What GAO Found
The four agencies GAO reviewed do not have procedures that define political interference in scientific decision-making or describe how it should be reported and addressed. These agencies within the Department of Health and Human Services (HHS) are: the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), the National Institutes of Health (NIH), and the Office of the Assistant Secretary for Preparedness and Response (ASPR).
The absence of specific procedures may explain why the four selected agencies did not identify any formally reported internal allegations of potential political interference in scientific decision-making from 2010 through 2021. Through semi-structured interviews and a confidential hotline, employees at CDC, FDA, and NIH told GAO they observed incidents that they perceived to be political interference but did not report them for various reasons. These reasons included fearing retaliation, being unsure how to report issues, and believing agency leaders were already aware. HHS could strengthen its desired goal of sustaining a culture of scientific integrity by developing procedures for reporting and addressing political interference in scientific decision-making. Such procedures would ensure that employees know how to report allegations, and that HHS’s agencies have a clear, consistent process for investigating and addressing such allegations. To help reduce employees’ fear of retaliation and encourage appropriate reporting, agencies could include information on whistleblower protections, and clarify any reporting requirements for employees who believe they observed potential political interference in scientific decision-making.
All four selected agencies—CDC, FDA, NIH, and ASPR—train staff on some scientific integrity-related topics, such as public health ethics, but only NIH includes information on political interference in scientific decision-making as part of its scientific integrity training (see figure). Training agency employees and contractors performing scientific activities would help agencies ensure that employees and contractors understand how to report allegations of political interference.
Elements of Scientific-Integrity-Related Procedures and Training at Selected HHS Agencies
aThe Office of the Assistant Secretary for Preparedness and Response follows HHS’s Policies and Principles for Assuring Scientific Integrity .
Why GAO Did This Study
Since 2007, Congress and multiple administrations have taken actions to help ensure that federal science agencies have scientific integrity policies and procedures in place that, among other things, protect against the suppression or alteration of scientific findings for political purposes. GAO defined scientific integrity as the use of scientific evidence and data to make policy decisions that are based on established scientific methods and processes, are not inappropriately influenced by political considerations, and are shared with the public when appropriate. GAO was asked to review scientific integrity policies and procedures, and how allegations of political interference in scientific decision-making are addressed at CDC, FDA, NIH, and ASPR.
This report examines the procedures in place to address such allegations and the extent to which agencies received them. It also examines training provided by selected agencies on scientific integrity policies and procedures, including those related to political interference. GAO analyzed the agencies’ scientific integrity policies, procedures, and trainings; interviewed agency officials, and employees, which includes managers and non-managers; and deployed a confidential hotline.
- Medicaid: HHS’s Preliminary Analyses Offer Incomplete Picture of Behavioral Health Demonstration’s Effectiveness
May 18, 2021What GAO Found The Protecting Access to Medicare Act of 2014 (PAMA) established the Certified Community Behavioral Health Clinics (CCBHC) demonstration and tasked the Department of Health and Human Services (HHS) with its implementation. CCBHCs aim to improve the behavioral health services they provide, particularly for Medicaid beneficiaries. Initially established for a 2-year period, the demonstration has been extended by law a number of times; most recently, it was extended to September 2023. States participating in the demonstration can receive Medicaid payments, consistent with federal requirements, for CCBHC services provided to beneficiaries. PAMA also required HHS to assess the effect of the demonstration on service access, costs, and quality. HHS’s preliminary assessments of the demonstration in eight states, with 66 participating CCBHCs, found the following: Access. CCBHCs commonly added services related to mental and behavioral health, such as medication-assisted treatment, and took actions to provide services outside the clinic setting, such as through telehealth. Costs. States’ average payments to CCBHCs typically exceeded CCBHC costs for the first 2 years of the demonstration. CCBHC payments and costs were more closely aligned in the second year for most states, better reflecting the payment methods prescribed under the demonstration. Quality. States and CCBHCs took steps, such as implementing electronic health records systems, to report performance on 21 quality measures. GAO found data limitations complicated—and will continue to affect—HHS’s efforts to assess the effectiveness of the demonstration. For example: Lack of baseline data. PAMA requires HHS to assess the quality of services provided by CCBHCs compared with non-participating areas or states. The demonstration marked the first time these clinics reported performance on quality measures, so no historical baseline data exist. HHS officials noted that with time, additional data may provide insight on the quality of services. Lack of comparison groups. PAMA requires HHS to compare CCBHCs’ efforts to increase access and improve quality with non-participating clinics and states. HHS was unable to identify comparable clinics or states due to significant differences among the communities. Lack of detail on Medicaid encounters. PAMA requires HHS to assess the effect of the demonstration on federal and state costs and on Medicaid beneficiaries’ access to services. HHS plans to use Medicaid claims and encounter data to assess such changes. However, GAO has previously identified concerns with the accuracy and completeness of Medicaid data and has made numerous recommendations aimed at improving their quality. HHS’s decisions in implementing the demonstration also complicated its assessment efforts. HHS allowed states to identify different program goals and target populations, and to cover different services. HHS also did not require states to use standard billing codes and billing code modifiers it developed. The lack of standardization across states limited HHS’s ability to assess changes in a uniform way. Why GAO Did This Study Behavioral health conditions—mental health issues and substance use disorders—affect millions of people. HHS estimates that 61 million adults had at least one behavioral health condition in 2019—41 million of whom did not receive any related treatment in the prior year. Many individuals with behavioral health conditions rely on community mental health centers for treatment, but the scope and quality of these services vary. To improve community-based behavioral health services, PAMA created the CCBHC demonstration and provided HHS with $25 million to support its implementation. PAMA directed HHS to assess the demonstration and to provide recommendations for its continuation, modification, or termination. To date, HHS has issued three annual reports assessing the initial demonstration period, which ran from 2017 to 2019. HHS plans to issue a fourth annual report and a final report by December 2021. This report describes HHS’s assessment of the demonstration regarding access, costs, and quality. Under the CARES Act, GAO is to issue another report on states’ experiences by September 2021. GAO reviewed federal laws and regulations; HHS guidance; and HHS’s assessments of the demonstration, including three issued reports, interim reports, and the analysis plan for future reports. GAO also interviewed HHS officials and officials from organizations familiar with community health clinics. HHS provided technical comments, which GAO incorporated as appropriate. For more information, contact Carolyn L. Yocom (202) 512-7114 or email@example.com.
- 401(k) Retirement Plans: Many Participants Do Not Understand Fee Information, but DOL Could Take Additional Steps to Help Them
August 26, 2021What GAO Found Almost 40 percent of 401(k) plan participants do not fully understand and have difficulty using the fee information that the Department of Labor (DOL) requires plans to provide to participants in fee disclosures, according to GAO’s analysis of its generalizable survey (see figure). GAO assessed participants’ understanding of samples from several large plans’ fee disclosures and other information about fees, and asked general knowledge questions about fees. For example, GAO found that 45 percent of participants are not able to use the information given in disclosures to determine the cost of their investment fee. Additionally, 41 percent of participants incorrectly believe that they do not pay any 401(k) plan fees. Prior GAO work has shown that even seemingly small fees can significantly reduce participants’ retirement savings over time. GAO Estimates of 401(k) Plan Participants’ Score Distribution on Survey’s Fee-Related Assessment Questions GAO’s review of selected countries and the European Union (EU) found they have implemented practices to help retirement plan participants understand and use fee information from plan disclosures. For example, stakeholders in those locations said layering data, a technique where information is presented hierarchically, can help participants understand disclosures by providing them key plan information first. Stakeholders also said other tools can help participants understand fee information. In Italy, for example, the government provides a supplemental online tool so participants can compare and calculate fees across plans and investment options, according to stakeholders. This tool also includes a fee benchmark—which is generally an average fee among comparable funds—that helps participants judge the value of an individual investment option. DOL could take additional steps to help 401(k) plan participants improve their understanding and use of fee information, based on GAO survey responses and analysis. DOL regulations require that disclosures present fee information in a format that helps participants compare investment options. However, disclosures are not required to include certain information, such as fee benchmarks and ticker information (unique identifying symbols used for many popular types of investments), that could be helpful for participants. Fee benchmarks can help participants to assess an investment option’s value, not only relative to other in-plan options but to options outside the plan. Ticker information can help participants identify many plan investments online to evaluate and compare them to options outside the plan. By requiring such information in disclosures, DOL could help participants better understand and compare their 401(k) plan fees when making investment choices that affect their retirement security. Why GAO Did This Study DOL regulations require 401(k) plans to provide the more than 87 million plan participants with a comprehensive disclosure of the fees they pay. GAO was asked to examine how well participants can understand and use the fee disclosures. This report (1) assesses the extent to which 401(k) plan participants can understand and use fee information in disclosures; (2) describes disclosure practices used by selected countries to help retirement plan participants; and (3) examines any additional steps that DOL could take to advance participant understanding and use of fee information. GAO conducted a nationally representative survey of 401(k) plan participants to assess their understanding of fee disclosure samples from among 10 large plans and of other fee information. To identify and describe disclosure practices used abroad, GAO interviewed stakeholders and reviewed fee disclosure documents from Australia, Italy, New Zealand, and the European Union, chosen because of their documented practices to improve participants’ understanding of fee disclosures. To identify any additional steps DOL could take, GAO also reviewed disclosures from 10 large plans, as well as relevant federal laws and regulations, and interviewed stakeholders in the U.S.
- Florida Businessman and CFO of Russian Natural Gas Company Arrested on Tax Charges Related to $93 Million Hidden in Offshore Accounts
September 23, 2021A federal grand jury in Fort Myers, Florida, returned an indictment on Sept. 22 charging a Florida businessman with defrauding the United States by not disclosing his substantial offshore assets, failing to report substantial income on his tax returns, failing to pay millions of dollars of taxes and submitting a false offshore compliance filing with the IRS in an attempt to avoid substantial penalties and criminal prosecution.
- Justice Department Seeks Forfeiture of Third Commercial Property Purchased with Funds Misappropriated from PrivatBank in Ukraine
December 30, 2020Today, the U.S. Department of Justice filed a civil forfeiture complaint in the U.S. District Court for the Southern District of Florida alleging that commercial real estate in Cleveland, Ohio, was acquired using funds misappropriated from PrivatBank in Ukraine as part of a multi-billion-dollar loan scheme.
- COVID-19: Efforts to Increase Vaccine Availability and Perspectives on Initial Implementation
April 14, 2021What GAO Found The federal government has taken several actions to increase the availability of COVID-19 vaccine doses and indicated it expects to have enough doses available for all adults in the United States by the end of May. As of April 1, 2021, the government had purchased 1.2 billion doses of one- and two-dose regimen vaccines. Also, vaccine companies reported making additional manufacturing sites operational, among other actions to expand capacity and mitigate challenges. Federal officials said projecting future availability of vaccine doses can be difficult, in part because of uncertainty surrounding complex manufacturing processes. Given this uncertainty, coupled with the significant manufacturing and distribution increases needed to have enough vaccine doses available for all adults, managing public expectations is critical. GAO’s prior work has found that timely, clear, and consistent communication about vaccine availability is essential to ensure public confidence and trust, especially as initial vaccine implementation did not match expectations. COVID-19 Vaccination Site Stakeholders GAO interviewed identified challenges with initial COVID-19 vaccine implementation. For example, some stakeholders said states often did not have information critical to distribution at the local level, such as how many doses they would receive and when. The federal government has begun initiatives—outlined in a national response strategy—to improve implementation, such as creating new vaccination sites. In its March 2021 distribution strategy, CDC provided a high-level description of its activities and noted that more details would be included in future reports to Congress. To meet the expectations set by recent announcements, such as the planned expansion of vaccine eligibility to all adults and the introduction of tools to help individuals find vaccines, it will be imperative that the federal government effectively coordinate and communicate its plans, as GAO recommended in September 2020. Why GAO Did This Study Providing the public with safe and effective vaccines to prevent COVID-19 is crucial to mitigating the public health and economic impacts of the disease. The U.S. had almost 30 million reported cases and over 545,000 reported deaths as of March 27, 2021. The federal government took a critical step in December 2020 in authorizing the first two COVID-19 vaccines and beginning distribution of doses across the nation. The government had distributed about 180.6 million vaccine doses, and about 147.8 million doses had been administered, as of March 27, 2021, according to Centers for Disease Control and Prevention (CDC) data. The CARES Act includes a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report examines, among other issues, actions the federal government has taken to increase the availability of COVID-19 vaccine doses, and challenges with initial vaccine implementation—that is, prioritizing, allocating, distributing, and administering vaccine doses—identified by stakeholders and steps the federal government has taken to improve vaccine implementation. GAO reviewed documents from the Departments of Defense and Health and Human Services, transcripts of public briefings, data from CDC, and interviewed or received written responses from federal officials, vaccine company representatives, and select public health stakeholders. GAO incorporated technical comments from the Department of Defense, the Department of Health and Human Services, and the Federal Emergency Management Agency as appropriate. For more information, contact Alyssa M. Hundrup at (202) 512-7114 or firstname.lastname@example.org.
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February 28, 2022A federal jury convicted an Illinois woman on fraud and tax offenses for cashing her deceased grandmother’s pension checks and preparing false tax returns.
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- Priority Open Recommendations: Office of Science and Technology Policy
July 15, 2021What GAO Found As of June 2021, the Office of Science and Technology Policy (OSTP) had 11 open recommendations. We are identifying three recommendations from our prior work as priorities for implementation by OSTP. These three recommendations relate to strengthening interagency collaboration on science and technology issues. As the challenges of the 21st century grow, it is increasingly important for executive agencies to consider how the federal government can maximize performance and results through improved collaboration. Our prior work has shown that many issues, including those in science and technology, cut across multiple agencies. In this regard, OSTP plays a critical role in bringing agencies together under the committees and subcommittees of the National Science and Technology Council. This mechanism provides a valuable opportunity for agencies to coordinate on implementing an administration’s research and development priorities and to address cross-cutting science and technology issues, such as scientific integrity, public access to federally funded research results, reliability of research results, supply chains for critical materials, and others. Strengthening interagency coordination in these areas could help amplify the synergistic effects of related research conducted by different agencies, avoid unnecessary overlapping or duplicative research and development efforts, and share lessons learned or coordinate actions to address science and technology issues. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. This is the first year that we are providing a priority recommendation letter to OSTP. For more information, contact John Neumann at (202) 512-6888 or email@example.com.
- Deputy Assistant Attorney General Michael Murray Delivers Remarks at University of Michigan Law School
October 14, 2020I am here today to speak about the intersection of the antitrust laws and the financial sector of our economy. The financial markets and the financial services industry are currently undergoing massive transformation. New technologies are disrupting how we do business, how we transact with each other, and how the economy functions. Much of this change benefits consumers with innovative, low cost, and convenient products and services. But with rapid change also comes the opportunity for anticompetitive conduct and its attendant harm. Incumbents may predict and resist their demise and seek to slow innovation and the growth of rivals, and market participants who should compete against each other can agree to act jointly to the detriment of the American consumer.
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- Michigan Insurance Salesman Indicted for Tax and Bankruptcy Fraud
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- Three Additional States Ask Court To Join Justice Department Antitrust Suit Against Google
December 17, 2020Today, the Attorneys General of Michigan and Wisconsin filed for permission to join the antitrust lawsuit filed by the United States and eleven other state Attorneys General against monopolist Google. This follows a similar recent motion by the California Attorney General to join the lawsuit on December 11, 2020.
- DOD Critical Technologies: Plans for Communicating, Assessing, and Overseeing Protection Efforts Should Be Completed
January 12, 2021Critical technologies—such as elements of artificial intelligence and biotechnology—are those necessary to maintain U.S. technological superiority. As such, they are frequently the target of theft, espionage, and illegal export by adversaries. The Department of Defense (DOD) has outlined a revised process (see figure) to better identify and protect its critical technologies including those associated with acquisition programs throughout their lifecycle or those early in development. Prior DOD efforts to identify these technologies were considered by some military officials to be too broad to adequately guide protection. The revised process is expected to address this by offering more specificity about what elements of an acquisition program or technology need to be protected and the protection measures DOD is expected to implement. It is also expected to support DOD’s annual input to the National Strategy for Critical and Emerging Technologies, which was first published in October 2020. Overview of DOD’s Revised Process to Identify and Protect Critical Acquisition Programs and Technologies DOD began implementing this process in February 2020, and officials expect to complete all steps for the first time by September 2021. DOD has focused on identifying critical acquisition programs and technologies that need to be protected and how they should be protected. It has not yet determined how it will communicate the list internally and to other agencies, which metrics it will use to assess protection measures, and which organization will oversee future protection efforts. By determining the approach for completing these tasks, DOD can better ensure its revised process will support the protection of critical acquisition programs and technologies consistently across the department. Once completed, the revised process should also inform DOD and other federal agencies’ protection efforts. Military officials stated they could use the list of critical acquisition programs and technologies to better direct resources. Officials from the Departments of State, Commerce, and the Treasury stated that they could use the list, if it is effectively communicated, to better understand what is important to DOD to help ensure protection through their respective programs. The federal government spends billions annually to develop and acquire advanced technologies. It permits the sale and transfer of some of these technologies to allies to promote U.S. national security, foreign policy, and economic interests. However, the technologies can be targets for adversaries. The John S. McCain National Defense Authorization Act for Fiscal Year 2019 requires the Secretary of Defense to develop and maintain a list of acquisition programs, technologies, manufacturing capabilities, and research areas that are critical for preserving U.S. national security advantages. Ensuring effective protection of critical technologies has been included on GAO’s high-risk list since 2007. This report examines (1) DOD’s efforts to identify and protect its critical technologies, and (2) opportunities for these efforts to inform government protection activities. GAO analyzed DOD critical acquisition program and technologies documentation, and held interviews with senior officials at DOD and other federal agencies responsible for protecting critical technologies. GAO is recommending that DOD specify how it will communicate its critical programs and technologies list, develop metrics to assess protection measures, and select the DOD organization that will oversee protection efforts beyond 2020. DOD concurred with the first recommendation and partially concurred with the second and third. GAO maintains the importance of all recommendations in this report. For more information, contact William Russell at (202) 512-4841 or firstname.lastname@example.org.
- Priority Open Recommendations: Nuclear Regulatory Commission
April 28, 2021What GAO Found In April 2020, GAO identified seven priority recommendations for the Nuclear Regulatory Commission (NRC). Since then, NRC implemented one of these recommendations by issuing a risk management strategy that addresses key elements foundational to effectively managing cybersecurity risks. The remaining six priority recommendations involve the following areas: addressing the security of radiological sources. improving the reliability of cost estimates. improving strategic human capital management. NRC’s continued attention to these issues could lead to significant improvements in government operations. Why GAO Did This Study Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015, GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Mark Gaffigan at (202) 512-3841 or email@example.com.
- Justice Department Reaches Proposed Consent Decree with the State of New Jersey to Resolve Claims that the Edna Mahan Correctional Facility for Women Violated the Constitution by Failing to Protect Prisoners from Sexual Abuse by Staff
August 10, 2021The Department of Justice’s Civil Rights Division and the U.S. Attorney’s Office for New Jersey today filed a complaint and a proposed consent decree with the State of New Jersey and New Jersey Department of Corrections concerning the Edna Mahan Correctional Facility for Women.
- Six Individuals in Hawaii Charged with Conspiring to Defraud the IRS and Other Fraud Offenses
October 15, 2021Three individuals were arrested this week in the District of Hawaii on conspiracy to defraud the IRS and other fraud charges.
- Federal Protective Service: Better Documented Cost Estimates Could Help Stakeholders Make Security Decisions
June 9, 2021What GAO Found The Federal Protective Service (FPS) provides security and protection at more than 9,000 federal facilities. FPS performs a variety of security activities in conjunction with the General Services Administration (GSA), which functions as the landlord at most of these facilities, and with the federal agencies, which occupy these facilities as tenants. These stakeholders can provide important perspectives on FPS’s performance of its key activities (see figure). The Federal Protective Service’s Three Key Security Activities Stakeholders expressed satisfaction with many aspects of FPS’s performance of key activities but also identified aspects where they thought FPS could make improvements. For example, stakeholders expressed satisfaction with the professionalism of FPS personnel and commended FPS’s coordination in responding to law enforcement incidents. However, some stakeholders said they would like to see FPS oversee contract guards more often. In addition, many stakeholders said that FPS could improve the cost estimates in its security assessment reports. GAO’s review of FPS’s Facility Security Assessment reports found that cost estimates for the recommended security measures lacked information that could help stakeholders make decisions to accept or reject FPS’s recommendations. Specifically, recent reports for 27 selected buildings did not document (1) the assumptions FPS made to produce the cost estimates (e.g., the scope of work) and (2) the sources FPS used to create the estimate. In one report, for example, FPS recommended additional fencing and provided a cost estimate with an exact dollar amount. However, FPS did not document the assumptions it used to develop the estimate, such as the height and linear feet of fence or the fencing material. According to GAO’s Cost Estimating and Assessment Guide , cost estimates should provide information about the assumptions and sources used to develop an estimate so that decision-makers can understand the level of uncertainty around the estimate. By providing detailed information about the cost estimates in Facility Security Assessment reports, FPS could better inform stakeholders and potentially increase implementation of recommended security measures, designed to increase the safety of people and property at these facilities. Why GAO Did This Study Over one million employees and a range of visitors seeking services at federal facilities depend on FPS to ensure the safety of both people and property at these locations. This report examines stakeholders’ perspectives on FPS’s performance of three key activities. GAO identified key activities from FPS data on work hours. GAO held discussion groups with stakeholders from 27 randomly selected facilities where FPS provided guard services and responded to incidents in fiscal year 2019 and analyzed stakeholder responses from 2017-2019 to GSA’s and FPS’s feedback instruments. These sources of stakeholder views are not representative but collectively provide insight into stakeholders’ satisfaction with how FPS is performing key activities. GAO also reviewed agency documents; interviewed FPS officials about FPS’s performance; and compared FPS’s security assessment reports to criteria in GAO’s Cost Estimating and Assessment Guide .
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