Bøger af U S Government Accountability Office

"In February 2009, the American Recovery and Reinvestment Act of 2009 (Recovery Act) initially provided states and the District of Columbia (the District) with an estimated $87 billion in increased Medicaid funds through December 2010, provided they met certain requirements. Funds were made available to states and the District through an increase in the Federal Medical Assistance Percentage (FMAP), the rate at which the federal government matches state expenditures for most Medicaid services. In March 2010, Congress passed the Patient Protection and Affordable Care Act (PPACA), which prohibits states from adopting certain changes to program eligibility in order to receive federal reimbursement, and in August 2010, extended increased FMAP rates through June 2011. GAO was asked to examine issues related to Medicaid funds under the Recovery Act. GAO examined (1) states' and the District's access to and use of increased FMAP funds, and (2) states' and the District's plans to sustain their Medicaid programs once these funds are no longer available. To do this work, GAO surveyed state Medicaid officials in the 50 states and the District in August 2009 and March 2010 about their program enrollment, uses of funds, program adjustments, and program sustainability. GAO obtained..."

" Due to its size, complexity, and susceptibility to mismanagement and improper payments, GAO has designated Medicare as a high-risk program. In 2013, Medicare financed health care services for approximately 51 million individuals at a cost of about $604 billion, and reported an estimated $50 billion in improper payments-payments that either were made in an incorrect amount or should not have been made at all. Most of these improper payments were made through the Medicare FFS program, which pays providers based on claims and uses contractors to pay the claims and ensure program integrity. This statement focuses on the progress made and steps still to be taken by CMS to improve improper payment prevention and recoupment efforts in the Medicare FFS program. This statement is based on relevant GAO products and recommendations issued from 2007 through 2014 using a variety of methodologies. GAO also updated information by examining public documents and, in April 2014, GAO received updated information from CMS on its actions related to laws and regulations discussed in this statement. What GAO Found The Centers for Medicare & Medicaid Services (CMS), the agency within the Department of Health and Human Services (HHS) that oversees Medicare, has made progress improving improper payment prevention and recoupment efforts in the Medicare fee-for-service (FFS) program, but further actions are needed. Provider enrollment. CMS has implemented certain provider enrollment screening procedures authorized by the Patient Protection and Affordable Care Act (PPACA) that address past weaknesses identified by GAO and others. The agency has also put in place other measures intended to strengthen existing procedures, but could do more to improve provider enrollment screening and ultimately reduce improper payments. For example, CMS has hired contractors to determine whether providers and suppliers have valid licenses, meet certain Medicare standards, and are at legitimate locations. CMS also recently contracted for fingerprint-based criminal history checks of providers and suppliers it has identified as high-risk. However, CMS has not implemented other screening actions authorized by PPACA that could further strengthen provider enrollment. Prepayment controls. In response to GAO's prior recommendations, CMS has taken steps to improve the development of certain prepayment edits-prepayment controls used to deny Medicare claims that should not be paid; however, important actions that could further prevent improper payments have not yet been implemented. For example, CMS has implemented an automated edit to identify services billed in medically unlikely amounts, but has not implemented a GAO recommendation to examine certain edits to determine whether they should be revised to reflect more restrictive payment limits. GAO has found that wider use of prepayment edits could help prevent improper payments and generate savings for Medicare. Postpayment claims reviews. Postpayment claims reviews help CMS identify and recoup improper payments. Medicare uses a variety of contractors to conduct such reviews, which generally involve reviewing a provider's documentation to ensure that the service was billed properly and was covered, reasonable, and necessary. GAO has found that differing requirements for the various contractors may reduce the efficiency and effectiveness of such reviews. To improve these reviews, GAO has previously recommended CMS examine ways to make the contractor requirements more consistent.

Credit programs, key agencies should better document procedures for estimating subsidy costs: report to the Ranking Member, Subcommittee on Financial Services and General Government, Committee on Appropriations, U.S. Senate. " Federal direct loans and loan guarantees outstanding have doubled from $1.5 trillion as of September 30, 2008, to $3.0 trillion as of September 30, 2015, as reported in the financial reports of the U.S. government. In light of the growing portfolio of...

"The United States and other member states have long-standing concerns about the management and operations of the Food and Agriculture Organization (FAO), a United Nations (UN) specialized agency charged with leading international efforts to defeat hunger. After an external evaluation found that FAO needed to reform, FAO adopted its reform plan, called the Immediate Plan of Action for FAO Renewal (IPA), which includes 272 action items. This report examines (1) the methodology that FAO uses to report on the status of its reform plan, (2) factors that affect FAO's ability to implement its reform plan, and (3) actions the United States has undertaken to support FAO reform efforts. GAO analyzed FAO documents, including FAO's most recent 2010 IPA progress report; interviewed U.S. and UN officials, and representatives of FAO member states; and analyzed 30 IPA action items from FAO's reform plan. "

"Compact of Free Association between the United States and the Republic of Palau, which entered into force in 1994, provided for several types of assistance aimed at promoting Palau's self-sufficiency and economic advancement. Included were 15 years of direct assistance to the Palau government; contributions to a trust fund meant to provide Palau $15 million each year in fiscal years 2010 through 2044; construction of a road system, known as the Compact Road; and federal services such as postal, weather, and aviation. U.S. agencies also provided discretionary federal programs related to health, education, and infrastructure. In 2008, GAO projected that total assistance in fiscal years 1994 though 2009 would exceed $852 million. In September 2010, the United States and Palau signed an agreement (the Agreement) that would, among other things, provide for additional assistance to Palau beginning in fiscal year 2011 and modify its trust fund. A bill, now pending, was introduced in the Senate on February 14, 2011, to approve the Agreement and appropriate funds to implement it. In this testimony, GAO updates a June 2011 testimony on (1) the Agreement's provisions for economic assistance to Palau, (2) its impact on the trust fund's likelihood of sustaining scheduled payments through fiscal year 2044, and (3) the projected role of U.S. assistance in Palau government..."

" As the U.S. workforce has become increasingly diverse, many private- and public-sector entities recognize the importance of recruiting and retaining minorities and women for management-level positions to improve their business. The 2007-2009 financial crisis has renewed questions about commitment within the financial services industry (e.g., banking and securities) to workforce diversity. The Dodd-Frank Act required that eight federal financial agencies and the Federal Reserve Banks implement provisions to support workforce and contractor diversity. GAO was asked to review trends and practices since the beginning of the financial crisis. This report examines (1) workforce diversity in the financial services industry, the federal financial agencies, and Reserve Banks, from 2007 through 2011 and (2) efforts of the agencies and Reserve Banks to implement workforce diversity practices under the Dodd-Frank Act, including contracting. GAO analyzed federal datasets and documents and interviewed industry representatives and officials from the federal financial agencies and Reserve Banks. "

"The catastrophic oil spill in the Gulf of Mexico has drawn attention to the exploration and production of oil and gas from leases on federal lands and waters. The Department of the Interior oversees oil and gas activities on federal lands and waters. Onshore, the Bureau of Land Management (BLM) has oversight responsibilities. Offshore, the newly created Bureau of Ocean Energy Management, Regulation, and Enforcement (BOEMRE), has oversight responsibilities. Prior to BOEMRE, the Minerals Management Service's (MMS) Offshore Energy and Minerals Management oversaw offshore oil and gas activities, while MMS's Minerals Revenue Management collected revenues from oil and gas produced. For the purposes of our testimony today, we present our findings in accordance with Interior's organizational structure prior to establishing BOEMRE. Over the past 5 years, GAO has issued numerous recommendations to the Secretary of the Interior to improve the agency's management of oil and gas resources-most recently in two reports issued in March 2010 (see app. II for a list of GAO reports). Overall, GAO's work in this area can be useful in evaluating potential strategies for reorganizing and improving oil and gas management at Interior. Specifically, GAO's work can..."

Recovery Act: contracting approaches and oversight used by selected federal agencies and states: report to the Republican Leader, U.S. Senate....

The administration is developing the National Disaster Recovery Framework (NDRF) in order to enhance the nations ability to deliver recovery assistance. The Federal Emergency Management Agencys (FEMA) Long-Term Community Recovery Branch (LTCR) is responsible for leading a network of primarily federal agencies, known as ESF-14, that supports long-term recovery. LTCRs experiences offer potential insights for developing the NDRF.GAO was asked to report on (1) the roles that LTCR played in recent disasters, (2) broad criteria and timing challenges that affected this assistance, (3) the effectiveness of specific coordination practices, and (4) the effectiveness of specific planning assistance practices. GAO focused on three disasters with significant LTCR involvement: the Greensburg tornado (2007), the Iowa floods (2008), and Hurricane Ike (2008). GAO reviewed agency documents and policies and interviewed relevant federal, state, and local officials.

Exposure to hazardous noise can have negative implications for both servicemember health and readiness. Moreover, in fiscal year 2009, some of the most common impairments for veterans receiving Veterans Affairs (VA) disability benefits were hearing related, as annual payments for such conditions exceeded $1.1 billion. To examine Department of Defense (DOD) efforts to prevent hearing loss, GAO is reporting on (1) how well the DOD and armed services identify and mitigate hazardous noise; (2) how well the military evaluates hearing conservation program performance; and (3) the status of DODs Hearing Center of Excellence and the extent that DOD and VA are sharing information to inform this and other efforts. GAO reviewed DOD and services policies and guidance, reviewed DOD performance data, interviewed officials and servicemembers, and conducted site visits to nine military bases.

" Rule of law assistance is an important component of U.S. efforts to build the capacity of foreign partners to support international peace and security. DIILS is DOD's lead global resource for providing professional legal education and assistance to foreign military personnel and civilian defense officials on core rule of law issues. Such issues include military justice, anticorruption, and professionalization of the military. In addition, DIILS provides defense institution-building assistance and statutorily required human rights training to foreign partners. In fiscal years 2013 through 2016, DIILS disbursed over $24 million. House Report 114-102 includes a provision for GAO to review DOD's efforts to build partner capacity in the rule of law. This report examines, among other things, the extent to which (1) DIILS has provided rule of law assistance to foreign partners and assessed its quality and (2) DOD has considered whether the size of DIILS's workforce aligns with the scope of its mission. GAO reviewed and analyzed agency funding, planning, and organizational structure documents for fiscal years 2013 through 2016. GAO interviewed U.S. officials in Washington, D.C., and conducted fieldwork in Newport, Rhode Island; Botswana; Germany; and Uganda. Locations were selected on the basis of the nature and timing of assistance"

" The financing of the federal government depends largely on IRS's ability to administer the tax laws, which includes providing service to taxpayers and enforcing the law to ensure everyone pays the taxes they owe. For fiscal year 2014, the President requested $12.9 billion for IRS, an increase of 9 percent over fiscal year 2012 actual levels. Because of the size of IRS's budget and the importance of its programs, GAO was asked to review the fiscal year 2014 budget request. In April and May 2013, GAO reported preliminary observations on IRS's budget. Among other things, this report assesses how IRS prioritizes new initiatives; steps IRS has taken to improve the PPACA cost estimate and the reporting transparency of the related IT investment; and the type of information available in the budget justification about major IT systems. To address these objectives, GAO reviewed the fiscal year 2014 budget justification, compared the updated PPACA cost estimate to GAO's Cost Estimating and Assessment Guide, and interviewed IRS Corporate Budget officials. "

" For nearly 20 years, the Army has had limited success in developing an information network-sensors, software, and radios-to give soldiers the exact information they need, when they need it, in any environment. The Army has declared its tactical network as its top modernization priority and estimated the modernization may cost up to $3 billion per year into the foreseeable future. The Army's current modernization approach is intended to leverage solutions developed by private industry. Given the costs and importance of the network, GAO was asked to examine aspects of the Army's effort to acquire network capabilities. This is the third report in response to the Subcommittee's requests. In this report, GAO examines the Army's progress in implementing competitive strategies for tactical networking systems. GAO selected a non-generalizable sample of 9 of these 25 systems that the Army indicated are critical for ensuring soldiers are able to send and receive mission-critical information between units, and that cover the breadth of warfighter operations. GAO reviewed acquisition strategies for evidence that the Army was seeking competition. "

TPPs play a vital role in preparing teachers, including helping them teach to new K-12 college- and career-ready standards recently adopted or under development in all states. Under Title II of the Higher Education Act, states collect information on TPPs and report it to Education, which reports it to the public. Education also administers competitive grant programs related to teacher preparation. In light of new K-12 standards and questions about TPP quality, GAO was asked to review TPP, state, and federal efforts. This report examines: (1) state oversight activities, (2) state and TPP actions related to new K-12 standards, and (3) the extent to which Education shares information about TPP quality. GAO reviewed relevant federal laws and documents, surveyed all state oversight offices (with a 100 percent response rate), and interviewed Education officials and various stakeholders, as well as a non-generalizable sample of officials in five states with varied approaches to oversight and 14 TPPs in those states. What GAO Recommends Among other things, GAO recommends that Education monitor states to ensure their compliance with requirements to assess whether any TPPs are low-performing and develop mechanisms to share information about TPP quality within the agency and with states. Education agreed with our recommendations.

"The federal government has set a goal of providing service to the public that matches or exceeds that of the private sector. Executive Order 12862 (September 11, 1993) and a related 1995 memorandum require agencies to post customer service standards and report results to customers. As requested, this report (1) assesses the extent to which federal agencies are setting customer service standards and measuring related results, (2) assesses the extent to which agencies are reporting standards and results to customers and using the results to improve service, and (3) identifies some customer service management tools and practices used by various governments. The report also examines the steps the Office of Management and Budget (OMB) is taking to facilitate agency use of tools and practices. GAO surveyed 13 federal services among those with the most contact with the public, reviewed literature and interviewed agency officials as well as knowledgeable individuals in the area of customer service. "

The Department of Energy (DOE) spends billions of dollars on construction projects-those that maintain nuclear weapons, conduct research, and process nuclear waste-and projects that clean up nuclear and hazardous wastes at DOE's sites; these projects are largely executed by contractors. DOE has struggled to keep these projects within cost and schedule estimates. GAO was asked to assess (1) DOE's cost-estimating policies and guidance, (2) the extent to which selected projects' cost estimates reflect best practices compiled in GAO's cost-estimating guide, and (3) DOE's recent actions to improve cost estimating. GAO reviewed relevant documents, including support for cost estimates at three major construction projects-those costing $750 million or more-and one environmental cleanup project, and interviewed DOE officials.

" NFIP was created in 1968 and is the only federal flood insurance available. It may be the sole source of insurance to some residents of flood-prone areas. Mainly due to catastrophic losses in 2005, the program became indebted to the U.S. Treasury and has been unable to repay this debt. Because of NFIP's financial instability and management challenges, GAO placed the program on its High-Risk List in 2006. The Biggert-Waters Flood Insurance Reform Act of 2012 introduced many changes to the program and mandates GAO to study the effects of increasing the maximum coverage limits ($250,000 for residential buildings and $500,000 for commercial buildings) and providing optional coverage for business interruption and additional living expenses. This report discusses (1) existing flood insurance coverage, (2) the potential effects of changing NFIP coverage limits, and (3) the potential effects of allowing NFIP to offer optional coverage for business interruption and additional living expenses. To address these objectives, GAO analyzed data from NFIP's databases of policies and claims, reviewed prior reports, and interviewed brokers, insurers, and representatives from consumer advocacy and industry organizations. "

" Since 2007, DOD and VA have jointly operated IDES-which is intended to expedite benefits for injured servicemembers. IDES replaced the departments' separate processes for evaluating servicemembers for fitness and disability. Initially a pilot at 3 military treatment facilities, IDES is now in place at military treatment facilities worldwide. In previous reports, GAO identified a number of challenges as IDES expanded to more facilities, including staffing shortages and difficultly meeting timeliness goals. In light of IDES' expansion, GAO was asked to examine: (1) the extent to which DOD and VA are meeting IDES timeliness and servicemember satisfaction performance goals, and (2) steps the agencies are taking to improve IDES performance. GAO analyzed IDES timeliness and customer satisfaction data, visited six IDES sites with varying performance, and interviewed DOD and VA officials. "

A small percentage of U.S. families saved in 529 plans in 2010, and those who did tended to be wealthier than others. According to the Survey of Consumer Finances (SCF), less than 3 percent of families saved in a 529 plan or Coverdell Education Savings Account (Coverdell)--a similar but less often used college savings vehicle also included in the SCF. While the economic downturn may have reduced income available for education savings, even among those families who considered saving for education a priority, fewer than 1 in 10 had a 529 plan (or Coverdell). Families with these accounts had about 25 times the median financial assets of those without. They also had about 3 times the median income and the percentage who had college degrees was about twice as high as for families without 529 plans (or Coverdells). States offer consumers a variety of 529 plan features that, along with several other factors, can affect participation. Some of the most important features families consider when choosing a 529 plan are tax benefits, fees, and investment options, according to experts and state officials GAO interviewed. These features can vary across the state plans. For example, in July 2012, total annual asset-based fees ranged from 0 to 2.78 percent depending on the type of plan. 529 plan officials and experts GAO interviewed said participation is also affected by families' ability to save, their awareness of 529 plans as a savings option, and the difficulty in choosing a plan given the amount of variation between plans. Selected states, however, have taken steps to address these barriers. For example, to address families' ability to save, particularly for low-income families, some states have adopted plans that include less risky investments, have low minimum contributions, and match families' contributions. Savings in 529 plans affect financial aid similarly to a family's other assets. For federal aid, a family's assets affect how much it is expected to contribute to the cost of college. If the amount of those assets exceeds a certain threshold, then a percentage is expected to be used for college costs. For example, for students who are dependent on their parents, the percentage of parental assets, including savings in 529 plans, that the family may be expected to contribute ranges from 2.64 to 5.64 percent. Many states and selected institutions also treat 529 plan savings the same as other family assets. However, a few states provide them with special treatment, such as exempting those funds from their financial aid calculation.

" NNSA has primary responsibility for ensuring the safety, security, and reliability of the nation's nuclear weapons stockpile. NNSA carries out these activities at three national labs, four production sites, and one test site-collectively known as the nuclear security enterprise. Contractors operate these sites under management and operations (M&O) contracts. The enterprise workforces often possess certain critical skills that can only be developed through a minimum of 3 years of experience working in a secure, classified environment. Because NNSA could have difficulty maintaining the critically skilled workforces necessary to ensure the safety, security, and reliability of the nation's nuclear weapons, GAO was asked to examine: (1) strategies NNSA and its M&O contractors use to recruit, develop, and retain critically skilled workforces; (2) how NNSA assesses the effectiveness of these strategies; and (3) challenges in recruiting, retaining, and developing this specialized workforce and efforts to mitigate these challenges. GAO reviewed NNSA's and its M&O contractors' human capital documents and interviewed officials. "

" The NTSB plays a vital role in transportation safety. It is charged with investigating all civil aviation accidents in the United States and selected accidents in other transportation modes, determining the probable cause of these accidents, and making appropriate recommendations, as well as performing safety studies. In 2006, NTSB's reauthorization legislation mandated GAO to annually evaluate its programs. From 2006 to 2008, GAO made 21 recommendations to NTSB aimed at improving management and operations across several areas. Since that time, NTSB has taken action to address all 21 recommendations. Some of these were completed by requiring only a single action, whereas others required continuing effort to achieve operational improvement. For this review, GAO examined the extent to which desired outcomes are being achieved in five areas where continuing effort was necessary. GAO analyzed workforce, financial, and program data, and interviewed agency officials about actions NTSB has taken. "

Among its responsibilities foraviation safety, the Federal AviationAdministration (FAA) issuesthousands of certificates andapprovals annually. Thesecertificates and approvals, which FAA bases on its interpretation offederal standards, indicate that suchthings as new aircraft, the design and production of aircraft parts andequipment, and new air operators are safe for use in the national airspace system. Past studies and industryspokespersons assert that FAAsinterpretations produce variation in its decisions and inefficiencies that adversely affect the industry.GAO was asked to examine the (1) extent of variation in FAAsinterpretation of standards for certification and approval decisions and (2) views of key stakeholders andexperts on how well these processeswork. To perform the study, GAOreviewed industry studies and reportsand FAA documents and processes; convened a panel of aviation experts;and interviewed officials fromvarious industry sectors, senior FAAofficials, and unions representingFAA staff.

" Created in 1993, CNCS distributes about $750 million in grants annually to volunteer and national service programs for needs ranging from disaster recovery to improving education. A 2014 CNCS Office of Inspector General (OIG) report cited problems with grant management. GAO was asked to review CNCS's efforts to improve its grant monitoring. This report examines (1) CNCS's process for grant monitoring; (2) the extent that this process aligns with relevant internal controls for identifying, analyzing, and responding to risk; and (3) the extent that CNCS has the capacity necessary to monitor grantees' compliance with grant requirements. GAO reviewed agency documents for fiscal years 2015 and 2016; analyzed fiscal year 2015 assessment and monitoring data (the most recent complete year of data available); interviewed agency officials and a nongeneralizable sample of program and grant officers who had experience with grants with negative outcomes, such as greater-than-expected monitoring needs or audit findings; and held discussion groups with a small nongeneralizable number of grantees attending two 2016 training conferences. "

" The effects of climate change on water resources have already been observed and are expected to continue. The Corps and Reclamation own and operate key water resource management infrastructure, such as dams and reservoirs. Adaptation-adjustments in natural or human systems to a new or changing environment that exploits beneficial opportunities or moderates negative effects-can be used to help manage the risks to vulnerable resources. In 2009, a law-commonly referred to as the SECURE Water Act-and a presidential executive order directed federal agencies to address the potential impacts of climate change. GAO was asked to review agency actions to address climate change impacts on water infrastructure. This report examines (1) actions taken by the Corps and Reclamation since 2009 to assess and respond to the potential effects of climate change on water infrastructure and (2) challenges, if any, faced by the Corps and Reclamation in assessing and responding to the potential effects of climate change on water infrastructure, and the steps the agencies are taking to address them. GAO analyzed the agencies' climate change adaptation guidance and planning documents and interviewed agency officials and other key stakeholders, including water users, environmental groups, and"

" The Sixth Amendment to the U.S. Constitution guarantees every person accused of a crime the right to counsel. States and localities generally fund indigent defense services, and the Department of Justice (DOJ) also provides funding that can be used for these services. GAO was asked to review federal support for indigent defendants. This report addresses, for fiscal years 2005 through 2010, the (1) types of support DOJ provided for indigent defense; (2) extent to which eligible DOJ funding was allocated or awarded for indigent defense, the factors affecting these decisions, and DOJ's actions to address them; (3) percentage of DOJ funding allocated for indigent defense and how it was used; (4) extent to which DOJ collects data on indigent defense funding; and (5) extent to which DOJ assesses the impacts of indigent defense grants, indigent defense programs have been evaluated, and DOJ has supported evaluation efforts. GAO surveyed (1) all 4,229 grant recipients about funding allocations and (2) a sample of 253 public defender offices about factors influencing their decisions to apply for funding. Though not all survey results are generalizable, they provide insights. GAO also analyzed grant related documents and interviewed relevant officials. "

" In 2015, approximately 2.2 million adolescents aged 12 to17 were current users of illicit drugs. The Drug-Free Communities Act of 1997 established the DFC Support Program-a federal grant program supporting drug abuse prevention efforts that engage schools, law enforcement, and other sectors of a community. The program targets reductions in the use of alcohol, tobacco, marijuana, and the illicit use of prescription drugs. The Office of National Drug Control Policy Reauthorization Act of 2006 includes a provision that GAO routinely assess ONDCP's programs and operations. This report addresses: (1) the extent to which ONDCP and SAMHSA use leading practices to coordinate program administration and the types of activities funded; and (2) the extent to which ONDCP's and SAMHSA's' operating procedures both ensure DFC grantees comply with governing statutes and provide a basis for performance monitoring. To conduct this work, GAO analyzed agency policies from 2013-2015 (most recent available); interviewed agency officials; and analyzed coordination efforts against relevant key practices GAO identified previously. GAO reviewed files obtained from a non-generalizable random sample of 30 grantees and interviewed a random subset of 10. "

" The Park Service manages more than 75,000 assets, including buildings, roads, and water systems, at 413 park units across all 50 states. In 2015, the agency estimated that its deferred maintenance on these assets was $11.9 billion. GAO was asked to review how the Park Service manages its maintenance needs. This report examines, among other things, (1) agency allocations to maintain assets in fiscal years 2006 through 2015, (2) the amount and composition of the agency's deferred maintenance in fiscal years 2009 through 2015, and (3) how the agency makes maintenance decisions. To conduct this work, GAO analyzed Park Service allocation data for fiscal years 2006 through 2015 and deferred maintenance data in fiscal years 2009 (first year data for all assets was available) through 2015 (most current data available); reviewed planning and guidance documents and compared the process for making asset management decisions to guidance developed by the National Academies, among others; and interviewed Park Service officials at headquarters, all seven regions, and 21 park units selected to include those with large and small amounts of deferred maintenance, among other things. This sample is not generalizable to all park units. "

" CMS collects MA encounter data to help ensure the proper use of federal funds by improving risk adjustment in the MA program-the private health plan alternative to traditional Medicare-and for other potential purposes. CMS's ability to make proper payments depends on the completeness and accuracy of MA encounter data. In July 2014, GAO reported that CMS had taken some, but not all, appropriate actions to validate the completeness and accuracy of encounter data and had not fully developed plans for using them. GAO was asked to provide an update on its July 2014 findings. In this report, GAO identifies (1) steps CMS has taken to validate MA encounter data, and (2) CMS's plans and time frames for using MA encounter data-as well as stakeholder perspectives on these steps and plans. To do this work, GAO compared CMS activities with the agency's protocol for validating Medicaid encounter data-comparable data collected and submitted by entities similar to MAOs-and federal internal control standards. In addition, GAO reviewed relevant agency documents and interviewed CMS officials on MA encounter data collection and reporting. GAO also reviewed comments in response to CMS's 2014 proposed rule and reports from stakeholder organizations.

" USEC is the only company that uses U.S.-developed technology to enrich uranium. According to DOE, under international agreements the U.S. must use uranium enriched with domestic technology to meet national security needs, such as for nuclear weapons. In 2012 and 2013, DOE transferred uranium to USEC to support the development of next generation enrichment technology and for other national security purposes. In May 2013, USEC ceased enrichment operations and, in March 2014, filed for Chapter 11 bankruptcy protection. In April 2014, DOE announced it would assume managerial responsibility for continued development of the next generation technology. GAO was asked to review recent DOE transactions involving USEC. This report examines (1) the uranium transactions DOE undertook in 2012 and 2013 involving USEC, (2) legal concerns regarding the transactions, (3) other issues the transactions raise, and (4) the extent to which DOE assessed impacts of the transactions on the domestic uranium market. To address these issues, GAO analyzed relevant laws and key documents and interviewed DOE, USEC, and uranium industry officials, among other steps. "

" BRT is a form of transit that has generated interest around the world to help alleviate the adverse effects of traffic congestion and potentially contribute to economic growth. BRT features can include improvements to infrastructure, technology, and passenger amenities over standard bus service to improve service and attract new riders. The use of federal funding for BRT in the United States has increased since 2005, when the Safe Accountable Flexible Efficient Transportation Equity Act: A Legacy for Users expanded eligibility for major capital projects under FTA's Capital Investment Grant Program to include corridor-based bus projects. BRT projects can be funded through New, Small, and Very Small Start grants under the Capital Investment Grant Program. GAO was asked to examine (1) features included in BRT projects funded by the FTA; (2) BRT project performance in terms of ridership and service and how they compare to rail transit projects; (3) how BRT-projects' costs differ from rail transit project costs; and (4) the extent to which BRT projects provide economic development and other benefits. To address these objectives, GAO sent questionnaires to officials of all 20 existing BRT and 20 existing rail-transit projects that the FTA recommended for funding from fiscal year 2005 through 2012 to collect information on project features, ridership, and service and interviewed select project sponsors. GAO also reviewed documents"