Bøger af U S Government Accountability Office

"To address challenges to the aviation industry's economic health and safety, the Federal Aviation Administration (FAA) is collaborating with the National Aeronautics and Space Administration (NASA) and other federal partners to plan and implement the Next Generation Air Transportation System (NextGen). NextGen will transform the current radar-based air traffic control system into a satellite-based system. Pilot and air traffic controller roles and responsibilities are expected to become more automated, thereby requiring an understanding of human factors, which studies how humans' abilities, characteristics, and limitations interact with the design of the equipment they use, environments in which they function, and jobs they perform. FAA and NASA are tasked with incorporating human factors issues into NextGen. As requested, this report discusses the extent to which FAA's and NASA's human factors research (1) is coordinated and (2) supports NextGen. To address these issues, GAO reviewed coordination mechanisms and planning documents and synthesized the views of nine aviation human factors experts. "

"Medicaid and the Children's Health Insurance Program (CHIP)-two joint federal-state health care programs for certain low-income individuals-play a critical role in addressing the health care needs of children. The Children's Health Insurance Program Reauthorization Act of 2009 required GAO to study children's access to care under Medicaid and CHIP, including information on physicians' willingness to serve children covered by Medicaid and CHIP. GAO assessed (1) the extent to which physicians are enrolled and serving children in Medicaid and CHIP and accepting these and other children as new patients, and (2) the extent to which physicians experience difficulty referring children in Medicaid and CHIP for specialty care, as compared to privately insured children. GAO conducted a national survey of nonfederal primary and specialty care physicians who serve children, and asked about their enrollment in state Medicaid and CHIP programs, whether they served and accepted Medicaid and CHIP and privately insured children, and the extent to which they experienced difficulty referring children in Medicaid and CHIP and privately insured children to specialty care. GAO also interviewed officials with the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human..."

By law, GAO is directed to assess the annual progress the Missile Defense Agency (MDA) made in developing and fielding the Ballistic Missile Defense System (BMDS). GAO issued its latest assessment of MDAs progress covering fiscal year 2009 in February 2010. This report supplements that assessment to provide further insight into MDAs prime contractor performance for fiscal year 2009. Prime contractors track earned value management (EVM) by making comparisons that inform the program as to whether the contractor is completing work at the cost budgeted and whether the work scheduled is being completed on time. Our analysis of contractor EVM data included examining contract performance reports for 14 BMDS contracts, reviewing the latest integrated baseline reviews, performing extensive analysis of data anomalies, and conducting interviews with Defense Contract Management Agency (DCMA) officialsthe independent reviewers of MDA contractor EVM systems.

" Water is a significant byproduct associated with oil and gas exploration and production. This water, known as "produced water," may contain a variety of contaminants. If produced water is not appropriately managed or treated, these contaminants may present a human health and environmental risk. GAO was asked to describe (1) what is known about the volume and quality of produced water from oil and gas production; (2) what practices are generally used to manage and treat produced water, and what factors are considered in the selection of each; (3) how produced water management is regulated at the federal level and in selected states; and (4) what federal research and development efforts have been undertaken during the last 10 years related to produced water. To address these objectives, GAO reviewed studies and other documents on produced water and interviewed federal and state regulatory officials, federal scientists, officials from oil and gas companies and water treatment companies, and other experts. GAO focused its review on the nine states that generate nearly 90 percent of the produced water, and conducted site visits in three states. "

" The global use of UAVs has increased significantly over time, raising concerns about their proliferation. MTCR and Wassenaar are the multilateral regimes that address UAV proliferation. MTCR seeks to limit the proliferation of weapons of mass destruction delivery systems, while Wassenaar seeks to limit the spread of certain conventional weapons and sensitive technologies with both civilian and military uses. This report is an unclassified version of a classified report issued in February 2012. GAO was asked to address (1) global trends in the use of UAV technology, (2) U.S. national security considerations concerning UAV proliferation, (3) multilateral and bilateral tools to control UAV proliferation, and (4) coordination of U.S. efforts to limit the spread of UAV technology. To conduct this review, GAO analyzed intelligence, licensing, and end-use monitoring data, and interviewed U.S. and foreign officials. "

" VA is required to give contracting preference to service-disabled and other veteran-owned small businesses. It must also verify the ownership and control of these firms to confirm eligibility. Prior reports by GAO and VA's Office of Inspector General identified weaknesses in VA's processes and controls that allowed ineligible firms to be verified. GAO was asked to review the verification program. For this report, GAO assessed (1) VA's progress in establishing a program for verifying firms' eligibility on a timely and consistent basis and (2) key operational and policy issues that VA would have to address should its verification program be implemented government-wide. GAO reviewed VA's policies and procedures; compared its initial strategic planning effort with previously identified leading strategic planning practices; interviewed VA officials and veterans' organizations; and analyzed government-wide contracting databases. "

" Federal programs for those experiencing or at risk for homelessness generally are designed to provide housing assistance and other services such as health care, job training, or food assistance. This report responds to the statutory requirement that GAO identify federal programs, agencies, offices, and initiatives that have duplicative goals or activities and addresses (1) the number of and funding levels for federal homelessness programs and the extent to which fragmentation, overlap, and duplication exists; (2) whether the programs have been evaluated; and (3) actions of the Interagency Council and federal agencies to coordinate efforts and the extent to which the federal strategic plan to prevent and end homelessness is an effective strategy. To address these objectives, GAO sent questionnaires to10 federal agencies and obtained and analyzed data for a range of programs. "

" Drug-related homicides have dramatically increased in recent years in Mexico along the nearly 2,000-mile border it shares with the United States. U.S. federal, state, and local officials have stated that the prospect of crime, including violence, spilling over from Mexico into the southwestern United States is a concern. GAO was asked to review crime rates and assess information on spillover crime along the border. Specifically, this report addresses: (1) What information do reported crime rates in southwest border communities provide on spillover crime and what do they show (2) What efforts, if any, have federal, state, and select local law enforcement agencies made to track spillover crime along the southwest border (3) What concerns, if any, do these agencies have about spillover crime (4) What steps, if any, have these agencies taken to address spillover crime GAO analyzed crime data from all of the 24 southwest border counties from 2004 through 2011 and federal documentation, such as threat assessments and DHS's plans for addressing violence along the southwest border. GAO interviewed officials from DHS and DOJ and their components. GAO also interviewed officials from 37 state and local law enforcement agencies responsible for investigating and tracking crime in the border counties in the four southwest border states (Arizona, California, New Mexico, and Texas). While the results of the interviews are not generalizable"

The Veterans Benefits, Health Care, and Information Technology Act of 2006 (the 2006 Act) requires the Department of Veterans Affairs (VA) to give priority to veteran-owned and service-disabled veteran-owned small businesses (VOSB and SDVOSB) when awarding contracts to small businesses. The 2006 Act also requires GAO to conduct a 3-year study of VAs implementation of the act. GAO evaluated (1) the extent to which VA met its prime contracting goals for VOSBs and SDVOSBs in fiscal years 2007-2009; (2) VAs progress in implementing procedures to verify the ownership, control, and status of VOSBs and SDVOSBs in its mandated database; and (3) VAs progress in establishing a review mechanism of prime contractors subcontracts with VOSBs and SDVOSBs. GAO obtained and analyzed data on VAs prime and subcontracting accomplishments, and reviewed a sample of verified businesses to identify any deficiencies in VAs verification program.

St. Lawrence Seaway: estimates for the Asset Renewal Program will change, and implementing best practices may improve the estimates reliability

"Many federal contractors establish offshore subsidiaries to take advantage of labor and market conditions. GAO has found that they also use offshore subsidiaries to reduce their U.S. tax burdens. In 2008, Congress passed the Heroes Earnings Assistance and Relief Tax (HEART) Act which resulted in contractor offshore subsidiaries paying certain payroll taxes for U.S. personnel working abroad. Fiscal year 2009's National Defense Authorization Act required GAO to report on the rationales, implications, and costs and benefits of defense contractors' use of offshore subsidiaries. We (1) assessed trends and purposes for contractors' offshore subsidiaries; (2) identified how contractors use subsidiaries to support defense contracts; (3) assessed DOD's oversight of contractors' use of offshore subsidiaries. To conduct our work, we reviewed data for the 29 U.S. publicly traded contractors with at least $1 billion in DOD spending in fiscal year 2008, reviewed several illustrative contracts selected based on categories of DOD services most often performed overseas, reviewed audit documents, and interviewed DOD officials about oversight. "

"In fiscal year 2010, the Department of Veterans Affairs (VA) provided health care to about 5.2 million veterans. Recent legislation has increased many Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF) veterans' priority for accessing VA's health care, and concerns have been raised about the extent to which VA is providing mental health care to eligible veterans of all eras. There also are concerns that barriers may hinder some veterans from accessing needed mental health care. GAO was asked to provide information on veterans who receive mental health care from VA. In this report, GAO provides information on (1) how many veterans received mental health care from VA from fiscal years 2006 through 2010, (2) key barriers that may hinder veterans from accessing mental health care from VA, and (3) VA efforts to increase veterans' access to VA mental health care. GAO obtained data from VA's Northeast Program Evaluation Center (NEPEC) on the number of veterans who received mental health care from VA. The number of veterans represents a unique count of veterans; veterans were counted only once, even if they received care multiple times during a fiscal year or across the 5-year period. GAO also reviewed literature published from 2006 to 2011, reviewed VA documents, and interviewed officials from VA and veterans service..."

Newborn screening timeliness: most states had not met screening goals, but some are developing strategies to address barriers: report to congressional committees.

" Human trafficking-the exploitation of a person typically through force, fraud, or coercion for such purposes as forced labor, involuntary servitude or commercial sex-is occurring in the United States. Traffickers seek out persons perceived to be vulnerable. Native Americans (i.e., American Indians or Alaska Natives) are considered to be a vulnerable population. DOJ, DHS, and the Department of the Interior investigate human trafficking crimes. Primarily, DOJ and HHS provide grants to fund victim services. GAO was asked to examine Native American human trafficking. This report focuses on federal efforts to address human trafficking, including the extent to which (1) agencies collect and maintain data on investigations and prosecutions of human trafficking in Indian country or of Native Americans regardless of location and (2) federal grant programs are available to help address such trafficking, and how many Native American trafficking victims have received assistance through these programs. GAO reviewed human trafficking investigation and prosecution data from fiscal years 2013 to 2016; reviewed solicitations for human trafficking-related grant programs; and interviewed grant program officials. "

Women represent an increasingly larger share of the total workforce in the United Statesconstituting nearly half of the total workforce. In addition, an increasing proportion of women in the workforce are more educated. However, research by GAO and others has shown that womens average pay has been and remains lower than that of men. Questions have been raised about the extent to which less-advantaged womenthat is, those who are low wage or less educatedexperience lower wages than less-advantaged men.GAO was asked to examine the differences in representation, key characteristics, and pay among women and men (1) with less education and (2) with low wages. GAO defined less-educated workers as those having a high school degree or less and low-wage workers as those earning an hourly wage rate in the bottom quintileor 20 percentof wages across the workforce. GAO analyzed data from the Department of Labors Current Population Survey (CPS); reviewed other work on similar topics; and interviewed agency officials, representatives of womens groups, and other researchers.

" U.S. international broadcasting is intended to communicate directly with audiences in countries with limited journalism alternatives and to inform, engage, and connect people around the world. BBG oversees two U.S. government entities-Voice of America and the Office of Cuba Broadcasting- and three nonprofit grantees that act as surrogates for local media-Middle East Broadcasting Networks, Inc.; Radio Free Asia; and Radio Free Europe/Radio Liberty. In 2003, GAO found overlap among BBG's language services. In its strategic plan for 2012- 2016, BBG recognizes the need to reduce language service overlap. GAO was asked to review issues related to international broadcasting. This report examines the extent to which (1) BBG language services overlap with one another and (2) BBG broadcasts in the same languages as other international broadcasters. GAO reviewed laws, reports, and other documents related to U.S. international broadcasting; analyzed information on the BBG entities; and interviewed representatives of the five BBG entities and international broadcasters. "

"Since GAO's first audit of the fiscal year 1997 consolidated financial statements of the U.S. government (CFS), material weaknesses in internal control and other limitations on the scope of GAO's work have prevented GAO from expressing an opinion on the consolidated financial statements, other than the Statement of Social Insurance (accrual-based consolidated financial statements). The Department of the Treasury (Treasury), in coordination with the Office of Management and Budget (OMB), is responsible for preparing the CFS. As part of the fiscal year 2009 CFS audit, GAO identified material weaknesses and other control deficiencies in Treasury's processes used to prepare the CFS that warrant management's attention and corrective action. The purpose of this report is to (1) provide details on new control deficiencies GAO identified during its audit of the fiscal year 2009 CFS that related to the preparation of the CFS, (2) recommend improvements, and (3) provide the status of corrective actions taken to address GAO's previous 44 recommendations in this area. "

"The Federal Housing Finance Agency (FHFA) relies extensively on computerized systems to carry out its mission to provide effective supervision, regulation, and housing mission oversight of the Federal National Mortgage Association (Fannie Mae), the Federal Home Loan Mortgage Corporation (Freddie Mac), and the federal home loan banks. Effective information security controls are essential to ensure that FHFA's financial information is protected from inadvertent or deliberate misuse, disclosure, or destruction. As part of its audit of FHFA's fiscal year 2009 financial statements, GAO assessed the effectiveness of the agency's information security controls to ensure the confidentiality, integrity, and availability of the agency's financial information. To do this, GAO examined FHFA information security policies, procedures, and other documents; tested controls over key financial applications; and interviewed key agency officials. "

The Department of Housing and Urban Developments (HUD) Federal Housing Administration (FHA) has helped millions purchase homes by insuring private lenders against losses from defaults on FHA-insured single-family mortgages. In recent years, FHA has experienced a dramatic increase in its market role due, in part, to the contraction of other mortgage market segments. The increased reliance on FHA mortgage insurance highlights the need for FHA to ensure that it has the proper controls in place to minimize financial risks while meeting the housing needs of borrowers. In addition to providing data on FHAs single-family workload, GAO was asked to evaluate (1) FHAs risk assessment strategy, including the extent to which it is consistent with HUD and GAO internal control standards, and (2) steps FHA has taken to manage the risks in its single-family programs. To address these objectives, GAO analyzed data from fiscal years 20062010 on single-family business volume and workload, reviewed FHA documents on risk assessment and changes made to manage risks (such as those to human capital), and interviewed FHA officials.

"Recent market declines have significantly diminished the asset value of state and local pension plans. Reported unfunded liabilities for these plans are estimated in the hundreds of billions of dollars. As a result, in the long term, these governments may need to make significant fiscal adjustments such as modifying employee benefits, or increasing contributions to plans. They may also alter investment strategies to attempt to maximize returns by assuming increased risk. Consequently, GAO was asked to examine: (1) who makes investment decisions for state and local defined benefit pension plans and what guides their decision making; (2) how plans allocate their assets and manage their investments; and (3) practices that plans are using to meet a range of challenges in governance, investment, or funding. To address these objectives, GAO reviewed relevant literature, interviewed experts in pension and retirement systems, conducted a survey of state and local plans, and performed more detailed reviews of plans in seven states. "

" The number of older adults, those over age 65, is expected to nearly double in the United States by 2050. When an older adult becomes incapable of making informed decisions, a guardianship may be necessary. Generally, guardianships are legal relationships created when a state court grants one person or entity the authority and responsibility to make decisions in the best interest of an incapacitated individual-which can include an older adult-concerning his or her person or property. While many guardians act in the best interest of persons under guardianship, some have been reported to engage in the abuse of older adults. GAO was asked to review whether abusive practices by guardians are widespread. This report describes (1) what is known about the extent of elder abuse by guardians; and (2) what measures federal agencies and selected state and local guardianship programs have taken to help protect older adults with guardians. GAO reviewed relevant research, reports, studies, and other publications issued by organizations with expertise on elder abuse and guardianship issues. GAO also conducted interviews with various guardianship stakeholders including federal agencies such as HHS, six selected state courts, and nongovernmental organizations with expertise in guardianship-related"

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. GAO identified 94 federal initiatives--implemented by 11 agencies--that foster green building in the nonfederal sector. About two-thirds of these initiatives are implemented by HUD (29 initiatives), EPA (18), and DOE (17). According to GAO's analysis of agency questionnaire responses, the initiatives vary in how they foster green building in the following ways: (1) Elements fostered. All initiatives foster at least one of six green building elements GAO identified. Three-quarters foster more than one element, and 21 initiatives across 7 agencies foster all six elements. (2) Direct or indirect fostering. Over two-thirds (64) of the initiatives foster green building directly, and the rest foster green building as part of a broader effort that is focused not primarily on green building but on other purposes, such as expanding the supply of affordable housing for low-income elderly. (3) Type of assistance. The initiatives provide multiple types of assistance, mostly through grants (47 initiatives) and technical assistance (45). (4) Recipients expected to benefit. The direct beneficiaries identified by agencies range from individual property owners and renters to state governments. About one-third of the initiatives have green building goals and performance measures; however, the overall results of most initiatives and their related investments are unknown. For example, according to HUD officials, to measure the results of the Green Retrofit Program for Multifamily Housing, HUD analyzes energy consumption data before and after retrofitting properties. Other agency officials reported various reasons for not having goals and measures, such as challenges in gathering reliable performance data. GAO identified some instances in which agencies have begun to collaborate to assess results but did not identify government wide collaboration on initiatives for the nonfederal sector. As GAO has reported, agencies and programs working collaboratively can often achieve more public value than when they work in isolation. Agencies with green building initiatives for the nonfederal sector may be missing opportunities to, among other things, reach agreement on government wide goals and measures for assessing the overall progress of their green building efforts. GAO recommends that DOE, HUD, and EPA lead an effort to collaborate with other agencies on assessing the results of federal green building initiatives for the nonfederal sector. DOE, HUD, and EPA generally agreed with the recommendation, and HUD and other agencies provided technical clarifications, which GAO incorporated into the report as appropriate.

"Why GAO Did This Study Since the enactment of the Help America Vote Act of 2002, there have been notable changes in how states and local election jurisdictions conduct key election activities, such as registration and voting. States regulate some aspects of elections, but the combinations of election administration policies can vary widely across the country's approximately 10,500 local election jurisdictions. GAO was asked to examine the benefits, challenges, and other considerations of various election administration policies. This report addresses the following questions: (1) What are the reported benefits and challenges of efforts to collect and share voter registration information electronically? (2) What is known about the effect of selected policies on voter turnout? (3) What is known about the costs of elections? To address these three questions, GAO reviewed and analyzed relevant literature from 2002 through 2015. GAO identified 118 studies that examined the effect of selected policies that have been or could be implemented by state or local governments on voter turnout. GAO reviewed the studies' analyses, and determined that the studies were sufficiently sound to support their results and conclusions. In addition, GAO conducted visits and interviewed state and local election officials

" While VA treats the majority of veterans in VA-operated facilities, in some instances it must obtain the services of non-VA providers to ensure that veterans are provided timely and accessible care. These non-VA providers are commonly reimbursed by VA using a fee-for-service arrangement known as fee basis care. VA's fee basis care program has grown rapidly in recent years-rising from about 8 percent of VA's total health care services budget in fiscal year 2005 to about 11 percent in fiscal year 2012. GAO was asked to review fee basis care program spending and utilization and factors that influence VAMC fee basis utilization. This report examines how fee basis care spending and utilization changed from fiscal year 2008 to fiscal year 2012, factors that contribute to the use of fee basis care, and VA's oversight of fee basis care program spending and utilization. GAO reviewed relevant laws and regulations, VA policies, and fee basis spending and utilization data from fiscal year 2008 through fiscal year 2012. In addition, GAO reviewed the fee basis care operations of six selected VAMCs that varied in size, services offered, and geographic location. "

"Why GAO Did This Study IHS, an agency in the Department of Health and Human Services (HHS), provides health care to American Indians and Alaska Natives. When care at an IHS-funded facility is unavailable, IHS's CHS program pays for care from non-IHS providers if the patient meets certain requirements and funding is available. The Patient Protection and Affordable Care Act requires GAO to study the administration of the CHS program, including a focus on the allocation of funds. IHS uses three primary methods to determine the allocation of CHS funds to the 12 IHS geographic area offices: base funding, which accounts for most of the allocation; annual adjustments; and program increases, which are provided to expand the CHS program. GAO examined (1) the extent to which IHS's allocation of CHS funding varied across IHS areas, and (2) what steps IHS has taken to address funding variation within the CHS program. GAO analyzed IHS funding data, reviewed agency documents and interviewed IHS and area office officials. What GAO Recommends GAO suggests that Congress consider requiring IHS to develop and use a new method to allocate all CHS program funds to account for variations across areas, notwithstanding any restrictions now in federal law. GAO also recommends, among other things, IHS use actual counts of CHS users in methods for allocating CHS funds. HHS concurred with two of GAO's"

Nuclear safety, countries' regulatory bodies have made changes in response to the Fukushima Daiichi accident: report to the Chairman, Subcommittee on Transportation and Infrastructure, Committee on Environment and Public Works, U.S. Senate.

The Department of Energy (DOE) has made $15 billion in loan guarantees and conditionally committed to an additional $15 billion, but the program does not have the consolidated data on application status needed to facilitate efficient management and program oversight. For the 460 applications to the Loan Guarantee Program (LGP), DOE has made loan guarantees for 7 percent and committed to an additional 2 percent. The time the LGP took to review loan applications decreased over the course of the program, according to GAO's analysis of LGP data. However, when GAO requested data from the LGP on the status of these applications, the LGP did not have consolidated data readily available and had to assemble these data over several months from various sources. Without consolidated data on applicants, LGP managers do not have readily accessible information that would facilitate more efficient program management, and LGP staff may not be able to identify weaknesses, if any, in the program's application review process and approval procedures. Furthermore, because it took months to assemble the data required for GAO's review, it is also clear that the data were not readily available to conduct timely oversight of the program. LGP officials have acknowledged the need for a consolidated system and said that the program has begun developing a comprehensive business management system that could also be used to track the status of LGP applications. However, the LGP has not committed to a timetable to fully implement this system. The LGP adhered to most of its established process for reviewing applications, but its actual process differed from its established process at least once on 11 of the 13 applications GAO reviewed. Private lenders who finance energy projects that GAO interviewed found that the LGP's established review process was generally as stringent as or more stringent than their own. However, GAO found that the reviews that the LGP conducted sometimes differed from its established process in that, for example, actual reviews skipped applicable review steps. In other cases, GAO could not determine whether the LGP had performed some established review steps because of poor documentation. Omitting or poorly documenting reviews reduces the LGP's assurance that it has treated applicants consistently and equitably and, in some cases, may affect the LGP's ability to fully assess and mitigate project risks. Furthermore, the absence of adequate documentation may make it difficult for DOE to defend its decisions on loan guarantees as sound and fair if it is questioned about the justification for and equity of those decisions. One cause of the differences between established and actual processes was that, according to LGP staff, they were following procedures that had been revised but were not yet updated in the credit policies and procedures manual, which governs much of the LGP's established review process. In particular, the version of the manual in use at the time of GAO's review was dated March 5, 2009, even though the manual states it was meant to be updated at least annually, and more frequently as needed. The updated manual dated October 6, 2011, addresses many of the differences GAO identified. Officials also demonstrated that LGP had taken steps to address the documentation issues by beginning to implement its new document management system. However, by the close of GAO's review, LGP could not provide sufficient documentation to resolve the issues identified in the review.

" Approximately 15,600 nursing homes participating in the Medicare and Medicaid programs provide care to 1.4 million residents each year. To help consumers make informed choices about nursing homes, CMS developed the Nursing Home Compare website, and on the site made available the Five-Star System, which rates homes on quality components. GAO was asked to assess the website and rating system as tools for consumers. GAO examined (1) the information CMS collects about the use of Nursing Home Compare, including its usefulness to consumers, and potential areas, if any, to improve the website, and (2) the extent to which the Five-Star System enables consumers to understand nursing home quality and make distinctions between homes. GAO reviewed CMS documents and interviewed CMS officials and national and a non-generalizable sample of state-level stakeholders from four states, selected on factors such as size. GAO also analyzed Five-Star System and consumer complaint data, and analyzed resident satisfaction data from two of the four selected states. "

"Interest has re-emerged in developing oil and gas in the nation's offshore areas, such as the North Aleutian Basin. Located on the outer continental shelf (OCS) where the Aleutian Islands meet the Alaskan mainland around Bristol Bay, the basin may contain sizable oil and gas deposits, although the area's environmental and cultural sensitivity has made oil and gas development in the area controversial. The Alaska OCS Region within the Department of the Interior's Minerals Management Service (MMS) oversees oil and gas development in this offshore area. GAO was asked to examine issues related to oil and gas development in the North Aleutian Basin. This report (1) describes the basin's estimated quantities of oil and gas and needed infrastructure; (2) identifies steps MMS is to take to meet federal requirements for oil and gas development; and (3) identifies challenges, if any, MMS faces in meeting these requirements in its Alaska OCS Region. GAO analyzed laws and documents and interviewed representatives from MMS, other federal agencies, state agencies, industry, and other stakeholders. "

Congress passed the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) in 2000 to compensate Department of Energy (Energy) workers for illnesses stemming from exposure to hazardous substances while working in the atomic weapons industry. Part B of the act provides a lump-sum payment and medical coverage for certain illnesses, while Part E compensates for impairments and lost wages resulting from exposure to toxins. The Department of Labor (Labor) adjudicates all claims and is assisted by the National Institute for Occupational Safety and Health (NIOSH) and Energy. GAO examined (1) claim-processing time, (2) costs of administering the program, (3) extent to which there are quality controls to ensure that claim determinations are supported with objective and scientific information, and (4) actions taken by agencies to promote program transparency for claimants. GAO obtained data on cost and claims processing from Labor and NIOSH, and interviewed agency officials, experts, and claimant advocates.