FINANCIAL MANAGEMENT: STATUS OF CFO ACT IMPLEMENTATION AT THE DEPARTMENT OF THE TREASURY Testimony by the Director of Civil Audits, Gregory M. Holloway In implementing the Chief Financial Officers Act, the Department of the Treasury has acknowledged the serious and long-standing problems with the financial management systems and related internal controls at several of Treasury's bureaus. Because the activities of the bureaus have a tremendous impact on federal government operations, Treasury must continue to enhance the effectiveness of its chief financial officer structure at both the department and the bureau level, invest in training for its financial management personnel, and correct the serious problems identified. (T-AIMD-94-157) August 1994 77 Reports to Congress 6 Testimonies HEALTH INSURANCE FOR THE ELDERLY: An estimated 3 million elderly Medicare beneficiaries owned multiple supplemental health insurance policies and paid about $1.8 billion in 1991 for policies that probably involved duplicate coverage. Many had supplemental coverage through employer-sponsored plans, and the 192 plans reviewed usually provided comprehensive coverage. About 500,000 other Medicare beneficiaries, who were also eligible for Medicaid because of limited incomes, spent a about $190 million on unnecessary supplemental insurance. (HEHS-94-185) MEDICAID: STATES USE ILLUSORY APPROACHES TO States are using misleading financial arrangements to maximize federal Medicaid contributions to their health care providers. Such transactions enabled three states reviewed by GAO to obtain about $800 million in federal funds without committing their share of matching funds, thereby effectively increasing the federal share of Medicaid expenditures. Congress should act to curtail such arrangements including prohibiting Medicaid payments that exceed costs to any government-owned facility. (HEHS-94-133) DRUG CONTROL: INTERDICTION EFFORTS IN The supply of drugs entering the United States through Central America remains virtually uninterrupted despite years of U.S. drug interdiction efforts. Drug traffickers have adjusted their modes of operation to evade U.S. air interdiction efforts and are increasingly using sea and land transportation to move drugs through Central America to the United States. Central American nations have neither the resources nor the institutional capability to address the new drug-trafficking modes and depend heavily on U.S. assistance. Various U.S. government agencies are working with some of the countries on a number of small-scale projects, but the outcome of these efforts is uncertain. (NSIAD-94-233) September 1994 76 Reports to Congress 16 Testimonies VETERANS' HEALTH CARE: IMPLICATIONS OF OTHER COUNTRIES' REFORMS FOR THE UNITED STATES Although significant differences exist in veterans' health benefits in the United States, Australia, Canada, Finland, and the United Kingdom, the evolution of the latter four countries' veterans' health care systems provides useful insights for the United States: maintaining a direct delivery system is not the only option for preserving or expanding veterans' health benefits, and increasing freedom to choose between Department of Veterans Affairs (VA) and non-VA providers will likely result in significant declines in demand for care in veterans facilities. (HEHS-94-210BR) U.S. POSTAL SERVICE: LABOR-MANAGEMENT Long-standing labor-management problems in the Postal Service have contributed to a poor quality of work life for postal employees and higher mailprocessing and delivery costs. GAO attributes these problems to an autocratic management style, adversarial employee and union attitudes, and performance management systems that do not reward work groups for teamwork or differentiate between good workers and poor ones. (GGD-94-201A and GGD-94-201B) TAX ADMINISTRATION: COMPLIANCE MEASURES AND AUDITS OF LARGE CORPORATIONS NEED IMPROVEMENT Due to the complexity of the tax law and the conflicting incentives that Internal Revenue Service (IRS) employees face in administering the law, it is impossible to determine the proper amount of tax that should be collected from the nation's 1,700 largest corporations through the Coordinated Examination Program (CEP). Historically, IRS has collected 22 percent of the additional taxes recommended in CEP audits. Although it is impossible to know what the proper amount should be, it is reasonable to assume that collecting 22 cents per dollar leaves room for improvement either in the audit recommendation process or in the appeals process or both. (GGD-94-70) SOCIAL SECURITY: RAPID RISE IN CHILDREN ON The number of children receiving Supplemental Security Income disability benefits more than doubled from about 297,000 in 1989 to about 771,000 in 1993. Increases in the number of awards for mental impairments accounted for more than two-thirds of the growth in awards. The dramatic growth in these awards was thought to be attributed to requirements imposed by the 1990 Sullivan v. Zebley Supreme Court decision. GAO found, however, that about 70 percent of these awards went to children whose impairments were severe enough to qualify on the basis of medical standards alone, without the need for an additional functional assessment that was mandated by the Supreme Court. (HEHS-94-225) |