Reports & Testimonies

In 2012, Health and Human Services (HHS) established a program to ensure the U.S. could rapidly produce medical countermeasures—such as drugs and vaccines—in public health emergencies. The program didn't meet its goals in responding to the COVID-19 pandemic, HHS found, and had trouble with large-scale production and quality control. HHS is transitioning to a new program but needs to take additional steps to ensure that...

Care Compare is a web-based tool that lets consumers compare the quality ratings of health care providers participating in the Medicare program. We found that the information on owners of nursing homes—both organizations and individuals—isn't organized in a way that allows consumers to identify homes that share the same owners. This makes it difficult for consumers to determine whether a given owner is associated with...

Treasury's State Small Business Credit Initiative is authorized to provide $10 billion to states, territories, and tribal governments to support small business lending and investment programs. All 50 states, five territories, the District of Columbia, and 283 tribal governments have applied for these funds. However, Treasury is taking longer than expected to review applications and disburse funds. We found that it could improve how it...

Administrative separation from the military can have lifelong implications regarding a veteran's benefits and future employment opportunities. Service members facing discharge for misconduct, unsatisfactory performance, and other reasons may present their case before an administrative separation board. These boards review evidence and recommend either retention or separation. Each service has established policies for convening these boards and selecting board members. These policies generally align with...

During the 2007-2009 financial crisis, investors in money market mutual funds "ran"—cashed in their shares at the same time—to avoid losses. In 2014, SEC tried to prevent runs by revising its rules. The change allowed funds to impose a "gate" to temporarily block investors' access to shares if the funds were low on cash and assets easily sold for cash. But during the pandemic, investors...

The COVID-19 pandemic and the war in Ukraine have disrupted global supply chains, which has resulted in numerous shortages—including for semiconductors used in automobile production. Federal agencies are working to strengthen global supply chains through diplomatic efforts. For instance, agencies have helped coordinate a U.S.-Mexico working group to collaborate on semiconductor and IT supply chains. However, companies may be reluctant to share data on their...

The Department of Defense child care program has taken steps to provide quality care. For example, DOD requires its child development centers and school-age care programs to be nationally accredited. DOD also aims to support service members and their families by meeting military-specific child care needs—such as those created by non-traditional work hours or frequent relocations. Families were largely satisfied with the quality of care...

The federal government distributed funds quickly during the COVID-19 pandemic. This led to an increase in fraud and other "improper payments"—payments that shouldn't have been made or were made in the incorrect amount. The extent of fraud in COVID-relief programs is not yet known but our estimate suggests that one program, Unemployment Insurance, made over $60 billion in fraudulent payments. We testified on contributing factors...

We testified that understanding pandemic origins can help policymakers craft responses to prevent future events. This could help reduce the high health and economic costs associated with pandemics. Genetic analysis and other technologies can help researchers detect a pandemic's origin. Investigations into the origins of diseases can be slow, but the technologies aren't the problem. For example, delays can result when investigators can't access biological...

Pandemics have high health and economic costs. Understanding their origins can help policymakers craft responses to prevent future pandemics. Several technologies can help researchers discover a pandemic's origin, such as using genetic analysis and disease tracking. These investigations can be slow, but the technologies aren't the problem. For example, delays can result when investigators can't access biological samples, or if there aren't enough trained investigators...

About half of Medicare users are enrolled in Medicare Advantage (MA), private plans that offer the same benefits covered under Original Medicare and may offer additional benefits, such as dental or vision. In recent years, MA plans could offer new types of supplemental benefits, like in-home support services. But are plans offering additional benefits, and are people using them? We analyzed data for 3,893 plans...

From FYs 2011-2021, the 10 Navy ship classes we reviewed faced persistent and worsening challenges including a decrease in the number of hours a ship is available for operations or training. These challenges included: An increase in the number of working ship parts removed and used elsewhere due to parts shortages An increase in casualty reports—i.e., reports of events that impair a ship's ability to...

Federal systems are vulnerable to cyberattacks. Our High Risk report identified 10 critical actions for addressing federal cybersecurity challenges. In this report, the second in a series of four, we cover the 3 actions related to Securing Federal Systems and Information: Improve implementation of government-wide cybersecurity initiatives Address weaknesses in federal agency information security programs Enhance the federal response to cyber incidents to better protect...

In the U.S., pediatric cancer is among the most deadly childhood diseases—but relatively few drugs are approved to treat it. To facilitate the development of safe new drugs to treat children, the RACE Act requires developers of certain adult cancer drugs to submit plans to also study their use in pediatric patients. This has increased the number of planned pediatric cancer studies, but it's too...

Auditors around the world use our Yellow Book—Government Auditing Standards—to perform audits. We maintain the Yellow Book and stay on top of domestic and international auditing standards. This year, we are proposing an update to enhance how audit organizations manage audit quality. Effective quality management can reasonably assure an audit organization that its people, audits, and reports adhere to professional standards and applicable laws. Another...

The Tennessee Valley Authority (TVA) provides electricity to 10 million customers in 7 states. TVA faces some climate-related risks that could affect its ability to generate and transmit electricity while keeping rates low. For example, in 2010, some TVA infrastructure was submerged in over 5 feet of water when 15 inches of rain fell in 2 days. Relocating this infrastructure to higher ground cost about...

The Federal Aviation Administration (FAA) is responsible for safely integrating drones into the national airspace—a complex network that includes airports, aircraft, and air traffic control facilities. FAA has developed various planning documents to manage its efforts to integrate drones. But, it has yet to develop a comprehensive strategy to guide these efforts. For example, FAA's documents don't include important elements—such as goals, objectives, and milestones—that...

The United States' adversaries are exploiting social media, IT, and other aspects of the "information environment" to undermine the nation's security. Such actions can include making false social media posts or interfering with GPS data used by DOD leaders to make decisions about their military options, such as troop positions. In response, DOD educates and trains its leaders to address such threats. However, DOD hasn't...

Combined sewer systems collect sewage and storm runoff in the same pipes for treatment. This means heavy rainfall can overwhelm system capacity, causing raw sewage to overflow into waterways. About 700 U.S. municipalities have such systems. In 1994, the Environmental Protection Agency told these municipalities to develop plans to address overflows and comply with the Clean Water Act. The 11 municipalities we reviewed faced challenges—such...