centers for Medicare & Medicaid Services (CMS) is responsible for imposing federal sanctions, typically on the basis of states' recommendations. One sanction--temporarily replacing a home's management--has been used infrequently. According to CMS guidance, temporary management may be used instead of termination in cases where nursing homes place residents at risk of death or serious injury--referred to as immediate jeopardy--or place residents at widespread risk of actual harm. CMS requires that a nursing home remove any immediate jeopardy within a short time frame of 23 calendar …

Testimony 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, and may also require companies to hire an independent monitor to oversee compliance. This testimony addresses (1) the extent to which prosecutors adhered to DOJ's monitor selection guidelines, (2) the prior work experience of monitors and companies' opinions of this experience, and (3) the extent to which companies raised concerns about their monitors, and whether DOJ had defined its role in resolving these concerns. Among other steps, GAO reviewed DOJ guidance and examined the 152 agreements negotiated from 1993 (when the first 2 were signed) through September 2009. GAO also interviewed DOJ officials, obtained information on the prior work experience of monitors who had been selected, and interviewed representatives from 13 companies with agreements that required monitors. These results, while not generalizable, provide insights into monitor selection and oversight."

A letter report issued by the Government Accountability Office with an abstract that begins "When a consumer uses a credit card to make a purchase, the merchant does not receive the full purchase amount because a certain portion of the sale is deducted to compensate the merchant's bank, the bank that issued the card, and the card network that processes the transaction. The level and growth of these rates have become increasingly controversial. The 2009 Credit Card Accountability, Responsibility, and Disclosure Act directed GAO to review (1) how the fees merchants pay have changed over time and the factors affecting the competitiveness of the credit card market, (2) how credit card competition has affected consumers, (3) the benefits and costs to merchants of accepting cards and their ability to negotiate those costs, and (4) the potential impact of various options intended to lower merchant costs. To address these objectives, GAO reviewed and analyzed relevant studies, literature, and data on the card payment market and interviewed industry participants, including large and small card issuers (including community banks and credit unions), card processors, card networks, large merchants representing a significant proportion of retail sales, and small merchants from a variety of industries, …

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) implemented the post-deployment health reassessment (PDHRA), which is required to be administered to servicemembers 90 to 180 days after their return from deployment. DOD established the PDHRA program to identify and address servicemembers' health concerns that emerge over time following deployments. This report is the second in response to a Senate Armed Services Committee report directing the Government Accountability Office (GAO) to review DOD's administration of the PDHRA, and to additional congressional requests. In this report, GAO examined (1) the extent to which DOD's central repository contains PDHRA questionnaires for active and Reserve component servicemembers who returned from deployment to Iraq or Afghanistan and (2) how DOD monitors the administration of the PDHRA to Reserve component servicemembers. To conduct this review, GAO performed a quantitative analysis using DOD deployment and PDHRA data, reviewed relevant PDHRA policies, and interviewed DOD officials."

A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Education (Education) awards about $45 billion in grants each year to school districts, states, and other entities. In addition, the American Recovery and Reinvestment Act of 2009 provided an additional $97 billion in grant funding. In a series of reports from 2002 to 2009, Education's Inspector General cited a number of grantees for failing to comply with financial and programmatic requirements of their grant agreements. GAO was asked to determine: (1) what progress Education has made in implementing a risk-based approach to grant monitoring, (2) to what extent Education's program offices have the expertise necessary to monitor grantees' compliance with grant program requirements, and (3) to what extent information is shared and used within Education to ensure the effectiveness of grant monitoring. To do this, GAO reviewed agency documentation related to Education's internal controls and interviewed senior Education officials and staff in 12 of the 34 offices that monitor grants."