Bøger af U S Government Accountability Office

"GAO has designated Medicare and Medicaid as high-risk programs, in part due to their susceptibility to improper payments-estimated to be about $70 billion in fiscal year 2010. Improper payments have many causes, such as submissions of duplicate claims or fraud, waste, and abuse. As the administrator of these programs, the Centers for Medicare and Medicaid Services (CMS) is responsible for safeguarding them from loss. To integrate claims information and improve its ability to detect fraud, waste, and abuse in these programs, CMS initiated two information technology system programs: the Integrated Data Repository (IDR) and One Program Integrity (One PI). GAO was asked to (1) assess the extent to which IDR and One PI have been developed and implemented and (2) determine CMS's progress toward achieving its goals and objectives for using these systems to help detect fraud, waste, and abuse. To do so, GAO reviewed system and program management plans and other documents and compared them to key practices. GAO also interviewed program officials, analyzed system data, and reviewed reported costs and benefits. GAO is recommending that CMS take steps to finalize plans and reliable schedules for fully implementing"

" Over 3 billion tons of HAZMAT are transported by commercial carriers in the United States each year. DOD accounted for about 1.6 million HAZMAT shipments in fiscal year 2013, using commercial and military carriers. These shipments can be high risk and highly sensitive and if improperly handled, labeled, or packaged could result in the loss of life, property damage, and harm to national security interests. The National Defense Authorization Act for Fiscal Year 2013 mandates GAO to review DOD's guidance, policies, and procedures regarding HAZMAT shipments. GAO examined the (1) statutes, regulations, guidance, policies, and procedures that govern DOD's handling, labeling, and packaging of HAZMAT shipments to support military operations and (2) extent to which DOD faces any challenges in implementing its policies and procedures for transporting HAZMAT in a safe, timely, and cost-effective manner. GAO examined DOD's and DOT's regulations and related DOD documentation for the transport of HAZMAT and found the 2009-13 data it examined sufficiently reliable for the purposes of the review. "

The electric industry is increasingly incorporating information technology (IT) systems into its operations as part of nationwide effortscommonly referred to as smart gridto improve reliability and efficiency. There is concern that if these efforts are not implemented securely, the electric grid could become more vulnerable to attacks and loss of services. To address this concern, the Energy Independence and Security Act of 2007 (EISA) provided the National Institute of Standards and Technology (NIST) and Federal Energy Regulatory Commission (FERC) with responsibilities related to coordinating the development and adoption of smart grid guidelines and standards.GAO was asked to (1) assess the extent to which NIST has developed smart grid cybersecurity guidelines; (2) evaluate FERCs approach for adopting and monitoring smart grid cybersecurity and other standards; and (3) identify challenges associated with smart grid cybersecurity. To do so, GAO analyzed agency documentation, interviewed responsible officials, and hosted an expert panel.

" DOD uses armored military vehicles for combat and operational support, but it also uses armored commercial vehicles to transport military and civilian personnel in areas that pose a threat to their safety. These vehicles differ in many ways, including mission and appearance. The House Armed Services Committee report accompanying the National Defense Authorization Act for Fiscal Year 2017 contained a provision for GAO to assess multiple aspects of DOD's procurement practices for ACPVs. This report assesses (1) DOD's guidance and procedures for acquiring ACPVs and how they compare with those at the Department of State; and (2) the extent to which selected DOD components adhere to guidance and procedures for ensuring the safety and quality of ACPVs. To conduct this work, GAO analyzed policies, procedures, and regulations that govern aspects of acquiring, armoring, inspecting, and managing ACPVs; interviewed DOD and State Department officials; and compared armoring standards DOD components-Army, Navy, Marine Corps, and Defense Intelligence Agency-use for ACPVs against minimally acceptable protection standards. GAO reviewed contract actions for selected DOD components between 2011 and 2015. "

Recent foreign-based intrusions on the computer systems of U.S. federal agencies and commercial companies highlight the vulnerabilities of the interconnected networks that comprise the Internet, as well as the need to adequately address the global security and governance of cyberspace. Federal law and policy give a number of federal entities responsibilities for representing U.S. cyberspace interests abroad, in collaboration with the private sector. More recently, the President appointed a national Cybersecurity Coordinator charged with improving the nations cybersecurity leadership. GAO was asked to identify (1) significant entities and efforts addressing global cyberspace security and governance issues, (2) U.S. entities responsible for addressing these issues and the extent of their involvement at the international level, and (3) challenges to effective U.S. involvement in global cyberspace security and governance efforts. To do this, GAO analyzed policies, reports, and other documents and interviewed U.S. government and international officials and experts from over 30 organizations.

"Why GAO Did This Study The approximately 725,000 spouses of active duty servicemembers face challenges to maintaining a career, including having to move frequently. Their employment is often important to the financial well-being of their families. For these reasons, DOD has taken steps in recent years to help military spouses obtain employment. Moreover, the federal government has hiring mechanisms to help military spouses obtain federal jobs. The National Defense Authorization Act for Fiscal Year 2012 requires GAO to report on the programs that help military spouses obtain jobs. This report examines: (1) DOD's recent efforts to help military spouses obtain employment, (2) DOD's steps to assess effectiveness of these efforts, and (3) the hiring mechanisms to help military spouses obtain federal jobs. GAO conducted interviews with DOD, the Office of Personnel Management, and two advocacy groups; conducted site visits; analyzed relevant data; and reviewed relevant documents, laws, and regulations. GAO Recommends GAO recommends that DOD consider incorporating (1) key collaboration practices as it develops its spouse employment guidance, and (2) key attributes of successful performance measures as it develops and finalizes its performance measures. DOD partially concurred with the two recommendations, citing steps it has already taken. GAO recognizes DOD's"

" U.S. government threat assessments have discussed plans by terrorists to use general aviation aircraft- generally, aircraft not available to the public for transport-to conduct attacks. Also, the September 11, 2001, terrorists learned to fly at flight schools, which are within the general aviation community. TSA, within DHS, has responsibilities for general aviation security, and developed AFSP to ensure that foreign students enrolling at flight schools do not pose a security threat. GAO was asked to assess (1) TSA and general aviation industry actions to enhance security and TSA efforts to obtain information on these actions and (2) TSA efforts to ensure foreign flight students do not pose a security threat. GAO reviewed TSA analysis comparing FAA data from January 2006 to September 2011 on foreign nationals applying for airman certificates with AFSP data, and interviewed 22 general aviation operators at eight airports selected to reflect geographic diversity and variations in types of operators. This is a public version of a sensitive security report GAO issued in June 2012. Information TSA deemed sensitive has been omitted, including two recommendations on TSA's vetting of foreign nationals. "

"Economic, environmental, and health concerns have spurred interest in "green building"-construction and maintenance practices designed to make efficient use of resources, reduce environmental problems, and provide long-term financial and health benefits. Federal laws and executive orders direct agencies to meet green building standards in federal buildings and to foster green building in the nonfederal sector; the latter includes private, state, local, and tribal entities and accounts for the majority of the nation's buildings. GAO was asked to (1) identify current initiatives by federal agencies to foster green building in the nonfederal sector and (2) determine what is known about the results of these initiatives. As part of the review, GAO sent questionnaires to the 11 agencies implementing the initiatives identified, including the Departments of Energy (DOE) and Housing and Urban Development (HUD) and the Environmental Protection Agency (EPA); examined agency documents; and spoke with agency officials. GAO did not report funding data because officials stated that agencies do not track many green building funds separately. "

"The Americans with Disabilities Act (ADA)-now in its 20th year-calls for the full participation of individuals with disabilities in society, including the workforce. Yet, many barriers exist that may prevent them from staying connected or returning to employment. For instance, eligibility requirements for receiving public disability benefits or health coverage are not always consistent with helping to keep individuals at work or facilitating their return. Also, employers may not know how to accommodate employees with disabilities or may lack financial incentives to do so. GAO convened a forum on March 16, 2010, to explore policy options and actions that could be taken to help adults with a current or past work history improve their participation in the workforce. Participants included experts and officials representing a variety of views. Prior to the forum, GAO surveyed a larger group of experts to help inform the discussion. Comments expressed during the forum or on the survey do not necessarily represent the views of all participants, the organizations they represent, or GAO. Although GAO is not making recommendations, based on our prior work and consistent with a past GAO proposal to Congress, GAO agrees with forum participants that strong federal..."

" FDIC has a demanding responsibility enforcing banking laws, regulating financial institutions, and protecting depositors. Because of FDIC's reliance on information systems, effective information security controls are essential to ensure that the corporation's systems and information are adequately protected from inadvertent or deliberate misuse, improper modification, unauthorized disclosure, or destruction. As part of its audit of the 2016 and 2015 financial statements of the Deposit Insurance Fund and the Federal Savings and Loan Insurance Corporation Resolution Fund, which are administered by FDIC, GAO assessed the effectiveness of the corporation's controls in protecting the confidentiality, integrity, and availability of its financial systems and information. To do so, GAO examined security policies, procedures, reports, and other documents; tested controls over key financial applications; and interviewed FDIC personnel. "

"Why GAO Did This Study Prescribing medications and filling those prescriptions increasingly relies on the electronic collection of individuals' health information and its exchange among health care providers, pharmacies, and other parties. While this can enhance efficiency and accuracy, it also raises privacy and security concerns. Federal law establishes the authority for the Secretary of HHS to develop standards for protecting individuals' health information (which includes Medicare beneficiaries) and to ensure that covered entities (such as health care providers and pharmacies) and their business associates comply with these requirements. The Medicare Improvements for Patients and Providers Act of 2008 required GAO to report on prescription drug use data protections. GAO's specific objective for this review was to determine the extent to which HHS has established a framework to ensure the privacy and security of Medicare beneficiaries' protected health information when data on prescription drug use are used for purposes other than direct clinical care. To do this, GAO reviewed HHS policies and other related documentation and interviewed agency officials. What GAO Recommends GAO recommends that HHS issue de-identification guidance and establish a plan for a sustained audit capability. HHS generally agreed with both recommendations but disagreed"

"The Department of Defense (DOD) is acquiring two new tactical wheeled vehicles (TWV): the Mine Resistant Ambush Protected (MRAP) All Terrain Vehicle (M-ATV) and the Joint Light Tactical Vehicle (JLTV). The $12.5 billion M-ATV is for use in Afghanistan; JLTV is the future replacement for vehicles like the High Mobility Multi-purpose Wheeled Vehicle (HMMWV). GAO was asked to assess (1) DOD's progress in rapidly acquiring and fielding M-ATVs, (2) JLTV's expected features and cost compared to other TWV, and (3) the extent to which the current plans for M-ATV and JLTV are consistent with the services' TWV investment strategies. GAO reviewed documents and held discussions with key officials to determine program strategies, costs, performance, and anticipated features; and compared M-ATV and JLTV plans with service strategies. "

" The Medicaid program marks its 50th anniversary on July 30, 2015. The joint federal-state program has grown to be one of the largest sources of health care coverage and financing for a diverse low-income and medically needy population. Medicaid is undergoing transformative changes, in part due to PPACA, which expanded the program by allowing states to opt to cover low-income adults in addition to individuals in historic categories, such as children, pregnant women, older adults, and individuals with disabilities. GAO has a large body of work on challenges facing Medicaid and gaps in federal oversight. This report describes (1) key issues that face the Medicaid program based on this work, and (2) program and other changes with implications for federal oversight. GAO reviewed its reports on Medicaid issued from January 2005 through July 2015; reviewed documentation from the Centers for Medicare & Medicaid Services (CMS), the HHS agency that oversees Medicaid; and interviewed CMS officials. "

" NNSA established the Megaports Initiative in 2003 to deter, detect, and interdict nuclear or other radiological materials smuggled through foreign seaports. The Initiative funds the installation of radiation detection equipment at select seaports overseas and trains foreign personnel to use this equipment to scan shipping containers entering and leaving these seaports-regardless of destination. NNSA provides partner countries with maintenance and technical support for about 3 years, after which it transfers the equipment and all related responsibilities to partner countries. GAO was asked to examine (1) the status of the Megaports Initiative and NNSA's plans for completing and sustaining it and (2) the benefits of the Initiative and factors that reduce its effectiveness. GAO analyzed key documents; interviewed agency officials; and visited eight Megaports in five countries, selected on the basis of port size and unique characteristics, among other things. "

" DOE's NNSA and EM ensure the safety, security, and reliability of the U.S. nuclear weapons stockpile and address environmental cleanup of Cold War sites. Together, NNSA and EM have outlined plans that could commit American taxpayers to $450 billion in programs and projects over decades to address their missions. NNSA and EM oversee contracts for the execution of both projects, including capital asset acquisitions, and programs central to the achievement of their missions. GAO has reported on the status of DOE's projects and programs and has repeatedly identified cost overruns as compared with cost estimates. A realistic cost estimate provides a basis for both an accurate budget and effective resource allocation. In a time of fiscal constraint, Congress needs high-quality cost information upon which to make decisions about NNSA's and EM's projects and programs. This testimony focuses on GAO's (1) prior findings and preliminary observations from ongoing work on cost-estimating practices for NNSA's and EM's capital asset projects, and (2) prior findings and preliminary observations from ongoing work on cost-estimating practices for NNSA's operating programs. It is largely based on prior GAO reports issued from January 2010 to February 2013. For its ongoing work, GAO reviewed DOE policies, orders, and guidance and interviewed DOE, NNSA, and contractor officials. GAO is making no new recommendations. DOE continues"

"Over $81 billion has been committed under the Troubled Asset Relief Program (TARP) to improve the domestic auto industry's competitiveness and long-term viability. The bulk of this assistance has gone to General Motors (GM) and Chrysler, who sponsor some of the largest defined benefit pension plans insured by the federal Pension Benefit Guaranty Corporation (PBGC). As part of GAO's statutorily mandated oversight of TARP, this report examines: (1) the impact of restructuring on GM's and Chrysler's pension plans; (2) the impact of restructuring on auto supply sector pension plans; (3) the impacts on PBGC and plan participants should auto industry pension plans be terminated; and (4) how the federal government is dealing with the potential tensions of its multiple roles as pension regulator, shareholder, and creditor. To conduct this study, GAO interviewed officials at GM, Chrysler, a labor union, a supplier association, the Departments of the Treasury and Labor, and PBGC; and reviewed relevant statutes, reports, and documents concerning the automakers' restructuring and pension plan funding. Treasury and PBGC generally..."

" DOD has increasingly focused on security cooperation activities designed to build the defense capacity of foreign partners and allies, furthering the U.S. objective of securing international peace and cooperation. Both the 2011 National Military Strategy of the United States of America and the 2011 National Strategy for Counterterrorism identify building partner capacity as a worldwide priority. As DOD continues to emphasize building partner capacity, the need for efficient and effective coordination with foreign partners and within the U.S. government has become more important, in part due to fiscal challenges, which can be exacerbated by overlapping or ineffective efforts. This testimony highlights opportunities to strengthen DOD's management of its building partner capacity efforts by focusing on three key practices: (1) setting clear goals and defining terminology, (2) coordinating activities and sharing information, and (3) sustaining efforts and evaluating progress. It is based on GAO's body of work on building partner capacity from April 2010 through November 2012. "

" The U.S. petroleum refining industry-the largest refining industry in the world-experienced a period of high product prices and industry profits from the early 2000s through about 2007. Since the recession of 2007 to 2009, the industry has been in transition. Federal and state agencies regulate petroleum refining and the use of petroleum products to protect human health and the environment, as well as for other purposes. EPA, DOT, and California recently proposed or strengthened five key regulations, including EPA and DOT's coordinated fuel economy and GHG vehicle emission standards, and EPA's RFS, which has required that refiners and others ensure transportation fuels include increasing amounts of renewable fuels such as ethanol produced from corn. GAO was asked to provide information on the domestic petroleum refining industry. This report examines: (1) major changes that have recently affected the industry and (2) the future of the industry. GAO reviewed information including studies by agencies and consultants and company financial filings; interviewed stakeholders, including agency officials and representatives of refiners and environmental organizations; and reviewed forecasts by the Energy Information Administration and others. "

"Approximately 90 percent of all federal background investigations are provided by the Office of Personnel Management's (OPM) Federal Investigative Services (FIS) division. In fiscal year 2009, FIS conducted over 2 million investigations of varying types, making the organization a major steward of personal information on U.S. citizens. GAO was asked to (1) describe how OPM uses personally identifiable information (PII) in conducting background investigations and (2) assess the extent to which OPM's privacy policies and procedures for protecting PII related to investigations meet statutory requirements and align with widely accepted privacy practices. To address these objectives, GAO compared OPM and FIS policies and procedures with key privacy laws and widely accepted practices. "

" Drug compounding is the process by which a pharmacist combines, mixes, or alters ingredients to create a drug tailored to the medical needs of an individual. An outbreak of fungal meningitis in 2012 linked to contaminated compounded drugs has raised concerns about state and federal oversight of drug compounding. GAO was asked to update its 2003 testimony on drug compounding. Specifically, this report addresses (1) the status of FDA's authority to oversee drug compounding, and the gaps, if any, between state and federal authority; (2) how FDA has used its data and authority to oversee drug compounding; and (3) the actions taken or planned by states or national pharmacy organizations to improve oversight of drug compounding. GAO reviewed relevant statutes and guidance; reviewed FDA data; and interviewed officials from FDA, national pharmacy organizations, and four states with varied geography, population, and pharmacy regulations. "

"The Native American Graves Protection and Repatriation Act (NAGPRA) required federal agencies and museums to (1) identify their Native American human remains and other objects, (2) try to culturally affiliate them with a present day Indian tribe or Native Hawaiian organization, and (3) repatriate them under the terms in the act. The National NAGPRA office, within the Department of the Interior's National Park Service (NPS), facilitates the government-wide implementation of NAGPRA. GAO was asked to determine, among other things, the (1) extent to which agencies have complied with their NAGPRA requirements, (2) actions taken by National NAGPRA, and (3) extent of repatriations reported by agencies. GAO reviewed records for eight key agencies with significant historical collections, surveyed agencies to obtain repatriation data, and interviewed agency, museum, and tribal officials. "

"Since 2007, attention has been focused on nursing home ownership by private investment (PI) firms. Nursing home providers are required to disclose parties with an ownership or control interest in order to participate in Medicare or Medicaid. CMS, the HHS agency responsible for managing these two programs, maintains ownership and chain data in its Provider Enrollment, Chain, and Ownership System (PECOS). GAO examined (1) the extent of PI nursing home ownership and firms' involvement in homes' operations, (2) whether PECOS reflects PI ownership, and (3) how HHS and states use ownership data for oversight. GAO identified PI ownership using a proprietary database and analyzed data from six PI firms about their interest and involvement in nursing homes. GAO examined PECOS data for selected PI-owned nursing home chains and discussed ownership data with officials from HHS, CMS, and six states that also collect data. "

The National Oceanic and Atmospheric Administration (NOAA) is a bureau within the Department of Commerce (Commerce). To help achieve NOAAs 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 NOAAs M&A services are funded, (2) assessed the extent to which NOAAs policies and procedures for M&A services conform to applicable standards, and (3) estimated salaries and expenses for NOAAs 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 NOAAs programs; and a subset of financial management centers (FMC) within the line offices, which manage specific programs and projects.

DATA Act, as reporting deadline nears, challenges remain that will affect data quality: report to congressional addressees.

The 2010 National Drug Threat Assessment stated that the availability of illicit drugs is increasing. The Drug Enforcement Administration (DEA), in the Department of Justice (DOJ), works with Immigration and Customs Enforcement (ICE), within the Department of Homeland Security (DHS), to carry out drug enforcement efforts. DEA and ICE signed a 2009 Interagency Agreement (Agreement) that outlined the mechanisms to provide ICE with authority to investigate violations of controlled substances laws (i.e., cross-designation). The Agreement also required DEA and ICE to deconflict (e.g., coordinate to ensure officer safety and prevent duplicative work) counternarcotics investigations, among other things. GAO was asked to assess the Agreement's implementation. This report addresses the extent to which DEA and ICE have taken actions (1) to implement the Agreement's cross-designation, deconfliction, and information-sharing provisions and (2) to monitor implementation of the Agreement and make needed adjustments. GAO analyzed documents such as the 2009 Agreement, related interagency agreements, and directives to field offices. GAO also interviewed DEA and ICE Headquarters officials as well as management officials and first line supervisors in 8 of the 21 DEA and 8 of 26 ICE field offices, based on geographic dispersion. Though not generalizable to all DEA and ICE offices, the interviews provided...

" DHS bought over $14 billion in goods and services in fiscal year 2011-over one quarter of its budget-and processed over 100,000 transactions to support its homeland security missions. In 2005, DHS established an oversight program to provide department-level insight into components' procurement of goods and services and to identify successful acquisition management approaches. DHS has also established specific initiatives, such as a strategic sourcing program in 2003 to reduce procurement costs and gain other efficiencies by consolidating requirements. GAO (1) assessed DHS's efforts to implement procurement oversight, and (2) identified DHS components' use of strategic sourcing to leverage their buying power. To do this, GAO reviewed procurement oversight policies and guidance, interviewed officials from OCPO and DHS components, reviewed prior GAO reports, reviewed on-site review findings and recommendations, and examined DHS and component documentation of oversight and strategic sourcing efforts. "

" The McKinney-Vento Homeless Assistance Act established a grant program to help the nation's homeless students-more than one million in school year 2011-12-have access to public education. Under the Education for Homeless Children and Youth grant program, states and their school districts are required to identify homeless children and provide them with needed services and support. In fiscal year 2014, Education received about $65 million to administer this program. Education provided formula grants to states, which competitively awarded funds to school districts to help meet program requirements. GAO was asked to review program implementation and oversight. GAO examined (1) how districts identify and serve homeless students and challenges they face (2) how Education and states collaborate with other service providers to address student needs and any barriers, and (3) the extent to which Education monitors program compliance. GAO reviewed relevant federal laws, guidance, and reports, and analyzed Education's state and school district survey data from school year 2010-11. GAO also interviewed federal officials, and state and local officials in 20 school districts-representing a mix of urban, suburban, and rural districts and grant status-in four states, selected for geographic diversity and other characteristics, such as experience"

" Cargo containers that are part of the global supply chain-the flow of goods from manufacturers to retailers-are vulnerable to threats from terrorists. The Maritime Transportation Security Act (MTSA) of 2002 and the Security and Accountability For Every (SAFE) Port Act of 2006 required the Department of Homeland Security (DHS) to take actions to improve maritime transportation security. Also, the Implementing Recommendations of the 9/11 Commission Act of 2007 (9/11 Act) required, among other things, that by July 2012, 100 percent of all U.S.-bound cargo containers be scanned. Within DHS, U.S. Customs and Border Protection (CBP) is responsible for container security programs to address these requirements. This testimony addresses, among other things, (1) efforts to gather advance information about container shipments to assess risks, (2) technologies used to protect the integrity of containers and scan them, and (3) the status of efforts to scan 100 percent of U.S.-bound containers. GAO's statement is based on products issued from April 2005 through July 2011, along with selected updates conducted from January to February 2012. Updates involved collecting information from CBP on the status of efforts to address GAO's prior recommendations on these issues and its plans to implement 100 percent scanning. "

"The United States legally imported more than 1 billion live animals from 2005 through 2008. With increased trade and travel, zoonotic diseases (transmitted between animals and humans) and animal diseases can emerge anywhere and spread rapidly. The importation of live animals is governed by five principal statutes and implemented by four agencies. GAO was asked to examine, among other things, (1) potential gaps in the statutory and regulatory framework governing live animal imports, if any, that may allow the introduction and spread of zoonotic and animal diseases and (2) the extent to which the agencies collaborate to meet their responsibilities, and face barriers, if any, to collaboration. GAO reviewed statutes, met with agency officials, visited ports of entry, and surveyed experts on animal imports. "