GAO Lists Areas to Improve Tax Compliance, Enforcement
GAO-15-404SP
- Institutional AuthorsGovernment Accountability Office
- Code Sections
- Subject Area/Tax Topics
- Jurisdictions
- LanguageEnglish
- Tax Analysts Document NumberDoc 2015-8860
- Tax Analysts Electronic Citation2015 TNT 72-17
April 14, 2015
Congressional Addressees
The gap between federal revenue and spending has created a long-term fiscal imbalance.1 Absent fiscal policy changes, this imbalance leads to continuous growth in federal debt that is unsustainable. Addressing this imbalance will require long-term changes to both spending and revenue, which will likely require difficult fiscal policy decisions. Significant action to mitigate this imbalance must be taken soon to minimize the disruption to individuals and the economy.
In the near term, executive branch agencies and Congress can act to improve the efficiency and effectiveness of government programs and activities. Opportunities to take action exist in areas where federal programs or activities are fragmented, overlapping, or duplicative. To bring these opportunities to light, Congress included a provision in statute for GAO to identify and report annually to Congress on federal programs, agencies, offices, and initiatives -- either within departments or government-wide -- that have duplicative goals or activities.2 As part of this work, we also identify additional opportunities to achieve greater efficiency and effectiveness that result in cost savings or enhanced revenue collection.
In our first four annual reports issued from 2011 through 2014, we presented 188 areas where opportunities existed for executive branch agencies or Congress to reduce, eliminate, or better manage fragmentation, overlap, or duplication; achieve cost savings; or enhance revenue.3 Figure 1 outlines the definitions we use for fragmentation, overlap, and duplication for this work. In these first four reports, we identified approximately 440 actions that executive branch agencies and Congress could take to address the opportunities for greater efficiency and effectiveness that we identified.
Figure 1: Definitions of Fragmentation, Overlap, and
Duplication
Source: GAO | GAO-15-404SP
This report is our fifth in the series, and it identifies additional areas where a broad range of federal agencies may be able to achieve greater efficiency or effectiveness. For each area, we suggest actions that the executive branch or Congress could take to reduce, eliminate, or better manage fragmentation, overlap, or duplication, or achieve other financial benefits. In addition to identifying new areas, we have continued to monitor the progress executive branch agencies and Congress have made in addressing the areas we previously identified. In 2013, we launched GAO's Action Tracker, a publicly accessible website that allows executive branch agencies, Congress, and the public to track the progress the government is making in addressing the issues we have identified. We plan to add areas and suggested actions identified in future reports to GAO's Action Tracker and periodically update the status of all identified areas and activities.
Section I of this report presents new areas in which we found evidence that fragmentation, overlap, or duplication exists among federal programs or activities. Although it may be appropriate for multiple agencies or entities to be involved in the same programmatic or policy area due to the nature or magnitude of the federal effort, the instances of fragmentation, overlap, or duplication we describe in Section I occur in areas where multiple programs and activities may be creating inefficiencies. Section II describes new areas where the federal government may achieve cost savings or enhance revenue collections. This report is based upon work GAO previously conducted in accordance with generally accepted government auditing standards or GAO's quality assurance framework.4 See appendix II for more information on our scope and methodology.
New Opportunities Exist to Improve Efficiency and Effectiveness Identified across the Federal Government
In this report, we present 66 actions that the executive branch or Congress could take to improve efficiency and effectiveness across 24 areas that span a broad range of government missions and functions. We suggest 20 actions to address 12 new areas in which we found evidence of fragmentation, overlap, or duplication in government missions such as agriculture, defense, health, homeland security, information technology, international affairs, and science and the environment. In addition, we present 46 opportunities for executive branch agencies or Congress to take actions to reduce the cost of government operations or enhance revenue collections for the U.S. Treasury across 12 areas of government.
20 Suggested Actions to Address New Evidence of Fragmentation, Overlap, or Duplication in 12 Areas
We consider programs or activities to be fragmented when more than one federal agency (or more than one organization within an agency) is involved in the same broad area of national need, which may result in inefficiencies in how the government delivers services, including the following example:
Consumer Product Safety Oversight: Oversight of consumer product safety involves at least 20 federal agencies, including the Consumer Product Safety Commission (CPSC), resulting in fragmented oversight across agencies. Although agencies reported that the involvement of multiple agencies with various expertise can help ensure more comprehensive oversight by addressing a range of safety concerns, they also noted that fragmentation can result in unclear roles and potential regulatory gaps. In addition, we found that although the agencies we reviewed for a November 2014 report collaborated on a variety of issues, they also reported that they face challenges when they work collaboratively. These challenges include staying informed about the regulatory activities of other agencies, coordinating on jurisdictional issues, and considering options to share data rather than purchasing the same data under multiple contracts.
Although a number of agencies have an oversight role in consumer product safety, no single entity has the expertise or authority to address the full scope of product safety activities. Moreover, some oversight agencies are independent regulatory agencies and not subject to the Office of Management and Budget's (OMB) interagency planning process and review of draft rules within the executive branch. In past work, GAO has noted that interagency mechanisms or strategies to coordinate programs that address crosscutting issues may reduce potentially duplicative, overlapping, and fragmented efforts. To strengthen coordination and achieve greater efficiency in oversight across consumer product safety agencies more broadly, we suggested that Congress consider establishing a formal comprehensive oversight mechanism for consumer product safety agencies to address crosscutting issues as well as inefficiencies related to fragmentation and overlap such as communication and coordination challenges and jurisdictional questions between agencies. Mechanisms could include, for example, formalizing relationships and agreements among consumer product safety agencies or establishing a task force or interagency work group. CPSC, the Department of Homeland Security (DHS), the Department of Housing and Urban Development, and the Department of Commerce's National Institute of Standards and Technology agreed with GAO's matter for congressional consideration, while the remaining agencies neither agreed nor disagreed.
Fragmentation can also be a harbinger for overlap or duplication. Overlap occurs when multiple agencies or programs have similar goals, engage in similar activities or strategies to achieve them, or target similar beneficiaries. We found overlap among federal programs or initiatives in a variety of areas, including the following:
Nonemergency Medical Transportation: Forty-two programs across six different federal departments provide nonemergency medical transportation (NEMT) to individuals who cannot provide their own transportation due to age, disability, or income constraints.5 For example, NEMT programs at both Medicaid, within the Department of Health and Human Services (HHS), and the Department of Veterans Affairs (VA) have similar goals (to help their respective beneficiaries access medical services), serve potentially similar beneficiaries (those individuals who have disabilities, are low income, or are elderly), and engage in similar activities (providing NEMT transportation directly or indirectly).
We found a number of challenges to coordination for these programs. For example, Medicaid and VA largely do not participate in NEMT coordination activities in the states we visited, in part because both programs are designed to serve their own populations of eligible beneficiaries. We also found that using certain coordination strategies -- in particular, cost or ride sharing -- could increase the risk of Medicaid funds being spent for individuals who do not qualify for Medicaid benefits. Without proper controls, cost or ride sharing with other non-Medicaid programs could allow for improper payments for individuals who do not qualify for Medicaid. Because Medicaid and VA are important to NEMT, as they provide services to potentially over 90 million individuals, greater interagency cooperation is needed to enhance services to transportation-disadvantaged individuals. An interagency coordinating council was developed to enhance federal, state, and local coordination activities, and it has taken some actions to address human service-transportation program coordination. However, the council has provided limited leadership and has not convened since 2008. For example, the council has not issued key guidance documents that could promote coordination, including an updated strategic plan.
To improve efficiency, we recommended that the Department of Transportation, which chairs the interagency coordinating council, should take steps to enhance coordination among the programs that provide NEMT. In response to this recommendation, DOT agreed that more work is needed to increase coordination activities with all HHS agencies, especially the Centers for Medicare & Medicaid Services (CMS). DOT also said the Federal Transit Administration is asking its technical assistance centers to assist in developing responses to NEMT challenges.
In other aspects of our work, we found evidence of duplication, which occurs when two or more agencies or programs are engaged in the same activities or provide the same services to the same beneficiaries. We found duplication among federal programs or initiatives in a variety of areas, including the following:
DOD US Family Health Plan: The US Family Health Plan (USFHP) -- a statutorily required component of the Department of Defense's (DOD) Military Health System -- duplicates the same TRICARE Prime benefit that is offered to military beneficiaries by DOD managed care support contractors.6 The USFHP was initially incorporated into the Military Health System in 1982 when Congress enacted legislation transferring ownership of certain U.S. Public Health Service hospitals to specific health care providers, referred to as designated providers under the program. During the implementation of the TRICARE program in the 1990s, Congress required the designated providers to offer the TRICARE Prime benefit to their enrollees in accordance with the National Defense Authorization Act (NDAA) for Fiscal Year 1997. Today, the USFHP remains a health care option required by statute to be available to eligible beneficiaries in certain locations, despite TRICARE's national presence through the managed care support contractors. However, the USFHP has largely remained unchanged, and its role has not since been reassessed within the Military Health System.
DOD contracts with managed care support contractors to administer TRICARE Prime -- TRICARE's managed care option -- in three regions in the United States (North, South, and West). Separately, TRICARE Prime is offered through the USFHP by designated providers in certain locations within the same three TRICARE regions that are served by a managed care support contractor. Thus, the USFHP offers military beneficiaries the same TRICARE Prime benefit that is offered by the managed care support contractors across much of the same geographic service areas and through many of the same providers. As a result, DOD has incurred added costs by paying the USFHP designated providers to simultaneously administer the same TRICARE Prime benefit to the same population of eligible beneficiaries in many of the same locations as the managed care support contractors. To eliminate this duplication within DOD's health system and potentially save millions of dollars, we suggested that Congress terminate the statutorily required USFHP.
EPA's and FDA's Laboratory Inspections: The Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA) within HHS may be duplicating each other's work by inspecting the same laboratories. Although EPA and FDA entered into an interagency agreement to collaborate on laboratory inspections in 1984, the agreement was not renewed in 2004 and formal communication ended by 2007. We found in May 2014 that they do not regularly communicate about scheduled inspections or share results from completed inspections.7 For example, one laboratory in Maryland was inspected by both EPA and FDA eight times from fiscal year 2005 to fiscal year 2012. A representative from this laboratory told us that some of the information in the laboratory's toxicology studies FDA officials examined during a 2011 inspection could have been shared with EPA officials. By not collaborating and communicating regularly, EPA and FDA may be missing opportunities to improve efficiency and effectiveness. For example, if EPA knew in advance that a laboratory was recently inspected by FDA, EPA inspectors could use FDA's inspection results to inform their decision regarding whether to conduct their own inspection. Moreover, information-sharing between agencies could help them leverage limited resources, because each agency can only inspect a certain number of laboratories each year.
To avoid potentially duplicative inspections and use limited resources more efficiently, we recommended that EPA and FDA take actions to regularly collaborate and share information on laboratory inspections through a formal written agreement such as a memorandum of understanding that outlines how the two agencies plan to regularly collaborate and share information on inspections. In response to our recommendation, EPA agreed to work with FDA to develop written procedures that outline how EPA and FDA plan to collaborate and share information on laboratory inspections. However, EPA stated that it did not agree that a formal memorandum of understanding between the two agencies was necessary. We agree and note that we did not prescribe the type of agreement the agencies should undertake and offered a memorandum of understanding as one example. FDA agreed with our recommendation but reiterated that there are legitimate reasons why some laboratory inspections may be conducted by both agencies at a single laboratory within a short period of time.
46 New Actions to Reduce Costs or Enhance Revenues Identified in 12 Areas
We suggest 46 actions that the executive branch and Congress can take to reduce the cost of government operations and enhance revenue collections for the U.S. Treasury in 12 areas. Examples of these actions include rescinding unobligated funds, re-examining the appropriate size of the Strategic Petroleum Reserve, modifying the way Medicare pays certain cancer hospitals, and increasing tax revenue collections.
Rescinding unobligated funds: Congress may wish to consider permanently rescinding the entire $1.6 billion balance of the U.S. Enrichment Corporation (USEC) Fund, a revolving fund in the U.S. Treasury. As part of a 2001 GAO legal opinion, we determined that the USEC Fund was available for two purposes, which have been fulfilled: (1) environmental clean-up expenses associated with the disposition of depleted uranium at two specific facilities and (2) expenses of USEC privatization. Regarding the first authorized purpose, the construction of intended facilities associated with the disposition of depleted uranium has been completed. Regarding the second authorized purpose, USEC privatization was completed in 1998 when ownership of USEC was transferred to private investors. In an April 2014 report to Congress, the Department of Energy's (DOE) National Nuclear Security Administration stated that the USEC Fund was one of two sources of funding that it was exploring to finance research, development, and demonstration of national nuclear security-related enrichment technologies. However, this is not one of the authorized purposes of the USEC Fund. Transparency in budget materials is important for informing congressional decisions, and DOE's efforts to utilize USEC Fund monies instead of general fund appropriations diminish that transparency. The House of Representatives included language to permanently rescind the USEC Fund in H.R. 4923, Energy and Water Development and Related Agencies Appropriations Act, which passed the House on July 10, 2014. However, the rescission was not included in Public Law 113-235, Consolidated and Further Continuing Appropriations Act, 2015. As of March 2015, legislation containing a similar rescission had not been introduced in the 114th Congress.
Re-examining the appropriate size of the Strategic Petroleum Reserve: DOE should assess the appropriate size of the Strategic Petroleum Reserve (SPR) to determine whether excess crude oil could be sold to fund other national priorities. The United States holds the SPR so that it can release oil to the market during supply disruptions to protect the U.S. economy from damage. After decades of generally falling U.S. crude oil production, technological advances have contributed to increasing U.S. production. Monthly crude oil production has increased by almost 68 percent from 2008 through April 2014, and increases in production in 2012 and 2013 were the largest annual increases since the beginning of U.S. commercial crude oil production in 1859, according to the Energy Information Administration (EIA).8
As of September 2014, the reserve had 106 days of imports, which DOE estimated was valued at about $45 billion as of December 2014. As a member of the International Energy Agency, the United States is required to maintain public and private reserves of at least 90 days of net imports and to release these reserves and reduce demand during oil supply disruptions. We found in September 2014 that DOE had taken steps to assess aspects of the SPR but had not recently reexamined its size. Without such a reexamination, DOE cannot be assured that the SPR is holding an appropriate amount of crude oil. If, for example, DOE found that 90 days of imports was an appropriate size for the SPR, it could sell crude oil worth $6.7 billion and use the proceeds to fund other national priorities. In addition, by reducing the SPR to 90 days, DOE may be able to reduce its operating costs by about $25 million per year.9 DOE concurred with our recommendation, stating that a broad, long-range review of the SPR is needed and that it has initiated a process for conducting a comprehensive reexamination of the appropriate size of the SPR.
Modifying the way Medicare pays certain cancer hospitals: To better control Medicare spending and generate cost savings of almost $500 million per year, Congress should consider changing Medicare's payment methods for certain cancer hospitals. Medicare pays the majority of hospitals using an approach known as the inpatient and outpatient prospective payment systems (PPS). Under a PPS, hospitals are paid a predetermined amount based on the clinical classification of each service they provide to beneficiaries. Beginning in 1983, in response to concern that certain cancer hospitals would experience payment reductions under such a system, Congress required the establishment of criteria under which 11 cancer hospitals are currently exempted from the inpatient PPS and receive payment adjustments under the outpatient PPS. Since these cancer hospitals were first established in the early 1980s, cancer care and Medicare's payment system have changed significantly. Advances in techniques and drugs have increased treatment options and allowed for more localized delivery of care. Along with these developments, the primary setting for cancer care has shifted from the inpatient setting to the outpatient setting. In addition, Medicare's current payment system better recognizes the resource intensity of hospital care than the system put in place in 1983.
While most hospitals are paid a predetermined amount based on the clinical classification of each service they provide to beneficiaries, Medicare generally pays these 11 cancer hospitals based on their reported costs, providing little incentive for efficiency. We found that if beneficiaries who received care at the 11 cancer hospitals had received inpatient and outpatient services at nearby PPS teaching hospitals, Medicare might have realized substantial savings in 2012. Specifically, we estimated inpatient savings of about $166 million; we calculated outpatient savings of about $303 million if forgone payment adjustments were returned to the Medicare Trust Fund.10 Until Medicare pays these cancer hospitals in a way that encourages greater efficiency, Medicare remains at risk for overspending.
Increasing tax revenue collections: Our 2015 annual report includes 21 actions that the federal government should take to potentially enhance tax revenue in the billions of dollars. Reducing the tax gap -- the difference between taxes owed and taxes paid on time -- by 1 percent through improved collections could increase tax revenues by almost $4 billion annually. Given that individual income tax misreporting accounts for the largest portion of the estimated annual $385 billion net tax gap, even small changes in IRS's enforcement programs could result in hundreds of millions of dollars of increased revenue.
Specifically, we recommended that IRS develop and implement a strategy to better estimate the extent and nature of misreporting by partnerships and S corporations and the effectiveness of partnership examinations in detecting this misreporting.11 In May 2014, we reported that IRS does not know the full extent of partnership and S corporation income misreporting. We estimated a rough order of magnitude of partnership and S corporation income misreported by individuals to be $91 billion per year in lost tax revenue for tax years 2006 through 2009. Further, IRS has limited information on the effectiveness of its examinations in detecting income misreporting by partnerships. For example, IRS estimated that 3 percent to 22 percent of identified misreporting by partnerships was double counted due to income flowing from one partnership to another or to other related parties. Without reliable information on the extent of partnership misreporting, or the results of its partnership examinations, IRS cannot make fully informed decisions about whether its allocation of enforcement resources across business types is justified. IRS stated that it had not fully evaluated our recommendations but said it would consider all of our recommendations and identify appropriate IRS actions while keeping resource limitations in mind.
In addition to the new areas presented in this year's annual report, we identified new actions from recently issued work that address six issues presented in our 2011-2013 annual reports. These areas include federal oversight of food safety, DOD joint basing operations and efficiency, DOD-VA electronic health records, geospatial investments, tax expenditures, and new markets tax credit. In particular, in our 2011 annual report, we reported that federal tax revenue losses for the New Markets Tax Credit (NMTC) were over $700 million for 2010, according to the Department of the Treasury (Treasury), and recommended that Congress consider converting the NMTC to a grant program to increase the equity that could be placed in low-income businesses and significantly reduce the $3.8 billion, 5-year revenue cost of the program. In 2014, we reviewed the financial structures of NMTC projects and recommended that Treasury issue further guidance on how other government programs can be combined with NMTCs; ensure adequate controls to limit the risks of unnecessary duplication and above-market rates of return; and ensure that more complete and accurate data are collected on fees and costs, the equity remaining in the business after 7 years, and loan performance.12 We will track the status of these and the other new actions through GAO's Action Tracker. See appendix III for a list of the new actions added to these six areas.
Finally, in addition to issues identified in our annual reports, in our February 2015 high-risk series update, we identified options to help reduce the risk of tax refund fraud due to identity theft.13 Identity theft occurs when an identity thief files a fraudulent tax return using a legitimate taxpayer's identifying information and claims a refund. IRS estimates it paid out $5.8 billion (the exact number is uncertain) in fraudulent refunds in filing season 2013 due to identity theft. While there are no simple solutions to combating identity refund fraud, we identified various options that could help, some of which would require legislative action. Because some of these options represent a significant change to the tax system that could likely burden taxpayers and impose significant costs to IRS for systems changes, it is important for IRS to assess the relative costs and benefits of the options. This assessment will help ensure an informed discussion among IRS and relevant stakeholders -- including Congress -- on the best option (or set of options) for preventing identity theft refund fraud.
Executive Branch Agencies and Congress Continue to Address Actions That Span the Federal Government
In addition to the new actions identified for this report, we have continued to monitor the progress that executive branch agencies or Congress have made in addressing the issues we identified in our last four reports. In our 2011-2014 annual reports, we identified approximately 440 actions that the executive branch and Congress could take to reduce, eliminate, or better manage fragmentation, overlap, or duplication or achieve other potential financial benefits.
Overall Progress on 2011-2014 Actions
Executive branch agencies and Congress have made progress in addressing a number of the actions we previously identified (fig. 2).14 In total, as of March 6, 2015, the date we completed our audit work, we found that 169 (37 percent) were addressed, 179 (39 percent) were partially addressed, and 90 (20 percent) were not addressed.15 An additional 46 actions have been assessed as addressed over the past year. These addressed actions include 13 actions identified in 2011, 14 actions identified in 2012, 11 actions identified in 2013, and 8 identified in 2014. See appendix IV for a list of all areas and the status of related actions.
Figure 2: Progress in Addressing 2011, 2012, 2013, and 2014
Actions as of the 2014 and 2015 Annual Reports
Source: GAO | GAO-15-404SP
Note: Actions assessed as "consolidated or other" are not assessed due to additional work or other information we considered. Additionally, 2014 actions were not assessed in 2014 since that was the year that the actions were identified.
We estimated that executive branch and congressional efforts to address suggested actions resulted in roughly $20 billion in financial benefits from fiscal years 2011 through 2014, with another approximately $80 billion in additional benefits projected to be accrued through 2023.16
Table 1 outlines a selection of our addressed actions that have resulted in or are expected to result in cost savings or enhanced revenue.
Table 1: Selected Addressed Actions with Associated Cost Savings
and Enhanced Revenues, 2011-2014
______________________________________________________________________
Annual report
2011
Addressed actions
Domestic Ethanol Production (Area 13): Congress allowed the Volumetric Ethanol Excise Tax Credit to expire at the end of 2011, which eliminated duplicative federal efforts directed at increasing domestic ethanol production and reduced revenue losses by $4.5 billion in fiscal year 2012 and $6.1 billion in fiscal year 2013.
Annual report
2011
Addressed actions
Farm Program Payments (Area 35): The Agricultural Act of 2014 eliminated direct payments to farmers and should save approximately $4.9 billion annually from fiscal year 2015 through fiscal year 2023, according to the Congressional Budget Office.
Annual report
2011
Addressed actions
Baggage Screening Systems (Area 78): The Transportation Security Administration (TSA) estimated that the agency saved a cumulative $104.5 million in personnel costs from fiscal years 2011 through 2013 from its efforts to replace or modify older checked baggage screening systems with more efficient in-line systems, as we suggested.
Annual report
2012
Addressed actions
Air Force Food Service (Area 33): In 2011, the Air Force issued a memorandum to the Major Commands directing a review of existing food service contracts. As a result, according to Air Force officials, the Air Force reviewed and renegotiated the food service contracts at eight installations for a total savings of over $2.5 million per year. In addition, according to Air Force officials, all food service contracts were validated again during fiscal year 2012 for additional savings of over $2.2 million per year. Air Force officials said that the Air Force will review contracts annually for areas where costs can be reduced.
Annual report
2012
Addressed actions
Overseas Defense Posture (Area 37): The United States Forces Korea conducted a series of consultations with the military services to evaluate the costs and benefits associated with tour normalization, as we suggested, and decided not to move forward with the full tour normalization initiative because it was not affordable. DOD's decision to not move forward with this initiative resulted in a cost avoidance of $3.1 billion from fiscal years 2012 through 2016.
Annual report
2012
Addressed actions
Passenger Aviation Security Fees (Area 48): The Bipartisan Budget Act of 2013 modifies the passenger security fee from its current per enplanement structure ($2.50 per enplanement with a maximum one-way-trip fee of $5.00) to a structure that increases the passenger security fee to a flat $5.60 per one-way-trip, effective July 1, 2014.a Pursuant to the act, collections under this modified fee structure will contribute to deficit reduction as well as to offsetting TSA's aviation security costs.b Specifically, the act identifies $12.6 billion in fee collections that, over a 10-year period beginning in fiscal year 2014 and continuing through fiscal year 2023, should contribute to deficit reduction.c Fees collected beyond those identified for deficit reduction are available, consistent with existing law, to offset TSA's aviation security costs. According to the House of Representatives and Senate Committees on the Budget, and notwithstanding amounts dedicated for deficit reduction, collections under the modified fee structure will offset about 43 percent of aviation security costs, compared to the approximate 30 percent currently offset under the existing fee structure.d
Annual report
2013
Addressed actions
Combat Uniforms (Area 2): Consistent with our recommendation, the Army chose not to introduce a new family of camouflage uniforms into its inventory, resulting in a cost avoidance of about $4.2 billion over 5 years.
Source: GAO. | GAO-15-404SP
FOOTNOTES TO TABLE 1
a See Pub. L. No. 113-67, § 601(b), 127 Stat. 1165, 1187 (2013), amending 49 U.S.C. § 44940(c).
b In addition, the first $250 million in fees collected each fiscal year are, consistent with existing law, to be deposited in the Aviation Security Capital Fund for use in supporting aviation security-related airport capital improvement projects or for other purposes specified in statute. See 49 U.S.C. §§ 44923(h), 44940(i).
c See 49 U.S.C. § 44940(i) (identifying, among other things, the specific amount to be credited as offsetting receipts and deposited in the general fund of the U.S. Treasury each fiscal year, 2014 through 2023).
d The Bipartisan Budget Act further revoked TSA's authority to collect the Aviation Security Infrastructure Security Fee, which TSA had been collecting from air carriers pursuant 49 U.S.C. § 44940(a)(2). See Pub. L. No. 113-67, § 601(a), 127 Stat. at 1187.
END OF FOOTNOTES TO TABLE 1
The following examples illustrate progress made by executive branch agencies and Congress in addressing our identified actions over the last 5 years.
Domestic Ethanol Production: In our 2011 annual report, we stated that the ethanol tax credit would cost about $5 billion in forgone revenues in 2011 and that Congress could reduce annual revenue losses by addressing duplicative federal efforts directed at increasing domestic ethanol production. To reduce these revenue losses, we suggested that Congress consider whether revisions to the ethanol tax credit were needed and suggested options to consider, including allowing the credit for the volumetric ethanol excise tax (for fuel blenders that purchase and blend ethanol with gasoline) to expire at the end of 2011. Congress allowed the tax credit to expire at the end of 2011.
Farm Program Payments: We reported in our 2011 annual report that Congress could save up to $5 billion annually by reducing or eliminating direct payments to farmers. These are fixed annual payments based on a farm's history of crop production. Farmers received them regardless of whether they grew crops and even in years of record income. Direct payments were expected to be transitional when first authorized in 1996, but subsequent farm bills continued these payments.17 Congress passed the Agricultural Act of 2014, which eliminated direct payments to farmers and should save approximately $4.9 billion annually from fiscal year 2015 through fiscal year 2023, according to the Congressional Budget Office.
Combat Uniforms: In our 2013 annual report, we found that DOD's fragmented approach could lead to increased risk on the battlefield for military personnel and increased development and acquisition costs. In response, DOD developed and issued guidance on joint criteria to help ensure that future service-specific uniforms will provide equivalent levels of performance and protection. In addition, a provision in the National Defense Authorization Act for Fiscal Year 2014 established as policy that the Secretary of Defense shall eliminate the development and fielding of service-specific combat and camouflage utility uniforms in order to adopt and field common uniforms for specific environments to be used by all members of the armed forces.18 Most recently, the Army chose not to introduce a new family of camouflage uniforms into its inventory, in part, because of this legislation, resulting in a cost avoidance of about $4.2 billion over 5 years.
Overseas Defense Posture: In our 2012 annual report, we suggested the Secretary of Defense should direct appropriate organizations within DOD to complete a business case analysis, including an evaluation of alternative courses of action, for the strategic objectives that have to this point driven the decision to implement tour normalization in South Korea -- that is, a DOD initiative to transform its defense posture in South Korea. DOD subsequently evaluated the costs and benefits and decided not to move forward with the full tour normalization initiative because it was not affordable. DOD's decision to not move forward with this initiative resulted in a cost avoidance of $3.1 billion from fiscal years 2012 through 2016. In addition, DOD fully addressed our recommended actions to develop comprehensive cost information and re-examine alternatives to planned initiatives. For example, the data that DOD reports to Congress now reflect all cost categories for new or ongoing funded posture initiatives in support of enduring operations that, according to DOD officials, have been approved by the Secretary of Defense. To further facilitate congressional oversight of plans to realign U.S. defense posture in the Pacific, DOD made corrective actions for mitigating financial risks and better defining future requirements, as we recommended. As a result of these actions, DOD decision makers will have additional fiscal context in which to review posture plans and requirements, and congressional committees should have a better understanding of the potential funding requirements associated with DOD budget requests.
Employment and Training: Congress and executive branch agencies have also taken actions to help address the proliferation of certain employment programs and improve the delivery of benefits. Specifically, in June 2012, we reported on 45 programs administered by nine federal agencies that supported employment for people with disabilities and found these programs were fragmented and often provided similar services to similar populations.19 The Workforce Innovation and Opportunity Act, enacted in July 2014, eliminated three programs that supported employment for people with disabilities, including the Veterans' Workforce Investment Program, administered by the Department of Labor, and the Migrant and Seasonal Farm worker Program and Projects with Industry, administered by the Department of Education.20 In addition, OMB worked with executive agencies to propose consolidating or eliminating two other programs, although Congress did not take action and both programs continued to receive funding. The Workforce Innovation and Opportunity Act also helped to promote efficiencies for some of the 47 employment and training programs that support a broader population (including people with and without disabilities), which we reported on in 2011. In particular, this law requires states to develop a unified state plan that covers all designated core programs in order to receive certain funding. As a result, states' implementation of the requirement may enable them to increase administrative efficiencies in employment and training programs -- a key objective of our prior recommendations.
Leadership Attention Needed to Continue Progress on Remaining Actions
Although Congress and executive branch agencies have made progress toward addressing the actions we have identified, further steps are needed to fully address the remaining actions, as shown in table 2. More specifically, 57 percent of the actions addressed to executive branch agencies and 66 percent of the actions addressed to Congress identified in our 2011-2014 reports remain partially or not addressed.21
Table 2: Status of 2011-2014 Actions Directed to Congress and the
Executive Branch, as of March 6, 2015
______________________________________________________________________________
Executive brancha Congressb Grand totals
____________________ __________________ _____________________
Total
Number of Number of number of Overall
Status actions Percentage actions Percentage actions percentage
______________________________________________________________________________
Addressed 149 39% 20 27% 169 37%
Partially
addressed 168 44 11 15 179 39
Not
addressed 52 14 38 51 90 20
Consolidated
or other 15 4 5 7 20 4
______________________________________________________________________________
Source: GAO. | GAO-15-404SP
Note: Actions assessed as "consolidated or other" are not assessed due to
additional work or other information we considered. See appendix II for more
information on how we assess the status of
actions.
FOOTNOTES TO TABLE 2
a Executive branch agencies took steps that addressed four
actions directed to Congress.
b Congress took steps that fully addressed one action and
partially addressed another action directed to executive branch agencies.
END OF FOOTNOTES TO TABLE 2
As our work has shown, committed leadership is needed to overcome the many barriers to working across agency boundaries, such as agencies' concerns about protecting jurisdiction over missions and control over resources or incompatible procedures, processes, data, and computer systems. Without increased or renewed leadership focus, opportunities will be missed to improve the efficiency and effectiveness of programs and save taxpayers' dollars. As figure 3 shows, we have directed actions to all 15 cabinet-level executive departments and at least 17 other federal entities. A substantial number of our actions are directed to the three departments that make up 55 percent of federal obligations in fiscal year 2014 -- DOD, Treasury, and HHS. Specifically, we have directed 126 actions to DOD, 89 actions to Treasury, and 60 actions to HHS.
Figure 3: Fiscal Year 2014 Obligations and
Number of Actions by Agency
Source: GAO | GAO-15-404SP
Notes: Individual actions are counted multiple times, when they are directed to more than one federal department or agency. Percentages are rounded to the nearest whole percent for items greater than 1 percent.
FOOTNOTES TO FIGURE 3
a U.S. Postal Service obligations are primarily funded by postal revenues, although the U.S. Postal Service receives minimal appropriations for overseas voting and mail for the blind. Additionally, the U.S. Postal Service has a maximum $15 billion in borrowing authority.
b Treasury's percentage of fiscal year 2014 obligations includes interest on the national debt.
c The judicial branch represented 0.2 percent of federal obligations in fiscal year 2014.
d Actions have also been directed to agencies and other federal entities that each represented less than 0.2 percent of federal obligations in fiscal year 2014.
END OF FOOTNOTES TO FIGURE 3
The following are examples of areas where additional leadership attention could potentially promote progress.
Reducing Contract Spending through Strategic Sourcing
In our 2013 annual report, we reported that federal agencies could achieve significant cost savings annually by expanding and improving their use of strategic sourcing -- a contracting process that moves away from numerous individual procurement actions to a broader aggregated approach. In particular, DOD, DHS, DOE, and VA accounted for 80 percent of the $537 billion in federal procurement spending in fiscal year 2011, but reported managing about 5 percent, or $25.8 billion, through strategic sourcing efforts. In contrast, leading commercial firms leverage buying power by strategically managing 90 percent of their spending -- achieving savings of 10 percent or more of total procurements costs. While strategic sourcing may not be suitable for all procurement spending, we reported that a reduction of 1 percent from procurement spending at these agencies would equate to over $4 billion in savings annually. However, a lack of clear guidance on metrics for measuring success has hindered the management of ongoing strategic sourcing efforts across the federal government. Since our 2013 report, OMB has made progress by issuing guidance on calculating savings for government-wide strategic sourcing contracts, and in December 2014 it issued a memorandum on category management that, among other things, identifies federal spending categories suitable for strategic sourcing. These categories cover some of the government's largest spending categories, including information technology and professional services. According to OMB, these categories accounted for $277 billion in fiscal year 2013 federal procurements. This level of spending suggests that by using smarter buying practices the government could realize billions of dollars in savings. In addition, the administration has identified expanded use of high-quality, high-value strategic sourcing solutions as one of its cross-agency priority goals, which are a limited set of outcome-oriented, federal priority goals. However, until OMB sets government-wide goals and establishes metrics, the government may miss opportunities for billions in cost savings through strategic sourcing.
More Effectively Targeting Defense Resources
Our work on defense has highlighted opportunities to improve efficiencies, reduce costs, and address overlapping and potentially duplicative services that result from multiple entities providing the same service, including the following examples.
Combatant Command Headquarters Costs: Our body of work has raised questions about whether DOD's efforts to reduce headquarters overhead will result in meaningful savings. In 2013, the Secretary of Defense directed a 20 percent cut in management headquarters spending throughout DOD, to include the combatant commands and service component commands. In June 2014 we found that mission and headquarters-support costs for the five geographic combatant commands and their service component commands we reviewed more than doubled from fiscal years 2007 through 2012, to about $1.7 billion. We recommended that DOD more systematically evaluate the sizing and resourcing of its combatant commands. If the department applied the 20 percent reduction in management headquarters spending to the entire $1.7 billion DOD used to operate and support the five geographic combatant commands in fiscal year 2012, we reported that DOD could achieve up to an estimated $340 million in annual savings.
Tactical Wheeled Vehicles: DOD spends billions of dollars each year to procure tactical wheeled vehicles, which are used to transport people, weapons, and cargo. Since 2008, GAO has identified tactical wheeled vehicle procurement as being at risk for duplication, and in 2009 GAO recommended that DOD develop a unified acquisition strategy. As of February 2015, DOD no longer plans to issue a comprehensive Tactical Wheeled Vehicle Roadmap, originally expected for release in the spring of 2013. The purpose of the roadmap was to document agreements and plans between DOD and the military services and to address our recommendation to reduce the risk of duplication. According to an official at the Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics, sharp reductions in fleet modernization funds prompted DOD to no longer use the roadmap approach. Instead, the department will evaluate each investment opportunity in terms of future force structure, fleet composition, best value, affordability, joint capabilities, and survivability through the joint capabilities integration development system and acquisition management system framework. Prior to this decision, DOD had taken numerous steps to address cost effectiveness and potential duplication within the tactical wheeled vehicle portfolio, as we recommended, but it stopped short of developing a comprehensive tactical wheeled vehicle strategy. Without a comprehensive roadmap that describes strategies and goals for the entire tactical wheeled vehicle portfolio, it will likely be difficult for DOD to ensure risk reduction and avoid duplication in future acquisitions of tactical wheeled vehicles, which could drive up acquisition and support costs. We maintain that a comprehensive strategy would help DOD manage the risk of duplication and cost growth.
Electronic Warfare: We reported in 2011 that all four military services in DOD had been separately developing and acquiring new airborne electronic attack systems and that spending on new and updated systems was projected to total more than $17.6 billion during fiscal years 2007-2016. While the department has taken steps to better inform its investments in airborne electronic attack capabilities, it has yet to assess its plans for developing and acquiring two new expendable jamming decoys to determine if these initiatives should be merged.22
More broadly, we identified multiple weaknesses in the way DOD acquires weapon systems and the actions that are needed to address these issues, which we recently highlighted in our high-risk series update.23 For example, further progress must be made in tackling the incentives that drive the acquisition process and its behaviors, applying best practices, attracting and empowering acquisition personnel, reinforcing desirable principles at the beginning of programs, and improving the budget process to allow better alignment of programs and their risks and needs. Addressing these issues could help DOD improve the returns on its $1.4 trillion investment in major weapon systems and find ways to deliver capabilities for less than it has in the past.
More Efficiently Managing Information Technology Investments
The federal government planned to spend at least $79 billion on information technology (IT) in fiscal year 2015. The magnitude of these expenditures highlights the importance of avoiding duplicative investments to better ensure the most efficient use of resources. Opportunities remain to reduce or better manage duplication and the cost of government operations in critical IT areas, many of which require agencies to work together to improve systems, including the following examples.
Information Technology Investment Portfolio Management: To better manage existing IT systems, in March 2012 OMB launched the Portfolio Stat initiative. PortfolioStat requires agencies to conduct an annual, agency-wide review of their IT portfolios to reduce commodity IT spending and demonstrate how their IT investments align with their missions and business functions, among other things. In 2014, we found that while the 26 federal agencies required to participate in PortfolioStat had made progress in implementing OMB's initiative, weaknesses existed in agencies' implementation of the initiative, such as limitations in the Chief Information Officer's authority. In the President's Fiscal Year 2016 Budget submission, the administration proposes to use PortfolioStat to drive efficiencies in agencies' IT programs. As noted in our recent high-risk series update, we have made more than 60 recommendations to improve OMB and agencies' implementation of PortfolioStat and provide greater assurance that agencies will realize the nearly $6 billion in savings they estimated they would achieve through fiscal year 2015.24
Federal Data Centers: In September 2014, we found that consolidating federal data centers would provide an opportunity to improve government efficiency and achieve cost savings and avoidances of about $5.3 billion by fiscal year 2017. Although OMB has taken steps to identify data center consolidation opportunities across agencies, weaknesses exist in the execution and oversight of the consolidation efforts. Specifically, we reported many agencies are not fully reporting their planned savings to OMB as required; GAO estimates that the savings have been underreported to OMB by approximately $2.2 billion. It will continue to be important for agencies to complete their inventories and implement their plans for consolidation to better ensure continued progress toward OMB's planned consolidation, optimization, and cost-savings goals.
Information Technology Operations and Maintenance: Twenty-seven federal agencies plan to spend about $58 billion -- almost three-quarters of the overall $79 billion budgeted for federal IT in fiscal year 2015 -- on the operations and maintenance of legacy investments. Given the magnitude of these investments, it is important that agencies effectively manage them to better ensure the investments (1) continue to meet agency needs, (2) deliver value, and (3) do not unnecessarily duplicate or overlap with other investments. Accordingly, OMB developed guidance that calls for agencies to analyze (via operational analysis) whether such investments are continuing to meet business and customer needs and are contributing to meeting the agency's strategic goals. In our 2013 annual report, we reported that agencies did not conduct such an analysis on 52 of the 75 major existing information technology investments we reviewed.25
As a result, there was increased potential for these information technology investments in operations and maintenance -- totaling $37 billion in fiscal year 2011 -- to result in waste and duplication. To avoid wasteful or duplicative investments in operations and maintenance, we recommended that agencies analyze all information technology investments annually and report the results of their analyses to OMB. Agencies have made progress in performing some operational analyses; however, until the agencies fully implement their policies and ensure complete and thorough operational analyses are being performed on their multi billion-dollar operational investments, there is increased risk that these agencies will not know whether these investments fully meet their intended objectives, therefore increasing the potential for waste and duplication.
Geospatial Investments: In a 2013 report, we found that 31 federal departments and agencies invested billions of dollars to collect, maintain, and use geospatial information -- information linked to specific geographic locations that supports many government functions, such as maintaining roads and responding to natural disasters. We found that federal agencies had not effectively implemented policies and procedures that would help them identify and coordinate geospatial data acquisitions across the government, resulting in duplicative investments.
In a 2015 report, we reported that federal agencies had made progress in implementing policies and procedures.26 However, critical items remained incomplete, including coordinating activities with state governments, which also use a variety of geospatial datasets -- including address data and aerial imagery -- to support their missions. We found that a new initiative to create a national address database could potentially result in significant savings for federal, state, and local governments. To foster progress in developing such a national database, we suggested that Congress consider assessing existing statutory limitations on address data. We also recommended that the interagency coordinating body for geospatial information (1) establish subcommittees and working groups to assist in furthering a national address database; and (2) identify discrete steps to further a national imagery program benefitting governments at all levels. Finally, we recommended that the Director of OMB require agencies to report on their efforts to implement policies and procedures before making new investments in geospatial data. OMB generally agreed with this recommendation. In addition, in March 2015, the Geospatial Data Act of 2015 was introduced and includes provisions to improve oversight and help reduce duplication in the management of geospatial data, consistent with our recommended actions.27 Fully addressing the actions in our two reports could help reduce duplicative investments and the risk of missing opportunities to jointly acquire data, potentially saving millions of dollars.28
DOD and Department of Veterans Affairs (VA) Electronic Health Records System: DOD and VA have abandoned their plans to develop a single electronic system for health records that both departments would share. Although the departments' 2008 study showed that over 97 percent of inpatient functional requirements were common to both DOD and VA, they have decided to pursue separate electronic health record system modernization efforts. In a February 2014 report, we found that the departments had based this decision on the assertion that pursuing separate systems would be less expensive and faster than the single, shared-system approach.29 However, the departments had not supported this assertion with cost and schedule estimates that compared the separate efforts with estimates for the single-system approach. As a result, we recommended that VA and DOD develop and compare the estimated cost and schedule of their current and previous approaches to creating an interoperable electronic health record and, if applicable, provide a rationale for pursuing a more costly or time-consuming approach. We also recommended that the departments develop plans for interoperability and ensure the Interagency Program Office -- established by law to act as a single point of accountability for the departments' development of interoperable health records -- has control over needed resources and clearer lines of authority.30 The departments generally agreed with our recommendations. Through continued duplication of efforts, the departments may be incurring unnecessary system development and operation costs and missing opportunities to support higher-quality health care for servicemembers and veterans.
The federal information technology acquisition reforms enacted in December 2014 reinforce a number of the actions that we have recommended to address IT management issues. For example, the law containing these reforms codifies federal data center consolidation, emphasizing annual reporting on cost savings and detailed metric reporting and OMB's PortfolioStat process, focusing on reducing duplication, consolidation, and cost savings. If effectively implemented, this legislation should improve the transparency and management of IT acquisitions and operations across the government.
Improving Fiscal Oversight of Medicare and Medicaid
Over the years, we have identified a number of actions that have the potential for sizable cost savings through improved fiscal oversight in the Medicare and Medicaid programs. For example, CMS could save billions of dollars by improving the accuracy of its payments to Medicare Advantage programs, such as through methodology adjustments to account for diagnostic coding differences between Medicare Advantage and traditional Medicare.31 In addition, we found that federal spending on Medicaid demonstrations could be reduced by billions of dollars if HHS were required to improve the process for reviewing, approving, and making transparent the basis for spending limits approved for Medicaid demonstrations.32 In particular, our work between 2002 and 2014 has shown that HHS approved several demonstrations without ensuring that they would be budget neutral to the federal government.
To address this issue, we suggested that Congress could require the Secretary of Health and Human Services to improve the Medicaid demonstration review process, through steps such as improving the review criteria, better ensuring that valid methods are used to demonstrate budget neutrality, and documenting and making clear the basis for the approved limits. We concluded in August 2014, that HHS's approval of $778 million dollars of hypothetical costs (i.e., expenditures the state could have made but did not) in the Arkansas demonstration spending limit and the department's waiver of its cost-effectiveness requirement is further evidence of our long-standing concerns that HHS is approving demonstrations that may not be budget-neutral.33 HHS's approval of the Arkansas demonstration suggests that the Secretary may continue to approve section 1115 Medicaid demonstrations that raise federal costs, inconsistent with the department's policy of budget neutrality. We maintain that enhancing the process HHS uses to demonstrate budget neutrality of its demonstrations could save billions in federal expenditures.
In our February 2015 high-risk series update, we reported that while CMS had taken positive steps to improve Medicare and Medicaid oversight in recent years, in several areas, CMS had still to address some issues and recommendations, and improper payment rates have remained unacceptably high.34 We have reported that to achieve and demonstrate reductions in the amount of Medicare improper payments, CMS should fully exercise its authority related to strengthening its provider and supplier enrollment provisions and address our open recommendations related to prepayment and postpayment claims review activities. Similarly, in the area of Medicaid, we have made recommendations targeted at (1) improving the completeness and reliability of key data needed for ensuring effective oversight, (2) implementing effective program integrity processes for managed care, (3) ensuring clear reporting of overpayment recoveries, and (4) refocusing efforts on program integrity approaches that are cost-effective. Table 3 summarizes selected recommendations we have made to reduce improper payments in these important areas. These recommendations, if effectively implemented, could improve program management, help reduce improper payments in these programs, and achieve cost savings.
Table 3: Selected GAO Recommendations To Help Reduce Medicare and
Medicaid Improper Payments and Improve Program Integrity
Selected GAO recommendations on Medicare
Improving use of automated edits.a In November 2012, we reported that use of prepayment edits saved Medicare at least $1.76billion in fiscal year 2010, but savings could have been greater if prepayment edits had been more widely used.b
Monitoring postpayment claims reviews. To improve the efficiency and effectiveness of Medicare program integrity efforts, were commended in July 2014 that CMS reduce differences between contractor postpayment review requirements, when possible, and monitor the database used to track recovery audit activities to ensure that all data were submitted, accurate, and complete.c
Removing Social Security numbers from Medicare cards. The health insurance claims number on Medicare beneficiaries' cards includes as one component the Social Security number of the beneficiary (or other eligible person, such as a spouse). This introduces risks that the beneficiaries' personal information could be obtained and used to commit identity theft.d To better position the agency to efficiently and cost-effectively identify, design, develop, and implement a solution to address this issue, we recommended that CMS direct the initiation of an IT project for identifying, developing, and implementing changes that would have to be made to CMS's affected systems.
Implementing actions authorized by the Patient Protection and Affordable Care Act (PPACA). We reported in our February 2015 update to our high-risk series that CMS should fully exercise its PPACA authority related to strengthening its provider and supplier enrollment provisions.e The following summarizes additional open recommendations and procedures authorized by PPACA that CMS should implement to make progress toward fulfilling the four outstanding criteria to remove Medicare improper payments from our high-risk list. CMS should
require a surety bond for certain types of at-risk providers and suppliers;
publish a proposed rule for increased disclosures of prior actions taken against providers and suppliers enrolling or revalidating enrollment in Medicare, such as whether the provider or supplier has been subject to a payment suspension from a federal health care program;
establish core elements of compliance programs for providers and suppliers;
improve automated edits that identify services billed in medically unlikely amounts;
develop performance measures for the Zone Program Integrity Contractors who explicitly link their work to the agency's Medicare FFS program integrity performance measures and improper payment reduction goals; and
require Medicare administrative contractors to share information about the underlying policies and savings related to their most effective edits.
Improving third-party liability efforts. Congress generally established Medicaid as the health care payer of last resort, meaning that if enrollees have another source of health care coverage -- such as private insurance -- that source should pay, to the extent of its liability, before Medicaid does. This is referred to as third-party liability. However, there are known challenges to ensuring that Medicaid is the payer of last resort. While CMS has issued guidance to states, we recommended additional actions that could help to improve cost-saving efforts in this area, such as monitoring and sharing information on third-party liability efforts and challenges across all states and providing guidance to states on oversight of third-party liability efforts related to Medicaid managed care plans.f
Increasing oversight of managed care. Most Medicaid beneficiaries are in managed care, and managed care expenditures have been growing at a faster rate than fee-for-service expenditures. In May 2014, we reported that most state and federal program integrity officials we interviewed told us that they did not closely examine managed care payments, focusing on fee-for-service claims instead.g To help improve the efficiency and effectiveness of program integrity efforts, we recommended that CMS require states to conduct audits of payments to and by managed care organizations, update managed care guidance on program integrity practices, and provide states with additional support in overseeing managed care program integrity.
Strengthening program integrity. Although CMS has taken positive steps to oversee program integrity efforts in Medicaid, other actions remain, such as improving reporting of key data, strengthening its efforts to calculate return on investment for its program integrity efforts, and using knowledge gained from its comprehensive reviews of states to better focus audit resources and improve recovery of improper payments.
Source: GAO. | GAO-15-404SP
FOOTNOTES TO TABLE 3
a To help ensure that payments are made properly, CMS uses controls called edits that are programmed into claims processing systems to compare claims data with Medicare requirements in order to approve or deny claims or flag them for further review.
b See GAO, Medicare Program Integrity: Greater Prepayment Control Efforts Could Increase Savings and Better Ensure Proper Payment, GAO-13-102 (Washington,D.C.: Nov. 13, 2012).
c GAO, Medicare Program Integrity: Increased Oversight and Guidance Could Improve Effectiveness and Efficiency of Postpayment Claims Reviews, GAO-14-474 (Washington,D.C.: July 18, 2014). We suggest actions related to monitoring postpayment claims reviews in this report; see area 7: Medicare Postpayment Claims Reviews.
d See GAO, Medicare Information Technology: Centers for Medicare and Medicaid Services Needs to Pursue a Solution for Removing Social Security Numbers from Cards, GAO-13-761 (Washington,D.C.: Sept. 10, 2013).
e See GAO, High-Risk Series: An Update, GAO-15-290 (Washington, D.C.: Feb. 11, 2015).
f See GAO, Medicaid: Additional Federal Action Needed to Further Improve Third-Party Liability Efforts, GAO-15-208 (Washington,D.C.: Jan. 28, 2015).
g See GAO, Medicaid Program Integrity: Increased Oversight Needed to Ensure Integrity of Growing Managed Care Expenditures, GAO-14-341 (Washington,D.C.: May 19, 2014).
END OF FOOTNOTES TO TABLE 3
Increasing Tax Revenue Collections
Over the last 4 years, our work identified multiple opportunities for the government to increase revenue collections. For example, in 2014, we identified three actions that Congress could authorize that could increase tax revenue collections from delinquent taxpayers by hundreds of millions of dollars over a 5-year period: limiting issuance of passports to applicants, levying payments to Medicaid providers, and identifying security clearance applicants.35 For example, Congress could consider requiring the Secretary of State to prevent individuals who owe federal taxes from receiving passports. We found that in fiscal year 2008, passports were issued to about 16 million individuals; about 1 percent of these collectively owed more than $5.8 billion in unpaid federal taxes as of September 30, 2008. According to a 2012 Congressional Budget Office estimate, the federal government could save about $500 million over a 5-year period by revoking or denying passports to those with certain federal tax delinquencies.
In addition, in our 2011 annual report, we highlighted the area of improper payments as having the potential for significant cost savings and reported on the federal government's challenges in determining the full extent to which improper payments occur and in ensuring appropriate actions are being taken to reduce them. In addition to Medicare and Medicaid, the Earned Income Tax Credit (EITC) has one of the highest estimates of improper payments government-wide.36 In particular, in fiscal year 2014, IRS reported program payments of $65.2 billion for the EITC. According to IRS, an estimated 27.2 percent, or $17.7 billion, of these program payments were improper.37 The estimated EITC improper payment rate has remained relatively unchanged since fiscal year 2003 (the first year IRS was required to report estimates of these payments to Congress), but the amount of improper EITC payments has increased from an estimated $10.5 billion in fiscal year 2003 to nearly $18 billion in fiscal year 2014.38
We have highlighted the persistent problems with improper EITC payments for years, and it is a factor underlying our continued designation of IRS Enforcement of Tax Laws as a high-risk area.39 As we have reported, although the EITC program has been modified a number of times since its enactment in 1975 to reduce complexity and help improve the program's administration, complexity remains a key factor contributing to improper payments in the program. Among other things, IRS uses audits to help identify EITC improper payments, and in June 2014, we reported that about 45 percent of correspondence audits (audits done by mail) that closed in fiscal year 2013 focused on EITC issues. However, the effectiveness of these audits may be limited because of regular backlogs in responding to taxpayers since 2011 and unclear correspondence that generates additional work for IRS, such as phone calls to IRS examiners. These issues impose unnecessary burdens on taxpayers and costs for IRS. IRS acknowledged these concerns and the limitations faced in significantly reducing EITC improper payments using the traditional audit process. Consequently, IRS has initiated several programs to address EITC improper payments, such as increasing outreach and education to taxpayers and return preparers.
In addition to these efforts, additional IRS and legislative actions are likely necessary to make any meaningful reduction in improper payments. We have recommended a number of executive branch actions or matters for congressional consideration that if effectively implemented, could help to reduce EITC improper payments (table 4).
Table 4: Selected GAO Matters and Recommendations That Could Help
Reduce Earned Income Tax Credit Improper Payments
______________________________________________________________________
Recommendation area Rationale
______________________________________________________________________
Regulating paid tax preparers In August 2014, IRS reported that 68
percent of all tax returns claiming
the EITC in tax years 2006 and 2007
were prepared by paid tax preparers
-- most of whom were not subject to
any IRS regulation -- and that from
43 percent to 50 percent of the
returns overclaimed the
credit.a Similarly, in our
undercover visits to randomly
selected tax preparers, a sample
that cannot be generalized, we found
errors in EITC claims, resulting in
significant overstatement of
refunds.b Based in part on
our recommendation, in 2010, IRS
initiated steps to regulate certain
preparers through testing and
education requirements; however, the
courts ruled that IRS lacked such
regulatory authority.c In
2014, we suggested that Congress
consider granting IRS the authority
to regulate paid tax preparers, if
it agrees that significant paid
preparer errors exist.
Accelerating W-2 filing IRS estimates that it paid $5.8
deadlines billion in fraudulent identity theft
refunds during the 2013 filing
season.d While we do not
know the extent to which improper
EITC payments are the result of
identity theft, IRS has reported
that improper payments are a mix of
unintentional mistakes and fraud.
IRS issues most refunds months
before receiving and matching
information returns, such as the W-2
"Wage and Tax Statement," to tax
returns. In August 2014, we
recommended that IRS estimate the
cost and benefits of options to
implement pre-refund matching using
W-2 data.e Given that any
change could impose burdens on
employers and taxpayers as well as
create additional costs to IRS for
systems and process changes,
Congress and other stakeholders need
information on this impact to fully
assess any potential changes.
Broadening math error authority IRS has statutory authority --
called math error authority -- to
correct certain errors, such as
calculation mistakes or omitted or
inconsistent entries, during tax
return processing of EITC claims.
According to the Treasury Inspector
General for Tax Administration, IRS
has math error authority to address
some erroneous claims, but
additional authority to
systematically disallow certain
erroneous EITC claims with
unsupported wages could reduce
improper payments.f
Treasury has proposed expanding IRS
authority to permit it to correct
errors in cases where information
provided by the taxpayer does not
match information in government
databases, among other things.
Expanding such math error authority
-- which at various times we have
suggested that Congress consider --
could help IRS correct additional
errors and avoid burdensome audits
and taxpayer penalties.
______________________________________________________________________
Source: GAO. | GAO-15-404SP
FOOTNOTES TO TABLE 4
a Internal Revenue Service, Compliance Estimates for
the Earned Income Tax Credit Claimed on 2006-2008 Returns,
Publication 5162 (8-2014) (Washington, D.C.: August 2014).
b GAO, Paid Tax Return Preparers: In a Limited
Study, Preparers Made Significant Errors, GAO-14-467T
(Washington, D.C.: Apr. 8, 2014), and Paid Tax Return Preparers: In a
Limited Study, Chain Preparers Made Significant Errors, GAO-06-563T
(Washington, D.C.: Apr. 4, 2006).
c Loving v. IRS, 917 F. Supp. 2d 67 (D.D.C.
2013), aff'd 742 F.3d 1013 (D.C. Cir. 2014).
d GAO, Identity and Tax Fraud: Enhanced
Authentication Could Combat Refund Fraud, but IRS Lacks an
Estimate of Costs, Benefits and Risks, GAO-15-119
(Washington,D.C.: Jan. 20, 2015).
e GAO, Identity Theft: Additional Actions Could Help
IRS Combat the Large, Evolving Threat of Refund Fraud,
GAO-14-633 (Washington,D.C.: Aug. 20, 2014).
f Treasury Inspector General for Tax Administration,
Existing Compliance Processes Will Not Reduce the Billions
of Dollars in Improper Earned Income Tax Credit and Additional Child
Tax Credit Payments.
END OF FOOTNOTES TO TABLE 4
Implementing Benefit Offsets
We have also identified opportunities to implement program benefit offsets, in which certain program benefits for individuals are reduced in recognition of other benefits received. Examples include the following:
Social Security Offsets: In our 2011 annual report, we reported that the Social Security Administration (SSA) needs data from state and local governments on retirees who receive pensions from employment not covered under Social Security to better enforce offsets and ensure benefit fairness. In particular, SSA needs this information to fairly and accurately apply the Government Pension Offset, which generally applies to spouse and survivor benefits, and the Windfall Elimination Provision, which applies to retired worker benefits. The Social Security's Government Pension Offset and Windfall Elimination Provision takes noncovered employment into account when calculating Social Security benefits. While information on receipt of pensions from noncovered employment is available for federal pension benefits from the federal Office of Personnel Management (OPM), it is not available to SSA for many state and local pension benefits. The President's Fiscal Year 2016 Budget submission re-proposed legislation that would require state and local governments to provide information on their noncovered pension payments to SSA so that the agency can apply the Government Pension Offset and Windfall Elimination Provision. The proposal includes funds for administrative expenses, with a portion available to states to develop a mechanism to provide this information. Also, we continue to suggest that Congress consider giving IRS the authority to collect the information that the SSA needs to administer these offsets. Providing information on the receipt of state and local noncovered pension benefits to SSA could help the agency more accurately and fairly administer the Government Pension Offset and Windfall Elimination Provision and could result in an estimated $2.4 billion-6.5 billion in savings over 10 years if enforced both retrospectively and prospectively. If Social Security only enforced the offsets prospectively, the overall savings would be less as it would not reduce benefits already received.
Disability and Unemployment Benefits: In our 2014 annual report, we found that 117,000 individuals received concurrent cash benefit payments, in fiscal year 2010, from the Disability Insurance and Unemployment Insurance programs totaling more than $850 million because current law does not preclude the receipt of overlapping benefits. Individuals may be eligible for benefit payments from both Disability Insurance and Unemployment Insurance due to differences in the eligibility requirements; however, in such cases, the federal government is replacing a portion of lost earnings not once, but twice. The President's Fiscal Year 2016 Budget submission proposes to eliminate these overlapping benefits, and during the 113th Congress, bills had been introduced in both the U.S. House of Representatives and the Senate containing language to reduce Disability Insurance payments to individuals for the months they collect Unemployment Insurance benefits. According to the Congressional Budget Office (CBO), this action could save $1.2 billion over 10 years in the Social Security Disability Insurance program. Congress should consider passing legislation to offset Disability Insurance benefit payments for any Unemployment Insurance benefit payments received in the same period.
Table 5 highlights some of our suggested actions within these and other areas that have significant potential cost-savings or revenue-enhancement opportunities, according to estimates from GAO, executive branch agencies, the Congressional Budget Office, or the Joint Committee on Taxation.
Table 5: Selected Areas with Associated Cost-Savings and
Revenue-Enhancement Opportunities Identified in Our 2011-2014
Annual Reports
______________________________________________________________________
Annual report Areas identified
______________________________________________________________________
Defense and Contracting
2011 Tactical Wheeled Vehicles (Area 6): A
department-wide acquisition strategy could reduce the
Department of Defense's (DOD) risk of costly
duplication in purchasing Tactical Wheeled Vehicles.
Reducing the number of joint light tactical vehicles
DOD procures could result in billions of
dollars in cost savings.
2011 Weapon Systems Acquisition Programs (Area 38):
Employing best management practices could help DOD
achieve significant cost savings on the $1.4 trillion
(fiscal year 2015 dollars) it expects to invest in the
development and procurement of its portfolio of 78
major defense acquisition programs
2014 Combatant Command Headquarters Costs (Area 12):
If the department applied the 20 percent reduction in
management headquarters spending to the $1.7 billion
DOD used to operate and support the five geographic
combatant commands in fiscal year 2012, DOD could
potentially achieve up to an estimated $340 million
in annual savings.
2013 Agencies' Use of Strategic Sourcing (Area 23):
Selected agencies could better leverage their buying
power and achieve additional savings by directing more
procurement spending to existing strategically sourced
contracts and further expanding strategic sourcing
practices to their highest-spending procurement
categories -- savings of 1 percent from selected
agencies' procurement spending alone would equate to
over $4 billion.
2013 Joint Basing (Area 20): A plan to achieve the
efficiencies and cost savings envisioned from joint
bases, coupled with a reevaluation of associated goals
and guidance, could lead to greater consolidation of
installation services at joint bases and better
position DOD to achieve its identified goals.
2012 Military Health Care Costs (Area 36): To help
achieve significant projected cost savings and other
performance goals, DOD needs to complete, implement,
and monitor detailed plans for each of its approved
health care initiatives.
2011 Military Personnel Costs (Area 37): A total
compensation approach would be needed to manage
military personnel costs -- which grew 31 percent from
fiscal year 2001 to fiscal year 2014.
Information Technology
2014 Information Technology Investment Portfolio
Management (Area 24): The Office of Management and
Budget and multiple agencies could help the federal
government realize billions of dollars in
savings by taking steps to better implement
PortfolioStat, a process to help agencies manage their
information technology (IT) investments.
2011 Federal Data Centers (Area 15): Consolidating
federal data centers would provide an opportunity to
improve government efficiency and achieve cost savings
and avoidances of about $5.3 billion by fiscal
year 2017.
2013 Information Technology Operations and
Maintenance (Area 30): Strengthening oversight of
key federal agencies' major IT investments in
operations and maintenance would provide an
opportunity for savings on billions in IT
investments.
2011 Enterprise Architecture (Area 14): Well-defined
and implemented enterprise architectures in federal
agencies can lead to consolidation and reuse of shared
services and elimination of antiquated and redundant
mission operations, which can result in significant
cost savings. For example, the Department of the
Interior demonstrated that it had used enterprise
architecture to modernize agency IT operations and
avoid costs through enterprise software license
agreements and hardware procurement consolidation,
resulting in financial savings of at least $80
million. In addition, the Department of Health and
Human Services (HHS) will achieve savings and cost
avoidance of over $150 million during fiscal
years 2011-2015 by leveraging its enterprise
architecture to improve its telecommunications
infrastructure.
Energy and Agriculture
2011 Oil and Gas Resources (Area 45): Improved
management of federal oil and gas resources could
result in approximately $2 billion in additional
revenue over 10 years.
2014 Advanced Technology Vehicles Manufacturing Loan
Program (Area 13): Unless the Department of Energy
can demonstrate demand for new Advanced Technology
Vehicles Manufacturing loans and viable applications,
Congress may wish to consider rescinding all or part
of the remaining $4.2 billion in credit subsidy
appropriations.
2013 Crop Insurance (Area 19): To achieve up to
nearly $2 billion per year in cost savings in the
crop insurance program, Congress could consider
limiting the subsidy for premiums that are provided on
behalf of individual farmers, reducing the subsidy, or
some combination of limiting and reducing these
subsidies.
Health Care
2014 Medicaid Demonstration Waivers (Area 21):
Federal spending on Medicaid demonstrations could be
reduced if HHS were required to improve the process
for reviewing, approving, and making transparent the
basis for spending limits approved for Medicaid
demonstrations. We estimated the federal share of
savings could have been up to $21 billion over 5
years for two states' recent demonstrations that
we reviewed.
2012 Medicare and Medicaid Fraud Detection Systems
(Area 46): The Centers for Medicare & Medicaid
Services would need to ensure widespread use of its
fraud detection systems to better position itself to
determine and measure progress toward achieving the
$21 billion in financial benefits that the
agency projected as a result of implementing these
systems.
Taxes and Fees
2014 Collection of Unpaid Federal Taxes (Area 15):
The federal government could increase tax revenue
collections by $500 million over a 5-year time
period, according to a 2012 Congressional Budget
Office estimate, by identifying and taking actions to
limit issuance of passports to applicants with unpaid
federal taxes.
2013 Tobacco Taxes (Area 31): Federal revenue losses
ranged from as much as $615 million to $1.1 billion
between April 2009 and 2011 because manufacturers
and consumers substituted higher-taxed smoking tobacco
products with similar lower-taxed products. To address
future revenue losses, Congress should consider
modifying tobacco tax rates to eliminate significant
tax differentials between similar products.
2011 Simple Tax Return Errors (Area 56): Congress
could grant the Internal Revenue Service (IRS) broader
authority, with appropriate safeguards against misuse
of that authority, to correct math errors during tax
return processing. In March 2015, the Joint Committee
on Taxation estimated that this change could result in
$166 million in savings over 10 years, similar
to last year's scoring.
2013 Agricultural Quarantine Inspection Fees (Area
18): The United States Department of Agriculture's
Animal and Plant Health Inspection Service could have
achieved as much as $325 million in savings
(based on fiscal year 2011 data, as reported) by more
fully aligning fees with program costs; although the
savings would be recurring, the amount would depend on
the cost-collections gap in a given fiscal year and
would result in a reduced reliance on U.S. Customs and
Border Protection's annual Salaries and Expenses
appropriations used for agricultural inspection
services.
2012 Immigration Inspection Fee (Area 49): The user
fee for immigration inspection of air and sea
passengers should be reviewed and adjusted to fully
recover the cost of the air and sea passenger
immigration inspection activities conducted by the
Department of Homeland Security's U.S. Immigration and
Customs Enforcement and U.S. Customs and Border
Protection rather than relying on general fund
appropriations; in 2012 this could have resulted in
reduced reliance on general fund appropriations used
for inspection services by about $175 million.
Homeland Security
2012 Domestic Disaster Assistance (Area 51): The
Federal Emergency Management Agency (FEMA) could
reduce the costs to the federal government related to
major disasters declared by the President by updating
the principal indicator on which disaster funding
decisions are based and better measuring a state's
capacity to respond without federal assistance. For
fiscal years 2004 through 2011, had FEMA adjusted the
indicator for increases in inflation or personal
income since 1986, fewer jurisdictions would have met
the primary criterion FEMA uses to determine whether
to recommend that the President declare a major
disaster, which could have reduced federal cost by
as much as $3.59 billion.
2013 Checked Baggage Screening (Area 28): By
reviewing the appropriateness of the federal cost
share the Transportation Security Administration (TSA)
applies to agreements that finance modification
projects related to the installation of checked
baggage screening systems at airport facilities, TSA
could, if a reduced cost share were deemed
appropriate, achieve cost efficiencies and be
positioned to install a greater number of optimal
baggage screening systems than currently anticipated.
According to TSA, as of March 2015, their data show
that lowering the cost share from 90 percent to 75
percent could result in roughly $140 million in
cost efficiencies during the fiscal year 2015 to
2030 timeframe.a
Income Security
2011 Social Security Offsets (Area 80): Social
Security needs data on pensions from noncovered
earnings to better enforce offsets and ensure benefit
fairness, estimated to result in $2.4-$6.5 billion
savings over 10 years if enforced both
retrospectively and prospectively. If Social Security
only enforced the offsets prospectively, the overall
savings would be less as it would not reduce benefits
already received.
2014 Disability and Unemployment Benefits (Area 8):
Congress should consider passing legislation to
prevent individuals from collecting both full
Disability Insurance benefits and Unemployment
Insurance benefits that cover the same period, which
could save $1.2 billion over 10 years in the
Social Security Disability Insurance program according
to the Congressional Budget Office.
2014 Veterans' and Survivors' Benefits (Area 23):
The Department of Veterans Affairs' direct spending
could be reduced -- by an average of about $4
million annually, according to the Congressional
Budget Office -- if new statutory provisions were
enacted, namely, a look-back review and penalty period
for claimants who transfer assets for less than fair
market value before applying for pension benefits that
are available to low-income wartime veterans who are
at least 65 years old or have disabilities unrelated
to their military service.
______________________________________________________________________
Source: GAO. | GAO-15-404SP
Note: The estimates in this table are from a range of sources,
including GAO, executive branch agencies, the Congressional Budget
Office, or the Joint Committee on Taxation.
FOOTNOTE TO TABLE 5
a We reported in 2013 that reducing the portion of
costs that TSA pays for facility modifications associated with the
installation of optimal baggage screening systems, from 90 percent to
75 percent, would lower the federal government's cost for airport
modification projects it supports by roughly $300 million from fiscal
year 2012 through fiscal year 2030. However, according to TSA, since
2012, many assumptions and cost estimates for airport modification
have changed. Specifically, TSA explained that as of March 2015, the
data show that lowering the cost share from 90 percent to 75 percent
would result in cost efficiencies of roughly $140 million during the
fiscal year 2015 to 2030 time frame. TSA stated that this variance in
estimates is driven by the fact that cost savings for 2012 through
2015 can no longer be realized and many assumptions and definitions
of related data elements have changed.
END OF FOOTNOTE TO TABLE 5
Existing and New Tools Can Assist in Identifying, Evaluating, and Addressing Fragmentation, Overlap, or Duplication
Addressing fragmentation, overlap, and duplication within the federal government is challenging. Even with sustained leadership, these are difficult issues to address because they may require agencies and Congress to re-examine (within and across various mission areas) the fundamental structure, operation, funding, and performance of a number of long-standing federal programs or activities with entrenched constituencies. As we have previously reported, these challenges are compounded by a lack of reliable budget and performance information. If fully and effectively implemented, the GPRA Modernization Act of 2010 (GPRAMA) and the Digital Accountability and Transparency Act of 2014 (DATA Act) hold promise for helping to improve performance and budget information and helping to address challenges in identifying and addressing areas of fragmentation, overlap, and duplication.40
GPRAMA establishes a framework aimed at taking a more crosscutting and integrated approach to focusing on results and improving government performance. Effective implementation of GPRAMA could help clarify desired outcomes, address program performance spanning multiple organizations, and facilitate future actions to reduce, eliminate, or better manage fragmentation, overlap, and duplication.41
The DATA Act requires actions that would help make spending data comparable across programs, allowing executive branch agencies and Congress to accurately measure the costs and magnitude of federal investments. As we have previously reported, better data and a greater focus on expenditures and outcomes are essential to improving the efficiency and effectiveness of federal efforts.42
To help analysts and decision makers better assess the extent of fragmentation, overlap and duplication, GAO has developed an evaluation and management guide ( GAO-15-49SP), which is being released concurrently with this report.43 The guide includes two parts. Part one is for analysts, including federal, state, and local auditors; congressional staff; researchers; and consultants. Part two is for policymakers, including congressional decision makers and executive branch leaders.
Part one provides four steps for analysts to identify and evaluate instances of fragmentation, overlap or duplication:
1. Identify fragmentation, overlap or duplication among a selected set of programs and understand how the programs are related.
2. Identify the potential positive and negative effects of any fragmentation, overlap, or duplication found.
3. Validate the effects and assess and compare the fragmented, overlapping or duplicative programs to determine their relative performance and cost-effectiveness.
4. Identify options to reduce or better manage the negative effects of fragmentation, overlap, or duplication.
Each step includes examples that illustrate how to implement suggested actions or consider different types of information. The guide also includes a number of Tip Sheets and Tools to help guide analysts' reviews of fragmentation, overlap, and duplication. The guide is constructed so that analysts may follow it from beginning to end, or apply only certain steps to their reviews. For example, analysts relying on existing GAO work that identifies fragmentation, overlap, and duplication among a number of programs may use the latter steps of the guide to evaluate and compare those programs and identify options for reducing or better managing the fragmentation, overlap, or duplication identified. The guide is meant to provide a framework for considering these issues and offers an approach for conducting a fragmentation, overlap, and duplication review and selecting options to reduce or better manage negative effects.
Part two provides guidance to help policymakers reduce or better manage fragmentation, overlap, and duplication. It includes two sections, one for congressional decision makers and one for executive branch leaders.
1. The first section of part two provides steps for congressional decision makers to consider that could include proposing legislation establishing deadlines for agencies to provide performance and other programmatic information with consequences for noncompliance, as well as, obtaining informal cost estimates of proposed legislation from the Congressional Budget Office. Congressional decision makers could also use existing processes, such as authorization or reauthorization, budget, appropriations or oversight, to establish such deadlines and consequences or to specifically appropriate funds to help establish a program's performance or cost-effectiveness, particularly when limited information is available about a program's performance.
2. The second section of part two addresses steps that executive branch leaders could take, including actions for mitigating the negative effects of fragmentation, overlap, or duplication through management approaches. These management approaches could include engaging in performance management activities, initiating and participating in collaborative efforts both within and among agencies, indentifying and implementing through guidance or rule-making efficiencies and other streamlining measures, and identifying and communicating to congressional decision makers opportunities for increasing efficiency that require congressional action to implement.
In recognition that the pervasiveness of fragmentation, overlap, and duplication may require attention beyond the program level, the guide also includes information on a number of options Congress and the executive branch may consider to address these issues government-wide. Some of these options are executive branch reorganization, special temporary commissions, interagency groups, automatic sunset provisions, and portfolio or performance-based budgeting. These options can be used independently or together to assist policymakers in evaluating and addressing fragmentation, overlap, and duplication beyond the programmatic level.
This report was prepared under the coordination of Orice Williams Brown, Managing Director, Financial Markets and Community Investment, who may be reached at (202) 512-8678 or williamso@gao.gov; and A. Nicole Clowers, Director, Financial Markets and Community Investment, who may be reached at (202) 512-8678 or clowersa@gao.gov. Specific questions about individual issues may be directed to the area contact listed at the end of each summary.
Comptroller General of the United
States
1 GAO's analysis of the Federal Fiscal Outlook can be found at http://www.gao.gov/fiscal_outlook/federal_fiscal_outlook/overview. See also, GAO, Financial Audit: U.S. Government's Fiscal Years 2014 and 2013 Consolidated Financial Statements , GAO-15-341R (Washington,D.C.: Feb. 25, 2015), and Congressional BudgetOffice, The Budget and Economic Outlook: 2015 to 2025 (Washington, D.C.: Jan. 26, 2015).
2 Pub. L. No. 111-139, § 21, 124 Stat. 29 (2010), 31 U.S.C. § 712 Note. See appendix I for the list of congressional addressees for this work.
3 GAO, Opportunities to Reduce Potential Duplication in Government Programs, Save Tax Dollars, and Enhance Revenue, GAO-11-318SP (Washington,D.C.: Mar. 1, 2011), 2012 Annual Report: Opportunities to Reduce Duplication, Overlap and Fragmentation, Achieve Savings, and Enhance Revenue, GAO-12-342SP (Washington,D.C.: Feb. 28, 2012), 2013 Annual Report: Actions Needed to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits, GAO-13-279SP (Washington,D.C.: Apr. 9, 2013),and 2014 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits, GAO-14-343SP (Washington,D.C.:Apr. 8, 2014).
4 We conducted the work for Area 16: U.S. Enrichment Corporation Fund under GAO's quality assurance framework. We use this framework when we conduct routine nonaudits, such as technical assistance provided to Congress. GAO's quality assurance framework requires that we plan and perform the engagement to meet our stated objectives and to discuss any limitations in our work. We maintain that the information and data obtained, and the analysis conducted, provide a reasonable basis for our findings and conclusions.
5 The six federal departments are the Departments of Agriculture, Health and Human Services, Education, Housing and Urban Development, Transportation, and Veterans Affairs.
6 TRICARE-eligible beneficiaries include active duty personnel and their dependents, medically eligible Reserve and National Guard personnel and their dependents, and retirees and their dependents and survivors.
7 Both EPA and FDA conduct laboratory inspections to test laboratories' compliance with the agencies' Good Laboratory Practices (GLP), which are intended to ensure the quality and integrity of data. For example, FDA's GLP regulations ensure the quality and integrity of the data for nonclinical laboratory studies of investigational drugs, medical devices, food additives, and other products.
8 EIA is a statistical agency within the Department of Energy that collects, analyzes, and disseminates independent information on energy issues.
9 The estimated operation savings was based on GAO's calculation of the amount of oil in excess of 90 days of net imports as of September 2014 and DOE's assessment of its annual operating cost for the SPR at $0.25 per barrel.
10 We estimated this inpatient savings amount within a range of plus or minus $4 million at a 95 percent confidence level. This savings estimate covers 9 of the 11 cancer hospitals due to missing 2012 data for 2 hospitals.
11 Partnerships and S corporations are flow-through entities, which are entities that generally do not pay taxes themselves on income, but instead, pass income or losses to their partners and shareholders, who must include that income or loss on their income tax returns.
12 GAO, New Markets Tax Credit: Better Controls and Data Are Needed to Ensure Effectiveness, GAO-14-500 (Washington,D.C.: July 10, 2014).
13 GAO, High-Risk Series: An Update, GAO-15-290 (Washington, D.C.: Feb. 11, 2015).
14 In assessing actions suggested for Congress, we applied the following criteria: "addressed" means relevant legislation has been enacted and addresses all aspects of the action needed; "partially addressed" means a relevant bill has passed a committee, the House of Representatives, or the Senate, or relevant legislation has been enacted but only addressed part of the action needed; and "not addressed" means a bill may have been introduced but did not pass out of a committee, or no relevant legislation has been introduced. In assessing actions suggested for the executive branch, we applied the following criteria: "addressed" means implementation of the action needed has been completed; "partially addressed" means the action needed is in development, or started but not yet completed; and "not addressed" means the administration, the agencies, or both have made minimal or no progress toward implementing the action needed.
15 Twenty actions were categorized as "consolidated or other" and were not assessed due to additional audit work or other information we considered.
16 In calculating these estimates, we relied on estimates from the Congressional Budget Office and the Joint Committee on Taxation, where possible. We also developed estimates based on agencies' data and used agencies' developed estimates. The totals reflect a summary of these estimates, which relied on different data sources and methodologies and considered different time periods. They represent a rough estimate of financial benefits and have been rounded down to the nearest $5 billion.
17 According to the conference report accompanying the 1996 Farm Bill, production flexibility contract payments -- the precursors to direct payments, which were similar in design -- were established to help farmers make a transition to basing their planting decisions on market signals rather than on government programs. Accordingly, production flexibility contract payments were scheduled to decrease over time and expire in 2002. Federal Agricultural Improvement and Reform Act of 1996, Pub. L. No. 104-127, 110 Stat. 888. However, farm bills passed in 2002 and 2008 continued these payments as "direct payments."
18 Subject to certain exceptions, the provision also prohibits the military departments from adopting new pattern designs or uniform fabrics unless they will be adopted by all services or the uniform is already in use by another service. See Pub. L. No. 113-66, § 352(a), (b) (2013). In addition, DOD must issue implementing guidance requiring the military departments to, among other things, ensure that new uniforms meet commanders of combatant command's geographic and operational requirements and continually work together to assess and develop new uniform technologies to improve warfighter survivability. See Pub. L. No. 113-66, § 352(f).
19 GAO's February 2012 annual report on opportunities to reduce duplication, overlap, and fragmentation across the federal government included 50 programs that supported employment for people with disabilities in fiscal year 2010. GAO later updated its analyses to exclude, for example, programs that had been phased out or ended as of April 2012. In June 2012, GAO reported on 45 programs that supported employment for people with disabilities.
20 Funding for Projects with Industry was eliminated in fiscal year 2011. As a result, we excluded it from our list of 45 programs in our June 2012 report.
21 Twenty actions, or 4 percent, have been consolidated into other areas and are no longer been assessed due to additional work or other information that we considered.
22 DOD employs expendable jamming decoys to degrade enemy air defense systems with the purpose of allowing U.S. aircraft to operate within threat environments.
23 GAO-15-290.
24 GAO-15-290.
25 Our review included major information technology investments at DOD, HHS, DHS, Treasury, and VA.
26 GAO, Progress Needed on Identifying Expenditures, Building and Utilizing a Data Infrastructure, and Reducing Duplicative Efforts, GAO-15-193 (Washington, D.C.: Feb. 12, 2015).
27 S. 740, 114th Cong. (2015).
28 We have added the recommendations from GAO-15-193 to GAO's Action Tracker.
29 GAO, Electronic Health Records: VA and DOD Need to Support Cost and Schedule Claims, Develop Interoperability Plans, and Improve Collaboration, GAO-14-302 (Washington, D.C.: Feb. 27, 2014).
30 We have added the recommendations from GAO-14-302 to GAO's Action Tracker.
31 Medicare Advantage is the private plan alternative to the original Medicare program. Medicare Advantage plans are paid a fixed, per member, per month payment to provide all services covered under original Medicare. This payment does not vary on the basis of the services beneficiaries receive.
32 Under Section 1115 of the Social Security Act, the Secretary of Health and Human Services can approve waivers of certain Medicaid requirements, and provide states with new spending authorities, for purposes of implementing Medicaid demonstration projects. The demonstrations under the law are for purposes of testing new ways to operate state programs and deliver services, and agency policy requires that the programs not increase federal spending.
33 GAO, Medicaid Demonstrations: HHS's Approval Process for Arkansas's Medicaid Expansion Waiver Raises Cost Concerns, GAO-14-689R (Washington, D.C.: Aug. 8, 2014).
34 GAO-15-290.
35 Federal law does not expressly prohibit an individual with unpaid federal taxes from being granted a security clearance; however, delinquent tax debt does pose a potential vulnerability that must be considered in making a broader determination of whether an applicant should be granted a security clearance.
36 Congress established the EITC in 1975 to (1) offset the impact of Social Security taxes on low-income families and (2) encourage low-income families to seek employment rather than public assistance. EITC eligibility depends on an individual's earned income. Credit amounts depend on the number of qualifying children who meet age, relationship, and residency tests. The credit gradually increases with income (the phase-in range), plateaus at a maximum amount (the plateau range), and then gradually decreases until it reaches zero (the phaseout range). For EITC, program payments include tax expenditures (a tax credit that offsets income taxes) and outlays (a refund if the credit exceeds the amount of taxes owed).
37 EITC overpayments are the difference between the EITC amount claimed by the taxpayer on his or her return and the amount the taxpayer should have claimed. EITC underpayments are defined as the amount of EITC disallowed by IRS in processing that should have been allowed.
38 These numbers have not been adjusted for inflation.
39 GAO-15-290.
40 Pub. L. No. 111-352, 124 Stat. 3866 (2011) (GPRAMA); Pub. L. No. 113-101, 128 Stat. 1146 (2014) (DATA Act).
41 For GAO's most recent work on GPRAMA, see GAO, Government Efficiency and Effectiveness: Inconsistent Definitions and Information Limit the Usefulness of Federal Program Inventories, GAO-15-83 (Washington D.C.: Oct. 31, 2014); Managing for Results: Selected Agencies Need to Take Additional Efforts to Improve Customer Service, GAO-15-84 (Washington D.C.: Oct. 24, 2014); and Managing for Results: Agencies' Trends in the Use of Performance Information to Make Decisions, GAO-14-747 (Washington D.C.: Sept. 26, 2014). In addition, information on GAO's work on GPRAMA can be found at http://www.gao.gov/key_issues/managing_for_results_in_government/issue_summary.
42 See GAO, Federal Data Transparency: Effective Implementation of the DATA Act Would Help Address Government-wide Management Challenges and Improve Oversight, GAO-15-241T (Washington, D.C.: Dec. 3. 2014).
43 See GAO, Fragmentation, Overlap, and Duplication: An Evaluation and Management Guide, GAO-15-49SP (Washington, D.C.: Apr. 14, 2015).
END OF FOOTNOTES
Abbreviations
AFRICOM U.S. Africa Command
AFSCN Air Force Satellite Control Network
AIDS acquired immunodeficiency syndrome
AMC Army Materiel Command
ATVM Advanced Technology Vehicles Manufacturing
AWPS Army Workload and Performance System
CAA Combating Autism Act of 2006
CAP Compliance Assurance Process
CDC Centers for Disease Control and Prevention
CIO chief information officer
CMS Centers for Medicare & Medicaid Services
CBO Congressional Budget Office
CPC Countries of Particular Concern
CPO Cash Product Office
DHA Defense Health Agency
DHS Department of Homeland Security
DI Disability Insurance
DOD Department of Defense
DOE Department of Energy
DOJ Department of Justice
DOL Department of Labor
DPMO Defense Prisoner of War/Missing Personnel Office
DSH disproportionate-share-hospital
EISA Energy Independence and Security Act
EPA Environmental Protection Agency
FAR Federal Acquisition Regulation
FDA Food and Drug Administration
FECA Federal Employees' Compensation Act
FEMA Federal Emergency Management Agency
FHA Federal Housing Administration
GLP Good Laboratory Practices
GPRA Government Performance and Results Act of 1993
GPRAMA GPRA Modernization Act of 2010
GSA General Services Administration
HHS Department of Health and Human Services
HIV human immunodeficiency virus
HRSA Health Resources and Services Administration
HUD Department of Housing and Urban Development
IACC Interagency Autism Coordinating Committee
IRS Internal Revenue Service
IT information technology
JPAC Joint Prisoner of War/Missing in Action Accounting
Command
JPME Joint Professional Military Education
LMP Logistics Modernization Program
MA Medicare Advantage
MAI Minority AIDS Initiative
NDNH National Directory of New Hires
NIH National Institutes of Health
NSF National Science Foundation
OARC Office of Autism Research Coordination
ODNI Office of the Director of National Intelligence
OHAIDP Office of HIV/AIDS and Infectious Disease Policy
OMB Office of Management and Budget
OPM Office of Personnel Management
PACOM U.S. Pacific Command
POW/MIA Prisoner of War/Missing in Action
QW quarterly wage
REO real estate-owned
RHS Rural Housing Service
SSA Social Security Administration
SMAIF Secretary's MAI Fund
TSA Transportation Security Administration
UI Unemployment Insurance
USAID U.S. Agency for International Development
USCIRF United States Commission for International Religious
Freedom
USDA Department of Agriculture
VA Department of Veterans Affairs
Report at a Glance
Section I of this report presents 12 areas in which we found evidence of fragmentation, overlap, or duplication among federal government programs.
Table 1: Fragmentation, Overlap, and Duplication Areas
Identified in This Report
_____________________________________________________________________________
Mission Areas Identified Page
_____________________________________________________________________________
Agriculture 1. EPA's and FDA's Laboratory Inspections: To avoid 50
potential duplication of certain types of
laboratory inspections and better leverage limited
resources, the Environmental Protection Agency and
the Food and Drug Administration should develop a
formal process to collaborate and share
information on planned inspections.
Defense 2. Ground Radar and Guided Munitions Programs: The 55
Department of Defense should take steps to
minimize the risk of future duplication within its
ground radar and guided munitions weapons systems.
3. Weapon System Milestone Decision Process: To 60
improve efficiency, the Secretary of Defense
should streamline the Department of Defense's
milestone decision process used for major weapon
system acquisition programs by eliminating reviews
that can be duplicative and are not highly valued
by acquisition officials.
General 4. Consumer Product Safety Oversight: More formal and 64
government comprehensive coordination among federal agencies
is needed to help increase efficiency and
effectiveness related to consumer product safety
oversight and address challenges related to
fragmentation and overlap.
5. Nonemergency Medical Transportation: To mitigate 70
the effects of overlap, the Department of
Transportation should take steps to enhance
federal, state and local coordination among 42
programs that provide nonemergency medical
transportation to individuals who cannot provide
their own transportation due to age, disability,
or income constraints.
Health 6. DOD US Family Health Plan: To potentially save 76
millions of dollars and eliminate duplication
within the Department of Defense's health care
system, Congress should terminate the statutorily
required US Family Health Plan because it offers
military beneficiaries the same health care
benefit offered by other DOD health care
contractors.
7. Medicare Postpayment Claims Reviews: To prevent 82
inappropriate duplicative postpayment claims
reviews by contractors, the Centers for Medicare &
Medicaid Services should monitor the Recovery
Audit Data Warehouse -- the database developed in
part to prevent duplicative reviews -- and develop
more complete guidance on contractors'
responsibilities.
8. Serious Mental Illness Programs: To help ensure 87
that the eight federal agencies administering over
100 programs supporting individuals with serious
mental illness are able to develop an overarching
perspective in order to understand the breadth of
programs and resources used -- including any
potential gaps or overlap -- greater coordination
of federal efforts is needed from the Department
of Health and Human Services, and within it, the
Substance Abuse and Mental Health Services
Administration, which is required to promote
coordination of programs relating to mental
illness throughout the federal government.
Homeland 9. Vulnerability Assessments of Critical 91
security/law Infrastructure: The Department of Homeland
enforcement Security could mitigate potential duplication or
gaps by consistently capturing and maintaining
data from overlapping vulnerability assessments of
critical infrastructure and improving data sharing
and coordination among the offices and components
involved with these assessments.
Information 10. DHS Processing of FOIA Requests: To address 97
technology duplication in the processing of Freedom of
Information Act requests, the Department of
Homeland Security should determine the viability
of re-establishing an agreement between two of its
component agencies that process immigration files.
International 11. Federal and States' Export Promotion: Because 102
affairs federal and state export promotion efforts
overlap, the Department of Commerce should take
steps to enhance collaboration among them to
promote economic development while ensuring the
most efficient use of limited federal resources.
Science and 12. Oceanic and Atmospheric Observing Systems 110
environment Portfolio: The National Oceanic and Atmospheric
Administration should analyze its portfolio of
observing systems to determine the extent to which
unnecessary duplication may exist.
Section II of this report summarizes 12 additional opportunities for agencies or Congress to consider taking action that could either reduce the cost of government operations or enhance revenue collections for the Treasury.
Table 2: Cost Savings and Revenue Enhancement Opportunities
Identified in This Report
_____________________________________________________________________________
Mission Areas Identified Page
_____________________________________________________________________________
Defense 13. Defense Facilities Consolidation and Disposal: To 114
help identify opportunities for saving costs by
consolidating or disposing of unutilized or
underutilized facilities, the Department of
Defense should ensure that data on the utilization
of DOD facilities -- which were collectively
valued at around $850 billion in fiscal year 2013
-- are complete and accurate.
14. DOD Headquarters Reductions and Workforce 120
Requirements: The Department of Defense could
potentially achieve hundreds of millions of
dollars in cost savings and help to ensure that
headquarters organizations are properly sized to
meet their assigned missions by reevaluating its
ongoing headquarters-reductions efforts and
conducting periodic reassessments of workforce
requirements.
Energy 15. Strategic Petroleum Reserve: The Department of 129
Energy could potentially realize savings by
reexamining the appropriate size of the Strategic
Petroleum Reserve -- which was valued at about $45
billion as of December 2014 -- and depending on
the outcome of the analysis, selling crude oil
from the reserve and using the proceeds to fund
other national priorities.
16. U.S. Enrichment Corporation Fund: Congress may 134
wish to consider permanent rescission of the
entire $1.6 billion balance of the U.S. Enrichment
Corporation Fund -- a revolving fund in the U.S.
Treasury -- because its purposes have been
fulfilled.
General 17. Tax Policies and Enforcement, 2015: By more 138
government effectively using data to manage various
enforcement programs, the Internal Revenue Service
could bolster tax compliance and potentially
collect hundreds of millions of dollars in
additional revenue.
Health 18. DOD TRICARE Improper Payments: To achieve 150
potential cost savings associated with billions of
dollars of improper payments, the Department of
Defense should implement a more comprehensive
improper payment measurement methodology and
develop more robust corrective action plans for
the military health care program known as TRICARE.
19. Medicare Payments to Certain Cancer Hospitals: To 156
achieve almost $500 million per year in program
savings, Congress should consider modifying how
Medicare pays certain cancer hospitals.
20. State Medicaid Sources of Funds: To potentially 161
save hundreds of millions of dollars, the Centers
for Medicare & Medicaid Services should ensure
that states report accurate and complete data on
state Medicaid sources of funds so that it may
better oversee states' financing arrangements that
can increase costs for the federal government.
Income 21. Children's Disability Reviews: To prevent an 168
security estimated $3.1 billion dollars in potential
overpayments over 5 years, the Social Security
Administration needs to conduct timely disability
reviews to better ensure that only eligible
children receive cash benefits from the
Supplemental Security Income program.
22. Supplemental Nutrition Assistance Program Fraud 173
and Abuse: States should be able to more
effectively fight fraud among beneficiaries of the
Supplemental Nutrition Assistance Program -- which
provided more than $76 billion in benefits in
fiscal year 2013 -- by using data to better focus
investigative efforts on high-risk households.
Information 23. Federal Software Licenses: In order to achieve 180
technology hundreds of millions of dollars in government-
wide savings, federal agencies should apply better
management of software licenses and the Office of
Management and Budget should issue a directive to
assist agencies in doing so.
Social 24. Disaster Relief Fund Administrative Costs: Cost 187
services savings of millions of dollars could be realized
if Federal Emergency Management Agency officials
enhance their oversight of the agency's
administrative costs obligated from the Disaster
Relief Fund for major disasters.
Table 3: Appendixes
_____________________________________________________________________
Appendixes Page
_____________________________________________________________________
Appendix I: List of Congressional Addressees 193
Appendix II: Objectives, Scope, and Methodology 194
Appendix III: New Actions of Fragmentation, Overlap, 199
and Duplication Added to Existing Areas
Appendix IV: List of Areas Identified in 202
2011-2015 Annual Reports, by Mission
Appendix V: Lists of Programs Identified 222
Section I: Areas in Which GAO Has Identified Fragmentation, Overlap, or Duplication
This section presents 12 areas in which we found evidence of fragmentation, overlap, or duplication among federal government programs.
* * * * *
17. Tax Policies and Enforcement, 2015
By more effectively using data to manage various enforcement programs, the Internal Revenue Service could bolster tax compliance and potentially collect hundreds of millions of dollars in additional revenue.
Why This Area Is Important
The Internal Revenue Service (IRS) has estimated that the gross tax gap -- the difference between taxes owed and taxes paid on time -- was $450 billion for tax year 2006 (the most recent year for which data were available). IRS estimated that it would eventually recover about $65 billion of this amount through late payments and enforcement actions, leaving a net tax gap of $385 billion. Because the net tax gap is so large and the effectiveness of various new IRS enforcement initiatives largely remains to be determined, tax law enforcement is on GAO's High-Risk List.1 The nation's long-term fiscal challenges heighten the importance of reducing the tax gap. Given that individual income tax misreporting accounts for the largest portion of the tax gap, even small changes in IRS's enforcement programs could result in hundreds of millions of dollars of increased revenue.
What GAO Found
In a series of reports in 2014, GAO identified areas where IRS could improve its enforcement programs and collect additional tax revenue.
IRS Correspondence Audits: Better Management Could Improve Tax Compliance and Reduce Taxpayer Burden
Auditing tax returns is a critical part of IRS's strategy to ensure tax compliance and address the tax gap. Most audits are correspondence audits, which are done by mail, where examiners review taxpayer correspondence and related documentation such as receipts, expense invoices, and payments. For audits closed in fiscal year 2012, correspondence audits accounted for
1.1 million (76 percent) of the total 1.5 million individual tax return audits, and
$9.2 billion (60 percent) of the total $15.3 billion in recommended additional taxes due and refunds disallowed for those audits.
However, in its June 2014 report, GAO found that unrealistic time frames included in IRS audit notices had contributed to taxpayer burden and IRS inefficiencies.2 In recent years, IRS experienced backlogs in responding to taxpayers -- dramatically increasing in 2013 -- causing taxpayer frustration and generating unnecessary phone calls. For example, notices issued in 2013 stated that IRS would specify a date to respond, which was usually within 30 to 45 days of the date of the notice, but the agency consistently had taken several months to do so. In some cases, refunds were delayed. The unclear notices generated phone calls from taxpayers about audit time frames that IRS examiners were not prepared to answer, leaving examiners with less time to conduct the audits. IRS's subsequent revisions to the notices -- which were intended to make the time frame more realistic -- were not based on analysis of historical data, nor did IRS have plans to analyze data to ensure the agency is responding in a timely manner consistent with the revised notices.
In commenting on this submission, IRS noted that the timing of this audit coincided with delays caused by significant budget issues during fiscal years 2013 and 2014. According to IRS, the agency continues to recover from budget-related setbacks. For example, IRS reports that the Small Businesses/Self-Employed division has improved its responsiveness to answering taxpayer replies within the timeframe stated in their acknowledgment letters. IRS also reports revising phone scripts to better inform taxpayers of delays in processing correspondence and initiating programming changes to allow for flexibility in providing taxpayers with more accurate response timeframes in acknowledgement letters. According to IRS, these letter changes will be effective in January 2016. GAO has asked IRS for more information and will continue to monitor progress on actions intended to reduce the need for taxpayer calls, ensure IRS is providing taxpayers with more realistic response time frames, and is using agency resources more efficiently.
In that same 2014 report, GAO also found that IRS could benefit from more information on performance that is clearly linked to IRS's strategic goals. IRS's strategic plan includes goals for achieving compliance results at the lowest costs while minimizing taxpayer burden by using data to inform resource allocation decisions. Further, Standards for Internal Control in the Federal Government -- as well as performance management practices -- call for agencies to take the following actions: establish program objectives and performance measures that clearly link to agency-wide goals; use accurate and complete performance information and document resource allocation decisions; and promptly evaluate program review findings to determine appropriate actions in response to any improvement recommendations.3 However, IRS
had no documented criteria on how staff are to use correspondence audit program data to make decisions, such as the number of audits to undertake or which tax issues to audit;
did not have documented program objectives or linkages between the performance measures and IRS-wide strategic goals for compliance, cost, and taxpayer burden;
had incomplete correspondence audit measures and data;
did not leverage some potentially useful, available decision-making data that could provide a more complete picture of audit compliance results and costs -- such as data on actual revenue collections and costs related to answering taxpayer calls and collecting additional taxes assessed from audits; and
did not have a plan or time frames to evaluate whether it should act on the recommendations of a recent program review that may improve the selection of tax returns for audit and better allocate examiner resources.
Without tools -- such as documented criteria, linkages between performance measures and strategic goals, complete data, and an established plan and evaluation timeline -- IRS risks making poor resource decisions on how many audits to do overall and which specific compliance issues to audit. Further, because it does not have a reasonable assurance that it is making decisions cost effectively and taking action to make progress towards the agency's goals, IRS risks missing noncompliance, unnecessarily burdening many taxpayers, and wasting resources.
Individual Retirement Accounts: IRS Could Bolster Enforcement on Multi-Million Dollar Accounts, but More Direction from Congress Is Needed
Congress has limited annual contributions to individual retirement accounts (IRA) to prevent the tax-favored accumulation of unduly large balances, but there is no total limit on IRA accumulations.4 In its October 2014 report, GAO estimated that hundreds of taxpayers have accumulated tens of millions of dollars in their IRA balances, likely by investing in assets unavailable to most investors, such as private stocks -- which may be initially valued very low and if successful, may offer high potential investment returns.5 Individuals who invest in these assets using certain types of IRAs, such as Roth IRAs, can escape taxation on investment gains. In addition, hard-to-value, nonpublicly traded assets -- particularly those under direct control of the IRA owner -- also pose a higher risk of the IRA owner engaging in prohibited, nonretirement-related IRA transactions.
To move forward with a service-wide strategy to target enforcement efforts, IRS must first conduct research to understand how many taxpayers (and the amounts associated with IRA assets) are at risk of noncompliance. Research identifying the numbers and types of custodians and taxpayers holding such hard-to-value assets could also help IRS target outreach activities and strategies (such as reminder notices) for improving compliance with IRA asset valuation and prohibited transaction requirements. Beginning for tax year 2015, IRS will require IRA custodians to report additional data about hard-to-value nonpublic assets on annual information returns, Form 5498 IRA Contribution Information. Identifying these taxpayers (and amounts associated with such IRA assets) would provide data for use in examination selection. However, efficient use of the new IRA asset-type data for examination selection depends on IRS approving its plan to digitize the data from paper forms.
IRS officials said IRA valuation cases are audit-intensive and difficult to litigate because of the subjective nature of valuation. In addition, an improper valuation made many years prior to its discovery by IRS may fall outside the 3-year statute of limitations for assessing taxes owed.6 Furthermore, according to IRS, noncompliant activity and prohibited transactions are not reflected on any filed tax return and are also difficult to detect within the 3-year statute of limitation period. As IRS gathers more information about IRA asset-type data from the Form 5498, it will be clearer whether the 3-year statute of limitations should be changed for tax assessments with regard to IRAs.
Partnerships and S Corporations: IRS Needs to Improve Information to Address Tax Noncompliance
Income earned through partnerships and S corporations accounts for billions of dollars of unpaid taxes, and their share of business activity is growing.7 In May 2014, GAO found that IRS does not know the full extent of partnership and S corporation income misreporting. Using IRS's compliance research studies on flow-through income misreporting by individual taxpayers and considering various caveats and uncertainties, GAO estimated a rough order of magnitude of the misreporting to be $91 billion per year in lost tax revenue for tax years 2006 through 2009.
GAO found that IRS has limited information on the effectiveness of its examinations in detecting income misreporting by partnerships. For example, IRS estimated that 3 percent to 22 percent of identified misreporting by partnerships was double counted due to income flowing from one partnership to another or to other related parties. Further, IRS does not know how income misreporting by partnerships affects taxes paid by partners. As a result, IRS does not have reliable information about its compliance results to fully inform decisions about allocating examination resources across different types of businesses. Without reliable information on the extent of partnership misreporting, or the results of its partnership examinations, IRS cannot make fully informed decisions about whether its allocation of enforcement resources across business types is justified and whether or not to update one of its major partnership examination selection tools, the discriminate income function formula.
IRS's processes for selecting returns to examine could also be improved. IRS officials told GAO that having more return information available electronically might improve examination selection; however, not all partnership and S corporation line items from paper returns are digitized. Further, enhancing digitization of paper-filed partnership and S corporation returns would involve costs to IRS. In the absence of funding for transcription, one way to increase digitization is a statutory mandate requiring increased electronic filing (e-filing) of tax and other returns.8 Expanding the mandate would increase digitized data available for examination selection. Improving IRS's selection of partnership and S corporation returns to examine would also benefit compliant taxpayers whose returns may otherwise be selected for examination and would reduce IRS's tax return processing costs.
Large Partnerships: With Growing Number of Partnerships, IRS Needs to Improve Audit Efficiency
In September 2014, GAO found that IRS audits few large partnerships and most audits result in no change to the partnership's return.9 For those large partnership audits that did result in a change to the partnership's return, the aggregate amount across all audits was minimal. According to IRS auditors, the audit results may be due to challenges such as finding the sources of income within multiple tiers while meeting the administrative tasks required by the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) within specified time frames.10 For example, IRS auditors said that it can sometimes take months to identify the partner authorized to represent the partnership in the audit, therefore reducing time available to conduct the audit (TEFRA does not require large partnerships to identify this partner on tax returns). Also under TEFRA, unless the partnership elects to be taxed at the entity level (which few do), IRS must pass audit adjustments through the ultimate partners. IRS officials stated that the process of determining each partner's share of the adjustment is paper and labor intensive. When hundreds of partners' returns have to be adjusted, the costs involved limit the number of audits IRS can conduct. Adjusting the partnership return instead of the partners' returns would reduce these costs; however, without legislative action, IRS's ability to do so is limited.
Understanding the reasons for the poor audit results is difficult because IRS (1) does not have activity codes that track audits of large partnerships returns, and (2) does not break out the audit results because the activity codes are not specific enough to identify large partnerships by asset and partner size.11 Addressing these issues could help IRS officials better allocate audit resources. In addition, IRS does not distinguish between field audits (which examine the partnership's tax return and supporting documentation) and campus audits (which pass through any audit adjustments as a result of the field audit to the partners' tax returns) when counting the number of large partnership audits. Instead, IRS counts both field audits and campus audits when calculating its audit rate for all partnerships, which misrepresents the number of audits that actually verify information reported on tax returns. According to Standards for Internal Control in the Federal Government, managers need accurate and complete information to help ensure efficient and effective use of resources.12 A single, consistently applied definition could assist IRS in establishing agreement on the scope of large partnership audit efforts and in ensuring that audit results can be assessed. Likewise, modifying IRS's current activity codes in order to identify large partnership returns, and breaking out field and campus audit rate data in order to accurately measure audit results, would allow IRS to analyze and plan resource usage for large partnership audits more efficiently and effectively.
IRS 2015 Budget: Return on Investment Data Needed to Better Set Priorities
In June 2014, GAO found that IRS does not calculate actual Return on Investment (ROI) to evaluate the performance of its initiatives once they are implemented; consequently, it does not have that data to inform decisions about allocating resources to those initiatives in the future. According to IRS officials, one reason they do not calculate actual ROI for enforcement initiatives is because it is difficult to determine which staff have actually worked on a particular initiative over a multiyear period. In addition, IRS officials cite difficulties in tracking ROI-related information on funded initiatives because of difficulties in matching information between IRS systems for formulating and executing its budget. Given these difficulties and the need to make numerous assumptions, the officials believe that any feasible estimates would be too uncertain to be useful.
Comparing projected ROI to actual ROI is consistent with project management concepts, internal control standards, Office of Management and Budget guidance, and GAO's prior work on performance management.13 In December 2012, GAO demonstrated how IRS planners could review actual ROI across different enforcement programs and across different groups of cases within these programs to better inform resource allocation decisions.14 GAO also recommended IRS identify research efforts that would enhance its ability to estimate ROI for specific enforcement activities, including initiatives.15 In addition, IRS established "funded program codes" (previously known as internal order codes) as a mechanism to track specific initiatives -- such as merchant card and cost basis reporting -- which could be used when estimating the ROI of future initiatives. While not the only factor in making resource decisions, actual ROI could provide useful insights on an initiative's productivity.
Actions Needed and Potential Financial or Other Benefits
GAO suggests that Congress should consider the following:
Revisiting the use of IRAs to accumulate large balances and considering ways to improve the equity of the existing tax expenditure on IRAs. Options could include limits on (1) the types of assets permitted in IRAs, (2) the minimum valuation for an asset purchased in an IRA, or (3) the amount of assets that can be accumulated in IRAs and employer-sponsored plans that get preferential tax treatment.
Expanding the mandate that partnerships and S corporations electronically file their tax returns in order to cover a greater share of filed returns.
Altering the TEFRA audit procedures to require partnerships that have more than a certain number of direct and indirect partners to pay any tax owed due to audit adjustments at the partnership level.
In its June 2014 report, GAO recommended that the Commissioner of Internal Revenue
collect data to analyze whether IRS is responding to taxpayers within the time frames cited in the revised audit notices;
further revise IRS notices (if delays continue) to provide more realistic response times based on the data and take other appropriate actions to ensure efficient use of IRS tax examiner resources;
establish formal program objectives;
ensure that the program measures reflect those objectives;
clearly link those measures with strategic IRS-wide goals for ensuring compliance in a cost-effective way while minimizing taxpayer burden;
document how decisions are to be made using performance information;
track and use other program data that have not been used; and
develop a plan and timeline for implementing recommendations to improve the selection of correspondence audit workload and allocation of examiner resources, or develop justifications for not implementing the recommendations.
In its October 2014 report, GAO recommended that the Commissioner of Internal Revenue take the following actions:
Approve plans to fully compile and digitize the new data from electronic and paper-filed Form 5498s to ensure the efficient use of the information on nonpublicly traded IRA assets.
Conduct research using the new Form 5498 data to identify IRAs holding nonpublic asset types and use that information for an IRS-wide strategy to target enforcement efforts.
Build on research data regarding IRAs holding nonpublic assets, and identify options to provide outreach targeting taxpayers with nonpublic IRA assets and their custodians, such as reminder notices that engaging in prohibited transactions can result in loss of the IRA's tax-favored status.
Add an explicit caution in the IRA publication for taxpayers about the potential risk of committing a prohibited transaction when investing in nonpublicly traded assets or directly controlling IRA assets.
Work in consultation with the Department of the Treasury on a legislative proposal to expand the statute of limitations on IRA noncompliance to help IRS pursue valuation-related misreporting and prohibited transactions that may have originated outside the current statute's 3-year window.
In its May 2014 report, GAO recommended that the Commissioner of Internal Revenue take the following actions:
Develop and implement a strategy to better estimate (1) the extent and nature of partnership misreporting, and (2) the effectiveness of partnership examinations in detecting this misreporting.
Use the better information on noncompliance and program effectiveness to determine whether (1) the differences in examination rates across different types of business entities are justified, and (2) an improved tool for selecting partnerships for examination should be developed.
In its September 2014 report, GAO recommended that the Commissioner of Internal Revenue
track the results of large partnership audits by (1) defining a large partnership based on asset size and number of partners; (2) revising the activity codes to align with the large partnership definition; and (3) accounting separately for field audits and campus audits.
In its June 2014 report, GAO recommended that the Commissioner of Internal Revenue
calculate actual ROI for implemented initiatives, compare the actual ROI to projected ROI, and provide the comparison to budget decision makers for initiatives where IRS allocated resources; and
use actual ROI calculations as part of resource allocation decisions.
IRS could collect additional revenue and generate other cost savings which GAO believes could be achieved by implementing its recommendations; for example, by using better data to target correspondence audits, as even a small percentage increase of additional taxes due could result in hundreds of millions of dollars of additional revenue. Further, more efficient use of the new IRA asset-type data could improve examination selection of IRAs that have accumulated tens of millions of dollars in balances. Other actions, such as developing a strategy to better estimate the extent of partnership misreporting and effectiveness of partnership examinations, could generate additional cost savings by achieving program efficiencies and better enforcing tax laws.
Agency Comments and GAO's Evaluation
In commenting on the five reports issued in May, June, September, and October of 2014 on which these analyses are based, IRS agreed with 13 of the 17 recommendations presented, but did not state whether it agreed or disagreed with 4. For those 13 it agreed with, IRS said it is taking action to address them or further action is contingent on funding. For example, in its response to GAO's recommendation to establish formal program objectives for correspondence audits while ensuring that the program measures reflect those objectives, and clearly link those measures with strategic IRS-wide goals, IRS agreed to ensure that the program objectives and measures established would be linked with the IRS-wide goals. Thus, if implemented effectively, IRS's action should address the intent of these three recommendations.
IRS did not agree or disagree with four of GAO's recommendations, but acknowledged related actions it is taking to address three of these four recommendations. First, in response to GAO's recommendation that IRS develop a plan and timeline for implementing recommendations to improve the selection of correspondence audit workload and allocation of examiner resources, IRS responded it will pursue efforts to improve its workload selection and maximize resource usage, but it did not comment on whether it would develop a plan and timeline for implementing the recommendations. IRS recently noted that the Office of Compliance Analytics has developed a planning tool to optimize distribution of planned starts based on several weighted measures. According to IRS, the tool is being tested in fiscal year 2015. GAO continues to believe it is important that IRS develop a plan and timeline for implementing these recommendations or document and justify its reasons for not doing so. As noted in GAO's June 2014 report, without timely follow-up on the recommendations, it will be difficult to hold IRS managers accountable for ensuring that any improvements needed are made. Furthermore, IRS may delay or miss opportunities to better select workload, allocate resources, reduce taxpayer burden, or otherwise improve the correspondence audit results without implementing these recommendations.
Second, in response to GAO's recommendation to calculate ROI for implemented initiatives, compare the actual ROI to projected ROI and provide the comparison to budget decision makers, IRS agreed that ROI is one of several factors relevant to making resource allocation decisions. However, IRS noted that determining the impact of an initiative will always rely on estimates, as the results of an initiative are the difference between actual results and what would have occurred in the absence of the initiative, which cannot be measured. Given the difficulty IRS has in attributing revenues to specific employees hired under an initiative, officials believe that any feasible estimate would need to be based on numerous assumptions and, therefore would be too uncertain to be useful. For this reason, IRS does not consider this additional analysis an effective use of its scarce research resources. GAO agrees that any post-implementation assessment of an initiative's results would be an estimate. The difficulty and reliability of such assessments would likely vary depending on the specifics of each initiative. GAO's previous recommendation -- that IRS undertake research to improve all of its enforcement resource allocation decisions -- would also enhance its ability to estimate initiative results.16 In the interim, IRS should be able to provide some information of use to Congress, such as whether funds that were requested for initiatives were actually used in the manner that IRS originally proposed.
Third, in response to GAO's recommendation to develop and implement a strategy to better estimate the extent and nature of partnership misreporting, and the effectiveness of partnership examinations in detecting this misreporting, IRS stated that it had not fully evaluated GAO's recommendations and expressed concern regarding actions requiring a significant expenditure of resources.
Fourth and finally, IRS reiterated this same point concerning GAO's recommendation to use the better information on noncompliance and program effectiveness to determine whether the differences in examination rates across different types of business entities are justified, and whether an improved tool for selecting partnerships for examination should be developed. However, IRS reported it would consider all of GAO's recommendations and would identify appropriate actions while keeping resource limitations in mind. It is these very resource limitations -- which were noted in GAO's May 2014 report -- that underscore the importance of GAO's recommendations to develop better information for making resource allocation decisions.
GAO provided a draft of this report section to IRS for review and comment. IRS provided comments, which were incorporated as appropriate.
How GAO Conducted Its Work
The information contained in this analysis is based on findings from the products in the related GAO products section. For the related products listed, GAO analyzed agency documents and interviewed officials from the Department of the Treasury, IRS, and other parties. GAO analyzed budget data from IRS and related budget documents. GAO also analyzed relevant federal laws, regulations, and procedures.
Related GAO Products
Individual Retirement Accounts: IRS Could Bolster Enforcement on Multi-Million Dollar Accounts, but More Direction from Congress Is Needed. GAO-15-16. Washington, D.C.: October 20, 2014.
Large Partnerships: With Growing Number of Partnerships, IRS Needs to Improve Audit Efficiency. GAO-14-732. Washington, D.C.: September 18, 2014.
IRS 2015 Budget: Long-Term Strategy and Return on Investment Data Needed to Better Manage Budget Uncertainty and Set Priorities. GAO-14-605. Washington, D.C.: June 12, 2014.
IRS Correspondence Audits: Better Management Could Improve Tax Compliance and Reduce Taxpayer Burden. GAO-14-479. Washington, D.C.: June 5, 2014.
Partnerships and S Corporations: IRS Needs to Improve Information to Address Tax Noncompliance. GAO-14-453. Washington, D.C.: May 14, 2014.
Tax Gap: IRS Could Significantly Increase Revenues by Better Targeting Enforcement Resources. GAO-13-151. Washington, D.C.: December 5, 2012.
Contact Information
For additional information about this area, contact James R. McTigue, Jr. at (202) 512-9110 or mctiguej@gao.gov.
FOOTNOTES
1 GAO, High-Risk Series: An Update, GAO-15-290 (Washington, D.C.: Feb. 11, 2015).
2 GAO, IRS Correspondence Audits: Better Management Could Improve Tax Compliance and Reduce Taxpayer Burden, GAO-14-479 (Washington, D.C.: June 5, 2014).
3 GAO, Auditing and Financial Management: Standards for Internal Control in the Federal Government, GAO/AIMD-00-21.3.1 (Washington, D.C.: Nov. 1, 1999).
4 IRAs serve dual roles by (1) providing a way for individuals not covered by a pension plan to save for retirement and (2) providing a place for retiring workers or individuals changing jobs to roll over, or transfer, their employer-sponsored plan balances. Two types of IRAs are geared toward individuals -- each with its own federal income tax benefits: traditional IRAs and Roth IRAs. Traditional IRA contributions, subject to certain limitations, can be deducted from taxable earnings. Taxes on earnings are deferred until distribution. In contrast, Roth IRA contributions, also subject to certain limitations, are made after tax and distributions are tax free.
5 GAO, Individual Retirement Accounts: IRS Could Bolster Enforcement on Multimillion Dollar Accounts, but More Direction from Congress Is Needed, GAO-15-16 (Washington, D.C.: Oct. 20, 2014).
6 Generally, IRS has 3 years from the date a return is filed (whether the return is filed on time or not) to make an assessment of tax liability. 26 U.S.C. § 6501(a). The statute of limitations is extended in certain situations, including when a taxpayer submits a fraudulent return or omits reporting a certain amount of gross income on the return.
7 Partnerships and S corporations are flow-through entities, which are entities that generally do not pay taxes themselves on income, but instead, pass income or losses to their partners and shareholders, who must include that income or loss on their income tax returns.
8 Currently, certain large partnerships and S corporations are required by statute to e-file. 26 U.S.C. § 6011(e)(2) and 26 C.F.R. § 301.6011-5. About 65 percent of partnerships and S corporations e-filed in 2011.
9 GAO defines large partnerships as those with 100 or more direct and indirect partners and $100 million or more in assets. Direct partners are partners that have a direct interest in the large partnership during the tax year. Direct partners may include taxable partners (such as a corporation or individual) and nontaxable partners (such as a partnership) that also have direct partners. Indirect partners are partners that have an interest in a partnership through interest in another partnership or other form of pass-through entity.
10 Pub. L. No. 97-248, §§ 401-407, 96 Stat. 324, 648-671 (1982).
11 These activity codes focus on whether a partnership reported having less or more than 11 partners, as well as reported gross receipts above or below $100,000. IRS has two activity codes for partnerships that pay an entity-level tax at the end of an IRS audit, and that had returns processed prior to January 1988.
12 GAO/AIMD-00-21.3.1
13 Office of Management and Budget (OMB), Preparation and Submission of Strategic Plans, Annual Performance Plans, and Annual Program Performance Results, OMB Circular A-11 (Washington, D.C.: June 2008); OMB, Guidelines and Discount Rates for Benefit-Cost Analysis of Federal Programs, OMB Circular A-94 (Washington, D.C.: undated); GAO, Tax Administration: IRS Needs to Further Refine Its Tax Filing Season Performance Measures, GAO-03-143 (Washington, D.C.: Nov. 22, 2002).
14 GAO, Tax Gap: IRS Could Significantly Increase Revenues by Better Targeting Enforcement Resources, GAO-13-151 (Washington, D.C.: Dec. 05, 2012).
15 One important research effort is to estimate the revenue and costs associated with "marginal" enforcement cases -- cases that would not have been worked if slightly fewer resources had been devoted to a particular enforcement activity.
16 GAO-13-151.
END OF FOOTNOTES
* * * * *
Appendix I: List of Congressional Addressees
The Honorable Thad Cochran
Chairman
The Honorable Barbara A. Mikulski
Vice Chairwoman
Committee on Appropriations
United States Senate
The Honorable Mike Enzi
Chairman
The Honorable Bernie Sanders
Ranking Member
Committee on the Budget
United States Senate
The Honorable Ron Johnson
Chairman
The Honorable Thomas R. Carper
Ranking Member
Committee on Homeland Security and Governmental Affairs
United States Senate
The Honorable Harold Rogers
Chairman
The Honorable Nita M. Lowey
Ranking Member
Committee on Appropriations
House of Representatives
The Honorable Tom Price
Chairman
The Honorable Chris Van Hollen
Ranking Member
Committee on the Budget
House of Representatives
The Honorable Jason Chaffetz
Chairman
The Honorable Elijah E. Cummings
Ranking Member
Committee on Oversight and Government Reform
House of Representatives
The Honorable Claire McCaskill
United States Senate
The Honorable Mark R. Warner
United States Senate
Appendix II: Objectives, Scope, and Methodology
Section 21 of Public Law 111-139, enacted in February 2010, requires GAO to conduct routine investigations to identify federal programs, agencies, offices, and initiatives with duplicative goals and activities within departments and governmentwide. This provision also requires GAO to report annually to Congress on its findings, including the cost of such duplication, and recommendations for consolidation and elimination to reduce duplication and specific rescissions (legislation canceling previously enacted budget authority) that Congress may wish to consider. As agreed with the key congressional committees, our objectives in this report are to (1) identify what potentially significant areas of fragmentation, overlap, and duplication as well as opportunities for cost savings and enhanced revenues exist across the federal government; and (2) identify what options, if any, exist to address fragmentation, overlap, and duplication in these areas and take advantage of opportunities for cost savings and enhanced revenues.
For the purposes of our analysis, we used the term "fragmentation" to refer to those circumstances in which more than one federal agency (or more than one organization within an agency) is involved in the same broad area of national need and there may be opportunities to improve how the government delivers these services. We used the term "overlap" when multiple agencies or programs have similar goals, engage in similar activities or strategies to achieve them, or target similar beneficiaries. We considered "duplication" to occur when two or more agencies or programs are engaged in the same activities or provide the same services to the same beneficiaries.1 This report presents 12 areas of fragmentation, overlap, or duplication where greater efficiencies or effectiveness in providing government services may be achievable. We also highlighted 12 other opportunities for potential cost saving or revenue enhancements.
GAO's Approach
Over the course of our 2011 through 2013 annual reports we conducted a systematic and practical examination across the federal government to provide reasonable coverage for areas of potential fragmentation, overlap, and duplication government-wide.2 Since then, we continue to consider a variety of factors to determine whether such potential instances or opportunities identified in our routine audit work warrant inclusion in this annual report. Such factors included, but were not limited to, the extent of potential cost savings, opportunities for enhanced program efficiency or effectiveness, the degree to which multiple programs may be fragmented, overlapping, or duplicative, whether issues had been identified by GAO or external sources, and the level of coordination among agency programs.
Each issue area contained in Sections I and II of this report lists any respective GAO reports and publications upon which it is based. Those prior GAO reports contain more detailed information on our supporting work and methodologies. For issues that update prior GAO work, we provide additional information on the methodologies used in that update in the section entitled "How GAO Conducted Its Work" of each issue area.
Identifying Actions
To identify what actions, if any, exist to address fragmentation, overlap, and duplication and take advantage of opportunities for cost savings and enhanced revenues, we reviewed and updated prior GAO work and recommendations to identify what additional actions agencies may need to take and Congress may wish to consider. For example, we used a variety of prior GAO work identifying leading practices that could help agencies address challenges associated with interagency coordination and collaboration and evaluating performance and results achieving efficiencies.3
To identify the potential financial and other benefits that might result from actions addressing fragmentation, overlap, or duplication, we collected and analyzed data on costs and potential savings to the extent it was available. Estimating the benefits that could result from eliminating unnecessary fragmentation, overlap, or duplication was not possible in some cases because information about the extent of duplication among certain programs was not available. Further, the financial benefits that can be achieved from eliminating duplication, overlap, or fragmentation were not always quantifiable in advance of congressional and executive branch decision making, and needed information was not readily available on, among other things, program performance, the level of funding devoted to overlapping programs, or the implementation costs and time frames that might be associated with program consolidations or terminations.
When possible, we also included tables in appendix V that provide a detailed listing of federally-funded program names and associated budgetary information. While there is no standard definition for what constitutes a program, they may include grants, tax expenditures, centers, loans, funds, and other types of assistance. A wide variety of budgetary information may be used to convey the federal commitment to these programs. When available, we collected obligations information for fiscal year 2013 for reporting across issue areas. In some instances, obligations data were not available, but we were able to report other budgetary information, such as appropriations. In other issue areas, we did not report any budgetary information, because such information was either not available or sufficiently reliable. For example, some agencies could not isolate budgetary information for some programs, because the data were aggregated at higher levels.
We assessed the reliability of any computer-processed data that materially affected our findings, including cost savings and revenue enhancement estimates. The steps that GAO takes to assess the reliability of data vary but are chosen to accomplish the auditing requirement that the data be sufficiently reliable given the purposes it is used for in our products. GAO analysts review published documentation about the data system and Inspector General or other reviews of the data. GAO may interview agency or outside officials to better understand system controls and to assure ourselves that we understand how the data are produced and any limitations associated with the data. GAO may also electronically test the data to see if values in the data conform to agency testimony and documentation regarding valid values, or compare data to source documents. In addition to these steps GAO often compares data with other sources as a way to corroborate our findings. Per GAO policy, when data do not materially affect findings and are presented for background purposes only, we may not have assessed the reliability depending upon the context in which the data are presented.
Assessing Status of Actions
To examine the extent to which the legislative and executive branches have made progress in implementing the approximately 440 actions in the 188 areas4 we have reported on in previous annual reports on fragmentation, overlap, and duplication, we reviewed relevant legislation and documents such as budgets, policies, strategic and implementation plans, guidance, and other information. We also analyzed, to the extent possible, whether or not financial or other benefits have been attained, and included this information as appropriate. In addition, we discussed the implementation status of the areas with officials at the relevant agencies.
Using the legislation and documentation collected from agencies, GAO analysts and specialists working on defense, domestic, and international areas assessed progress for each of the approximately 440 actions within their areas of expertise. A core group of GAO staff examined all assessments to ensure consistent and systematic application of the criteria, and made adjustments, as appropriate.
We used the following criteria in assessing the status of actions.5
In assessing legislative branch actions, we applied the following criteria: "addressed" means relevant legislation is enacted and addresses all aspects of the action needed; "partially addressed" means a relevant bill has passed a committee, the House of Representatives, or the Senate, or relevant legislation has been enacted but only addressed part of the action needed; and "not addressed" means a bill may have been introduced but did not pass out of a committee, or no relevant legislation has been introduced.6
In assessing executive branch actions we applied the following criteria: "addressed" means implementation of the action needed has been completed; "partially addressed" means the action needed is in development, started but not yet completed; and "not addressed" means the administration, the agencies, or both have made minimal or no progress toward implementing the action needed.
GAO provided drafts of these assessments to the agencies involved for their technical comments and incorporated these comments, as appropriate. In providing the drafts to the agencies for review, we communicated that we would use an as of date of March 6, 2015, for all assessments. In addition to summarizing any comments received on our assessments, we incorporated a summary of comments on the prior GAO work upon which each issue area is based. Consistent with GAO policy, we are not reprinting copies of agencies' comment letters with this report, as the work included is based predominantly on previously issued GAO reports. Copies of agency comment letters associated with previous reports can be found in those reports, if applicable.
This report is based upon work GAO previously conducted in accordance with generally accepted government auditing standards, or GAO's quality assurance framework. Generally accepted government auditing standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives. In addition, Area 16: U.S. Enrichment Corporation Fund was conducted from April 2014 to May 2014 under GAO's quality assurance framework. We use GAO's quality assurance framework when we conduct routine nonaudits, such as technical assistance provided to Congress. GAO's quality assurance framework requires that we plan and perform the engagement to meet our stated objectives and to discuss any limitations in our work. We maintain that the information and data obtained, and the analysis conducted, provide a reasonable basis for our findings and conclusions.
FOOTNOTES TO APPENDIX II
1 We recognize that there could be instances where some degree of program fragmentation, overlap, and duplication, may be warranted due to the nature or magnitude of the federal effort.
2 See GAO-14-343SP.
3 GAO, Results-Oriented Government: Practices That Can Help Enhance and Sustain Collaboration among Federal Agencies, GAO-06-15 (Washington, D.C.: Oct. 21, 2005)and Managing for Results: A Guide for Using the GPRA Modernization Act to Help Inform Congressional Decision Making, GAO-12-621SP (Washington, D.C.: June 15, 2012).
4 To provide a more accurate picture of the progress made in the identified areas, starting in 2015, we are reporting the status of each action under each area (see appendix IV). New actions are assessed as pending.
5 Based on subsequent audit work that we conducted, 12 actions reported in 2011 and 8 actions reported in 2012 were not assessed this year, and we have categorized those areas and actions as "consolidated or other." These actions have either been consolidated, redirected from a Congressional to an executive branch action, or revised to reflect updated information or data that we obtained. In addition, we added 19 new actions to areas on which we reported in 2011-2014, these newly added actions are listed in appendix III. The status of new actions has not yet been assessed.
6 On January 6th, 2015 the 114th United States Congress convened and all pending legislation from the 113th Congress expired. Therefore, all of the legislative branch actions that were assessed as partially addressed under the 113th Congress reverted to not addressed because the relevant bill was not enacted into law before the end of the 113th Congress and no similar bill has passed out of committee in the 114th Congress as of March 6, 2015.
END OF FOOTNOTES TO APPENDIX II
* * * * *
Appendix III: New Actions of Fragmentation, Overlap, and
Duplication Added to Existing Areas
As part of our April 2015 update of the Action Tracker, we are adding 19 new actions based on GAO reports that fall within the scope of six existing areas identified in prior fragmentation, overlap, and duplication annual reports.
Table 1: New Actions to Existing Areas in 2015
Mission
Agriculture
Annual Report
2011
Area
Area 1: Food Safety
Associated GAO Product
GAO-15-180
Actions Identified
Action 1: Congress should consider formalizing the Food Safety Working Group through statute to help ensure sustained leadership across food safety agencies over time.
Mission
Defense
Annual Report
2013
Area
Area 20: Joint Basing
Associated GAO Product
GAO-14-577
Actions Identified
Action 1: To help ensure DOD's approach to joint basing achieves the goals as outlined by DOD in its justification for the 2005 BRAC recommendation and leverages additional opportunities to reduce duplication of effort that could in turn generate cost savings and increased efficiencies, Congress should consider directing the Deputy Under Secretary of Defense (Installations and Environment), in collaboration with the military services and joint bases, to evaluate the purpose of the program and determine whether the current goals, as stated in the 2005 BRAC Commission recommendation, are still appropriate, or whether goals should be revised; communicate these goals to the military services and joint bases, and adjust program activities accordingly; provide direction to the joint bases on requirements for meeting program goals, including determining reporting requirements and milestones; and determine any next steps for joint basing, including whether to expand it to other installations.
Mission
General Government
Annual Report
2011
Area
Area 66: New Markets Tax Credits
Associated GAO Product
GAO-14-500
Actions Identified
Action 1: The Secretary of the Treasury should issue guidance on how funding or assistance from other government programs can be combined with the New Markets Tax Credit (NMTC), including the extent to which other government funds can be used to leverage the NMTC by being included in the qualified equity investment.
Action 2: The Secretary of the Treasury should ensure that controls are in place to limit the risk of unnecessary duplication at the project level in funding or assistance from government programs and to limit above market rates of return, i.e., returns that are not commensurate with the NMTC investor's risk.
Action 3: The Secretary of the Treasury should ensure that the Community Development Financial Institutions Fund reviews the disclosure sheet that Community Development Entities (CDE) are required to provide to low-income community businesses to determine whether it contains data that could be useful for the Fund to retain.
Action 4: The Secretary of the Treasury should ensure that the Community Development Financial Institutions (CDFI) Fund clarifies the instructions for reporting the amount of any equity which may be acquired by the low-income community business at the end of the 7-year New Markets Tax Credit (NMTC) compliance period.
Action 5: The Secretary of the Treasury should also ensure that the Community Development Financial Institutions (CDFI) Fund clarifies the instructions it provides to Community Development Entities (CDE) about reporting loan performance and make the reporting of that data mandatory.
Mission
General Government
Annual Report
2011
Area
Area 17: Tax Expenditures
Associated GAO Product
GAO-13-518
Actions Identified
Action 1: The Director of the Office of Management and Budget (OMB) should review whether all relevant tax expenditures that contribute to a cross-agency priority (CAP) goal have been identified, and as necessary, include any additional tax expenditures in the list of federal contributors for each goal.
Action 2: The Director of the Office of Management and Budget (OMB) should assess the contributions relevant tax expenditures are making toward the achievement of each cross-agency priority (CAP) goal.
Action 3: The Director of the Office of Management and Budget (OMB) should ensure that agencies adhere to OMB's guidance for website updates by providing complete information about the organizations, program activities, regulations, tax expenditures, policies, and other activities -- both within and external to the agency -- that contribute to each Agency Priority Goal (APG).
Action 4: The Director of the Office of Management and Budget (OMB) should include tax expenditures in the federal program inventory effort by designating tax expenditure as a program type in relevant guidance.
Action 5: The Director of the Office of Management and Budget (OMB) should develop, in coordination with the Secretary of the Treasury, a tax expenditure inventory that identifies each tax expenditure and describes its definition, its purpose, and its related performance and budget information.
Mission
Health
Annual Report
2011
Area
Area 18: DOD-VA Health Records
Associated GAO Product
GAO-14-302
Actions Identified
Action 1: To bring transparency and credibility to the Secretaries of Veterans Affairs and Defense's assertion that the Department of Veterans Affairs's (VA) and the Department of Defense's (DOD) current approach to achieving an interoperable electronic health record will cost less and take less time than the previous single-system approach, the secretaries should (1) develop a cost and schedule estimate for their current approach, from the perspective of both departments, that includes the estimated cost and schedule of VA's VistA Evolution program, DOD's DOD Healthcare Management System Modernization (DHMSM) program, and the departments' joint efforts to achieve interoperability between the two systems; then, compare the cost and schedule estimates of the departments' current and previous (i.e., single-system) approaches. If the results of the comparison indicate that the departments' current approach is estimated to cost more and/or take longer than the single-system approach, the secretaries should (1) provide a rationale for pursuing the current approach despite its higher cost and/or longer schedule and (2) report the cost and schedule estimates of the current and previous approaches, results of the comparison of the estimates, and reasons (if applicable) for pursuing a more costly or time-consuming approach to VA's and DOD's congressional authorizing and appropriations committees.
Action 2: To better position the Departments of Veterans Affairs (VA) and Defense (DOD) to achieve an interoperable electronic health record, the Secretaries of Veterans Affairs and Defense should develop a plan that, at a minimum, describes (1) the clinical domains that the interoperable electronic health record will address; (2) a schedule for implementing the interoperable record at each VA and DOD location; (3) the estimated cost of each major component (i.e., VistA Evolution, DHMSM, etc.) and the total cost of the departments' interoperability efforts; (4) the organizations within VA and DOD that are involved in acquiring, developing, and implementing the record, as well as the roles and responsibilities of these organizations; (5) major risks to the departments' interoperability efforts and mitigation plans for those risks; and (6) the departments' approach to defining, measuring, tracking, and reporting progress toward achieving expected performance (i.e., benefits and results) of the interoperable record.
Action 3: To better position the Interagency Program Office (IPO)for effective collaboration between the Departments of Veterans Affairs (VA) and Defense (DOD) and to efficiently and effectively fulfill the office's stated purpose of functioning as the single point of accountability for achieving interoperability between the departments' electronic health record systems, the Secretaries of Veterans Affairs and Defense should ensure that the IPO has authority (1) over dedicated resources (e.g., budget and staff), (2) to develop interagency processes, and (3) to make decisions over the departments' interoperability efforts.
Mission
Information Technology
Annual Report
2013
Area
Area 11: Geospatial Investments
Associated GAO Product
GAO-15-193
Actions Identified
Action 1: To better facilitate the coordination of -- and accountability for -- the estimated billions of dollars in federal geospatial investments, the Director of the Office of Management and Budget (OMB) should improve oversight of progress on the National Spatial Data Infrastructure (NSDI). OMB should require federal agencies to report on their efforts to establish and implement policies for identifying geospatial metadata on the Geospatial Platform, and procedures for utilizing the Marketplace feature of the Geospatial Platform, before making new investments in geospatial data.
Action 2: To better facilitate coordination of federal investments in address data and reduce duplication, the Secretary of the Interior, as the Federal Geographic Data Committee (FGDC) Chair, should direct the FGDC Steering Committee to create an address data theme with associated subcommittees and working groups to assist in furthering a national address database.
Action 3: To better facilitate coordination of federal investments in geospatial imagery and reduce duplication, the Secretary of the Interior, as the Federal Geographic Data Committee (FGDC) Chair, should direct the FGDC Steering Committee to direct the National Digital Orthoimagery Program to reassess the feasibility of the "Imagery for the Nation" initiative, with the goal of identifying discrete steps that could be taken to further a national imagery program benefitting governments at all levels.
Action 4: To increase coordination between various levels of government and reduce duplication of effort, resources, and costs associated with collecting and maintaining accurate address data, Congress should consider assessing the impact of the disclosure restrictions of Section 9 of Title 13 and Section 412 of Title 39 of the U.S. Code in moving toward a national geospatial address database. If warranted, Congress should consider revising those statutes to authorize the limited release of addresses, without any personally identifiable information, specifically for geospatial purposes. Such a change, if deemed appropriate, could potentially result in significant savings across federal, state, and local governments.
Source: GAO. l GAO-15-404SP
* * * * *
Appendix IV: Areas Identified in 2011 - 2015 Annual
Reports, by Mission
This enclosure presents the areas we identified in our 2011-2015 annual reports. It also includes our assessment of the progress made in each of the approximately 440 actions that we identified in our 2011, 2012, 2013, and 2014 annual reports in which Congress and the executive branch could take actions to reduce or eliminate potential fragmentation, overlap, and duplication or achieve other potential financial benefits.1 We have not yet made any assessments of progress for its 2015 areas. Table 1 presents our assessment of progress made in implementing the actions needed in the areas related to fragmentation, overlap, or duplication. Table 2 presents our assessment of progress made in implementing the actions needed in the areas related to cost savings or revenue enhancement.2
Table 1: GAO Identified Areas and Assessment of Actions of
Fragmentation, Overlap, and Duplication in 2011-2015
Annual Reports
Table 2: GAO Identified Areas of Cost-Savings and
Revenue-Enhancement Opportunities in 2011-2015
Annual Reports
FOOTNOTES TO APPENDIX IV
1 GAO, Opportunities to Reduce Potential Duplication in Government Programs, Save Tax Dollars, and Enhance Revenue, GAO-11-318SP(Washington,D.C.: Mar. 1, 2011); GAO, 2012 Annual Report: Opportunities to Reduce Duplication, Overlap, and Fragmentation, Achieve Savings, and Enhance Revenue, GAO-12-342SP(Washington,D.C.: Feb. 28,2012); GAO, 2013 Annual Report: Actions Needed to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits. GAO-13-279SP(Washington,D.C.:Apr 9, 2013); and GAO, 2014 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits. GAO-14-343SP (Washington, D.C.: Apr 8, 2014). Twenty actions were categorized as "consolidated or other" and were not assessed due to additional audit work or other information we considered.
2 Tables 1 and 2 provide a snapshot of the overall action status for each area, and the ordering of the action status assessments does not correlate with the action numbering on GAO's Action Tracker. For more information on the status of individual actions, please see GAO's Action Tracker.
END OF FOOTNOTES TO APPENDIX IV
* * * * *
Appendix V: Lists of Programs Identified
This appendix includes lists of federal programs or other activities related to issue areas in this report, and their obligations data, where such information was available. In some cases, we did not report budgetary information because it was either not available or sufficiently reliable. For some issue areas, agencies were not able to readily provide programmatic information needed to determine whether and to what extent programs are actually duplicative. Additionally, in some instances of fragmentation, overlap, or duplication, it may be appropriate for multiple agencies or entities to be involved in the same programmatic or policy area due to the nature or magnitude of the federal effort.
Table 1: Defense Acquisitions Programs: Programs and
Related Budgetary Information
_____________________________________________________________________________
Total Estimated
Acquisition Costs
Agency Program name Program description (as of December 2014)
_____________________________________________________________________________
Department Defense Major Weapons $1.4 trillion
of Defense Acquisitions Systems
_____________________________________________________________________________
Source: GAO analysis of DOD data. | GAO-15-404SP
Table 2: Consumer Product Safety:
List of Agencies with a Direct Oversight Role
_____________________________________________________________________________
Examples of products
Agency Role regulated
_____________________________________________________________________________
Coast Guard Regulates safety All original equipment
standards for installed on boats;
recreational boats. limited equipment
installed after
purchase (inboard
engines, outboard
engines, stern drive
units, and inflatable
life jackets)
Consumer Product Oversees consumer Toys, cribs, power
Safety Commission products produced or tools that are used by
(CPSC) distributed in the consumers, lighters,
United States for sale and household products
to, or use by,
consumers in or around
a residence or school
or in recreation or
otherwise.
Department of Housing Mitigates lead-based Structural materials in
and Urban Development paint hazards in manufactured homes
(HUD) federally assisted such as particle
housing. It also board, plywood,
establishes federal drywall, steel frames,
standards for the and windows
design and
construction of
manufactured homes.
Environmental Conducts risk Insect repellents,
Protection Agency assessments of toilet bowl
(EPA) pesticides and sanitizers/disinfectants
registers them for use ant traps, and flea
in the United States. powder
Also evaluates and
manages risks of Some household products
chemicals. such as window cleaners;
flame retardants used
in furniture and
electronics; and
formaldehyde emissions
from composite wood
products (e.g.,
kitchen cabinets)
Food and Drug Ensures the safety, Prescription drugs,
Administration (FDA) efficacy, and security over-the-counter
of human and drugs, contact lenses,
veterinary drugs, breast pumps,
biological products, cosmetics such as
medical devices, and lipstick and eye
electronic products liner, cell phones,
that emit radiation. and toy laser products
Also ensures the
safety of cosmetics.
Additionally,
regulates food and
tobacco products, but
are outside the scope
of this study.
National Highway Sets and enforces Motor vehicles, motor
Traffic Safety safety performance vehicle equipment such
Administration (NHTSA) standards for motor as tires and
vehicles and motor motorcycle helmets,
vehicle equipment. and child restraint
systems (when sold for
use in vehicles)
Nuclear Regulatory Licenses and regulates Consumer products that
Commission (NRC) civilian use of contain NRC-regulated
certain radioactive materials such as
materials. tritium watches, smoke
detectors, and
electron tubes
Pipeline and Hazardous Ensures that hazardous Hazardous materials
Materials Safety materials are packaged (such as consumer
Administration (PHMSA) and handled safely fireworks, lithium
during transportation. batteries, and
compressed gas) in
transport
_____________________________________________________________________________
Source: GAO analysis of agency data. | GAO 15-404SP
Note: Some agencies have broader responsibilities than those listed in the
table, which focuses on aspects of each agency's work that relate to consumer
product safety.
Table 3: Nonemergency Medical Transportation (NEMT):
List of Federal Programs
_____________________________________________________________________________
Agency Program name Program description
_____________________________________________________________________________
Department of Community Facilities Program funds are
Agriculture Loans and Grants available for health
care projects (assisted
living, nursing homes,
etc.) and may be used
to purchase vehicles to
transport
patients/residents for
medical appointments
and shopping.
Department of Education State Vocational Transport for services
Rehabilitation Services to medical
Program appointments.
Centers for Independent Transport for services
Livinga to medical
appointments.
Independent Living Transport for services
State Grantsb to medical
appointments.
Independent Living Transport for services
Services for Older to medical
Individuals Who Are appointments.
Blind
Special Education- Transport for services
Grants for Infants and to medical
Toddlers appointments.
Supported Employment Transport for services
Services for Individuals to medical
with Most Significant appointments.
Disabilities
Rehabilitation Services Transport for services
American Indians with to medical
Disabilities appointments.
Department of Urbanized Area Formula NEMT and any other type
Transportation Program of trips are allowable,
as general public
transportation trips
are not differentiated
by purpose.
Formula Grants for Rural NEMT and any other type
Areas of trips are allowable,
as general public
transportation trips
are not differentiated
by purpose.
Enhanced Mobility of Grants and other
Seniors and Individuals programs can be
with Disabilitiesc developed at the local
level through the
locally developed
coordinated planning
process that can serve
to address
transportation gaps for
seniors and people with
disabilities and could
include partnerships
with NEMT funded
programs like Medicaid.
New Freedom Program Grants and other
programs can be
developed at the local
level through the
locally developed
coordinated planning
process that can serve
to address
transportation gaps for
people with
disabilities and could
include partnerships
with NEMT funded
programs like Medicaid.
Department of Health Special Programs for These funds are
and Human Services the Aging, Title III, flexible and can be
Part B, Grants for used for both medical
Supportive Services and and non-medical
Senior Centers transportation.
Special Programs for Transportation to
the Aging, Title VI, access needed services
Part A, Grants to which may include
Indian Tribes, Part B, medical appointments
Grants to Native and medical treatments.
Hawaiians
Comprehensive Community Transportation to
Mental Health Services access needed services
for Children with which may include
Serious Emotional medical appointments
Disturbances for a child with mental
health issues.
Coordinated Services Transportation services
and Access to Research for an eligible
for Women, Infants, individual to access
Children and Youth HIV-related health
services, including
services needed to
maintain the client in
HIV Medical care,
directly or through
voucher.
Urban Indian Health Vehicle purchase or
Services lease, bus token, taxi
fare.
Health Center Program Health centers are
required to provide
services that enable
individuals to use the
services of the health
center (including
outreach and
transportation
services).
Special Diabetes Public transportation,
Program for Indians mileage reimbursement,
Diabetes Prevention and and purchase of motor
Treatment Projects vehicles.
Substance Abuse and Bus tokens/pass, cab
Mental Health Services- fare, gas card.
Access to Recovery
Transitional Living Transport to medical
Program and Maternity appointments, for
Group Homes for employment training,
Homeless Youth school, and other
services identified.
Head Start Head Start grantees
have flexibility to
provide nonemergency
medical transportation
to children to medical
and dental
appointments.
Social Services Block Travel to obtain
Grants medical care; may
include special modes
of transportation.
Children's Health Transportation to
Insurance Program primary and
preventative health
care services for
eligible low-income
women.
Medicaid State Medicaid Agencies
are required to assure
transportation for
beneficiaries to
covered medical care
when the beneficiary
has no other means of
transportation.
Depending on the
claiming authority, the
state has many options
to structure their NEMT
program but Federal
Financial Participation
is only available for
this specific purpose.
Rural Health Care Program funds can be
Services Outreach, used to support NEMT
Rural Health Network costs such as
Development, and Small personnel, contractual
Health Care Provider services (with NEMT
Quality Improvement service providers)
Program and/or promotion of
NEMT services.
HIV Emergency Relief Program funds can be
Project Grants used for the provision
of transportation
services for an
eligible individual to
access HIV-related
health services,
including services
needed to maintain the
client in HIV Medical
care, directly or
through voucher.
HIV Care Formula Grants Program funds can be
used for the provision
of transportation
services for an
eligible individual to
access HIV-related
health services,
including services
needed to maintain the
client in HIV Medical
care, directly or
through voucher.
Services are conveyance
services provided,
directly or through a
voucher, to a client to
enable him or her to
access health care
services.
HIV Early Intervention Program funds can be
Services used for the provision
of transportation
services for an
eligible individual to
access HIV-related
health services,
including services
needed to maintain the
client in HIV Medical
care, directly or
through voucher.
Healthy Start Program funds can be
Initiative used for bus tokens,
taxi vouchers,
reimbursement of own
vehicle.
Community Mental Health If the individual
Services Block Grant requires this services
and it cannot or is not
funded by Medicaid,
States can use the
funding for this
service.
Substance Abuse Authorizing legislation
Prevention and neither prescribes nor
Treatment Block Grant prohibits funding of
NEMT. The exception is
Interim Final Rule (45
CFR 96. 120-137)
explicitly prescribes
transportation for
substance using
pregnant women and
women with dependent
children.
Maternal and Child If a state identifies
Health Services Block this service as one
Grant to the States that relates to an
identified priority
need, it may choose to
support such an
activity.
Department of Congregate Housing The grant can be used
Housing and Urban Services program for up to 40 percent of
Development the cost of supportive
services which can
include NEMT.
Community Development NEMT could qualify as
Block an eligible service.
Grants/Entitlement
Grants
Community Development NEMT could qualify as
Block Grants/Special an eligible service.
Purpose Grants/Insular
Areas
Community Development NEMT could qualify as
Block Grants/State's an eligible service.
program and Non-
Entitlement Grants in
Hawaii
Housing Opportunities NEMT could qualify as
for Persons with AIDS an eligible service.
Resident Opportunity & Expenses to support
Self-Sufficiency residents participating
Program in the program obtain
medical services such
as obtaining eyeglasses
for work.
Department of Veterans Veterans Medical Care The Beneficiary Travel
Affairs Benefits Program (BT) has
authority to provide
both emergency and non-
emergency transport to
eligible beneficiaries
in relation to VA or VA
authorized non-VA care.
VA Homeless Providers Funds granted to
Grant and Per Diem community homeless
Program providers may be used
to purchase vehicles to
provide NEMT.
Veterans Transportation Transportation of
Program Veterans to VA Medical
Centers and CBOC's.
_____________________________________________________________________________
Source: GAO analysis of information from the Departments of Agriculture,
Education, Health and Human Services, Housing and Urban Development,
Transportation and Veterans Affairs, the Catalog of Federal Domestic
Assistance, and applicable statutes and regulations. | GAO-15-404SP
Notes: Total federal spending on NEMT is unknown.
FOOTNOTES TO TABLE 3
a On July 22, 2014, this program was transferred to HHS by the
Workforce Innovation and Opportunity Act and is being administered by the
Department of Education during this transition.
b On July 22, 2014, this program was transferred to HHS by the
Workforce Innovation and Opportunity Act and is being administered by the
Department of Education during this transition.
c The Over-the-Road Bus Program was repealed by MAP-21,
effective October 2012. The Federal Public Transportation Act of 2012 repealed
the New Freedom program (49 U.S.C. § 5317) as a separate program and
instead merged the program into the Enhanced Mobility of Seniors and
Individuals with Disabilities program (49 U.S.C. § 5310), effective
October 2012.
END OF FOOTNOTES TO TABLE 3
Table 4: Department of Defense Health Care:
Program and Related Budgetary Information
_____________________________________________________________________________
Fiscal year
Agency Program name Program description 2013 obligations
_____________________________________________________________________________
Department of (DOD) Health Care Provides health care $48,400,000,000
Defense to eligible military
beneficiaries world-
wide through the
TRICARE program.
US Family Health Provides the TRICARE $1,120,000,000
Plan Prime benefit to
eligible military
beneficiaries
in six areas of the
country.
_____________________________________________________________________________
Source: Department of Defense. | GAO-15-404SP
List of Programs and Related Budgetary Information
_____________________________________________________________________
Agency
Air Force
Program name
Baseline Psychological Testing for Recruits
Program description Department of Defense
A screening program completed during basic military training at Joint Base San Antonio to identify mental health and behavioral problems.
Fiscal year 2013 Obligations
$800,000a
Program name
Virtual Reality Exposure Therapy
Program description Department of Defense
Selected Air Force medical treatment facilities are outfitted with interactive virtual reality systems for use in enhanced exposure therapy between behavioral health providers and patients suffering from conditions such as post-traumatic stress disorder (PTSD), mild traumatic brain injury, addictions, phobias, and anger management issues.
Fiscal year 2013 Obligations
280,000
Agency
Air National Guard
Program name
Psychological Health Program
Program description Department of Defense
Provides assessment services, ensures continuity and engagement in treatment, and prevents servicemembers from falling through the cracks. This program does not provide direct treatment services.
Fiscal year 2013 Obligations
14,460,000
Agency
Army National Guard
Program name
Psychological Health Program
Program description Department of Defense
Provides assessment services, ensures continuity and engagement in treatment, and prevents servicemembers from falling through the cracks. This program does not provide direct treatment services.
Fiscal year 2013 Obligations
14,400,000
Agency
Navy
Program name
Overcoming Adversity and Stress Injury Support
Program description Department of Defense
This is a 10-week comprehensive residential treatment program for Active Duty members with combat related stress disorders, including PTSD. Includes evidence-based treatment such as cognitive processing therapy, along with psychopharmacological interventions and complementary alternative treatments.
Fiscal year 2013 Obligations
1,133,000
Department of Health and Human Services
_____________________________________________________________________
Agency
Substance Abuse and Mental Health Services Administration
Program name
Community Mental Health Services Block Grant
Program description Department of Defense
Distributes funding to eligible states and territories for a variety of mental health prevention and treatment services; planning; administration; and educational activities under the state plan for comprehensive community-based mental health services for children with serious emotional disturbance and adults with serious mental illness.
Fiscal year 2013 Obligations
463,809,000b
Program name
Consumer and Consumer Support Technical Assistance
Program description Department of Defense
Provides support for technical assistance to facilitate the restructuring of the mental health system by promoting consumer directed approaches for adults with serious mental illness.
Fiscal year 2013 Obligations
1,775,000b
Program name
Criminal and Juvenile Justice
Program description Department of Defense
Diverts individuals with serious mental illness from the criminal justice system by providing support services that connect the individual to behavioral health, housing, and job placement services.
Fiscal year 2013 Obligations
4,754,000b
Program name
Mental Health Homelessness Prevention
Program description Department of Defense
Provides comprehensive services focusing on outreach, engagement, intensive case management, mental health services, substance abuse treatment, benefits support, and linkage to permanent housing.
Fiscal year 2013 Obligations
23,018,000b
Program name
Mental Health Transformation Grant
Program description Department of Defense
Supports state and local governments creation or capacity expansion of evidence-based practices addressing the prevention of mental illness; trauma-informed care; screening, treatment and support services for military personnel; and housing and employment support.
Fiscal year 2013 Obligations
8,551,000b
Program name
Minority HIV/AIDS
Program description Department of Defense
Expands behavioral health services to individuals who are at risk for or have serious mental illness and/or co-occurring substance use disorder and are at risk or living with HIV/AIDS. Supports programs that develop or expand behavioral health and primary care networks in order to reduce the impact of behavioral health problems, HIV risk and HIV-related health disparities.
Fiscal year 2013 Obligations
7,340,000b
Program name
Primary and Behavioral Health Care Integration
Program description Department of Defense
Funds the coordination and integration of primary care services into publicly-funded community behavioral health settings. The program encourages grantees to engage in necessary partnerships, expand infrastructure and increase the availability of primary health care and wellness services to individuals with mental illness.
Fiscal year 2013 Obligations
28,858,000b
Program name
Projects for Assistance in Transition from Homelessness
Program description Department of Defense
Supports services and resources to people with serious mental illness, including those with co-occurring substance use disorder, who are experiencing homelessness or at risk for homelessness. Provides funds for community-based outreach, case management, screening and diagnostic treatment, alcohol or drug treatment, and a limited set of housing services.
Fiscal year 2013 Obligations
61,405,000b
Program name
Protection and Advocacy for Individuals with Mental Illness
Program description Department of Defense
Provides grant awards to support protection and advocacy systems designated by the governor of each state or mayor of the District of Columbia. These systems monitor compliance with the Constitution and federal and state laws within public and private residential care, treatment facilities, and non-medical community-based facilities for individuals with serious mental illness, children, and youth.
Fiscal year 2013 Obligations
33,571,000b
Program name
State and Community Partnerships to Integrate Services
Program description Department of Defense
Supports the creation of developmentally-appropriate local systems of care to improve outcomes of youth and young adults with serious mental health conditions. The grants fund integration of local systems with state, tribal, or territorial levels in areas such as education, employment, housing, mental health and co-occurring disorders, and decrease contacts with the juvenile and criminal system.
Fiscal year 2013 Obligations
2,929,000b
Program name
Statewide Consumer Network
Program description Department of Defense
Provides funding to consumer-driven organizations to enhance statewide service system capacity. Promotes skill development, business management, and partnership building as part of the recovery process for mental health consumers.
Fiscal year 2013 Obligations
2,094,000b
Program name
Statewide Family Network
Program description Department of Defense
Provides information, referrals, and support at the state and local level to families who have a child with a serious emotional disturbance.
Fiscal year 2013 Obligations
2,810,000b
Program name
System of Care Expansion Implementation Cooperative
Program description Department of Defense
Supports broad-scale operation, expansion and integration of systems of care to improve behavioral outcomes of children and youth with serious emotional disturbances and their families.
Fiscal year 2013 Obligations
92,085,000b
Department of Justice
_____________________________________________________________________
Fiscal year 2013 Obligations
164,200,000c
Agency
Bureau of Prisons
Program name
Dual Diagnosis Residential Drug Abuse Program
Program description Department of Defense
An intensive residential substance abuse treatment program providing services for inmates with co-occurring substance use disorders and serious mental illnesses. The program is 9-months, unit-based, and offers cognitive-behavioral interventions in a modified therapeutic community setting.
Fiscal year 2013 Obligations
c
Program name
Mental Health Step Down Unit
Program description Department of Defense
Offers an intermediate level of care for inmates with serious mental illness who do not require inpatient treatment, but lack the skills to function independently in a general population prison. Programs operate as modified therapeutic communities and utilize cognitive behavioral treatments, cognitive rehabilitation, and skills training.
Fiscal year 2013 Obligations
c
Program name
Steps Toward Awareness, Growth, and Emotional Strength
Program description Department of Defense
A unit-based residential psychology treatment program that focuses on inmates with serious mental illness and a primary diagnosis of Borderline Personality Disorder. Uses evidence-based treatments to increase time between disruptive behaviors and increase pro-social skills, and aims to prepare inmates for transition to less secure prison settings or promote successful reentry to society.
Fiscal year 2013 Obligations
c
Social Security Administration
_____________________________________________________________________
Agency
Office of Retirement and Disability Policy
Program name
Homeless with Schizophrenia Presumptive Disability
Program description
Aims to remove barriers to supplemental security income for individuals who have been diagnosed with schizophrenia or schizoaffective disorder who are known to be homeless by helping them through the application process and providing presumptive disability payments.
Fiscal year 2013 obligations
N/Ad
Department of Veterans Affairs
______________________________________________________________________
Agency
Veterans Health Administration
Program name
Intensive Community Mental Health Recovery
Program description
Provides veterans with serious mental illness intensive recovery-oriented mental health services in their home and community that enable them to live in the community of their choosing. Connects veterans with a team that may include peer specialists, social workers, psychologists and physicians.
Fiscal year 2013 obligations
142,533,000
Program name
Mental Health Residential Rehabilitation Treatment
Program description
Provides residential rehabilitation and treatment services for veterans with mental health and substance use disorders, medical conditions and psychosocial needs, such as homelessness and unemployment. The program addresses the goals of rehabilitation, recovery, and community integration. It provides specific treatment for mental health, substance use disorders and medical conditions.
Fiscal year 2013 obligations
858,119,000
Program name
Psychosocial Rehabilitation and Recovery Center
Program description
Supports recovery and integration into the community for veterans with serious mental illness and severe functional impairment. Includes individual assessment and curriculum planning, skills training classes, family education programs, psychiatric services, compensated work therapy, and case management services.
Fiscal year 2013 obligations
77,307,000
Program name
Re-Engaging Veterans with Serious Mental Illness
Program description
Identifies veterans with schizophrenia or bipolar disorder who have received care but have been lost to follow-up (no outpatient visits and no inpatient visits of more than 2 days) for at least 1 year. Contact information of identified veterans are sent to a social worker or psychologist at VA medical centers and community outpatient clinics who make efforts to locate, contact, assess the needs, and invite the veterans to return to care.
Fiscal year 2013 obligations
e
Program name
Specialized PTSD
Program description
Provides a range of inpatient and outpatient treatments for veterans diagnosed with military-based PTSD. These services use psychotherapies and psychopharmacology. Examples of specialty PTSD inpatient treatment are: Domiciliary PTSD, Women's Trauma Recovery Program. Specialty PTSD outpatient treatment includes Substance Use PTSD and Women's Stress Disorder Treatment Team.
Fiscal year 2013 obligations
372,364,000
Program name
Therapeutic and Supported Employment Services
Program description
A continuum of recovery-oriented vocational rehabilitation programs that help veterans with mental health disabilities (including individuals with co-occurring physical disabilities) and a history of occupational dysfunction overcome barriers to employment and return to the workforce.
Fiscal year 2013 obligations
133,747,000
Program name
VA Specialized Homeless Services
Program description
A continuum of care designed to assist eligible homeless veterans and veterans at risk for homelessness. Services include homelessness prevention and rapid re-housing; assistance to veterans involved with the justice system; community case management; and employment assistance.
Fiscal year 2013 obligations
1,404,890,000
Program name
Inpatient Mental Health
Program description
Provides services to veterans with acute and severe emotional and/or behavioral symptoms that may cause a safety risk to the self or others, and/or may result in severely compromised functional status, including veterans with serious mental illness. Programs provide a range of intensive clinical services (e.g., close safety monitoring, close medication management) and frequent group therapy and psychoeducation.
Fiscal year 2013 obligations
1,766,716,000
Legend:
HUD Department of Housing and Urban Development
PTSD post-traumatic stress disorder
VA Department of Veterans Affairs
Source: GAO analysis of questionnaire responses. | GAO-15-404SP
Notes: Obligations are rounded to the nearest thousand.
FOOTNOTES TO TABLE
a This amount only includes the analytic component. The amount for the clinical component is unknown.
b This amount only includes the obligated funds for the grants, not the obligated amount for the overall program.
c This amount includes all services and programs offered through the Department of Justice's Psychology Services departments. These departments provide routine mental health screening, evaluation, grief counseling, individual therapy, group therapy, and crisis intervention. Psychology Services departments also provide specialty programming for specific populations.
d This was a pilot program designed and operated internally by Social Security Administration staff, with assistance from partner agencies in the involved communities. There was no obligated funding for this program in fiscal year 2013.
e Case identification was through the Serious Mental Illness Treatment Resource and Evaluation Center. Subsequently, targeted outreach was conducted at local medical centers and clinics as part of the overall program of care for veterans with serious mental illness.
END OF FOOTNOTES TO TABLE
Table 6: Department of Homeland Security (DHS) Vulnerability
Assessment Tools and Methods
______________________________________________________________________
DHS office or component
Protective Security Coordination Division
Assessment tool or method
Infrastructure Survey Tool (IST)
Site Assistance Visit (SAV)
Description
ISTs consist of voluntary assessments that gather information on an asset's current security posture and overall security awareness.
SAVs consist of an IST and also identify security and resilience gaps and provide options for consideration to mitigate these identified gaps.
DHS office or component
Federal Protective Service (FPS)
Assessment tool or method
Modified Infrastructure Survey Tool (MIST)
Fiscal year 2013 obligations
MIST is a vulnerability assessment based on the IST assessment that has been modified to meet specific FPS criteria.
DHS office or component
Infrastructure Security Compliance Division (ISCD)
Assessment tool or method
Chemical Facility Anti-Terrorism Standards Security Vulnerability Assessment (SVA)
Description
ISCD requires certain chemical facilities to self-report vulnerability and other information through the SVA.
DHS office or component
Transportation Security Administration (TSA)
Assessment tool or method
Baseline Assessment for Security Enhancements (BASE)
Freight Rail Risk Analysis Tool
Joint Vulnerability Assessment (JVA)
Critical Facility Security Review (CFSR)
Description
BASE assessments are composed of 205 questions for reviewing a transit systems security posture.
Freight Rail Risk Analysis Tool assessments began in fiscal year 2009 focusing on high priority tunnels and bridges based on an industry provided list of assets.
TSA and the Federal Bureau of Investigation (FBI) are to conduct joint threat and vulnerability assessments at each high-risk U.S. airport at least every 3 years. Airports not identified as one of the 34 high-risk airports may receive a JVA through a voluntary request, as a host of a National Special Security Event, or at the direction of TSA senior leadership.
CFSRs are a walkthrough of a pipeline facility that includes asking a common list of questions, discussions with asset owners and operators including corporate executives and security advisers, reviews of plans to protect the pipeline assets, and the adoption of established security guidelines by the assets.
DHS office or component
United States Coast Guard
Assessment tool or method
Maritime Transportation Security Act (MTSA) -- regulated facility vulnerability assessments
Port Security Assessment
Description
MTSA and its implementing regulations require owners and operators of maritime facilities to conduct security assessments that identify their security vulnerabilities for use in developing security plans to mitigate these vulnerabilities.
The Coast Guard conducts voluntary vulnerability assessments on 25 port facilities annually at five port locations. These efforts are to support risk mitigation strategies.
Source: GAO analysis of DHS documents and interviews with DHS officials. | GAO-15-404SP
Table 7: Federal Export Promotion: List of Activities and Related
Budgetary Information
______________________________________________________________________
Department of Commerce (Commerce)
______________________________________________________________________
Agency or subagency
International Trade Administration
Activity
Export promotion
Activity description
ITA's export promotion activities include efforts to raise awareness about exporting and to provide businesses with export counseling, training, and information on market opportunities; help connecting with potential buyers abroad; and help obtaining financing.
Fiscal Year 2013 budget
$267,674,000
Small Business Administration (SBA)
______________________________________________________________________
Agency or subagency
Office of International Trade
Activity
Export promotion
Activity description
SBA's export promotion activities include conducting outreach and providing training, counseling, and export financing for small businesses.
Fiscal Year 2013 budget
$974,000a
______________________________________________________________________
Source: Commerce, SBA, and the Congressional Research Service. | GAO-15-404SP
Note: The total amount of U.S. government funds expended on federal export promotion is unclear because comparable budget information for federal agencies involved in export promotion is not readily available.
FOOTNOTE TO TABLE 7
a This amount includes salaries and operating expenses only.
END OF FOOTNOTE TO TABLE 7
Table 8: National Oceanic and Atmospheric Administration's
Estimated Operations and Maintenance Costs for the Ocean, Coastal,
and Great Lakes Observing Systems by Office for Fiscal Year 2013
______________________________________________________________________________
Observing System Managing
Office and System Name Fiscal Year 2013a
______________________________________________________________________________
National Environmental Satellite, Data,
and Information Service
Geostationary Operational Environmental
Satellite N/O/P $25,900,000
Jason Ocean Surface Topography Mission (2,3 & CS)b 1,600,000
Marine Optical Buoy 2,900,000
Polar-Orbiting Operational
Environmental Satellite 29,000,000
Suomi National Polar-Orbiting
Partnership Satellite 6,600,000
National Marine Fisheries Service
Chesapeake Bay Interpretive Buoy System 800,000
Ecosystem Surveys 6,590,000
Fish Surveys 16,440,000
National Ocean Service
Coral Reef Ecosystem Integrated
Observing System/National Coral Reef
Monitoring Plan 5,200,000
Hydrographic Surveying 25,100,000
Integrated Ocean Observing
System High Frequency Radars 5,000,000
National Current Observation Program 1,000,000
National Estuarine Research Reserves
System System-Wide Management Program 3,700,000
National Marine Sanctuary
System-Wide Monitoring 2,360,000
National Status and Trends Program 1,700,000
National Water Level Observation Network 4,700,000
National Ocean Service-Shoreline 6,100,000
Physical Oceanographic Real-Time Systemc 0
Regional Ocean Observing System 18,100,000
National Weather Service
Coastal Weather Buoys 18,240,000
Coastal-Marine Automated Network 680,000
Deep-Ocean Assessment and
Reporting of Tsunamis 8,770,000
Global Ocean Observing System
Tropical Atmosphere Ocean Array 3,380,000
Pacific Tsunami Warning Center
Sea Level Network 120,000
Voluntary Observing Ship 1, 500,000
Office of Oceanic and Atmospheric Research
Airborne Oceanographic Product 50,000
Arctic Observing Network 3,450,000
Ecosystems and Fisheries-Oceanography
Coordinated Investigations 1,000,000
Global Ocean Observing System
Argo Profiling Floats 10,300,000
Global Ocean Observing System
Global Drifter Program 3,470,000
Global Ocean Observing System Global
Sea Level Observing System 1,330,000
Global Ocean Observing System
Global Tropical Moored Buoy
Array-Prediction and Research
Moored in the Atlantic 1,180,000
Global Ocean Observing System
Global Tropical Moored Buoys
Array-Research Moored for
African-Asian-Australian Monsoon
Analysis 2,820,000
Global Ocean Observing System
Ocean Carbon Network 7,000,000
Global Ocean Observing System
Ocean Reference Stations 5,910,000
Global Ocean Observing System-Ships
of Opportunity 2,050,000
Ocean Acoustic Monitoring System 140,000
Real-time Coastal Observation Network 450,000
Western Boundary Time Series and
South Atlantic Meridional
Overturning Circulation 820,000
Office of Marine and Aviation Operations
NOAA Aircraft 28,000,000
NOAA Ships 153,000,000
Total $416,440,000
_____________________________________________________________________________
Source: National Oceanic and Atmospheric Administration |
GAO-15-404SP
a NOAA's estimated costs for fiscal year 2013 were based on final appropriations for this year.
b The estimates reported for here include costs to operate and maintain the Jason-2 mission. Development costs for the Jason-3 mission, with the operational environmental satellite scheduled to be launched in fiscal year 2015, are not included.
c The Physical Oceanographic Real-Time System is a cost-sharing program where local partners provide funding for the sensor systems and their ongoing maintenance.
END OF FOOTNOTES TO TABLE 8
Table 9: DOD Real Property Portfolio: List of Military
Services and Facilities' Property Replacement Value
_____________________________________________________________________
Military service Number of assets Plant replacement value
_____________________________________________________________________
Army 270,277 $306,430,000,000
Navy 111,200 $214,230,000,000
Marine Corps 47,986 $63,780,000,000
Air Force 132422 $259,280,000,000
Washington Headquarters Services 715 $6,530,000,000
Total 562,600 $850,250,000,000
_____________________________________________________________________
Source: Office of the Secretary of Defense (OSD). | GAO-15-404SP
Table 10: Department of Defense: List of Headquarters Organizations
_____________________________________________________________________
Department of Defense
_____________________________________________________________________
Office of the Secretary of Defense
Joint Staff
Offices of the Secretary of the Army and Army Staff
Office of the Secretary of the Navy and Office of the Chief of Naval
Operations
Offices of the Secretary of the Air Force and Air Staff
Headquarters, Marine Corps
U.S. Special Operations Command
U.S. Strategic Command
U.S. Transportation Command
_____________________________________________________________________
Source: GAO-14-439 and GAO-15-10 | GAO-15-404SP
Table 11: Strategic Petroleum Reserve: List of Programs and
Related Budgetary Information
_____________________________________________________________________________
FY 2014 actual
Agency or subagency Program name Program description obligationsa
_____________________________________________________________________________
Department of Energy
_____________________________________________________________________________
Office of Fossil Strategic The SPR is a $187,835,037
Energy Petroleum government-held
Reserve (SPR) emergency
stockpile of crude
oil. The program
funds the
management,
operations,
maintenance, and
security of SPR
storage sites, as
well as site
inspection and
remediation
activities.
Office of Fossil SPR Petroleum Funds all SPR $218,544,500
Energy Account petroleum
acquisitions,
associated
transportation
costs, custom
duties, terminal
charges, and other
miscellaneous
costs. The account
also holds
receipts from any
crude oil sales.
_____________________________________________________________________________
Source: DOE. | GAO-15-404SP
FOOTNOTE TO TABLE 11
a These obligations include "recoveries of prior year unpaid
obligations" that were re-obligated in FY2014.
END OF FOOTNOTE TO TABLE 11
Table 12: U.S. Enrichment Corporation (USEC) Fund -- Program and Financing:
Related Budgetary Information
_____________________________________________________________________________
Unavailable
Balances --
Offsetting
Total Investments: Collections:
Fiscal Year Fiscal Year
2015 2015
Organization Purpose (Estimate) (Estimate)
_____________________________________________________________________________
United States USEC privatization $1,634,000,000 ($1,634,000,000)
Enrichment expenses and
Corporation (Fund) environmental
clean-up expenses
pursuant to Public
Law 105-204
_____________________________________________________________________________
Source: Budget of the United States Government, Fiscal Year 2015. U.S.
Enrichment Corporation Fund as presented in the Appendix for Other Independent
Agencies. | GAO-15-404SP
FOOTNOTE TO TABLE 12
aThe President's Budget estimates that the USEC Fund will
receive $16 million in offsetting collections in fiscal year 2015. However,
the President's Budget also notes that "spending authority from offsetting
collections [are] precluded from obligation."
END OF FOOTNOTE TO TABLE 12
Table 13: TRICARE benefits: Program and Related Budgetary Information
______________________________________________________________________________
Agency or Program FY 2013
subagency Program name description benefits issued
______________________________________________________________________________
Department of
Defense
______________________________________________________________________________
Defense Health TRICARE TRICARE includes several $21,000,000,000
Agency Purchased benefit options to provide
Care health care to military
service members, retirees,
and their families,
including care provided in
military treatment
facilities or, through the
TRICARE purchased care
program, by civilian
providers who are
reimbursed by the
department.
_____________________________________________________________________________
Source: Defense Health Agency | GAO-15-404SP
Table 14: Medicare: Program and Related Budgetary Information
_____________________________________________________________________________
Agency or Program Calendar year
subagency Program name description 2013 program cost
______________________________________________________________________________
Centers for Medicare Hospital inpatient and $178,600,000,000
Medicare & hospital outpatient services
Medicaid benefits covered by Medicare Part
Services A and Part B.
_____________________________________________________________________________
Source: The Boards of Trustees of the Medicare Trust Funds. | GAO-15-404SP
Table 15: Medicaid Financing: Program and Related Budgetary Information
_____________________________________________________________________________
Agency or FY 2012
subagency Program name Program description estimated cost
_____________________________________________________________________________
Centers for Medicaid A joint federal-state $431,900,000,000a
Medicare & program that finances
Medicaid health care for low-
Services income individuals,
including children,
families, and aged or
disabled individuals
_____________________________________________________________________________
Source: GAO analysis of Centers for Medicare & Medicaid Services data. | GAO-
15-404SP
Note: Department of Health and Human Services, 2013 Actuarial Report on the
Financial Outlook for Medicaid (Washington, D.C.: 2013).
FOOTNOTE TO TABLE 15
a The $431,900,000,000 represents $22,600,000,000 in
administrative costs, $236,600,000,000 in federal share of Medicaid payments,
and $172,600,000,000 in state share of Medicaid payments.
END OF FOOTNOTE TO TABLE 15
Table 16: Supplemental Security Income: Program and Related
Budgetary Information
______________________________________________________________________________
FY 2013
Agency Program name Program description obligations
______________________________________________________________________________
Social Security Supplemental The Supplemental Security $56,485,774,000
Administration Security Income Income program guarantees
a minimum level of income
to financially needy
individuals who are aged,
blind, or disabled.
______________________________________________________________________________
Source: GAO analysis of Social Security Administration data. | GAO-15-404SP
Table 17: Supplemental Nutrition Assistance Benefits: Program and Related
Budgetary Information
______________________________________________________________________________
FY 2013
Agency or subagency Program Name Program description benefits issued
______________________________________________________________________________
U.S. Department of
Agriculture
U.S. Department of Supplemental SNAP, formerly known $76,066,280,000
Agriculture Food and Nutrition as the federal Food
Nutrition Service Assistance Stamp Program, aims
Program (SNAP) to help low-income
individuals and
households obtain a
more nutritious
diet.
______________________________________________________________________________
Source: GAO analysis of Supplemental Nutrition Assistance Program data. | GAO-
15-404SP
Table 18: Department of Homeland Security, FEMA's Disaster Relief Fund:
Related Budgetary Information
______________________________________________________________________________
FY 2014
Agency or subagency Program Name Program description Appropriation
______________________________________________________________________________
Federal Emergency Disaster Relief To carry out the $6,220,908,000a
Management Agency Fund Robert T. Stafford
Disaster Relief and
Emergency Assistance
Act
______________________________________________________________________________
Source: GAO | GAO-15-404SP
FOOTNOTE TO TABLE 18
a Pub. L. No. 113-76, 128 Stat. 5, 263 (2014).
END OF FOOTNOTE TO TABLE 18
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- Institutional AuthorsGovernment Accountability Office
- Code Sections
- Subject Area/Tax Topics
- Jurisdictions
- LanguageEnglish
- Tax Analysts Document NumberDoc 2015-8860
- Tax Analysts Electronic Citation2015 TNT 72-17