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VA Health Care: Management and Oversight of Fee Basis Care Need Improvement
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Veterans Affairs' (VA) fee basis care spending increased from about $3.04 billion in fiscal year 2008 to about $4.48 billion in fiscal year 2012. The slight decrease in fiscal year 2012 spending from the fiscal year 2011 level was due to VA's adoption of Medicare rates as its primary payment method for fee basis providers. VA's fee basis care utilization also increased from about 821,000 veterans in fiscal year 2008 to about 976,000 veterans in fiscal year 2012."
Date:
May 31, 2013
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Oil and Gas: Interior Has Begun to Address Hiring and Retention Challenges but Needs to Do More
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of the Interior (Interior) continues to face challenges hiring and retaining staff with key skills needed to manage and oversee oil and gas operations on federal leases. Interior officials noted two major factors that contribute to challenges in hiring and retaining staff: lower salaries and a slow hiring process compared with similar positions in industry. In response to GAO's survey, officials from a majority of the offices in the three Interior bureaus that manage oil and gas activities--the Bureau of Land Management (BLM), the Bureau of Ocean Energy Management (BOEM), and the Bureau of Safety and Environmental Enforcement (BSEE)--reported ongoing difficulties filling vacancies, particularly for petroleum engineers and geologists. Many of these officials also reported that retention is an ongoing concern as staff leave for positions in industry. Bureau of Labor Statistics data confirm a wide gap between industry and federal salaries for petroleum engineers and geologists. According to Office of Personnel Management (OPM) data, the fiscal year 2012 attrition rate for petroleum engineers at BLM was over 20 percent, or more than double the average federal attrition rate of 9.1 percent. However, the …
Date:
January 31, 2014
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Coast Guard: Observations on Progress Made and Challenges Faced in Developing and Implementing a Common Operational Picture
Testimony issued by the Government Accountability Office with an abstract that begins "The Coast Guard, a component of the Department of Homeland Security (DHS), has made progress in developing its Common Operational Picture (COP) by increasing the information in the COP and increasing user access to this information. The Coast Guard has made progress by adding internal and external data sources that allow for better understanding of anything associated with the global maritime domain that could affect the United States. The COP has made information from these sources available to more COP users and decision makers throughout the Coast Guard. For example, in 2006, the ability to track the location of Coast Guard assets, including small boats and cutters, was added to the COP. This capability--also known as blue force tracking--allows COP users to locate Coast Guard vessels in real time and establish which vessels are in the best position to respond to mission needs. In addition to adding information to the COP, the Coast Guard has also made the information contained in the COP available on more computers and on more systems, which, in turn, has increased the number of users with access to the COP."
Date:
July 31, 2013
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Delaware River Deepening Project: Comprehensive Reanalysis Corrected Errors, but Several Issues Still Need to Be Addressed
A letter report issued by the Government Accountability Office with an abstract that begins "In 1992 Congress authorized the U.S. Army Corps of Engineers (Corps) to implement the Delaware River deepening project, which would deepen the river's shipping channel from 40 to 45 feet. In 2002 GAO reviewed the Corps' economic analysis of the project, concluding that it contained significant limitations. GAO recommended that the Corps prepare a comprehensive economic reanalysis, which the Corps completed in 2004. GAO was asked to determine the extent to which (1) the reanalysis addressed the limitations GAO identified; (2) the reanalysis's benefit projections, as updated, reflect current and anticipated market and industry conditions; and (3) the Corps has accounted for other key issues that could affect the project. GAO reviewed Corps project documentation and interviewed federal officials along with representatives of affected states, firms, and environmental groups."
Date:
March 31, 2010
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
IRS Management: Cost Estimate for New Information Reporting System Needs to be Made More Reliable
A letter report issued by the Government Accountability Office with an abstract that begins ""
Date:
January 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Patient Protection and Affordable Care Act: Effect on Long-Term Federal Budget Outlook Largely Depends on Whether Cost Containment Sustained
A letter report issued by the Government Accountability Office with an abstract that begins "The effect of the Patient Protection and Affordable Care Act (PPACA), enacted in March 2010, on the long-term fiscal outlook depends largely on whether elements in PPACA designed to control cost growth are sustained. There was notable improvement in the longer-term outlook after the enactment of PPACA under GAO's Fall 2010 Baseline Extended simulation, which assumes both the expansion of health care coverage and the full implementation and effectiveness of the cost-containment provisions over the entire 75-year simulation period. However, the federal budget remains on an unsustainable path. Further, questions about the implementation and sustainability of these provisions have been raised by the Centers for Medicare & Medicaid Services' Office of the Actuary and others, due in part to challenges in sustaining increased health care productivity. The Fall 2010 Alternative simulation assumed cost containment mechanisms specified in PPACA were phased out over time while the additional costs associated with expanding federal health care coverage remained. Under these assumptions, the long-term outlook worsened slightly compared to the pre-PPACA January 2010 simulation."
Date:
January 31, 2013
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Privacy: Federal Law Should Be Updated to Address Changing Technology Landscape
Testimony issued by the Government Accountability Office with an abstract that begins "Technological developments since the Privacy Act became law in 1974 have changed the way information is organized and shared among organizations and individuals. Such advances have rendered some of the provisions of the Privacy Act and the E-Government Act of 2002 inadequate to fully protect all personally identifiable information collected, used, and maintained by the federal government. For example, GAO has reported on challenges in protecting the privacy of personal information relative to agencies use of Web 2.0 and data-mining technologies."
Date:
July 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Final Review of Expenses from the Department of Justice Permanent Indefinite Appropriation Covering the 7-Month Period Ending September 30, 2009
Correspondence issued by the Government Accountability Office with an abstract that begins "This report presents the results of our review of the expenses paid from the Department of Justice (DOJ) permanent, indefinite appropriation covering the 7- month period ending September 30, 2009. The expenses we reviewed were those paid out of the permanent, indefinite appropriation by DOJ between March 1, 2009, and September 30, 2009, to cover Independent and Special Counsel administrative activities. With the October 2009 repeal of the requirement for a GAO review and report on such expenses, this represents our final report."
Date:
March 31, 2010
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Defense Health Care: 2008 Access to Care Surveys Indicate Some Problems, but Beneficiary Satisfaction Is Similar to Other Health Plans
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Defense (DOD) provides health care and mental health care through its TRICARE program. Under TRICARE, beneficiaries may obtain care through TRICARE Prime, an option that includes the use of civilian provider networks and requires enrollment. TRICARE beneficiaries who do not enroll in this option may obtain care from nonnetwork providers through TRICARE Standard, or from network providers through TRICARE Extra. In addition, qualified National Guard and Reserve servicemembers may purchase TRICARE Reserve Select, a plan whose care options are similar to those of TRICARE Standard and TRICARE Extra. We refer to servicemembers who use TRICARE Standard, TRICARE Extra, or TRICARE Reserve Select as nonenrolled beneficiaries. The National Defense Authorization Act for Fiscal Year 2008 directed GAO to analyze the adequacy of DOD's surveys of TRICARE beneficiaries and providers and report what the surveys' results indicate about access to care for nonenrolled beneficiaries. To do so, GAO evaluated the surveys' methodology by interviewing DOD officials and reviewing relevant documentation, including the Office of Management and Budget's (OMB) survey standards. GAO also assessed the surveys' results by interviewing DOD officials, obtaining relevant documentation, and analyzing …
Date:
March 31, 2010
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Medicaid: Improving Responsiveness of Federal Assistance to States during Economic Downturns
A letter report issued by the Government Accountability Office with an abstract that begins "In response to the most recent U.S. recession, from December 2007 to June 2009, Congress passed the American Recovery and Reinvestment Act of 2009 (Recovery Act). To help states maintain their Medicaid programs and provide states with general fiscal relief, the Recovery Act temporarily increased the federal share of Medicaid funding for states. The federal funding states receive for Medicaid is determined by a statutory formula--the Federal Medical Assistance Percentage (FMAP). The Recovery Act also required GAO to study options for providing a temporary increased FMAP in response to future recessions. GAO reviewed how past recessions affected states' ability to fund Medicaid, examined the responsiveness of past increased FMAP assistance to state needs, and identified options for adjusting the increased FMAP formula for use during future recessions. To conduct this work, GAO reviewed its previous reports on recessions and the increased FMAP and similar work from other organizations. GAO analyzed federal Medicaid data and enrollment data provided by state Medicaid directors. GAO also analyzed labor market data from the Bureau of Labor Statistics, state revenue data from the Census Bureau, and the Federal Reserve Bank of …
Date:
March 31, 2011
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Management Report: Improvements Needed in SEC's Internal Controls and Accounting Procedures
Correspondence issued by the Government Accountability Office with an abstract that begins "On November 16, 2009, we issued our opinion on the U.S. Securities and Exchange Commission's (SEC) fiscal years 2009 and 2008 financial statements. We also issued our opinion on the effectiveness of SEC's internal controls over financial reporting as of September 30, 2009, and our evaluation of SEC's compliance with selected provisions of laws and regulations during fiscal year 2009. The purpose of this report is to present (1) our recommendations related to the significant deficiencies we reported and discussed in our opinion report; (2) less significant internal control issues we identified during our fiscal year 2009 audit of SEC's internal controls and accounting procedures, along with our related recommended corrective actions; (3) the status of the recommendations reported as open in our April 2, 2009, management report (see enclosure I), and (4) the status of the security weaknesses in information systems controls at SEC that we identified in public and "Limited Official Use Only" reports issued in 2005, 2007, 2008, and 2009, that were unresolved at the time of our March 16, 2009, information security reports."
Date:
March 31, 2010
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
H-1B Visa Program: Multifaceted Challenges Warrant Re-examination of Key Provisions
A statement of record issued by the Government Accountability Office with an abstract that begins "This testimony comments on the H-1B program. Congress created the current H-1B program in 1990 to enable U.S. employers to hire temporary, foreign workers in specialty occupations. The law capped the number of H-1B visas issued per fiscal year at 65,000, although the cap has fluctuated over time with legislative changes. The H-1B cap and the program itself have been a subject of continued controversy. Proponents of the program argue that it allows companies to fill important and growing gaps in the supply of U.S. workers, especially in the science and technology fields. Opponents of the program argue that there is no skill shortage and that the H-1B program displaces U.S. workers and undercuts their pay. Others argue that the eligibility criteria for the H-1B visa should be revised to better target foreign nationals whose skills are undersupplied in the domestic workforce. Our comments in this statement for the record are based on the results of our recent examination of the H-1B program, highlighting the key challenges it presents for H-1B employers, H-1B and U.S. workers, and federal agencies. Specifically, this statement presents information on …
Date:
March 31, 2011
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Patient Protection and Affordable Care Act: HHS's Process for Awarding and Overseeing Exchange and Rate Review Grants to States
A letter report issued by the Government Accountability Office with an abstract that begins "The Department of Health and Human Services (HHS) has a structured process for awarding Patient Protection and Affordable Care Act (PPACA) exchange and rate review grants to states. These grants are designed to help states establish exchanges--new health insurance marketplaces through which individuals and small businesses can obtain insurance--and review issuers' proposed rate increases. The grant award process consists of a series of steps during which the agency solicits, screens, and evaluates grant applications, and then makes funding awards. Once HHS deems that applications meet program eligibility criteria, applications go through various reviews, including a review by independent experts and HHS officials. On the basis of these reviews, HHS determines whether states' proposed activities are allowable, and if so, whether the associated requests for grant funding are reasonable. Based on recommendations from the reviews, HHS determines whether to award grants to states, and if so, the amounts of any grants to be awarded."
Date:
May 31, 2013
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Medical Devices: FDA Should Expand Its Consideration of Information Security for Certain Types of Devices
A letter report issued by the Government Accountability Office with an abstract that begins "Several information security threats exist that can exploit vulnerabilities in active implantable medical devices, but experts caution that efforts to mitigate information security risks may adversely affect device performance. Threats to active devicesthat is, devices that rely on a power source to operatethat also have wireless capability can be unintentional, such as interference from electromagnetic energy in the environment, or intentional, such as the unauthorized accessing of a device. Several experts consider certain threats to be of greater concern than others; for example, experts noted less concern about interference from electromagnetic energy than other threats. Incidents resulting from unintentional threats have occurred, such as a malfunction resulting from electromagnetic interference, but have since been addressed. Although researchers have recently demonstrated the potential for incidents resulting from intentional threats in two devicesan implantable cardioverter defibrillator and an insulin pumpno such actual incidents are known to have occurred, according to the Food and Drug Administration (FDA). Medical devices may have several such vulnerabilities that make them susceptible to unintentional and intentional threats, including untested software and firmware and limited battery life. Information security risks resulting from certain threats …
Date:
August 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Private Health Insurance: The Range of Base Premiums for Individuals Age 19 and 64 in the Individual Market by State in January 2013
Correspondence issued by the Government Accountability Office with an abstract that begins "GAO reported the range of base premiums prior to underwriting for individual market health insurance plans as displayed on the HealthCare.gov Plan Finder in January 2013. The base premiums were for individuals aged 19 and 64 in each of the 50 states and the District of Columbia. The base premiums reflected information from data submitted by insurers to the Center for Consumer Information and Insurance Oversight (CCIIO) within the Department of Health and Human Services' (HHS) Centers for Medicare & Medicaid Services (CMS). They represented the lowest premium amounts that would have been available to different categories of individuals at that time; however, actual premium amounts paid by consumers could have been higher as they would have been determined after more complete underwriting for health conditions and other factors, and some individuals could have been denied coverage. GAO also reported on base premiums prior to underwriting for an urban and rural zip code in four select states, one from each census region. The states included: Illinois, Nevada, Pennsylvania, and Texas. This supplements data on base premiums in the individual market in January 2013 for other categories of individuals …
Date:
January 31, 2014
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
Terrorist Watchlist: Routinely Assessing Impacts of Agency Actions since the December 25, 2009, Attempted Attack Could Help Inform Future Efforts
A letter report issued by the Government Accountability Office with an abstract that begins "In July 2010, the federal government finalized guidance to address weaknesses in the watchlist nominations process that were exposed by the December 2009 attempted attack and to clarify how agencies are to nominate individuals to the watchlist. The nominating agencies GAO contacted expressed concerns about the increasing volumes of information and related challenges in processing this information. Nevertheless, nominating agencies are sending more information for inclusion in the terrorist watchlist after the attempted attack than before the attempted attack. Agencies are also pursuing staffing, technology, and other solutions to address challenges in processing the volumes of information. In 2011, an interagency policy committee began an initiative to assess the initial impacts the guidance has had on nominating agencies, but did not provide details on whether such assessments would be routinely conducted in the future. Routine assessments could help the government determine the extent to which impacts are acceptable and manageable from a policy perspective and inform future efforts to strengthen the nominations process."
Date:
May 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Managing for Results: GAO's Work Related to the Interim Crosscutting Priority Goals under the GPRA Modernization Act
Correspondence issued by the Government Accountability Office with an abstract that begins "The act requires that OMB develop federal government priority goals (crosscutting goals) and a federal government performance plan, which is to be updated annually and released concurrently with the Presidents budget. Specifically, it requires OMB, starting with the 2015 budget and in coordination with agencies and in consultation with the Congress, to developevery 4 yearslong-term, outcome-oriented goals for a limited number of crosscutting policy areas and goals for management improvement areas, including: financial management; human capital management; information technology management; procurement and acquisition management; and real property management. The goals are to be updated or revised every 4 years. In addition, OMB is required to develop interim priority goals, starting with the 2013 budget. OMB is also required to provide information on how these federal government priority goals will be achieved in a federal government performance plan."
Date:
May 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
DEPARTMENT OF ENERGY: Additional Opportunities Exist to Streamline Support Functions at NNSA and Office of Science Sites
A letter report issued by the Government Accountability Office with an abstract that begins "Support function costs at NNSA and Science sites for fiscal years 2007 through 2011 are not fully known because DOE changed its data collection approach beginning in 2010 to improve its data and, as a result, does not have complete and comparable cost data for all years. In fiscal years 2007 through 2009, total support costs for NNSA and Science sites grew from $5 billion to about $5.5 billion (nominal dollars). Costs for fiscal year 2010 are unknown because DOE was pilot-testing its new reporting system and only collected data from some sites. For fiscal year 2011, the data are more complete, but changes to DOEs definitions for support functions make it difficult to compare costs across all years. DOE has taken some steps to ensure the quality of the data in its new system and plans to fully implement a quality control process, such as peer reviews, to ensure data can be compared across sites, but has not yet done so."
Date:
January 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Medicare Advantage: Enrollment Increased from 2010 to 2011 while Premiums Decreased and Benefit Packages Were Stable
A letter report issued by the Government Accountability Office with an abstract that begins "Enrollment and spending in Medicare Advantage (MA) plans--the private plan alternative to the Medicare fee-for- service (FFS) program--have more than doubled since 2004. MA plans generally receive larger payments from Medicare than what these plans would require to provide the original Medicare FFS benefit package. Plans must use this additional money to reduce cost sharing, reduce premiums, and offer additional benefits. The Patient Protection and Affordable Care Act, enacted in 2010, required that the Centers for Medicare & Medicaid Services (CMS)--the agency within the Department of Health and Human Services (HHS) that administers Medicare--make changes in how Medicare pays MA plans. These changes, once fully implemented, are expected to reduce MA enrollment and payments, and lead to less generous benefit packages. GAO was asked to examine trends in MA from 2010 to 2011. This study assesses the extent to which the following changed from 2010 to 2011: (1) MA enrollment, (2) MA premiums and cost-sharing requirements, and (3) the additional benefits offered by MA plans. GAO analyzed data for the most common types of MA plans, accounting for about 71 percent of both the 11.1 million …
Date:
October 31, 2011
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Financial Management: NOAA Needs to Better Document Its Policies and Procedures for Providing Management and Administration Services
A letter report issued by the Government Accountability Office with an abstract that begins "The National Oceanic and Atmospheric Administration (NOAA) is a bureau within the Department of Commerce (Commerce). To help achieve NOAA's program goals, it relies on management and administration (M&A) services, such as legal support and information technology. In response to the fiscal year 2010 Consolidated Appropriations Act Conference Report, GAO (1) examined how NOAA's M&A services are funded, (2) assessed the extent to which NOAA's policies and procedures for M&A services conform to applicable standards, and (3) estimated salaries and expenses for NOAA's budget for fiscal year 2009. Among other things, GAO reviewed documents on M&A services and data on M&A costs from NOAA officials for its headquarters; line offices, which are responsible for executing NOAA's programs; and a subset of financial management centers (FMC) within the line offices, which manage specific programs and projects."
Date:
January 31, 2011
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Information on Defective Drywall
Correspondence issued by the Government Accountability Office with an abstract that begins "GAO found that numerous claims for damage have been addressed through legal settlements partly paid by commercial insurance reimbursements. Three of the four insurers with whom GAO spoke contributed to legal settlements by paying for CGL claims stemming from lawsuits against their policyholders, and one of these insurers also made payments for CGL claims separate from legal settlements. The legal settlements from defective drywall lawsuits involve hundreds of companies in the drywall supply chain (including importers, suppliers, and builders), and most of the lawsuits have been consolidated under multidistrict litigation in the United States District Court for the Eastern District of Louisiana. One of the legal settlements involves one of the two primary manufacturers of defective drywall and provides an uncapped amount of funds to address damage to affected homes, as well as $30 million for other expenses. This manufacturer's settlement is part of a group of settlements that guarantees more than $350 million to assist affected home owners, with the potential to increase."
Date:
July 31, 2013
Creator:
United States. Government Accountability Office.
Object Type:
Text
System:
The UNT Digital Library
VA Health Care: VA Has Taken Steps to Make Services Available to Women Veterans, but Needs to Revise Key Policies and Improve Oversight Processes
A letter report issued by the Government Accountability Office with an abstract that begins "In 2008, VA provided health care to over 281,000 women veterans, a fast growing subgroup of veterans. Women veterans seeking VA health care need access to an array of services and Congress has raised concerns about how well VA is prepared to meet the physical and mental health care needs of women. GAO was asked to examine (1) the on-site availability of health care services at VA facilities for women veterans, (2) the extent to which VA facilities are following VA policies that apply to the delivery of health care to women veterans, and (3) key challenges that VA facilities face in providing health care to women veterans and how VA is addressing these challenges. GAO reviewed applicable laws and VA policies, interviewed officials, and visited a judgmental sample of 9 VA medical centers (VAMC) and 10 community-based outpatient clinics (CBOC) chosen, in part, based on the number of women using services. GAO also visited 10 VA counseling centers (Vet Centers)."
Date:
March 31, 2010
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Combating Nuclear Smuggling: Megaports Initiative Faces Funding and Sustainability Challenges
A letter report issued by the Government Accountability Office with an abstract that begins "As of August 2012, the National Nuclear Security Administration (NNSA) had completed 42 of 100 planned Megaports projects in 31 countries and, as of December 2011, NNSA had spent about $850 million on the Megaports Initiative (Initiative). NNSA’s Initiative has equipped these seaports with radiation detection equipment, established training programs for foreign personnel, and created a sustainability program to help countries operate and maintain the equipment. However, the administration’s fiscal year 2013 budget proposal would reduce the Initiative’s budget by about 85 percent, and NNSA plans to shift the Initiative’s focus from establishing new Megaports to sustaining existing ones. As a result, NNSA has suspended ongoing negotiations and cancelled planned deployments of equipment in five countries."
Date:
October 31, 2012
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library
Climate Change: Energy Infrastructure Risks and Adaptation Efforts
A letter report issued by the Government Accountability Office with an abstract that begins "According to assessments by the National Research Council (NRC) and the U.S. Global Change Research Program (USGCRP), U.S. energy infrastructure is increasingly vulnerable to a range of climate change impacts--particularly infrastructure in areas prone to severe weather and water shortages. Climate changes are projected to affect infrastructure throughout all major stages of the energy supply chain, thereby increasing the risk of disruptions. For example:"
Date:
January 31, 2014
Creator:
United States. Government Accountability Office.
Object Type:
Report
System:
The UNT Digital Library