Correspondence issued by the Government Accountability Office with an abstract that begins "From 2007 to 2011, FHWA apportioned about $53 billion in flexible funding to states, which is about 29 percent of total federal-aid highway funding apportioned to the states during that time. States transferred about $5 billion, or 10 percent of their apportioned flexible funding, to FTA for transit projects. Four states--California, New Jersey, New York, and Virginia--accounted for the majority of flexible funding transferred to FTA for transit projects. The portion of flexible funding transferred and the impact of the transferred funding on the total transit funding available in the states varied considerably. For example, while four states transferred more than 25 percent of their apportioned flexible funding to FTA for transit projects from 2007 to 2011, 16 states transferred less than 2 percent of their apportioned flexible funding over this period. In addition, transferred flexible funding accounted for over 50 percent of the available federal transit funding in Vermont compared to New York, where flexible funding accounted for about 5 percent of the total federal transit funding available to the state. Urbanized areas over 1 million in population received most (more than 75 percent) of the transferred …

Correspondence issued by the Government Accountability Office with an abstract that begins "What GAO Found"

Correspondence issued by the Government Accountability Office with an abstract that begins "In fiscal year (FY) 2012, we found that four federal departments--the Department of Health and Human Services (HHS), Department of Veterans Affairs (VA), Department of Defense, and Department of Education--administered 91 programs that supported postsecondary training or education specifically for direct care health professionals. The departments reported obligating about $14.2 billion for these programs in FY 2012 with the majority (78 percent) of funding going to programs that supported graduate medical education--postgraduate internship and residency training for physicians and certain other health professionals. Specifically, two programs administered by HHS's Centers for Medicare & Medicaid Services--Medicare payments to teaching hospitals for Direct Graduate Medical Education and Medicare payments to teaching hospitals for Indirect Medical Education-- accounted for about 66 percent of total reported health care workforce training funding in FY 2012."

Other written product issued by the Government Accountability Office with an abstract that begins "Participants identified a range of challenges and opportunities associated with data analytics--which involve a variety of techniques to analyze and interpret data to facilitate decision making--as discussed below."

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses our past work examining the Department of Homeland Security's (DHS) progress and challenges in developing and acquiring new technologies to address homeland security needs. DHS acquisition programs represent hundreds of billions of dollars in life-cycle costs and support a wide range of missions and investments including border surveillance and screening equipment, nuclear detection equipment, and technologies used to screen airline passengers and baggage for explosives, among others. Since its creation in 2003, DHS has spent billions of dollars developing and procuring technologies and other countermeasures to address various threats and to conduct its missions. Within DHS, the Science and Technology Directorate (S&T) conducts general research and development and oversees the testing and evaluation efforts of DHS components, which are responsible for developing, testing, and acquiring their own technologies. This testimony focuses on the findings of our prior work related to DHS's efforts to acquire and deploy new technologies to address homeland security needs. Our past work has identified three key challenges: (1) developing technology program requirements, (2) conducting and completing testing and evaluation of technologies and (3) incorporating information on costs and benefits in making …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses our past work examining the management of research and development (R&D) at the Department of Homeland Security (DHS). DHS acquisition programs represent hundreds of billions of dollars in life-cycle costs and support a wide range of missions and investments including Coast Guard ships and aircraft, border surveillance and screening equipment, nuclear detection equipment, and technologies used to screen airline passengers and baggage for explosives. Since its creation in 2003, DHS has spent billions of dollars on R&D on technologies and other countermeasures to address various threats and to conduct its missions. Within DHS, the Science and Technology Directorate (S&T) conducts overall R&D efforts to improve homeland security. Among other things, S&T works with DHS components to provide assistance in researching and developing technologies to meet their specific missions, while the components themselves are responsible for developing, testing, and acquiring these technologies. For example, DHS's Domestic Nuclear Detection Office (DNDO) is charged with developing, acquiring, and deploying equipment to detect nuclear and radiological materials, supporting the efforts of DHS and other federal agencies. The Transportation Security Administration (TSA) is responsible for securing the nation's transportation systems …

Testimony issued by the Government Accountability Office with an abstract that begins "What GAO Found"

Correspondence issued by the Government Accountability Office with an abstract that begins "Information on the overall effectiveness (or impact) of the CDBG and HOME programs is limited. According to HUD officials, the agency has faced challenges in evaluating the impact of CDBG and HOME because, among other things, such an evaluation would have to compare neighborhoods that received program assistance with those that did not. Our previous work has also identified the difficulties of evaluating the impact of block grant programs that do not represent a uniform package of activities or desired outcomes across the country, as well as the common problem of attributing differences in communities’ outcomes to the effect of a program in the absence of controls for other explanations. As a result, few comprehensive studies on the impact of the CDBG and HOME programs exist, but studies that focused on specific activities have generally found that each of the programs has made positive contributions. We identified two studies that attempted to examine the overall impact of the CDBG program on communities, but both studies encountered evaluation challenges due to the program’s design. For example, a 1995 study that HUD considers the most comprehensive evaluation of CDBG suggests …

Testimony issued by the Government Accountability Office with an abstract that begins "GAO's work over the past several years has highlighted long-standing, widespread, and significant problems with improper payments in the federal government. Fiscal year 2010 marked the 7th year of implementation of the Improper Payments Information Act of 2002 (IPIA). IPIA requires executive-branch agencies to identify programs and activities susceptible to significant improper payments, estimate annual amounts improperly paid, and report these estimates and actions taken to reduce them. On July 22, 2010, the Improper Payments Elimination and Recovery Act of 2010 (IPERA) was enacted. IPERA amended IPIA and expanded requirements for recovering overpayments across a broad range of federal programs. This testimony addresses (1) progress federal agencies have reported in estimating and reducing improper payments in fiscal year 2010, (2) challenges that continue to hinder full reporting of improper payment information, and (3) recent efforts by Congress and the executive branch intended to improve transparency and accountability for reporting, reducing, and recovering improper payments. This testimony is primarily based on prior GAO reports. GAO summarized available fiscal year 2010 improper payment information reported by federal executive-branch agencies and actions taken by the executive branch and Congress intended to …

Correspondence issued by the Government Accountability Office with an abstract that begins "This letter responds to the mandate contained in Section 1312(c) of the Small Business Jobs Act of 2010, for GAO to conduct a study of the Small Business Administration's (SBA) Procurement Center Representatives (PCR) and Commercial Market Representatives (CMR), including ways to improve their effectiveness. To fulfill this mandate, we provided congressional staff a briefing on the results of this work in meetings with them on March 22, 23, and 24, 2011. Each year, the federal government awards hundreds of billions of dollars in contracts for goods and services--more than $500 billion in fiscal year 2010 alone. It uses this buying power to maximize procurement opportunities for small businesses through long-standing policies such as set-asides and requiring large contractors to set goals for using small business subcontractors. SBA's PCRs and CMRs play an important role in helping ensure that small businesses gain access to contracting and subcontracting opportunities. In particular, a PCR's key responsibilities include reviewing proposed agency contract events--such as potentially bundled or consolidated contracts--and making set-aside recommendations to agency contracting officers (through informal and formal means), reviewing agency small business programs (surveillance reviews), and counseling small …

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, so far in the 2013 filing season, GAO found the following:"

Correspondence issued by the Government Accountability Office with an abstract that begins "The Joint Strike Fighter (JSF) program began in 1996 with an acquisition strategy that called for a competitive engine acquisition program. The program planned to first develop and procure the F135 primary engine and, with a few years lag time, develop the F136 second (or alternate) engine to compete with the F135 engine for future procurements and life-cycle support activities. The Department of Defense (DOD) requested funding for both engines annually as the JSF program progressed until the fiscal year 2007 budget submission, at which point the DOD stopped requesting funding for the F136 alternate engine. Defense officials believe that the operational risks of relying on a single engine supplier are low and do not justify the extra costs to maintain a second engine source. DOD further states that there is no guarantee that having an engine competition will create enough long-term savings to outweigh the up-front costs and now intends to acquire only the F135 primary engine. However, Congress has continued to fund the alternate engine development program annually through fiscal year 2010. According to the Secretary of Defense, DOD would need an additional $2.9 billion in …

Testimony issued by the Government Accountability Office with an abstract that begins "The F-35 Lightning II, also known as the Joint Strike Fighter (JSF), is the Department of Defense's (DOD) most costly and ambitious aircraft acquisition, seeking to simultaneously develop and field three aircraft variants for the Air Force, Navy, Marine Corps, and eight international partners. The JSF is critical for recapitalizing tactical air forces and will require a long-term commitment to very large annual funding outlays. The estimated total investment cost is currently about $385 billion to develop and procure 2,457 aircraft. Because of a history of relatively poor cost and schedule outcomes, defense leadership over the past year has directed a comprehensive restructuring of the JSF program that is continuing. This testimony draws substantially from our extensive body of work on the JSF, including the current annual review mandated in the National Defense Authorization Act for Fiscal Year 2010, Pub. L. No. 111-84 244 (2009). Our draft report is being reviewed by the Department and we expect to issue it early next month. That report and this testimony discusses (1) program cost and schedule changes and their implications on affordability; (2) progress made during 2010; (3) design and …

Testimony issued by the Government Accountability Office with an abstract that begins "DOJ has a number of initiatives to support body armor use by state and local law enforcement, including grant funding, research, standards development, and testing programs. Two separate BJA grant programs provide funding to state and local law enforcement to facilitate their body armor purchases. The BVP program offers 2-year grants on a reimbursable, matching basis to state and local law enforcement agencies to assist in their purchasing of ballistic-resistant and stab-resistant body armor. Generally, the JAG program provides 4-year grant money up front that can be used to fund body armor procurement along with other criminal justice activities. Since the BVP program’s inception in 1999, it has reimbursed grantees $247 million for their purchases of nearly 1 million vests. The JAG program has provided nearly $4 billion from fiscal years 2006 through 2011, but BJA does not know how much of this amount grantees have spent on body armor because it is not required to track expenditures for specific purposes. Instead, BJA reports that from fiscal years 2006 through 2011, 357 grantees intended to use JAG funds for ballistic-resistant vest procurement, but it does not track how …

Guidance issued by the Government Accountability Office with an abstract that begins ""

Testimony issued by the Government Accountability Office with an abstract that begins "Somali pirates have attacked 640 ships and taken more than 3,150 hostages since 2007. A few U.S.-flagged vessels have been affected--most recently the SV Quest, a private yacht on which four Americans were killed in February 2011. The growing frequency and severity of attacks renew the urgency to address the piracy threat. As Somalia is unable to repress piracy, the U.S. National Security Council (NSC) developed the interagency Countering Piracy off the Horn of Africa: Partnership and Action Plan in December 2008 to prevent, disrupt, and prosecute piracy in collaboration with international and industry partners. In September 2010, GAO issued a report evaluating the extent to which U.S. agencies (1) have implemented the plan, and the challenges they face, and (2) have collaborated with partners. This testimony is based on the September 2010 report and its objectives, and work GAO conducted in March 2011 to update report findings."

Correspondence issued by the Government Accountability Office with an abstract that begins "Please see the report (GAO-13-454R) for the tables on Transitional Medical Assistance (TMA) enrollment and expenditures which includes states that provided additional data subsequent to our December 2012 report."

Correspondence issued by the Government Accountability Office with an abstract that begins "Spending on prescription drugs in Medicaid--the joint federal-state program that finances medical services for certain low-income adults and children--totaled $15.2 billion in fiscal year 2008. State Medicaid programs do not directly purchase prescription drugs; instead, they reimburse retail pharmacies for covered prescription drugs dispensed to Medicaid beneficiaries. The federal government provides matching funds to state Medicaid programs to help cover a portion of the cost of these reimbursements. For certain outpatient prescription drugs for which there are three or more therapeutically equivalent versions, state Medicaid programs may only receive federal matching funds for reimbursements up to a maximum amount, which is known as a federal upper limit (FUL). FULs were designed as a cost-containment strategy and have historically been calculated as 150 percent of the lowest published price for the therapeutically equivalent versions of a given drug from among the prices published nationally in three drug pricing compendia. The prices from these compendia are list prices suggested by drug manufacturers and do not reflect actual transaction prices. State Medicaid programs have the authority to determine their own reimbursement amounts to retail pharmacies for covered prescription drugs. However, for …

Testimony issued by the Government Accountability Office with an abstract that begins "To reduce spending on durable medical equipment (DME) and related items, under federal law the Centers for Medicare & Medicaid Services (CMS) is phasing in, with several rounds of bidding, a competitive bidding program (CBP) for certain DME and other items. Because of numerous concerns, the Medicare Improvements for Patient and Providers Act of 2008 (MIPPA) terminated the CBP round 1 supplier contracts and required CMS to repeat the CBP round 1, the rebid that began in 2009. In November 2009, GAO issued the report Medicare: CMS Working to Address Problems from Round 1 of the Durable Medical Equipment Competitive Bidding Program (GAO-10-27) that documented problems in CMS's implementation of CBP round 1. This statement discusses some of the problems GAO identified and how CMS has or plans to address them in the ongoing CBP rebid bidding process, particularly (1) the bid submission information provided to suppliers, (2) the electronic bid submission system, and (3) the bid disqualification notification process. For the 2009 report, GAO reviewed data provided by CMS and relevant laws and regulations, and interviewed CMS officials. For this statement, GAO also obtained select information on …

Testimony issued by the Government Accountability Office with an abstract that begins "GAO has designated Medicare as a high-risk program since 1990, in part because the program's size and complexity make it vulnerable to fraud, waste, and abuse. Fraud represents intentional acts of deception with knowledge that the action or representation could result in an inappropriate gain, while abuse represents actions inconsistent with acceptable business or medical practices. Waste, which includes inaccurate payments for services, also occurs in the Medicare program. Fraud, waste, and abuse all can lead to improper payments, overpayments and underpayments that should not have been made or that were made in an incorrect amount. In 2009, the Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--estimated billions of dollars in improper payments in the Medicare program. This statement, will focus on challenges facing CMS and selected key strategies that are particularly important to helping prevent fraud, waste, and abuse, and ultimately to reducing improper payments, including challenges that CMS continues to face. It is based on nine GAO products issued from September 2005 through March 2010 using a variety of methodologies, including analysis of claims, review of relevant policies and procedures, stakeholder interviews, and …

Testimony issued by the Government Accountability Office with an abstract that begins "This testimony discusses preventing and addressing government payment errors in the Medicare program. Medicare, which provides health insurance for those aged 65 and older and certain disabled persons, is susceptible to improper payments due to its size and complexity. Because the Medicare program has paid billions of dollars in error each year, the Centers for Medicare & Medicaid Services (CMS)--the agency that administers Medicare--conducts a number of activities to reduce improper payments. CMS administers the Medicare program with the help of Medicare claims administration contractors, which are not only responsible for processing and paying approximately 4.5 million claims per day, but for also conducting pre-payment reviews of claims to prevent improper payments before claims are paid, as well as post-payment reviews of claims potentially paid in error. To supplement these and other program integrity efforts, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 directed CMS to conduct a 3-year demonstration project on the use of a new type of contractors---recovery audit contractors (RAC)---in identifying underpayments and overpayments, and recouping overpayments in the Medicare program. The RAC demonstration program began in 2005. Subsequently, the Tax Relief and …

Correspondence issued by the Government Accountability Office with an abstract that begins "A mentor-protege program is an arrangement in which mentors--businesses, typically experienced prime contractors--provide technical, managerial, and other business development assistance to eligible small businesses, or protege. In return, the programs provide incentives for mentor participation, such as credit toward subcontracting goals, additional evaluation points toward the awarding of contracts, an annual award to the mentor providing the most effective developmental support to a protege, and in some cases, cost reimbursement. Overall, mentor-protege programs seek to enhance the ability of small businesses to compete more successfully for federal government contracts by furnishing them with assistance to improve their performance. We identified 13 federal agencies that currently have mentor-protege programs including the Department of Homeland Security (DHS), Department of Defense (DOD), Department of Energy (DOE), Department of State (DOS), Environmental Protection Agency (EPA), Federal Aviation Administration (FAA), General Services Administration (GSA), Department of Health and Human Services (HHS), National Aeronautics and Space Administration (NASA), Small Business Administration (SBA), Department of the Treasury (Treasury), United States Agency for International Development (USAID), and the Department of Veterans Affairs (VA). The Small Business Jobs Act of 2010 required that we conduct a study …

Correspondence issued by the Government Accountability Office with an abstract that begins "In summary, there were nearly 70 different types of leasable minerals extracted from federal lands and waters in fiscal years 2010 and 2011, but their volume cannot be aggregated because they use different units of measure. For example, the volumes of the four most valuable of these minerals--oil, gas, natural gas liquids, and coal--are measured in barrels, million cubic feet (mcf), gallons, and tons, respectively. According to ONRR data, the total value of all leasable minerals extracted from federal and Indian land and sold in fiscal years 2010 and 2011 was $92.3 billion and $98.6 billion, respectively."

Other written product issued by the Government Accountability Office with an abstract that begins "The National Aeronautics and Space Administration's (NASA) total portfolio of major projects saw cost and schedule growth that remains low compared to GAO's first review of the portfolio. Some projects in this year's portfolio launched within their cost and schedule baselines; however, several others are undergoing replans, which could temper the portfolio's positive performance. For example, the Mars Atmosphere and Volatile EvolutioN project launched on time and cost about $35 million less than its baseline estimate, but NASA officials are reporting that issues with the Ice, Cloud, and Land Elevation Satellite-2 project's primary instrument are driving costs to exceed the original baseline by at least 15 percent, and that the project will miss its committed launch date."