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Medicaid Managed Care: Improved Oversight Needed of Payment Rates for Long-Term Services and Supports
GAO-17-145: Published: Jan 9, 2017. Publicly Released: Feb 8, 2017.
Out of six states with Medicaid managed long-term services and supports (MLTSS) programs that GAO selected for review, five set clear financial incentives in their payment rates for managed care organizations (MCO) to provide care in the community versus in an institution. However, most of the selected states did not opt to link payments or penalties to MCO performance on MLTSS goals. These goals,...
Medical Devices: Cancer Risk Led FDA to Warn Against Certain Uses of Power Morcellators and Recommend New Labeling
GAO-17-231: Published: Feb 7, 2017. Publicly Released: Feb 8, 2017.
Between 1991 and 2014, the Food and Drug Administration (FDA)—the federal agency responsible for the oversight of medical devices—cleared 25 submissions for laparoscopic power morcellators for the U.S. market. FDA cleared the submissions for these devices, which cut tissue into small pieces to facilitate removal through small incision sites of gynecological and other types of minimally invasiv...
Supply Chain Security: Providing Guidance and Resolving Data Problems Could Improve Management of the Customs-Trade Partnership Against Terrorism Program
GAO-17-84: Published: Feb 8, 2017. Publicly Released: Feb 8, 2017.
Staff from U.S. Customs and Border Protection's (CBP) Customs-Trade Partnership Against Terrorism (C-TPAT) program have faced challenges in meeting C-TPAT security validation responsibilities because of problems with the functionality of the program's data management system (Portal 2.0). In particular, since the system was updated in August 2015, C-TPAT staff have identified instances in which the...
Capitol Police Board: Fully Incorporating Leading Governance Practices Would Help Enhance Accountability, Transparency, and External Communication
GAO-17-112: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
The Capitol Police Board (Board) has wide-ranging responsibilities and according to experts with knowledge of law enforcement oversight bodies, like civilian oversight boards, the Board's scope is unique by comparison. For example, the Board has authority for security decisions, as well as certain human capital and personnel matters, including the approval of officer terminations.In 2013, the Boar...
Critical Infrastructure Protection: Additional Actions by DHS Could Help Identify Opportunities to Harmonize Access Control Efforts
GAO-17-182: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
The six selected federally-administered critical infrastructure access control efforts GAO reviewed generally followed similar screening and credentialing processes. Each of these efforts applies to a different type of infrastructure. For example, the Transportation Security Administration's Transportation Worker Identification Credential controls access to ports, the Department of Defense (DOD) C...
Drug-Free Communities Support Program: Agencies Have Strengthened Collaboration but Could Enhance Grantee Compliance and Performance Monitoring
GAO-17-120: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
The Office of National Drug Control Policy (ONDCP) and the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) employ leading collaboration practices to administer the Drug Free Communities (DFC) Support Program and have funded a range of drug prevention activities. Both agencies have improved their collaboration since GAO last reported...
Federal Disaster Assistance: FEMA's Progress in Aiding Individuals with Disabilities Could Be Further Enhanced
GAO-17-200: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
The Federal Emergency Management Agency (FEMA) has taken steps to improve its disaster services for people with disabilities and its support to other entities, such as state and local governments. FEMA established the Office of Disability Integration and Coordination (ODIC) following enactment of the Post-Katrina Emergency Management Reform Act of 2006 (Post-Katrina Act) to lead the agency's effor...
Information Technology: HUD Needs to Address Significant Weaknesses in Its Cost Estimating Practices
GAO-17-281: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
The cost estimates that the Department of Housing and Urban Development (HUD) developed for the four selected information technology (IT) investments were unreliable and, thus, lacked a sound basis for informing the department's investment and budgetary decisions. GAO's Cost Estimating and Assessment Guide (Cost Guide) defines best practices that are associated with four characteristics of a rel...
U.S. Postal Service: Key Considerations for Restoring Fiscal Sustainability
GAO-17-404T: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
The U.S. Postal Service's (USPS) deteriorating financial condition is unsustainable as a result of trends including:Declining mail volume : First-Class Mail—USPS's most profitable product—continues to decline in volume as communications and payments migrate to electronic alternatives. USPS expects this decline to continue for the foreseeable future.Growing expenses: Key USPS expenses such as...
Veterans Affairs Information Technology: Management Attention Needed to Improve Critical System Modernizations, Consolidate Data Centers, and Retire Legacy Systems
GAO-17-408T: Published: Feb 7, 2017. Publicly Released: Feb 7, 2017.
GAO noted in July 2016 that the Department of Veterans Affairs (VA) had moved forward with an effort to modernize its health information system—the Veterans Health Information Systems and Technology Architecture (VistA)—but that the department is uncertain of its long-term plan for addressing its electronic health record system needs beyond fiscal year 2018. Beyond modernizing VistA, GAO repor...