Archive for March, 2011

New From the GAO

March 31, 2011 Comments off

New GAO Reports, Correspondence and Testimonies (PDFs)
Source: Government Accountability Office
31 March 2011


1. State and Local Governments: Knowledge of Past Recessions Can Inform Future Federal Fiscal Assistance. GAO-11-401, March 31.  Highlights

2. Medicaid: Improving Responsiveness of Federal Assistance to States during Economic Downturns. GAO-11-395, March 31.  Highlights

3. 2011 Tax Filing: IRS Dealt with Challenges to Date but Needs Additional Authority to Verify Compliance. GAO-11-481, March 29.

4. Tax Preparer Regulation: IRS Needs a Documented Framework to Achieve Goal of Improving Taxpayer Compliance. GAO-11-336, March 31.  Highlights

5. Refugee Assistance: Little Is Known about the Effectiveness of Different Approaches for Improving Refugees’ Employment Outcomes. GAO-11-369, March 31.  Highlights


1. Federal Reserve Banks: Areas for Improvement in Information Systems Controls. GAO-11-447R, March 31.


1. H-1B Visa Program: Multifaceted Challenges Warrant Re-examination of Key Provisions, statement for the record by Andrew Sherrill, director, education, workforce, and income security, before the Subcommittee on Immigration Policy and Enforcement, House Committee on the Judiciary. GAO-11-505T, March 31.

2. Border Security: DHS Progress and Challenges in Securing the U.S. Southwest and Northern Borders, by Richard M. Stana, director, homeland security and justice issues, before the Senate Committee on Homeland Security and Governmental Affairs. GAO-11-508T, March 30.  Highlights

Review of VBA’s Pension Management Centers

March 31, 2011 Comments off

Review of VBA’s Pension Management Centers (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General

We conducted this review to determine if the Veterans Benefits Administration’s (VBA) Pension Management Centers (PMCs) ensure that pensioners receive timely benefit payments. We also assessed the implementation of prior recommendations from OIG’s FY 2007 audit of VBA’s Pension Maintenance Program. PMCs assumed processing responsibilities for live and death pension applications and Dependency and Indemnity Compensation in FY 2008 and 2009, respectively. This change increased the claims processing workload significantly at the PMCs. We found VBA did not process original death pension claim benefits timely because PMCs were not adequately prepared to process additional claims added to their workload from VA Regional Offices in FYs 2008 and 2009. In addition, VBA did not process Internal Revenue Service and Social Security Administration Income Verification Matches (IVM) timely, which resulted in overpayments. Lastly, VBA’s PMC performance measures in the Performance and Accountability Report do not adequately measure all the work processed. VBA has taken sufficient measures to address prior OIG recommendations. We identified an opportunity for VBA to ensure IVM actions are processed timely that can potentially save $205 million in overpayments. We recommended establishment of an operational plan to ensure PMCs efficiently and effectively manage the workload. VBA also needs to establish timeliness performance standards for completing Income Verification Matches to reduce overpayments, and to modify the Performance and Accountability Report performance measures to reflect the current workload and ensure transparency over actual performance. The Acting Under Secretary for Benefits agreed with our report findings and recommendations and plans to complete all corrective actions by November 30, 2011.

Report to nation finds continued declines in many cancer rates; special feature highlights changes in brain tumor rates and survival

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Report to nation finds continued declines in many cancer rates; special feature highlights changes in brain tumor rates and survival
Source: National Cancer Institute

Rates of death in the United States from all cancers for men and women continued to decline between 2003 and 2007, the most recent reporting period available, according to the latest Annual Report to the Nation on the Status of Cancer. The report also finds that the overall rate of new cancer diagnoses for men and women combined decreased an average of slightly less than 1 percent per year for the same period.

A graph with two lines, one in blue showing lung cancer death rates peaking for men in the 1980s and another in red showing lung cancer death rates for women just starting to decline in 2007The drop in cancer death rates continues a trend that began in the early 1990s. The report finds, for the first time, lung cancer death rates decreased in women, more than a decade after rates began dropping in men.

The report is co-authored by researchers from the North American Association of Central Cancer Registries (NAACCR), the National Cancer Institute (NCI), part of the National Institutes of Health, the Centers for Disease Control and Prevention, and the American Cancer Society. It appeared online March 31, 2011, in the Journal of the National Cancer Institute, and in print on May 4, 2011.

Of special note, childhood cancer incidence rates (rates of new diagnoses) continued to increase while death rates in this age group decreased. Childhood cancer is classified as cancers occurring in those 19 years of age or younger.

Overall cancer incidence rates in men were essentially unchanged. There was a very small uptick in prostate cancer rates, and if these rates were excluded from the analysis, there would be a continued decline in overall male incidence rates.

In the Special Feature section of the report, the authors explore the diversity of brain tumors and other nervous system cancers beyond those that are identified as malignant, including those that are borderline and benign. The researchers analyzed data between 2004 and 2007 and found that in adults, non-malignant tumors were about twice as common as malignant tumors.

+ Full Report (PDF)
+ Annual Report to the Nation on the Status of Cancer, 1975-2007, Featuring Trends in Brain Cancer: Questions and Answers

Guide for Implementing or Enhancing an Endangered Missing Advisory

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Guide for Implementing or Enhancing an Endangered Missing Advisory (PDF)
Source: Office of Juvenile Justice and Delinquency Prevention (DoJ)

The unauthorized absence of a child from the home is a family crisis that requires immediate and collaborative attention. Over the past two decades the AMBER Alert Program has grown into a nationally coordinated effort under the Office of Justice Programs, which has significantly improved the strategies and the methods for recovering endangered and abducted children. More than 500 children have been returned home as a result of AMBER Alert plans, which have been established in every state.

Despite such progress, however, gaps remain in the recovery of missing children whose cases do not meet the strict criteria for AMBER Alert and of missing adults, whose cases are not covered by AMBER Alert. To assist communities in closing these gaps, the Office of Juvenile Justice and Delinquency Prevention has initiated a project to help states, communities, and law enforcement agencies develop a strategy in which the Endangered Missing Advisory (EMA) plays a crucial role.

This guide provides AMBER Alert coordinators, law enforcement, and public safety professionals with an effective and efficient way to implement an EMA plan. It offers recommendations to assist law enforcement in developing strategies to recover missing children and adults and includes relevant findings to inform policymakers’ efforts to address the problem.

Workplace Violence 1993-2009

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Workplace Violence 1993-2009
Source: Bureau of Justice Statistics

Presents information on violence in the workplace against employed persons based on the Bureau of Justice Statistics’ National Crime Victimization Survey and the Bureau of Labor Statistics’ Census of Fatal Occupational Injuries. This report includes both nonfatal and fatal forms of violence. Comparisons are made with violence against unemployed persons and violence against employed persons outside of the workplace. Information on type of workplace violence is included. Also discussed is violence by occupation as well as information on victim and crime characteristics such as gender and race distribution, offender weapon use, police notification, and victim injury.

Highlights include the following:

  • From 2002 to 2009, the rate of nonfatal workplace violence has declined by 35%, following a 62% decline in the rate from 1993 to 2002.
  • Between 2005 and 2009, law enforcement officers, security guards, and bartenders had the highest rates of nonfatal workplace violence.
  • Among workplace homicides that occurred between 2005 and 2009, about 28% involved victims in sales and related occupations and about 17% involved victims in protective service occupations.

+ Full Report (PDF)

Federal Agencies Address Legal Issues Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program

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Federal Agencies Address Legal Issues Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program
Source: U.S. Department of Health and Human Services, Office of Inspector General
From e-mail:

Today, as part of a cross-agency, coordinated effort, several Federal
agencies issued documents addressing legal issues regarding Accountable
Care Organizations participating in the Medicare Shared Savings Program
(Shared Savings Program).

The Centers for Medicare & Medicaid Services (CMS) issued a proposed
rule that would establish accountable care organizations (ACO) under the
Shared Savings Program. The CMS proposed rule is available online at

CMS and HHS Office of Inspector General (OIG) jointly issued a notice
with comment period outlining proposals for waivers of certain Federal
laws-the physician self-referral law, the anti-kickback statute, and
certain provisions of the civil monetary penalty law-in connection with
the Shared Savings Program. CMS and OIG are also asking for comments on
further waiver design considerations for the Shared Savings Program and
for the separate waiver authority for the Center for Medicare and
Medicaid Innovation under section 1115A of the Social Security Act. The
joint notice with comment period is available online at

The Federal Trade Commission and the Department of Justice jointly
issued a “Proposed Statement of Enforcement Policy Regarding Accountable
Care Organizations Participating in the Medicare Shared Savings Program”
(Antitrust Policy Statement). The Antitrust Policy Statement is
available online at:

And the Internal Revenue Service (IRS) issued a notice requesting
comments regarding the need for guidance on participation by tax-exempt
organizations in the Shared Savings Program through ACOs. The IRS notice
is available online at,,id=222814,00.html

CBO’s Analysis of the Major Health Care Legislation Enacted in March 2010 (Testimony)

March 31, 2011 Comments off

CBO’s Analysis of the Major Health Care Legislation Enacted in March 2010 (PDF)
Source: Congressional Budget Office
From CBO Director’s Blog:

Effects of the Legislation on Insurance Coverage and on the Federal Budget

  • Number of People with Insurance Coverage: We estimate that the legislation will increase the number of nonelderly Americans with health insurance by roughly 34 million in 2021. About 95 percent of legal nonelderly residents will have insurance coverage in that year, compared with a projected share of 82 percent in the absence of that legislation and 83 percent currently. The legislation will generate this increase through a combination of a mandate for nearly all legal residents to obtain health insurance; the creation of insurance exchanges through which certain people will receive federal subsidies; and a significant expansion of Medicaid.
  • Costs of Expanded Insurance Coverage: According to our latest estimate, the provisions of the laws related to health insurance coverage will have a net cost to the Treasury from changes in direct spending and revenues of $1.1 trillion during the 2012-2021 decade. (Direct spending is that which is not controlled by annual appropriation acts.) That amount is larger than CBO’s original estimate of the cost of those provisions during the 2010-2019 decade that represented the 10-year budget window when the original estimate was produced. The increase owes almost entirely to the shift in the budget window; as you can see in the figure below, the revisions in any single year are quite small. Over the eight-year period (2012-2019) that is common to our original analysis and the most recent one, the net cost of the coverage provisions is now 2 percent higher than CBO and JCT estimated in March 2010.

Comparison of CBO’s 2010 and 2011 Estimates for PPACA and the Health Care Provisions of the Reconciliation Act

(Billions of dollars, by fiscal year)