Reports & Testimonies
GAO’s reports and testimonies give Congress, federal agencies, and the public timely, fact-based, non-partisan information that can improve government operations and save taxpayers billions of dollars.
Most Recent Reports
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Public Health Preparedness: Mpox Response Highlights Need for HHS to Address Recurring Challenges
Health and Human Services was initially charged with coordinating the federal response to a 2022 global outbreak of mpox—a smallpox-related virus. State and local jurisdictions cited challenges in the federal response such as difficulty accessing and using vaccines and tests, which may have led to unnecessary suffering. We added HHS's leadership and coordination of public health emergencies to our High Risk List earlier in 2022...
Medicaid: COVID-19 Vaccination Data Access and Strategies Used to Improve Immunization Rates
Medicaid needs to ensure that its beneficiaries receive COVID-19 vaccines to prevent hospitalizations and deaths. But during the public health emergency, COVID-19 vaccines were provided to the public for free, and not by state Medicaid programs. Consequently, Medicaid didn't always know which of its beneficiaries had received the vaccines. We reviewed 6 state Medicaid programs and found that 4 of them got vaccination data on...
Military Justice: Quality Data Needed to Improve Oversight of Navy and Marine Corps Disciplinary Measures
The Navy and the Marine Corps may impose punishments—such as extra duties or loss of pay—against service members for minor offenses. Commanding officers at sea may discipline service members via the "vessel exception" that prohibits service members from refusing punishment by demanding a trial. The Navy and the Marine Corps report data on these punishments. But data on use of the "vessel exception" may be...
Federal Food Purchases: Buying from Small Businesses and Local Sources
This Q&A report discusses federal food purchases for places like schools and military bases. The Agricultural Marketing Service and Defense Logistics Agency are the two largest federal purchasers, awarding billions of dollars in contracts annually to procure food. The agencies are generally required to buy domestic food—but they aren't required to buy locally grown food. Agency documentation suggests that they both attempt to source, or...
Civil Monetary Penalties: Federal Agencies' Compliance with the 2023 Annual Inflation Adjustment Requirements
When enforcing regulations, federal agencies use fines to hold violators accountable and to deter future violations. But if agencies don't regularly adjust these fines for inflation, they may become less effective deterrents. Congress enacted the Federal Civil Penalties Inflation Adjustment Act of 1990 partly to address this issue. In 2015, Congress amended the act to require GAO to annually review agencies' compliance with certain provisions...
Cybersecurity: Implementation of Executive Order Requirements is Essential to Address Key Actions
In 2021, the President issued an executive order to help protect federal IT systems from cyberattacks. The order contains 55 leadership and oversight requirements. DHS's Cybersecurity and Infrastructure Security Agency, the National Institute of Standards and Technology, and the Office of Management and Budget are responsible for implementing them. These agencies have fully completed 49 of 55 requirements. Remaining requirements include improving software that is...
Discretionary Grants: DOT Should Improve Clarity and Transparency of Program Management
The nation's people and freight depend on an aging transportation system to keep moving. The Department of Transportation administers billions of dollars in competitive grants to improve it. As the cost of transportation repairs exceeds the available funding, this Snapshot highlights the importance of using this money wisely. But we previously found that DOT's processes for reviewing grant applications and making award decisions wasn't documented...
Electronic Health Records: DOD Has Deployed New System but Challenges Remain
DOD provides crucial health care services to millions of service members, retirees, and their families. DOD has been working to modernize how it handles patients' electronic health records and has deployed a new electronic records system to its health care facilities. In 2022, DOD began conducting an annual survey of user satisfaction with this new system. User satisfaction rates have improved over the past 2...
Foreign Investment in the U.S.: Efforts to Mitigate National Security Risks Can Be Strengthened
Foreign investment in U.S. companies benefits the economy but can also pose national security risks—such as by giving foreign investors access to sensitive data. The Committee on Foreign Investment in the U.S. reviews these investments and enters into agreements with companies to address risks. Over the last decade, the number of agreements has quadrupled and the work of monitoring and enforcing compliance has grown. But...
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Retirement Security: The U.S. Virgin Islands' Pension Plan Faces Risks Paying Government Employee Benefits
The U.S. Virgin Islands' Government Employees' Retirement System remains one of the lowest funded public pension plans in the U.S. While most public plans in our review had enough funding to cover 60 to 111% of plan liabilities as of 2021, USVI's plan had enough to cover about 10%. The USVI government secured additional funding for the plan through an excise tax on rum in...
Aviation Safety: Federal Efforts to Address Unauthorized Drone Flights Near Airports
The Federal Aviation Administration prohibits unauthorized drone flights near airports because they can pose safety risks to other aircraft and disrupt air traffic control. Local authorities respond to these incidents with assistance from the federal government, if needed. Some federal agencies have authority to use drone detection and counter-drone technologies, in certain situations. The military has used these technologies for many years and FAA is...
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Restrictive Housing: Actions Needed to Enhance BOP and ICE Management and Oversight
We testified about our prior work related to use of restrictive housing, formerly referred to as "solitary confinement," in federal prison and detention facilities. In some cases, this includes isolating 1-2 people in cells for nearly 24 hours per day. The Bureau of Prisons uses restrictive housing for about 8% of its prison population each year—about 11,000 people in FY 2023. U.S. Immigration and Customs...
Fraud Risk Management: 2018-2022 Data Show Federal Government Loses an Estimated $233 Billion to $521 Billion Annually to Fraud, Based on Various Risk Environments
No area of the federal government is immune to fraud. We estimated that the federal government could lose between $233 billion and $521 billion annually to fraud. Given the scope of this problem, a government-wide approach is required to address it. The Office of Management and Budget, working with agencies and the oversight community, should develop guidance to improve fraud-related data—providing a more uniform approach...
Medicare and Medicaid: Additional Actions Needed to Enhance Program Integrity and Save Billions
Both Medicare and Medicaid are susceptible to payment errors—over $100 billion worth in 2023. Known as "improper payments," these are payments that are either made in an incorrect amount or should not have been made at all. We testified about our numerous recommendations to CMS and Congress that reduced improper payments, enhanced program integrity, and saved billions of dollars in Medicare and Medicaid. Other recommendations...
Counternarcotics: DOD Should Improve Coordination and Assessment of Its Activities
According to the U.S. government, illicit drugs and the criminal organizations that produce and traffic them are a significant threat. DOD leads federal efforts to monitor the air and water transport of drugs like cocaine and fentanyl into the U.S. DOD set up a joint operation area including the western U.S. border and parts of Latin America. But 3 of DOD's regional components' areas of...
Homeland Security: DHS Internal Entities Facilitate Information Sharing in Key Areas and Collaborate as Needed
Nine formal groups within the Department of Homeland Security routinely share information to advise leaders, guide internal policies, and identify potential threats. We found no unnecessary duplication among the groups, but some of their purposes and activities had the potential for overlap. Agency officials said groups collaborate to avoid duplication. For example, the Homeland Security Intelligence Council—composed of less-senior staff than the Counter Threats Advisory...
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Prescription Drugs: Selected States' Regulation of Pharmacy Benefit Managers
Private health plans contract with pharmacy benefit managers—companies that help oversee prescription drug benefits and control costs. We studied 5 states that have laws to regulate these companies. We found, for example, that all 5 states regulated the companies' drug pricing and pharmacy payments—including by limiting companies' use of manufacturer rebates and their ability to pay pharmacies less than health plans are charged. State regulators...
Persistent Chemicals: Navy Efforts to Address PFAS at Joint Base Pearl Harbor-Hickam
PFAS—a group of synthetic chemicals called per- and polyfluoroalkyl substances—are used in firefighting foams and other products. Some PFAS are linked to environmental contamination and human health problems. This Q&A covers our work on the Department of Defense's detection and treatment of PFAS contamination at Joint Base Pearl Harbor-Hickam in Hawaii. In 2022, 1,300 gallons of firefighting foam was accidentally released there. As of February...
F-35 Sustainment: Costs Continue to Rise While Planned Use and Availability Have Decreased
The F-35 aircraft is DOD's most advanced and costly weapon system. DOD currently has about 630 F-35s, plans to buy about 1,800 more, and intends to use them through 2088. We reported in this Q&A that DOD's projected costs to sustain the F-35 fleet keep increasing—from $1.1 trillion in 2018 to $1.58 trillion in 2023. Yet DOD plans to fly the F-35 less than originally...
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Military Health Care: DOD Should Improve Its Process for Clinical Adverse Actions against Providers
The Defense Health Agency investigates concerns about the quality and safety of care that individual health care providers deliver in DOD medical facilities. If DHA finds evidence for those concerns, it can prohibit providers from DOD facilities or limit the services they can provide. DHA must also report the provider to a federal database that hospitals and others can use to screen providers. But DHA...