    Professional Boxing: Issues Related to the Protection of Boxers'
    Health, Safety, and Economic Interests (21-JUL-03, GAO-03-699).

    The Professional Boxing Safety Act of 1996 established minimum
    health and safety standards for professional boxing and provided
    for limited federal oversight by the Department of Justice and
    the Federal Trade Commission. In 2000, the Muhammad Ali Boxing
    Reform Act amended the act to better protect boxers' economic
    well-being and enhance the integrity of the sport. However,
    reports of problems continue, including permanent and sometimes
    fatal injuries, economic exploitation, and corruption. GAO was
    asked to (1) identify fundamental elements considered important
    to protect professional boxers and enhance the integrity of the
    sport; (2) assess the extent to which provisions of the
    Professional Boxing Safety Act of 1996, as amended (the act),
    cover these elements and determine whether selected state and
    tribal boxing commissions have documentation indicating
    compliance with the act's provisions; (3) determine whether
    selected states and tribes have provisions that cover additional
    elements; and (4) identify federal actions taken under the act.
    -------------------------Indexing Terms-------------------------
    REPORTNUM:   GAO-03-699
        ACCNO:   A07617
      TITLE:     Professional Boxing: Issues Related to the Protection of
    Boxers' Health, Safety, and Economic Interests
         DATE:   07/21/2003
      SUBJECT:   Federal legislation
    	     Occupational safety
    	     Regulatory agencies
    	     Sports

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    GAO-03-699

                                           A

    Letter

    July 21, 2003 The Honorable John McCain Chairman, Committee on Commerce,
    Science, and Transportation United States Senate Dear Mr. Chairman:
    Congress has recognized that boxing is the only major professional sport
    in the United States without a central regulatory authority that
    establishes and enforces uniform rules, business practices, and ethical
    standards. There is no other major professional sport in which the rules
    and regulations* and their enforcement* vary so widely. As a result, the
    sport

    has been plagued with reports of permanent and sometimes fatal injuries,
    the economic exploitation of boxers, and corruption. The Association of
    Boxing Commissions, a 15- year- old nonprofit organization representing 46
    state and 8 tribal boxing commissions located throughout the United
    States, 1 promotes uniform health and safety provisions for professional
    boxing, but has no enforcement authority over its members, and its
    effectiveness in regulating boxing depends on mutual cooperation.

    In 1996, because the states and tribes, which are primarily responsible
    for establishing provisions to regulate professional boxing, were not
    uniformly protecting the health and safety of professional boxers,
    Congress enacted the Professional Boxing Safety Act of 1996. This act
    established minimum health and safety standards and licensing provisions,
    along with enforcement responsibilities and penalties for violations. In
    2000, Congress amended the 1996 act by passing the Muhammad Ali Boxing
    Reform Act, which established provisions to protect boxers from economic
    exploitation and to enhance the integrity of the sport.

    1 These commissions are state or tribal organizations that are responsible
    for regulating professional boxing within their jurisdictions, including
    implementing and enforcing federal and state or tribal provisions related
    to boxing.

    The 1996 act, as amended (the act), authorizes the Department of Justice
    to investigate and prosecute violations of the law and it provides for
    state and civil remedies as well as federal criminal prosecution. Within
    the Department of Justice, the Federal Bureau of Investigation is
    responsible for investigating violations of the law. Generally, the U. S.
    Attorneys are responsible for prosecuting violations of laws. The act
    further provides that organizations sanctioning boxing matches 2 annually
    provide certain information to the Federal Trade Commission or otherwise
    make such information available to the public through the Internet. The
    Federal Trade

    Commission is required to make the information provided to it available to
    the public.

    This report responds to your request that we review current efforts to
    protect the health, safety, and economic well- being of professional
    boxers and to enhance the integrity of the sport. As agreed with your
    office, we addressed the following questions:  What fundamental elements
    are considered important to address major

    health and safety, economic, and integrity problems facing professional
    boxing?

     To what extent do the act*s provisions cover these elements, and to what
    extent do selected state and tribal boxing commissions have documentation
    indicating compliance with the act*s provisions?

     To what extent have the selected states and tribes adopted provisions
    that cover fundamental elements that are not covered in the act?  What
    actions have the Department of Justice and the Federal Trade

    Commission taken under the act? To identify the fundamental elements that
    are considered important to address major health and safety, economic, and
    integrity problems facing professional boxing, we reviewed congressional
    testimony and studies on professional boxing conducted by a task force of
    the National Association

    of Attorneys General, the Department of Health and Human Services, and 2
    Sanctioning organizations are private entities that designate the champion
    and rank challengers for each weight class. These organizations are
    required to identify their rating officials and to annually disclose their
    criteria and policies for rating boxers, as well as their sanctioning
    fees, by- laws, and procedures for appealing ratings.

    the Department of Labor. From these sources, which documented problems in
    the boxing industry and recommended actions to address them, we identified
    major problems facing the sport and consolidated the recommendations into
    15 fundamental elements that are considered important in helping to
    provide an adequate level of health, safety, and economic protection to
    boxers and enhance the integrity of the sport. We discussed these elements
    with the Association of Boxing Commissions, which agreed that the elements
    could help provide the desired protection

    and enhancement. To assess the extent to which the act covers the elements
    we identified, we analyzed the act*s provisions and determined how many
    address the fundamental elements, either fully or partially. To assess the
    extent to which selected state and tribal boxing commissions have
    documented their compliance with the act*s provisions, we selected 8 3 of
    the 46 state boxing commissions and 2 4 of the 8 tribal boxing commissions
    for review. These 10

    commissions accounted for 383, or 49 percent, of the 777 professional
    boxing events held in the United States in 2001. (See app. I for a listing
    of the professional boxing events held by state and tribal commissions in
    2001.) At 2 state (Indiana and Michigan) and the 2 tribal (Miccosukee and
    Mohegan Sun) commissions, we reviewed the case files for all professional

    boxing events held in 2001, the most recent year for which we could obtain
    complete information, and at the remaining commissions, we randomly
    selected a sample of case files for review. From our reviews of these case
    files, we determined the extent to which each of the 8 state and 2 tribal
    boxing commissions had documentation indicating compliance in 2001

    with provisions in the act that related to the fundamental elements. We
    did not independently verify that the provisions were met. Our findings
    for these 10 commissions cannot be generalized to all 46 state and 8
    tribal boxing commissions.

    To assess the extent to which selected states and tribes have provisions
    that cover fundamental elements in addition to those covered in the act,
    we reviewed the boxing provisions of the eight states and two tribes and
    identified fundamental elements that do not appear in the act. We
    confirmed with the boxing commissions of these states and tribes that they
    agreed with our analysis of their provisions. We did not assess the extent
    to

    3 California, Florida, Indiana, Michigan, Missouri, Nevada, Pennsylvania,
    and Texas. 4 The Mohegan Sun (Connecticut) and Miccosukee (Florida)
    tribes.

    which the states and tribes had implemented or enforced the provisions
    that cover the additional fundamental elements. To determine what actions
    the Department of Justice and the Federal Trade

    Commission have taken under the act, we asked Justice officials whether
    they had initiated any civil enforcement proceedings or criminal
    prosecutions of potential violators of the act in the eight states and two
    tribal jurisdictions covered by our review. We also reviewed the

    department*s central case management system for possible cases prosecuted
    during fiscal years 1996 through 2002. To determine whether the
    sanctioning organizations were making the information they are required to
    provide available to the public, we reviewed the Internet Web sites of 14
    sanctioning organizations to see whether the required information was
    posted. We conducted our review from September 2002 through July 2003 in

    accordance with generally accepted government auditing standards. Appendix
    V provides further details about our objectives, scope, and methodology.
    Results in Brief From our review of congressional testimonies and national
    studies dating

    from 1994 through 2002, we identified 15 fundamental elements that are
    considered important to protect boxers* health, safety, and economic
    wellbeing and enhance the integrity of the sport. Six of these elements
    address health and safety issues, four establish economic protections for
    boxers, and five would help prevent corruption.

    The act*s provisions cover 10 of the fundamental elements that we
    identified* 1 fully and 9 partially. For example, one provision fully
    covers the element requiring evaluations of medical information on boxers
    and assessments of the risks involved in allowing them to fight before
    each match, but only partially covers the element requiring prefight and
    postfight medical examinations, including neurological testing. (The
    provision requires prefight examinations, but not postfight examinations
    or neurological testing.) The 8 state and 2 tribal boxing commissions that
    we reviewed varied in the extent to which they had documentation
    indicating compliance with the act*s 10 provisions. All 10 commissions had
    documentation indicating compliance at least 75 percent of the time for 3
    provisions* those requiring prefight medical exams, disclosure of purses
    and payments, and registration of boxers* but only 2 commissions had
    documentation at least 75 percent of the time for the provision
    prohibiting

    conflicts of interest. The commissions* documentation for the remaining 6
    provisions varied within this range. When asked why they did not document
    their compliance with particular provisions, the commissions often did not
    provide a reason, but when they did, they generally identified conflicts
    between state and federal law, said they were unaware of the federal
    provision, or said they thought documentation was not needed. The eight
    states and two tribes that we reviewed vary in the extent to which

    they have adopted provisions that cover health and safety, economic, and
    integrity elements in addition to those covered by the act*s provisions.
    Each of these states and tribes has some provisions that cover additional
    elements. The number of additional elements enacted by an individual state
    or tribe ranges from 10 (California) to 4 (Missouri). All 10 states and
    tribes have enacted the element requiring uniform boxing and scoring
    rules, but California was the only state that enacted 3 additional
    elements* for monitoring injuries sustained during training, suspending
    boxers for debilitating training injuries, and providing pension plans for
    boxers. The primary reason provided by the states and tribes for not
    enacting elements in addition to those covered by the act was that the
    elements would be too costly to implement.

    Federal action under the act has been limited. According to the Department
    of Justice, it has not exercised its authority to prosecute cases because
    no cases have been referred to it by federal law enforcement authorities.
    The department said there were no records of cases brought by the U. S.
    Attorneys* offices under the federal boxing legislation during fiscal
    years 1996 through 2002 and that no referrals from law enforcement
    agencies were made. Justice officials also said violations of the boxing
    statutes are misdemeanors and the department generally applies its
    resources to prosecuting felonies. The Association of Boxing Commissions,
    in commenting on a draft of this report, said it had made two referrals to
    U. S. Attorneys* offices, which were not prosecuted. The association said
    one

    referral was dismissed because the issue was subsequently resolved and the
    association had not received a response to the other referral. The Federal
    Trade Commission*s responsibility under the act is limited to making the
    information it receives from sanctioning organizations available to the
    public. The commission said it periodically checks the various sanctioning
    organizations* Web sites to assess whether the required information has
    been made available to the public. Our review of the Web sites of 14
    sanctioning organizations found that this information was posted on the
    Internet. Legislation was recently introduced to significantly amend the
    act by, among other things, creating a new organization within

    the Department of Labor that would provide oversight and enforcement of
    the federal boxing laws. This new federal organization is intended to
    facilitate more uniform enforcement of federal requirements aimed at
    enhancing boxers* health, safety, and economic interests as well as the
    integrity of the sport.

    The Department of Justice and the Federal Trade Commission had only
    technical comments on our draft report. In commenting on our report, the
    president of the Association of Boxing Commissions said much needs to be
    done to achieve uniformity in the regulation of boxing. Some of the states
    and tribes who commented on our report would welcome federal involvement
    while others said they are concerned about the costs of implementing any
    new measures. Some also noted that no federal agency is enforcing the
    existing federal laws protecting professional boxers.

    Fundamental Elements According to our review of congressional testimonies
    5 and national studies

    on professional boxing dating from 1994 through 2002, 6 15 fundamental
    Considered Important

    elements are considered important in helping address the sport*s major to
    Address Health and

    problems. Six elements could help to protect the health and safety of
    Safety and Economic professional boxers, four could help to protect their
    economic interests,

    Problems Facing and five could help to correct problems affecting the
    integrity of the sport.

    Professional Boxing The six elements that could help to protect the health
    and safety of boxers

    would provide  medical examinations, including neurological testing;
    monitoring of training injuries;  assessments of medical risks;

     health and life insurance;  the presence of appropriate medical
    personnel and equipment; and  enforcement of suspensions for injuries.

    5 Senate Committee on Commerce, Science, and Transportation, Subcommittee
    on Consumer Affairs, Foreign Commerce, and Tourism: Hearing on the Federal
    Regulation of Boxing (Washington, D. C.: May 22, 2002); Senate Committee
    on Commerce, Science, and Transportation, Testimony on Boxing and Federal
    Laws (Washington, D. C.: May 23, 2001); Senate Committee on Commerce,
    Science, and Transportation: Hearing on Reform of Professional Boxing
    Industry (Washington, D. C.: Apr. 22, 1999); Senate Committee on Commerce,
    Science, and Transportation, Hearing on Professional Boxing (Washington,
    D. C.: May 22, 1997); House Economic and Educational Opportunities
    Committee Workforce

    Protections Subcommittee and the House Committee on Commerce Subcommittee
    on Commerce Trade and Hazardous Materials, The Professional Boxing
    Corporation Act of 1995 (Washington, D. C.: June 11, 1996); Senate
    Committee on Commerce, Hearing on Health and Safety of Professional Boxing
    (Washington, D. C.: Jan. 20, 1994).

    6 National Association of Attorneys General Boxing Task Force, Office of
    New York State Attorney General Eliot Spitzer, May 2000; Department of
    Health and Human Services,

    Professional Boxing Safety Act of 1996: National Institute for
    Occupational Safety and Health Report to Congress, Study on Health,
    Safety, and Equipment Standards for Boxing (Washington, D. C.: June 1,
    1998); and Department of Labor, Pension Plans for Professional Boxers: A
    Study Prepared by the Segal Company for the Secretary of Labor as Mandated

    by Congress (Washington, D. C.: December 1997).

    According to the testimonies and studies, these elements are important
    because, although the overall rate of injury is lower in professional
    boxing than in many other sports, the risk of severe or permanent brain
    injury is greater. Neurological testing may be needed to detect such
    injury. Furthermore, because injuries may occur during training and
    sparring as

    well as during boxing events, monitoring during training was recommended,
    and health and life insurance may be needed before and after as well as
    during events. In some instances, the treatment a fighter

    receives in the initial minutes after an injury determines whether the
    fighter recovers or sustains permanent damage or death. Having an
    ambulance and qualified medical personnel on- site, rather than on call,
    can be critical. Enforcement of suspensions imposed by boxing commissions
    in other states is important to prevent injured boxers from trying to
    fight outside the states in which they are registered before their
    injuries have healed.

    The four elements that could help to protect boxers* economic interests
    would

     require pension plans for boxers,  require full disclosure of purses
    and payments,  require minimum uniform contractual terms between boxers
    and

    promoters, and  prohibit conflicts of interest. Without a union to
    represent their economic interests, boxers have often been exploited, and
    although the sport has generated enormous wealth for others, many
    professional boxers have been left penniless. Comprehensive pension plans
    for boxers are almost nonexistent, and boxers have sometimes been left to
    pay trainers out of their share of the fight purse when the financial
    responsibilities of promoters and managers were not disclosed in advance.
    Conflicts of interest between promoters and managers and long- term
    contracts with promoters have also disadvantaged boxers.

    The 5 elements that could help to correct problems affecting the integrity
    of the sport would

     require registration and training for judges, referees, and others;

     prevent sanctioning organizations from exercising undue influence in the
    selection of judges;

     establish uniform boxing and scoring rules;  require reviews of
    sanctioning organizations* rankings of boxers; and  require knowledge of
    the sport for commission officials. Reports of unqualified officials,
    last- minute changes in the procedures for selecting judges, nonstandard
    boxing and scoring rules, fraudulent rankings that have resulted in injury
    and even death for weaker boxers, and political appointments to boxing
    commissions have undermined the integrity of the sport.

    Table 1 sets forth the 15 elements we identified. For more detailed
    information on the problems discussed in the testimonies and studies and
    the recommendations made to address these problems, see appendix II.

    Table 1: Fundamental Elements Considered Important to Address Major
    Problems Facing Professional Boxing Health and safety Economic protection
    Integrity of the sport

    1. Conduct prefight and postfight medical 7. Require pension plans for
    boxers. 11. Require registration and training for examinations, including
    neurological testing. boxers, trainers, managers, promoters, physicians,
    and other ring officials. 2. Monitor injuries sustained during gym

    8. Require full and open disclosure of all 12. Ensure that sanctioning
    organizations training (e. g., sparring) before events. purses and costs
    of bouts, breaking out do not influence the selection of judges. amounts
    paid to promoters, sanctioning bodies, judges, trainers, boxers, and
    others.

    3. Evaluate medical information on boxers 9. Prohibit conflicts of
    interest for boxers,

    13. Require uniform boxing and scoring and assess the risks involved
    before promoters, managers, judges, referees,

    rules for events, such as the championship allowing a boxer to fight.

    state boxing commission representatives, rules of the Association of
    Boxing and sanctioning organization Commissions (ABC). representatives.

    4. Ensure the presence of appropriate 10. Require minimum uniform
    contractual 14. Require standards for rating boxers, medical personnel and
    equipment during terms between boxers and promoters. considering their
    records of wins and losses, and after each match and require the filing
    weight differentials, caliber of opponents,

    of postfight medical reports. and number of past fights. 5. Require health
    and life insurance for

    15. Require officials serving on boxing boxers before, during, and after
    each match. commissions to have knowledge of professional boxing. 6. Honor
    other states* suspensions of boxers; monitor training injuries in real
    time, and suspend boxers who sustain debilitating training injuries.

    Source: GAO. Note: Our identification of the fundamental elements is based
    on the congressional testimonies and national studies that we reviewed.
    Some of these elements have multiple effects and may be related to more
    than one category (e. g., health and safety, economic protection, or
    integrity of the sport). For example, the element prohibiting conflicts of
    interest not only affects the economic interests of boxers but may also be
    related to the integrity of the sport.

    The Act*s Provisions The act*s provisions fully or partially cover 10 of
    the elements that we

    Fully or Partially Cover identified as important to address the health and
    safety, economic, and

    integrity problems facing professional boxing. Our analysis shows that one
    10 Fundamental

    of the act*s provisions fully covers the element that requires evaluations
    of Elements, and Selected medical information on boxers and assessments of
    the risks involved in

    Commissions Varied in allowing them to fight before each match. The act*s
    provisions partially

    cover 9 elements. For example, one provision partially covers the element
    the Extent to Which

    requiring medical examinations, including neurological testing, before and
    They Had

    after a fight. (The provision requires prefight, but not postfight,
    examinations and no neurological testing.) Another provision partially
    Documentation

    covers the element requiring the presence of medical personnel and
    Indicating Compliance

    equipment at fights and the filing of postfight medical reports. (It
    requires the presence of medical personnel and equipment, but not the
    filing of postfight medical reports.) Table 2 sets forth our analysis of
    the extent to

    which the act*s provisions cover the fundamental elements we identified.

    Table 2: Extent to Which the Act*s Provisions Cover Fundamental Elements
    to Help Address Major Problems in Professional Boxing

    Extent to which the act covers the Act*s provision Fundamental element
    element

    Health and safety

    Require prefight medical examinations. Conduct prefight and postfight
    medical Partially* the act*s provision does not examinations, including
    neurological testing. require a postfight medical examination or

    any neurological testing. Evaluate medical information on boxers and

    Evaluate medical information on boxers and Fully assess the risks involved
    before allowing a

    assess the risks involved before allowing a boxer to fight.

    boxer to fight. Ensure the presence of appropriate medical Ensure the
    presence of appropriate medical Partially* the act*s provision does not
    personnel and equipment during and after

    personnel and equipment during and after require the filing of postfight
    medical reports. each match.

    each match and require the filing of postfight reports.

    Require health insurance for boxers during Require health and life
    insurance for boxers Partially* the act*s provision does not each match.
    before, during, and after each match. require health insurance for boxers
    before

    and after each match, and it does not require life insurance.

    Honor other states* suspensions of boxers. Honor other states* suspensions
    of boxers, Partially* the act*s provision does not monitor training
    injuries in real time, and

    require states to monitor training injuries in suspend boxers who sustain
    debilitating real time or suspend boxers who sustain training injuries.

    debilitating training injuries.

    (Continued From Previous Page)

    Extent to which the act covers the Act*s provision Fundamental element
    element

    Economic protection

    Require full and open disclosure of all Require full and open disclosure
    of all

    Partially* the act*s provision does not purses and costs of bouts,
    breaking out

    purses and costs of bouts, breaking out require such disclosure for boxers
    and amounts paid to promoters and judges.

    amounts paid to promoters, judges, trainers, trainers. boxers, and others.

    Prohibit conflicts of interest for promoters Prohibit conflicts of
    interest for boxers,

    Partially* the act*s provision does not and commission representatives.
    promoters, managers, judges, referees,

    prohibit conflicts of interest for judges and state boxing commission
    representatives,

    referees. and sanctioning organization representatives.

    Recommend minimum uniform contractual Require minimum uniform contractual
    terms Partially* the act*s provision establishes terms between boxers and
    promoters. between boxers and promoters. guidelines for, but does not
    require such

    terms.

    Integrity of the sport

    Require registration for boxers and Require registration and training for
    boxers,

    Partially* the act*s provision does not certification and approval for
    ring officials. trainers, managers, promoters, physicians,

    require registration for trainers, managers, and other ring officials.

    promoters or physicians, and it does not require training for any parties.

    Recommend standards for rating boxers, Require standards for rating
    boxers,

    Partially* the act*s provision establishes considering their records of
    wins and losses, considering their records of wins and losses,

    guidelines for, but does not require, such weight differentials, caliber
    of opponents, weight differentials, caliber of opponents, standards. and
    number of past fights.

    and number of past fights. Source: GAO.

    On March 13, 2003, the Senate Committee on Commerce, Science, and
    Transportation approved S. 275, a bill that would further amend the act.
    If enacted, the proposed legislation would expand the act*s coverage of
    four fundamental elements* those dealing with the evaluation of medical
    information, minimum contractual terms, the selection of judges, and
    reviews of rankings. In addition, the proposed legislation would establish
    the United States Boxing Administration (USBA) within the Department of
    Labor and empower it to consider other fundamental elements in

    addressing professional boxers* health, safety, and other concerns. USBA
    would be responsible for providing oversight, administering the federal
    boxing laws, and issuing minimum standards to protect the health, safety,
    and general interests of professional boxers. Its responsibilities would
    also include licensing boxers, promoters, managers, and sanctioning
    organizations and maintaining a registry of medical records and medical
    suspension information on all boxers. USBA would also be authorized to
    conduct investigations and to suspend or revoke licenses for misconduct

    after providing notice and hearing.

    Selected Boxing The 8 state and 2 tribal boxing commissions that we
    reviewed varied in the

    Commissions* extent to which they had documentation indicating compliance
    with the 10

    Documentation of provisions of the act related to the fundamental elements
    we identified.

    Compliance Varied The act does not require the commissions to document
    their compliance.

    However, because documentation constituted the only verifiable evidence of
    compliance, we reviewed all available documentation in the commissions*
    event files, including pre- and post- fight medical examination check
    sheets, insurance coverage forms, copies of contracts between boxers and
    promoters, event sheets identifying boxers* registration

    numbers, promoters* revenue reports to commissions, and statements of
    independence signed by ring officials.

    All 10 commissions had documentation indicating compliance at least 75
    percent of the time for three provisions* those that require prefight
    medical examinations, disclosure of amounts paid to promoters, and
    registration of boxers* but only 2 commissions had documentation at least
    75 percent of the time for the provision prohibiting conflicts of
    interest. (See fig. 1.) Five of the commissions said they usually complied
    with this provision but did not document their compliance. The 10
    commissions* documentation for the remaining six provisions varied within
    this range. (See table 4 in app. 3 for the results of our analysis of the
    commissions*

    documentation.) When asked why they did not always document their
    compliance with the provisions, the commissions often did not provide a
    reason, but when they did, they generally pointed to privacy or liability
    concerns, said they were unaware of the federal provisions, or said they
    thought documentation was not needed. For details on the reasons the

    commissions provided for not documenting compliance, see appendix III.

    Figure 1: Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions Related to 10 Fundamental Elements

    Note: The figure represents the number of commissions that had
    documentation indicating compliance at least 75 percent to 100 percent of
    the time for the respective provisions.

    Selected States and The eight states and two tribes that we reviewed vary
    in the extent to which

    Tribes Vary in the their provisions cover health and safety and economic
    elements in addition

    to those covered in the act. Each of these states and tribes has some
    Extent to Which Their

    provisions that cover additional fundamental elements or portions of
    Provisions Cover

    fundamental elements. The number of such provisions enacted by an
    Additional individual Commission ranges from 10 (California) to 4
    (Missouri). All 10 states and tribes have provisions fully covering the
    additional element that

    Fundamental Elements requires uniform boxing and scoring rules, and eight
    states or tribes have

    provisions fully covering the additional element that requires the filing
    of postfight medical reports. California was the only state with
    provisions fully covering 3 other additional elements* for monitoring
    injuries sustained during training, enforcing suspensions for debilitating
    training injuries, and providing pension plans for boxers. Four states or
    tribes have provisions that go beyond the act in requiring postfight
    medical examinations, but none of these states or tribes requires
    neurological

    testing. Similarly, three states or tribes have provisions that go beyond
    the act in requiring that boxers be provided with health insurance before
    and after, as well as during, each match, but none of these states or
    tribes requires life insurance. Figure 2 summarizes the results of our
    analysis. The primary reason provided by the states and tribes for not
    having provisions covering additional elements was that the provisions
    would be too costly to implement. For more details, see appendix IV.

    Figure 2: Extent to Which State and Tribal Provisions Cover Additional
    Fundamental Elements

    Federal Action under Actions taken by the Department of Justice under the
    act have been

    the Act Has Been limited. Justice officials said the department does not
    prosecute cases

    unless they are referred to it by federal law enforcement agencies. There
    Limited

    were no records of cases brought by U. S. Attorneys under the federal
    boxing legislation during fiscal years 1996 through 2002, and there were
    no referrals from law enforcement agencies. Because the act provides for
    state and civil remedies in addition to federal criminal prosecution,
    Justice officials said that cases could be referred to state authorities
    rather than to U. S. Attorneys. Furthermore, the officials said,
    violations of the act are misdemeanors, and U. S. Attorneys generally
    pursue only felony cases,

    although they would prosecute a misdemeanor if circumstances warranted. 7
    In commenting on a draft of this report, the president of ABC said that
    ABC

    had made two referrals to U. S. Attorneys* offices. The first, made in
    October 2002, concerned the World Boxing Association*s ratings of a boxer.
    According to the ABC president, the referral was dismissed because the

    World Boxing Association provided the U. S. Attorney with a copy of its
    rating criteria and the boxers were well known. The ABC president said
    that the other referral, made to the Arkansas U. S. Attorney in 2001,
    reported that professional boxing was occurring in bars without the
    supervision of the Arkansas boxing commission. The ABC president said that
    ABC had not received a response to the referral and the case had not been
    prosecuted.

    The Federal Trade Commission*s (FTC) responsibility under the act is
    limited to making available to the public the information it receives from
    sanctioning organizations. FTC has no responsibility for enforcing
    compliance or verifying the accuracy of the information. 8 FTC officials
    said they periodically check the sanctioning organizations* Web sites to
    assess whether the required information has been made available to the
    public and has found the Web sites to be adequate. Our review of the Web
    sites of

    7 Our report focuses on enforcement of the Professional Boxing Safety Act
    only. Criminal violations under the act are punishable only as
    misdemeanors. When violations of the act are also violations of other
    criminal statutes, prosecution of the felony may overshadow punishment of
    the misdemeanor. 8 Sanctioning organizations are required to identify
    their rating officials and to annually

    disclose their criteria and policies for rating boxers, as well as their
    sanctioning fees, bylaws, and procedures for appealing ratings. They can
    send this information to FTC or post it on the Internet.

    14 sanctioning organizations found that this information was posted on the
    Internet. FTC officials also said they had not received any consumer
    complaints related to the boxing industry.

    In February 2003, legislation was introduced in the Senate that would
    amend the act by, among other things, creating a new organization within
    the Department of Labor to provide oversight and enforcement of the
    federal boxing laws. The purpose of this new federal organization is to
    facilitate more uniform enforcement of federal requirements designed to
    enhance boxers* health, safety, and economic interests as well as the
    integrity of the sport. This organization would have the authority to
    issue regulations, including requirements for documentation; to monitor
    and oversee the commissions* compliance with the existing federal
    protections

    for professional boxers; and to establish additional protections, if
    necessary. Concluding

    Although our review was limited to eight state and two tribal boxing
    Observations

    commissions, the uneven documentation of compliance we found with the
    act*s provisions to protect the health, safety, and economic well- being
    of professional boxers does not provide adequate assurance that
    professional boxers are receiving the minimum protections established in
    federal law. Without complete and accurate information on the extent to
    which the act

    is being enforced and without a federal agency to proactively ensure
    nationwide compliance, there is little assurance of compliance. While the
    Justice Department has the authority to prosecute violations of the act,
    it focuses its limited resources on prosecuting felonies, is not
    responsible for monitoring compliance, and would prosecute a case only if
    it received a referral from a federal law enforcement agency. Since 1996,
    it has received no referrals from federal law enforcement agencies and
    pursued no cases

    of violation of the act. If enacted, the legislation would create a new
    organization within the Department of Labor that could address this gap in
    the oversight and enforcement of the federal boxing laws.

    Agency Comments and We requested comments on a draft of this report from
    the Department of

    Our Evaluation Justice, the Federal Trade Commission, and the Association
    of Boxing

    Commissions (ABC). The Department of Justice*s GAO liaison and the Federal
    Trade Commission*s GAO liaison and Office of General Counsel provided only
    oral technical comments, which we incorporated as appropriate. The
    president of ABC provided written comments, which are

    reproduced in appendix VI. We also provided the boxing commissions of the
    eight states and two tribes that we reviewed with the opportunity to
    review and comment on the facts in the report that related to their
    operations. We received written comments from the Missouri, Miccosukee,
    Mohegan Sun, Pennsylvania and Texas boxing commissions; these comments
    appear in appendixes VII through XI. As of July 16, 2003, we had received
    no comments from the California, Florida, Indiana, Michigan, and Nevada
    boxing commissions.

    In his written comments, provided on June 30, 2003, the president of ABC
    said that while ABC has had some successes, much work needs to be done to
    achieve uniformity in the regulation of boxing. He said that feedback from
    ABC*s membership on federal involvement in regulating professional boxing
    is mixed: many members regard such involvement as intervention, while
    others welcome it. He also said that some members believe that making
    certain types of testing (e. g., neurological testing) mandatory

    would have a negative impact on their jurisdictions because of the cost.
    According to the president, ABC is frustrated with the lack of enforcement
    of the Professional Boxing Safety Act of 1996. He said that violations of
    the act occur frequently, yet no government agency has been willing to
    enforce

    the current laws. The president said that he hopes the members can use the
    act*s 10 provisions as a starting point for standardizing the regulation
    of boxing. The Administrator of the Missouri Office of Athletics, who is
    also the

    president of ABC, provided written comments on the portion of a draft of
    this report applicable to Missouri on June 30, 2003 (see app. VII). While
    noting that the Missouri Office of Athletics encourages the standardized
    regulation of boxing, he said he also recognizes that any actions taken
    will have an economic impact on the sport that will have to be considered.
    In addition, he questioned who would enforce any new federal boxing
    provisions and stated the current law is not being enforced. He said that
    both state and tribal boxing commissions, through ABC, should work to
    standardize the regulation of boxing in the areas discussed in our report.
    He also made some technical comments, which we incorporated in the body of
    the report.

    The Miccosukee, Mohegan Sun, Pennsylvania and Texas boxing commissions
    also provided written comments, which appear in appendixes VIII, IX, X,
    and XI, respectively. In their comments, they expressed appreciation of
    our work, indicating, for example, that our report helps to clarify issues
    related to the protection of boxers* health, safety, and

    economic interests. In addition, the Miccosukee and Pennsylvania boxing
    commissions cited tribal or state regulations that cover portions of some
    of 15 the elements we identified in the report as fundamental to
    protecting boxers* health, safety, and economic interest and to enhancing
    the integrity of the sport. In some instances, the Miccosukee and
    Pennsylvania boxing commissions noted that it would be difficult for them
    to implement certain elements because of personnel and budgetary
    constraints or because of their limited jurisdiction. For example, the
    Miccosukee commission said that it could not monitor training injuries
    because it would not be feasible for the Miccouskee commission or any
    other boxing commission to send representatives to gyms throughout the
    United States and other countries to monitor real time training injuries.
    The Miccosukee commission also indicated that in the future it could
    complete and file checklists in event files to document its compliance
    with certain provisions, such as the one requiring the presence of
    appropriate medical personnel and equipment during and after events. The
    commission said that the lack of documentation in its files does not
    adequately reflect its compliance with

    this provision. The Pennsylvania commission noted the diversity among
    various boxing commissions in implementing the federal law. Finally, the
    Texas commission said it lacked authority to implement several of the 15
    fundamental elements identified in the report.

    We recognize that boxing commissions vary in their approach to regulating
    boxing because of differences in their laws or regulations, local
    situations, and available budgetary and personnel resources. Furthermore,
    we recognize in our report that a lack of documentation does not
    necessarily mean that a requirement was not met. However, we had no other
    practical means to assess the extent to which the federal requirements
    were being addressed. Additionally, we agree with the Miccosukee
    commission that appropriately completed checklists would help to document
    compliance.

    Finally, we believe that our findings, along with the comments we received
    on our draft report, should provide Congress with useful information as it
    considers S. 275.

    As agreed with your office, unless you publicly announce its contents
    earlier, we plan no further distribution of this report until 5 days after
    the date of this letter. At that time, we will provide copies of the
    report to the Ranking Minority Member, Senate Committee on Commerce,
    Science, and Transportation, and the Chairman and Ranking Minority Member,
    House Energy and Commerce. Copies of the report will also be sent to the
    Attorney General, the Chairman of the Federal Trade Commission, the

    Secretary of Labor, the Association of Boxing Commissions, the California
    State Athletic Commission, the Florida State Athletic Commission, the
    Indiana Boxing Commission, the Michigan Bureau of Commercial Services, the
    Missouri Office of Athletics, the Nevada Athletic Commission, the
    Pennsylvania Athletic Commission, the Texas Boxing and Wrestling Program,
    the Miccosukee Athletic Commission, and the Mohegan Tribal Gaming
    Commission Athletic Unit, and to others on request. In addition,

    the report will be available at no charge on the GAO Web site at http://
    www. gao. gov.

    Key contributors to this report are listed in appendix XI. If you or your
    staff have any questions, please contact me on (202) 512- 2834 or ungarb@
    gao. gov.

    Sincerely yours, Bernard L. Ungar, Director Physical Infrastructure Issues

    Appendi xes Professional Boxing Events Held in the United

    Appendi x I

    States during Calendar Year 2001 State or Indian tribal commission Number
    of events held a Percentage of total events

    California b 85 11% Texas b 62 8% Nevada b 55 7% Pennsylvania b 52 7%
    Missouri b 40 5% Florida b 33 4% New York 28 4% Illinois 25 3% Colorado 24
    3% Mississippi 22 3% Indiana b 22 3% Ohio 21 3% Tennessee 19 2% New Jersey
    19 2% Michigan b 18 2% Puerto Rico 15 2% Arizona 15 2% West Virginia 14 2%
    Virginia 14 2% Oklahoma 14 2% Massachusetts 14 2% Washington 13 2% Georgia
    13 2% Kentucky 10 1% Iowa 10 1% South Carolina 9 1% Miccosukee (FL) b 9 1%
    Maryland 8 1% Wisconsin 7 1% Utah 7 1% Mohegan Sun (CT) b 7 1% Louisiana 7
    1% New Mexico 6 1% Mashantucket Pequot (CT) 6 1%

    (Continued From Previous Page)

    State or Indian tribal commission Number of events held a Percentage of
    total events

    Hawaii 6 1% Delaware 6 1% Rhode Island 5 1% North Dakota 5 1% Arkansas 5
    1% Washington, D. C. 4 1% Idaho 4 1% Oregon 3 0% North Carolina 3 0%
    Nebraska 3 0% Saginaw Chippewa (MI) 2 0% Pueblo de San Juan (NM) 2 0%
    Oneida (NY) 2 0% Yakahama Nation (WA) 1 0% New Hampshire 1 0% Connecticut
    1 0% Alaska 1 0%

    Tot al 777 100%

    Source: Fight Fax, Inc. a An event is a meeting of boxers at a place such
    as a casino or sports arena where one or more bouts

    (matches between two boxers) are held on a particular day. b The state and
    tribal boxing commissions we selected for our review.

    Note: We did not verify the information we received from Fight Fax, Inc.,
    the official record- keeping body of the Association of Boxing
    Commissions.

    Fundamental Elements to Address Health and Safety, Economic, and Integrity
    Problems in

    Appendi x II

    Professional Boxing For each of the 15 fundamental elements that we
    identified, this appendix provides a summary of a major problem in
    professional boxing that the element is designed to address. The summaries
    are based on the congressional testimony and national studies* by the
    National Association of Attorneys General (NAAG) Task Force, the
    Department of Health and Human Services, and the Department of Labor* that
    we reviewed. The summaries also include recommendations made at the
    hearings and in the studies to address the problems. The problems are
    divided into three categories: health and safety, economic protection, and
    integrity of the sport.

    Health and Safety Conduct Medical

    In June 1998, the U. S. Department of Health and Human Services reported
    Examinations, Including

    the results of a study mandated by Congress on health, safety, and
    equipment standards for boxing. 1 The study found that although the
    overall Neurological Testing

    rate of injury is lower in professional boxing than in many other sports,
    the risk of sustaining a severe or permanent brain injury is greater in
    boxing because fighters are exposed to repeated blows to the head. Head
    injuries account for a significant portion of all boxing injuries. Factors
    such as poor boxing ability, reduced supervision, and small stature are
    thought to increase the likelihood of traumatic head injury. Similarly,
    the length of a boxer*s career and the total number of bouts in training,
    sparring, and competition combined have been linked to the severity of
    neurological damage. Because neurological damage is not always detected
    during routine medical examinations, neurological testing may be necessary
    to

    identify it. Monitor Training Injuries According to a professional boxing
    trainer with over 25 years of experience

    whom we interviewed, boxers are required to train and spar in the gym
    daily for months in preparation for a fight. He said that during the
    sparring sessions, many boxers sustain injuries that are not reported to
    the boxing commissions. As a result, some of the boxers participate in
    events with pre1

    Professional Boxing Safety Act of 1996: National Institute for
    Occupational Safety and Health Report to Congress, Study on Health,
    Safety, and Equipment Standards for Boxing (June 1, 1998).

    existing injuries, exposing themselves to further injury or harm. In an
    effort to protect the health and safety of professional boxers, the NAAG
    task force recommended in 2000 that state inspectors inspect boxing gyms
    if adequate funding and staff are available. Evaluate Medical

    To help protect the health and safety of boxers, the NAAG task force
    Information and Assess

    recommended that all commissions implement a medical classification Risks

    system that would establish risk levels for boxing injuries. For a fighter
    whose record included any element of a high- risk classification (e. g.,
    repeated knockouts), the task force further recommended that

    commissions be required to impose a temporary suspension until the fighter
    received a medical clearance or required examination, such as a
    neurological examination conducted by a neurologist using magnetic
    resonance imaging and an electrocardiogram.

    Ensure Presence of Medical In 2001, a representative of the Nevada
    Attorney General testified 2 that

    Personnel and Equipment although common sense dictates that an on- site
    ambulance is needed for all

    and File Postfight Reports boxing matches and should be available to
    transport an injured boxer to a

    hospital, many promoters would prefer to call 911 if an ambulance is
    needed. The representative said that while this arrangement may be more
    cost- effective for the promoter, the treatment of a fighter in the
    initial

    minutes after an injury* whether waiting for an ambulance to arrive or
    receiving immediate and appropriate medial care* is critical in
    determining whether the fighter will recover or suffer permanent damage or
    death. Similarly, in 1983, the World Medical Association 3 said that
    professional boxing events should be held in locations where

     adequate neurosurgical facilities are immediately available for
    emergency treatment of an injured boxer,  a portable resuscitator with
    oxygen equipment and appropriate

    endotracheal tubes are available at ringside, and 2 Senate Committee on
    Commerce, Science, and Transportation, Testimony on Boxing and Federal
    Laws, (Washington, D. C.: May 23, 2001). 3 The World Medical Association
    is an international organization created to ensure the independence of
    physicians and to work for the highest possible standards of ethical
    behavior and care by physicians.

     an ambulance is continuously on- site to transport any seriously injured
    boxer to a hospital immediately. The Professional Boxing Safety Act of
    1996, as amended (the act), requires the continuous presence of a ringside
    physician and an ambulance or

    medical personnel with appropriate resuscitation equipment at each boxing
    event, unless equivalent protection is required by the boxing commission*s
    provisions.

    A Pennsylvania Athletic Commission official testified 4 in May 2001 that
    boxing commissions should be required to develop criteria for licensing
    professional boxers, which should include reviews of boxers* fight records

    (i. e., wins, losses, knockouts) and suspensions, and a centralized
    database of medical examination information on all licensed boxers. He
    said that the database should be accessible only to boxing commission
    officials and would provide boxing commissions with an additional
    screening mechanism to use in their license determination process.

    Require Health and Life The president of the Association of Boxing
    Commissions (ABC) told us that

    Insurance current insurance provisions require promoters to provide health
    insurance

    coverage only during a boxing event. However, he said such coverage does
    not protect boxers in other instances when they may need medical treatment
    but do not have health insurance or the financial resources to pay for
    treatment. For example, boxers may sustain injuries during an event but
    not recognize until later that they have been injured and need treatment.
    Many boxers also sustain injuries during training or sparring. In 1996, a
    New Jersey Boxing Commission representative testified 5 that boxers spend
    far more time sparring in gyms than competing in events; as a result, they
    are more likely to sustain injuries during this period. The

    representative said that to prevent injuries to the head and other parts
    of the body, the amount and intensity of sparring should be monitored. A
    trainer we interviewed said that boxers should have health and life
    insurance coverage throughout the training period, as well as before,
    after, 4 Senate Committee on Commerce, Science, and Transportation:
    Testimony on Boxing and Federal Laws (Washington, D. C.: May 23, 2001).

    5 House Economic and Educational Opportunities Committee Workforce
    Protections Subcommittee and the House Committee on Commerce Subcommittee
    on Commerce Trade and Hazardous Materials, The Professional Boxing
    Corporation Act of 1995 (Washington, D. C.: June 11, 1996).

    and during an event, in order to address any medical conditions or
    injuries. However, he said many insurance companies do not offer boxers
    health and life insurance at affordable prices. Enforce Suspensions In
    2002, the president of ABC testified before the Senate Committee on

    Commerce, Science, and Transportation on the need for the uniform
    enforcement of all suspensions imposed by boxing commissions. Currently,
    such enforcement is applicable only to suspensions imposed on boxers for

    recent knockouts or for a series of consecutive losses and medical
    reasons. The president said that in some instances, commissions have
    suspended boxers for falsifying documents or other types of inappropriate
    behavior and that to avoid serving the imposed suspensions, some boxers
    have

    traveled to other states and obtained a license to continue boxing.
    Economic Protection Require Pension Plans for

    Professional boxing offers no long- term financial protection for its
    Boxers

    participants, although purses for the big events are in the millions of
    dollars and televised worldwide, often on a pay- per- view basis. The New
    York State Attorney General testified in 1999 6 that the boxing industry
    has generated enormous wealth for virtually everyone except professional
    boxers. He

    added that over the decades, the interests of professional boxers have
    been ignored, leaving many penniless and medically at risk. In 1996,
    Congress mandated that the Secretary of Labor undertake a study on the
    feasibility of establishing a pension plan for professional boxers.
    According to the study, 7 apart from programs run by the California
    commission and by the International Boxing Federation for its championship
    fights, comprehensive pensions for boxing are virtually nonexistent. The
    study concluded that a comprehensive program, if implemented for
    professional boxers, would consist of a charitable trust, a defined
    contribution plan, a

    6 Senate Committee on Commerce, Science, and Transportation: Hearing on
    Reform of Professional Boxing Industry (Washington, D. C.: Apr. 22, 1999).
    7 Pension Plans for Professional Boxers: A Study Prepared by the Segal
    Company for the Secretary of Labor as Mandated by Congress (December
    1997).

    defined benefit plan, and a disability income and survivor*s benefit
    program. Disclose Purses and Break

    In 1997, a reporter testified 8 that in 1986 a boxer was guaranteed
    $300,000, Out Payments

    with up to another $100,000 in training fees, for a fight. Out of a
    potential $400,000, the boxer was paid about $99,000. The manager did not
    pay the trainer and the boxer paid the trainer out of his share of the
    purse, leaving the boxer with $69,000. To address problems such as this,
    the NAAG task force study recommended that a model contract be developed
    to outline

    contractual disclosure requirements between the promoters, managers, and
    boxers. The model contract should specify the rights and responsibilities
    of all parties, such as the contest requirements, compensation (including
    a full accounting and disclosure of all deductions from a boxer*s purse),
    licenses, and remedies for lack of good faith, collusion, or breach of
    contract, including arbitration provisions.

    Prohibit Conflicts of A Texas Boxing and Wrestling Program official cited
    reports of fights in

    Interest which a manager managed both boxers and the manager and promoter

    were related. Such business arrangements limited the boxers* chances of
    receiving fair payment. The official said that in theory, a manager is
    supposed to negotiate the most favorable economic terms for the fighter,
    while the promoter is supposed to make the largest possible profit on the

    event. Establish Uniform

    There are frequent reports of boxers* economic exploitation. For example,
    Contractual Terms

    in January 2003, officials of the Mohegan Tribe Department of Athletic
    Regulations reported that a boxer had been fighting for more than a year
    and had never received payment for participating in events throughout the
    United States, although the manager was receiving the boxer*s fight
    purses. For this violation, the commission revoked the manager*s license
    for an indefinite period. In 2001, a Pennsylvania Athletic Commission
    official said that for years fighters have been contractually tied to
    promoters for a series of boxing events, limiting their ability and
    opportunities to pursue other promoters and to box in other events. The
    official said that the Muhammad

    8 Senate Committee on Commerce, Science, and Transportation, Hearing on
    Professional Boxing (Washington, D. C.: May 22, 1997).

    Ali Boxing Reform Act, which limits the contracts between the boxer and
    promoter to 1 year, is a step in the right direction to correct this
    problem. Integrity of the Sport

    Require Registration and A Nevada State Athletic Commission official
    testified in 1994 9 that boxing

    Training for Judges, referees have to decide in a split second which
    fighter has won a bout.

    Referees, and Others Accordingly, he said, judges should have the ability
    to closely observe the

    fighters and base their decisions on consistent scoring criteria. The NAAG
    task force made recommendations to help enhance the integrity of the
    sport, including the following:  ABC should develop a standardized
    testing program to be administered

    to judges and referees.  Judges and referees should be required to pass
    this examination before

    they receive their licenses.  To be licensed as a referee, an individual
    should have prior experience

    officiating in amateur competition or in other states or jurisdictions.
    All referees should be required to receive training and attend a minimum
    of two medical training seminars each year.  To be licensed as a judge,
    an applicant should be proficient in the rules and regulations of boxing
    and have prior experience officiating in amateur competition or in other
    ABC states or jurisdiction.

     To be licensed as a ringside physician, a physician should have a state
    medical license, be in good standing in the respective state, and have
    experience as a licensed physician for a minimum of 2 years.

     Ringside physicians should be required to receive training in ringside
    medicine.

    9 Senate Committee on Commerce, Hearing on Health and Safety of
    Professional Boxing (Washington, D. C.: Jan. 20, 1994).

     Promoters and managers should be licensed and regulated. Prevent Undue
    Influence The president of ABC testified in 2002 10 on the need for
    standards to prevent sanctioning organizations from interfering with
    boxing commissions* selection of judges and referees. According to the
    president, that need was demonstrated during a nationally televised
    championship fight in 2001. He said that several weeks before the
    scheduled event, the sanctioning organization and the state boxing
    commission agreed that the sanctioning organization would designate the
    referee and one judge and the commission would designate the remaining two
    judges. However, less than 5 minutes before the event was to begin, a
    representative from the sanctioning organization threatened to withdraw
    the organization*s sanction* an action that would reduce the status of the
    fight to a nontitled

    event* if the commission did not agree to replace one of the judges
    selected by the commission with a judge designated by the sanctioning
    organization. The commission agreed to the sanctioning organization*s

    demands in order to retain the title status of the fight. Because the
    sanctioning organization was allowed to select two of the three judges,
    the president of ABC said the outcome of the event might have been
    compromised.

    Require Uniform Boxing In June 1996, a former Nevada Athletic Commission
    official testified 11 that

    and Scoring Rules every boxing match in the United States should be
    conducted under the

    same boxing and scoring rules. While noting that ABC has established
    Unified Championship Rules for title bouts, he said that some commissions
    do not implement the same rules. The official said that standardizing
    boxing and scoring rules is important because fighters can have difficulty
    concentrating on protecting themselves in the ring when they are trying to
    remember whether a particular state uses a rule. Similarly, it is
    difficult for referees to focus on a bout if they are worrying about
    changes in the rules for different bouts.

    10 Senate Committee on Commerce, Science, and Transportation, Subcommittee
    on Consumer Affairs, Foreign Commerce, and Tourism: Hearing on the Federal
    Regulation of Boxing (Washington, D. C.: May 22, 2002).

    11 Senate Committee on Commerce, Science, and Transportation, Hearing on
    Effective Regulation of the Boxing Industry: A Cooperative Effort
    (Washington, D. C.: May 23, 2001).

    Review Sanctioning The NAAG task force study reported that sanctioning
    organizations*

    Organizations* Rankings rankings often are not based on objective
    assessments of talent or records

    of fighters* wins and losses. Instead, according to the study, boxers
    associated with certain promoters may be highly ranked regardless of their
    skill and ability. The study reported that this creates fraud that can
    have deadly consequences. For example, a fight advertised as a major
    championship battle may turn out to be a mismatch, as was a bout held on
    November 13, 1982, between Ray *Boom- Boom* Mancini and Duk Koo Kim of
    South Korea. Mancini knocked out Kim, who never regained consciousness and
    died. The World Boxing Association had rated Kim as a top contender, even
    though he was not among Korea*s top 40 fighters.

    Require Knowledge of In 2002, an entertainment manager testified 12 that
    state boxing

    Professional Boxing for commissions are generally underfunded and
    dominated by political

    Commission Officials appointees with limited knowledge of the sport. He
    said that many of these

    officials do not understand the boxing industry well enough to regulate
    it. 12 Senate Committee on Commerce, Science, and Transportation,
    Subcommittee on Consumer Affairs, Foreign Commerce, and Tourism: Hearing
    on Federal Regulation of Boxing (Washington, D. C.: May 22, 2002).

    Selected Boxing Commissions* Documentation of Compliance with the Act*s

    Appendi x III

    Provisions This appendix presents the results of our analysis of the eight
    state and two tribal boxing commissions* documentation of compliance with
    the act*s provisions and provides information on the reasons given by the
    commissions for not having documentation. Figure 3 summarizes the results
    of our analysis of the commissions* documentation.

    Figure 3: Selected Commissions* Documentation of Compliance with the Act*s
    Provisions for Boxing Events Held in 2001

    Note: This analysis reflects (1) actual percentages for Indiana, Michigan,
    and the Miccosukee and Mohegan Sun tribal jurisdictions, where we examined
    documentation for all events held in 2001, and (2) estimated percentages
    for California, Florida, Missouri, Nevada, Pennsylvania, and Texas, where
    we examined documentation for a statistical sample of all events held in
    2001. Typically, one boxing event consists of 6 to 10 bouts, each of which
    may have its own documentation. a The California and Indiana commissions
    said they complied with the provision but did not provide

    documentation for our review, citing privacy or other concerns. A
    California official sought higher- level approval for our review, but it
    was not obtained until after we had completed our work at the commission.

    b The California commission said it usually complied with this provision
    but did not document its compliance. c The California, Indiana, Missouri,
    Nevada, Pennsylvania, and Miccosukee commissions said they usually or
    always complied with this provision but did not document their compliance.

    d The Indiana commission did not provide documentation for our review. e
    The California, Michigan, and Nevada commissions said they usually
    complied with this provision but did not document their compliance. f In
    figure 1 (p. 14), we categorized two commissions (Pennsylvania and the
    Miccosukee Tribe) as

    having documentation for this provision at least 75 percent of the time. g
    The California, Florida, Indiana, Nevada, and Texas commissions said they
    complied with this

    provision but did not document their compliance. In commenting on a draft
    of this report, the Missouri Office of Athletics said that Missouri does
    not have a commission, but is staffed by 3 officials. Since Missouri does
    not have procedures to prohibit conflicts of interest for the 3 officials,
    we considered the 3 officials as a commission that did not have
    documentation evidencing compliance with this provision. h The California
    commission said it had purged its documentation for this provision from
    its files, and the Indiana commission said it was experiencing computer
    problems and could not provide the documentation.

    The remainder of the appendix provides information on the extent to which
    the 10 boxing commissions had documentation indicating compliance with
    each of the act*s provisions related to a fundamental element. For the
    commissions that did not have or did not provide documentation for our
    review, the appendix also includes the reasons given by the commissions
    for not having or providing the documentation. When a reason is not
    specified, the commission did not provide a reason.

    Figure 4: Evaluate Medical Information and Assess Risks

    Four of the 10 state and tribal boxing commissions (California, Indiana,
    Michigan, and Missouri) provided us with documentation of compliance less
    than 50 percent of the time with the act*s provision requiring the
    evaluation before each match of medical information and the assessment of
    risks involved in allowing a boxer to fight. The Missouri boxing
    commission said that it does not collect and maintain medical information
    because state law concerning confidentiality, disclosure, and civil
    liability issues prohibited them from doing so. The Michigan boxing
    commission said that they were advised by its legal counsel to limit the
    amount of medical information collected due to the commission*s limited
    authority to collect and protect such information. The Indiana Boxing
    Commission said it maintained medical information on professional boxers,
    but would not

    provide that information for review because of confidentiality and civil
    liability concerns. A Texas official said that the Texas Boxing and
    Wrestling Program used prelicense and prefight examinations, along with
    information obtained from Fight Fax, Incorporated, 1 detailing a boxer*s
    record of wins and losses and medical suspensions, to assess the risks
    involved in allowing a boxer to fight before each match. This official
    added that when reported information indicated that a boxer*s physical
    condition was questionable, the commission might require the boxer to
    undergo additional medical tests to ensure that he or she was not
    participating in an event with a pre- existing injury. According to the
    official, the Texas Boxing and Wrestling Program does not disclose medical
    information it maintains on boxers to other commissions because of
    confidentiality and civil liability concerns. The California State
    Athletic Commission said it maintained medical information, such as the
    results of annual physicals and any neurological tests, on professional
    boxers registered in California, but it did not make this information
    available for review during our visit to the commission.

    1 Fight Fax, Incorporated, is the official record- keeping body of ABC.

    Figure 5: Require Minimum Uniform Contractual Terms

    Seven of the 10 state or tribal boxing commissions (Florida, Michigan,
    Nevada, Pennsylvania, Texas, Miccosukee, and Mohegan Sun) had
    documentation at least 75 percent of the time for the provision requiring
    minimum uniform contractual terms between boxers and promoters; the
    Indiana Commission had documentation 50 to 74 percent of the time; and the
    California and Missouri commissions had documentation less than 50 percent
    of the time. The Director of the Indiana Boxing Commission said that the
    commission*s representatives were responsible for obtaining copies of all
    contracts between promoters and boxers before an event and for ensuring
    that boxers were paid in accordance with the contractual terms. However,
    contracts between the promoters and boxers were missing from most of the
    commission*s event files. The director said that in some cases boxers
    forgot to forward their bout agreements to the commission after the
    matches. The Executive Officer of the California State Athletic Commission
    said that the contractual agreements between boxers and promoters were
    submitted to the commission before events and no events were held unless
    copies of the agreements were on file. However, many of the 2001 event
    files that we reviewed had no documentation of contractual agreements
    between boxers and promoters. No reason was given for the missing
    contracts. According to a Missouri Office of Athletics official, its legal
    counsel advised the commission against requiring boxing contracts because
    such agreements involved civil matters that were outside the jurisdiction
    of the Missouri Office of Athletics.

    Figure 6: Require Standards for Rating Boxers to Protect against
    Mismatches

    Nine of the state and tribal boxing commissions (Florida, Indiana,
    Michigan, Missouri, Nevada, Pennsylvania, Texas, Miccosukee, and Mohegan
    Sun) that we reviewed had documentation at least 75 percent of the time
    for the provision requiring standards for rating boxers*, considering
    their records of wins and losses, weight differentials, caliber of
    opponents, and numbers of past fights, to protect against mismatches. The
    California State Athletic Commission was the only commission we reviewed
    that lacked documentation for this provision. According to the Executive
    Officer, the commission reviewed the reports of Fight Fax, Incorporated,
    and the commission*s chief inspector determined whether boxers were
    matched in accordance with their boxing skill levels, but the commission
    did not maintain any records on this process.

    Figure 7: Conduct Prefight Medical Examinations

    All 10 of the state and tribal boxing commissions had documentation at
    least 75 percent of the time for the provision requiring medical
    examinations before fights.

    Figure 8: Ensure Presence of Medical Personnel and Equipment

    Six of the 10 state and tribal boxing commissions (California, Indiana,
    Missouri, Nevada, Pennsylvania, and Miccosukee) had documentation less
    than 50 percent of the time for the provision requiring the presence of
    appropriate medical personnel and equipment during and after each match.
    Officials from these 6 commissions said that no fight would proceed

    without emergency medical service and an ambulance on- site during events,
    but they did not document their compliance with this requirement.
    Furthermore, in commenting on a draft of this report, the Administrator of
    the Missouri Office of Athletics noted that the act does not require such
    documentation. The Florida, Michigan, Texas, and Mohegan Sun boxing
    commissions documented the presence of emergency medical personnel and
    equipment during the events at least 75 percent of the time.

    Figure 9: Require Health Insurance During Matches

    Three of the 10 state and tribal boxing commissions (Florida, Indiana, and
    Michigan) lacked documentation at least 75 percent of the time for the
    provision requiring health insurance for boxers during matches. The

    Florida State Athletic Commission said that it had not documented boxers*
    health insurance because of a clerical mistake. The Director of the
    Indiana Boxing Commission said that many of the commission*s 2001 event
    files

    were missing documentation of health insurance coverage because in
    Indiana, a majority of the professional boxing events were organized by
    the same promoters, who usually secured an annual policy covering all of
    the events for the year. We asked the official for documentation of health
    insurance coverage for the events whose files were missing such
    documentation. However, this documentation was not made available

    during our review.

    Figure 10: Honor Suspensions Imposed by Other Commissions

    Three of the 10 state and tribal boxing commissions (California, Michigan,
    and Nevada) had documentation less than 50 percent of the time indicating
    that they had enforced suspensions of boxers imposed by other commissions.
    Officials from these 3 commissions said that before approving fights, they
    reviewed the suspension information received from

    Fight Fax and the national suspension list to ensure that boxers were not
    participating in events while serving suspensions imposed by other
    commissions. The officials added that although this information was
    reviewed, they did not maintain a record of the information in the event
    files.

    Figure 11: Require Disclosure of Purses and Payments to Promoters and
    Judges

    All 10 of the state and tribal boxing commissions we reviewed had
    documentation at least 75 percent of the time for the provision requiring
    the disclosure of all purses and amounts paid to promoters. Two of the 10
    commissions (Indiana and Missouri) had documentation less than 75 percent
    of the time for the provision requiring the disclosure of amounts paid to
    judges. The Director of the Indiana Boxing Commission said that the
    commission verified all forms of payment before events and ensured that
    all payments were made immediately after the events, but the commission
    did not make this information available during our review. The Missouri
    Office of Athletics said that the commission did not always document
    amounts paid to judges because Missouri law did not require the disclosure
    of such information. The official added that the promoters usually pay the
    judges by check through the Missouri Office of Athletics for tax purposes.

    Figure 12: Prohibit Conflicts of Interest for Boxers, Promoters, and
    Commission Representatives

    The Miccosukee Athletic Commission was the only boxing commission with
    documentation at least 75 percent of the time for the provision that calls
    for ensuring that there are no conflicts of interest for boxers and
    promoters. Officials from the Michigan, Missouri, and Mohegan Sun boxing
    commissions said they were unaware that the provision had been enacted in
    federal law. The Director of the Indiana Boxing Commission said Indiana
    had not experienced any problems with boxers and promoters relating to
    conflicts of interest; therefore, the commission felt documentation for
    this provision was unnecessary.

    The Pennsylvania Athletic Commission was the only boxing commission with
    documentation at least 75 percent of the time for the provision that calls
    for ensuring that there are no conflicts of interest for boxers and
    commission representatives. Officials from the Michigan, Missouri, and
    Mohegan Sun commissions said they were unaware that the provision had been
    enacted in federal law, and officials from the California, Florida,
    Indiana, Nevada, and Texas 2 commissions said they did not maintain
    documentation for this provision because they believed these issues were
    addressed through discussions.

    Figure 13: Require Registration for Boxers and Certification and Approval
    for Ring Officials

    All 10 of the state and tribal boxing commissions we reviewed had
    documentation at least 75 percent of the time for the provision requiring
    boxers to be registered. Two of the 10 commissions (California and 2 In
    commenting on a draft of this report, the Texas Department of Licensing
    and Regulation said that all of its employees are required to sign a
    certification that they have read the

    department*s conflict of interest policies. However, when we met with the
    Texas boxing commission officials they said there was no documentation of
    this for us to review.

    Indiana) had documentation less than 50 percent of the time for the
    provision requiring ring officials to be certified and approved. The
    Executive Officer of the California State Athletic Commission said the
    commission documented only current registrations and had purged the 2001
    data from its files. During our review, the Director of the Indiana Boxing
    Commission said the commission was experiencing computer problems and
    could not provide us with the list of ring officials certified and
    approved in 2001.

    State and Tribal Provisions That Cover Additional Health, Safety,
    Economic, and

    Appendi x IV

    Integrity Elements This appendix provides information on the extent to
    which the 10 states and tribes that we reviewed had provisions covering
    health, safety, economic, and integrity elements in addition to those
    covered by the act. The appendix also provides the states* and tribes*
    reasons for not having provisions covering certain elements. When reasons
    are not specified, the

    commissions did not provide them. Conduct Postfight

    None of the 10 state and tribal commissions we reviewed had provisions
    Medical Examinations,

    requiring postfight medical examinations, including neurological testing,
    for all boxers who participate in events outside their own jurisdictions.
    Including Neurological

    Three of the commissions said they did not have provisions requiring Test
    i ng

    postfight medical examinations or neurological testing because they did
    not have the financial resources to administer such requirements and it
    would not be feasible to require small promoters or boxers to pay for
    them. However, the California, Indiana, Nevada, Texas, and Pennsylvania
    boxing

    commissions said they required postfight medical examinations when a
    commission requested that a previously injured boxer obtain a medical
    release before being allowed to fight.

    Monitor Training California was the only commission that required the
    monitoring of injuries

    Injuries sustained during training before events. Five of the state and
    tribal boxing

    commissions (Indiana, Missouri, Mohegan Sun, Pennsylvania, and Texas)
    agreed that from a safety perspective, monitoring boxers* gym activities
    was a good concept, but they said they did not have the personnel or
    financial resources to monitor local gym activities. The Executive
    Director of the Pennsylvania Athletic Commission said that Pennsylvania
    did not require the monitoring of gym injuries before events, but he
    personally visited each local gym once or twice a year to monitor gym
    activities.

    File Postfight Medical Eight of the state and tribal commissions
    (California, Indiana, Michigan,

    Reports Missouri, Nevada, Pennsylvania, Texas, and Mohegan Sun) required
    the

    filing of postfight medical reports. The Executive Director of the Florida
    State Athletic Commission said Florida did not require the filing of
    postfight medical reports because the commission and the small promoters
    and boxers did not have the financial resources to pay for physicians to
    conduct such examinations. The official added that in many cases the small
    promoters struggled to pay for the physicians needed to conduct the
    required prefight examinations. The Executive Director of the Miccosukee

    Athletic Commission said that the commission did not require the filing of
    postfight medical reports; however, he said a medical referral might be
    given to a boxer if the ringside physician suspected that the boxer had
    been injured and a follow- up examination or observation was needed.

    Require Health and Life None of the state and tribal commissions require
    that boxers be provided

    Insurance Before and with health and life insurance before and after each
    match. Generally, the

    commissions required the promoters to secure health insurance during a
    After Fights

    match, as the act requires. Some of the policies provided extended
    coverage for medical and accidental death and dismemberment for up to 1
    year following the match. Four of the commissions (Michigan, Missouri,
    Pennsylvania, and Texas) said that providing coverage to boxers before or
    between matches* that is, during training* would be too costly. They

    stated that it is not the commissions* responsibility to provide coverage,
    since boxers are independent contractors.

    Enforce Suspensions California was the only state that required its
    commission to suspend for Training Injuries

    boxers for training injuries. All of commissions agreed that suspending
    boxers for gym injuries was not feasible because many of the commissions
    were experiencing personnel and budgetary constraints and did not have the
    resources to monitor gym activities.

    Require Pension Plans California was the only state that required pension
    plans for professional boxers. Officials at the other nine commissions
    said that this was a positive

    initiative; however, six of the commissions (Indiana, Miccosukee,
    Michigan, Missouri, Pennsylvania, and Texas) questioned the contribution
    sources and basis for qualification. The Boxing Administrator of the Texas
    Boxing and Wrestling Program said that the problems associated with
    pension and retirement plans were similar to those attending the health
    insurance issue and that they were social rather than professional boxing
    issues. According to the Director of the Indiana Boxing Commission,
    pension plans would benefit boxers a great deal, particularly if boxers
    were older and nearing retirement, younger and intending to make a career
    of professional boxing, or injured and without an alternative source of
    income. The official said that problems would arise with funding, because

    promoters have little incentive to fund pension plans for boxers and might
    be unable to afford the additional expense. He said that deducting money

    from each boxer*s purse would also be difficult, because most boxers do
    not earn more than a few hundred dollars per bout.

    According to the Executive Director of the Pennsylvania Athletic
    Commission, the commission is pursuing funding for pension plans. The
    official added that in 1992, the commission attempted to use its budget
    surplus to start a trust for professional boxers; however, because of
    shortfalls elsewhere in the state*s budget, the funds were expended on
    other projects. The commission is initiating a charitable trust under ABC

    that has received some voluntary contributions thus far. The goal is to
    reach $500,000 in principal and operate the program using the account*s
    interest. The official said that because professional boxers are not

    unionized, a traditional pension fund would not be feasible. The
    Enforcement Division Director of the Michigan Bureau of Commercial
    Services said that the commission views operating a pension plan as
    outside the state*s role to protect the consumer. In addition, the
    official

    said, promoters operating in Michigan would not be willing to fund a
    pension plan. Officials from the Missouri Office of Athletics and the
    Miccosukee Athletic Commission supported the establishment of a pension
    plan; however, they questioned the feasibility of doing so, since boxers
    are independent contractors.

    Require Disclosure of Two of the state and tribal boxing commissions
    (Florida and Mohegan Sun)

    All Purses and required full and open disclosure of all purses and costs
    of bouts, with the

    amounts paid to trainers and boxers broken out. According to the Payments
    to Trainers

    Executive Officer of the California State Athletic Commission, California
    and Boxers

    has no provision requiring the disclosure of all purses and costs to
    trainers, but does require that the amounts paid and costs assessed to
    boxers be disclosed. The Enforcement Division Director of the Michigan
    Bureau of Commercial Services said that the commission did not have a
    provision requiring the disclosure of all purses and costs to trainers and
    boxers because the commission did not enforce any such agreements between
    these parties, as directed by their legal counsel. The Boxing
    Administrator of the Texas Boxing and Wrestling Program said that Texas
    only had provisions requiring the disclosure of all purses and costs to
    promoters and boxers. However, the Texas official said that the
    organization documented information on the fees that the trainers were
    paid from the boxer*s purse,

    although there was no requirement for such documentation.

    Prohibit Conflicts of Eight state and tribal commissions (Florida,
    Indiana, Michigan, Nevada,

    Interest for Judges and Pennsylvania, Texas, Miccosukee, and Mohegan Sun)
    prohibited conflicts

    of interest for judges and referees. According to the Missouri Office of
    Referees

    Athletics official, the commission has provisions for ensuring that there
    are no conflicts of interest for state boxing commission representatives.
    The official did not explain why the provisions do not address conflicts
    of interest for managers, judges, and referees. The Enforcement Division
    Director of the Michigan Bureau of Commercial Services said that a number
    of state officials resigned after the act established conflict of interest
    standards.

    Require Registration Missouri was the only commission we reviewed with a
    provision requiring

    and Training for trainers, managers, promoters, and physicians to be
    registered and receive

    training. Officials from six of the commissions (California, Florida,
    Indiana, Trainers, Managers,

    Miccosukee, Pennsylvania, and Texas) said that they had provisions
    Promoters, and requiring these occupations to be registered, but because
    of limited Physicians financial resources, the provisions governing
    training were applicable only to physicians and ring officials.

    Preclude Sanctioning Seven of the 10 state and tribal commissions
    (California, Florida, Missouri,

    Organizations from Nevada, Pennsylvania, Texas, and Mohegan Sun) we
    reviewed had

    provisions for selecting judges and ensuring that sanctioning
    organizations Exercising Undue

    do not influence the selection process. Influence

    Select Uniform Boxing All 10 of the commissions we reviewed had provisions
    for selecting the

    and Scoring Rules boxing and scoring rules for events, such as ABC*s rules
    for championship

    events. Require Boxing

    Seven of the 10 commissions (California, Florida, Michigan, Nevada,
    Knowledge for

    Pennsylvania, Texas, and Miccosukee) had provisions that require officials
    who serve on boxing commissions to have knowledge of professional
    Commission Officials

    boxing. According to the Administrator of the Missouri Office of
    Athletics, the governor appoints the officials serving on the state*s
    boxing commission, and, as a result, some of these officials may not have
    a

    professional boxing background or knowledge. Similarly, representatives of
    the Mohegan Tribe appoint the officials serving on the Mohegan Tribal
    Gaming Commission Athletic Unit and therefore, according to the unit*s
    legal counsel, some of the officials may not have an extensive background

    in boxing. However, this has not been the commission*s experience, the
    counsel said.

    Appendi x V

    Objectives, Scope, and Methodology In analyzing the adequacy of efforts to
    protect the health, safety, and economic well- being of professional
    boxers and to enhance the integrity of the sport, our objectives were to
    (1) identify fundamental elements considered important to address the
    major health and safety, economic, and integrity problems facing
    professional boxing; (2) assess the extent to which the act*s provisions
    cover these elements and whether selected state and tribal boxing
    commissions have documentation indicating compliance

    with the act*s provisions; (3) assess the extent to which selected states
    and tribes have adopted provisions that cover fundamental elements in
    addition to those covered in the act; and (4) determine what actions the
    Department of Justice and the Federal Trade Commission (FTC) have taken
    under the act.

    To identify fundamental elements that are considered important to address
    the major health and safety, economic, and integrity problems facing
    professional boxing, we reviewed recent congressional testimony and
    studies conducted by a task force of the National Association of Attorneys
    General, the Department of Health and Human Services, and the Department
    of Labor. From these sources, which documented problems in the boxing
    industry and made recommendations to address them, we identified major
    problems facing the sport and consolidated the recommendations into 15
    fundamental elements that, if implemented, could provide an adequate level
    of health, safety, and economic protection to boxers and help enhance the
    integrity of the sport. We discussed these elements with the Association
    of Boxing Commissions, which agreed that the elements could provide the
    desired protection and enhancement.

    To assess the extent to which the act*s provisions cover the fundamental
    elements we identified, we analyzed the act*s provisions and determined
    how many cover fundamental elements, either fully or partially. To assess
    the extent to which selected state and tribal boxing commissions have
    documented their compliance with the act*s provisions, we identified 8 of
    the 46 state boxing commissions and 2 of the 8 tribal boxing commissions
    for review. We looked at provisions in the act that were related to the 15
    fundamental elements. The eight states are California, Florida, Indiana,
    Michigan, Missouri, Nevada, Pennsylvania, and Nevada; the two tribes are

    the Mohegan Sun (Connecticut) and the Miccosukee (Florida). We selected
    California, Florida, Missouri, Nevada, Pennsylvania, and Texas because
    they held the largest number of professional boxing events in calendar
    year 2001, the most recent year for which complete data were available. We
    selected Michigan and Indiana to represent states that held a smaller
    number of events in calendar year 2001 than the other states selected. We

    selected the Miccosukee and Mohegan Sun tribes because they were the
    Indian tribes that held the largest number of professional boxing events
    in calendar year 2001. The state and tribal commission we selected
    accounted for 49 percent of all professional boxing events held in the
    United States during calendar year 2001.

    At the Indiana, Michigan, Miccosukee, and Mohegan Sun commissions, we
    reviewed the cases files for all professional boxing events held in 2001,
    and at the remaining commissions, we reviewed the case files for a random
    selection of professional boxing events held in 2001. Because we randomly
    selected boxing events in these states for review, our sample for each of
    these states is just one of many samples we could have drawn. Since each
    sample could have produced a different estimate, we express our confidence
    in the precision of the estimates for our particular samples using 95
    percent confidence intervals. These are ranges within which we are
    confident that 95 out of 100 samples drawn from these particular events
    would include the true value for all the events in the state. All the
    estimates based on sample data in table 3 have 95 percent confidence
    intervals not

    exceeding plus or minus 10 percentage points, unless otherwise indicated.
    To present the results of our case file reviews, we divided the actual or
    estimated percentages of cases with documentation into three compliance
    categories: 75 to 100 percent, 50 to 74 percent, and below 50 percent. We
    did not independently verify the documented compliance, and the results

    of our reviews at these 10 commissions cannot be generalized to all boxing
    events held nationwide during 2001.

    The documentation that we reviewed at the selected commissions varied.
    Because the act does not require documentation and the commissions have no
    uniform record- keeping standards, we considered all types of
    documentation maintained and provided to us by the commissions for our
    review. Such documentation included pre- and post- fight medical
    examination check sheets, insurance coverage forms, copies of contracts

    between boxers and promoters, event sheets identifying boxers*
    registration numbers, promoters* revenue reports to commissions, and
    statements of independence signed by ring officials.

    To assess the extent to which selected states and tribes have adopted
    provisions that cover fundamental elements in addition to those covered in
    the act, we reviewed the boxing provisions enacted by the eight states and
    two tribes and identified provisions that cover fundamental elements or
    portions of fundamental elements that the act does not cover. We confirmed
    with the boxing commissions of these states and tribes that they

    agreed with our analysis of their provisions, and we asked these officials
    why their state or tribe had not enacted provisions covering additional
    fundamental elements. Our findings for these selected states and tribes
    cannot be generalized to all 46 states and eight tribes. We did not assess
    the

    extent to which the states and tribes had implemented or enforced the
    provisions that cover additional fundamental elements.

    To determine what actions the Department of Justice and FTC have taken
    under the act, we determined the role that each is assigned under the act.
    We then met with Justice officials to identify whether any investigations
    or

    prosecutions had been conducted under the act in the jurisdictions of the
    eight state and two tribal commissions in 2001. In addition, we reviewed
    Justice*s central case management system for possible cases prosecuted
    during fiscal years 1996 through 2002. We also met with FTC officials to
    determine whether they had received consumer complaints related to the
    boxing industry. Furthermore, to determine that the sanctioning
    organizations were making the required information available to the
    public, we reviewed the Internet Web sites of 14 sanctioning
    organizations.

    We performed our work in accordance with generally accepted government
    auditing standards from September 2002 through July 2003 in Washington, D.
    C., and at the following state or tribal boxing commission locations:
    California State Athletic Commission, Sacramento, California; Florida
    State Athletic Commission, Tallahassee, Florida; Indiana Boxing
    Commission, Indianapolis, Indiana; Michigan Bureau of Commercial Services,
    Lansing, Michigan; Missouri Office of Athletics, Jefferson City, Missouri;
    Nevada Athletic Commission, Las Vegas, Nevada; Pennsylvania Athletic
    Commission, Harrisburg, Pennsylvania; Texas Boxing and Wrestling Program,
    Austin, Texas; Miccosukee Athletic Commission, Miami, Florida; and the
    Mohegan Tribal Gaming Commission Athletic Unit, Uncasville, Connecticut.

    Comments from the Association of Boxing

    Appendi x VI Commissions

    Comments from the Missouri Office of

    Appendi x VII Athletics

    Comments from the Miccosukee Athletic

    Appendi x VIII Commission

    Comments from the Mohegan Tribal Gaming

    Appendi x IX Commission Athletic Unit

    Comments from the Pennsylvania Athletic

    Appendi x X Commission

    Comments from the Texas Department of

    Appendi x XI Licensing and Regulations

    Appendi x XII

    Contacts and Contributors Contact John S. Baldwin, Sr. (202) 512- 2834
    Contributors Frederick Lyles, Jr., John Vocino, Bernice Benta, Christopher
    Factor,

    Elizabeth Eisenstadt, Jerry Sandau, Brandon Haller, Bert Japikse, and
    Sidney Schwartz

    (543027)

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    Report to the Chairman, Committee on Commerce, Science, and
    Transportation, U. S. Senate

    July 2003 PROFESSIONAL BOXING Issues Related to the Protection of Boxers*
    Health, Safety, and Economic Interests

    GAO- 03- 699

    Contents Letter 1

    Results in Brief 4 Fundamental Elements Considered Important to Address
    Health

    and Safety and Economic Problems Facing Professional Boxing 7 The Act*s
    Provisions Fully or Partially Cover 10 Fundamental

    Elements, and Selected Commissions Varied in the Extent to Which They Had
    Documentation Indicating Compliance 11 Selected States and Tribes Vary in
    the Extent to Which Their

    Provisions Cover Additional Fundamental Elements 14 Federal Action under
    the Act Has Been Limited 16 Concluding Observations 17 Agency Comments and
    Our Evaluation 17

    Appendixes

    Appendix I: Professional Boxing Events Held in the United States during
    Calendar Year 2001 21

    Appendix II: Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing 23 Health and Safety 23
    Economic Protection 26 Integrity of the Sport 28

    Appendix III: Selected Boxing Commissions* Documentation of Compliance
    with the Act*s Provisions 31

    Appendix IV: State and Tribal Provisions That Cover Additional Health,
    Safety, Economic, and Integrity Elements 41 Conduct Postfight Medical
    Examinations, Including Neurological

    Testing 41 Monitor Training Injuries 41 File Postfight Medical Reports 41
    Require Health and Life Insurance Before and After Fights 42 Enforce
    Suspensions for Training Injuries 42 Require Pension Plans 42 Require
    Disclosure of All Purses and Payments to Trainers and

    Boxers 43 Prohibit Conflicts of Interest for Judges and Referees 44
    Require Registration and Training for Trainers, Managers,

    Promoters, and Physicians 44 Preclude Sanctioning Organizations from
    Exercising Undue

    Influence 44

    Select Uniform Boxing and Scoring Rules 44 Require Boxing Knowledge for
    Commission Officials 44

    Appendix V: Objectives, Scope, and Methodology 46

    Appendix VI: Comments from the Association of Boxing Commissions 49

    Appendix VII: Comments from the Missouri Office of Athletics 51

    Appendix VIII: Comments from the Miccosukee Athletic Commission 53

    Appendix IX: Comments from the Mohegan Tribal Gaming Commission Athletic
    Unit 59

    Appendix X: Comments from the Pennsylvania Athletic Commission 60

    Appendix XI: Comments from the Texas Department of Licensing and
    Regulations 62

    Appendix XII: Contacts and Contributors 64 Contact 64 Contributors 64

    Tables Table 1: Fundamental Elements Considered Important to Address Major
    Problems Facing Professional Boxing 10

    Table 2: Extent to Which the Act*s Provisions Cover Fundamental Elements
    to Help Address Major Problems in Professional Boxing 11

    Figures Figure 1: Selected Boxing Commissions* Documentation of Compliance
    with the Act*s Provisions Related to 10

    Fundamental Elements 14 Figure 2: Extent to Which State and Tribal
    Provisions Cover

    Additional Fundamental Elements 15 Figure 3: Selected Commissions*
    Documentation of Compliance

    with the Act*s Provisions for Boxing Events Held in 2001 31 Figure 4:
    Evaluate Medical Information and Assess Risks 32 Figure 5: Require Minimum
    Uniform Contractual Terms 34 Figure 6: Require Standards for Rating Boxers
    to Protect against

    Mismatches 35 Figure 7: Conduct Prefight Medical Examinations 35 Figure 8:
    Ensure Presence of Medical Personnel and Equipment 36 Figure 9: Require
    Health Insurance During Matches 36 Figure 10: Honor Suspensions Imposed by
    Other Commissions 37

    Figure 11: Require Disclosure of Purses and Payments to Promoters and
    Judges 38 Figure 12: Prohibit Conflicts of Interest for Boxers, Promoters,
    and Commission Representatives 38

    Figure 13: Require Registration for Boxers and Certification and Approval
    for Ring Officials 39

    Abbreviations

    ABC Association of Boxing Commissions FTC Federal Trade Commission NAAG
    National Association of Attorneys General USBA United States Boxing
    Administration

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    a

    GAO United States General Accounting Office

    Based on GAO*s review of congressional testimonies and national studies
    dating from 1994 through 2002, GAO identified 15 fundamental elements that
    are considered important to protect boxers* health, safety, and economic
    well- being and to enhance the integrity of the sport.

    The act addresses 10 of the 15 fundamental elements that GAO identified.
    The 8 (of 46) state and 2 (of 8) tribal boxing commissions that GAO
    selected for review accounted for 49 percent of the fights in 2001 and
    varied in the extent to which they had documentation indicating compliance
    with the 10 provisions of the act related to the fundamental elements. For
    example, all 10 commissions had documentation indicating compliance at
    least 75 percent of the time for 3 provisions* requiring prefight medical
    exams, disclosure of purses and payments, and registration of boxers* but
    only 2

    commissions had documentation indicating compliance at least 75 percent of
    the time for a provision prohibiting conflicts of interest. Commissions
    either gave no reason for the lack of documentation, cited privacy or
    liability concerns, or said they were unaware of the federal provision.

    The eight states and two tribes that GAO reviewed vary in the extent to
    which they adopted additional provisions that cover elements not covered
    by the act*s provisions. The number of such provisions ranges from 10
    (California) to 4 (Missouri). For example, the states have provisions
    requiring the filing of postfight medical reports, uniform boxing and
    scoring rules, and boxing commission officials* knowledge of the sport.

    Federal actions taken under the act have been limited. The Department of
    Justice said it has not exercised its authority to prosecute cases because
    none have been referred to it by federal law enforcement authorities.
    Furthermore it noted that violations under the act are misdemeanors, and
    it

    generally applies its resources to prosecuting felonies. The Federal Trade
    Commission periodically checks the Web sites of the organizations that
    sanction professional boxing events to see whether they have posted the
    information that they are required to make available to the public and has
    found them to be adequate. Legislation was recently introduced to
    significantly amend the act by, among other things, creating a new
    organization within the Department of Labor that would provide oversight
    and enforcement of boxing laws. This new federal organization is intended
    to facilitate more uniform enforcement of federal requirements aimed at
    enhancing boxers* health, safety, and general interests as well as the
    integrity of the sport.

    The Department of Justice and the Federal Trade Commission provided only
    technical comments on our report. The Association of Boxing Commissions
    and five state and tribal commissions had concerns about the lack of
    existing federal enforcement and the economic impact of any additional
    federal requirements. The Professional Boxing Safety Act of 1996
    established minimum health and safety standards for professional boxing
    and provided

    for limited federal oversight by the Department of Justice and the Federal
    Trade Commission. In

    2000, the Muhammad Ali Boxing Reform Act amended the act to better protect
    boxers* economic well- being and enhance the integrity of the sport.
    However, reports of problems continue, including permanent and sometimes
    fatal injuries, economic exploitation, and corruption.

    GAO was asked to (1) identify fundamental elements considered important to
    protect professional boxers and enhance the integrity of the sport; (2)
    assess the extent to which provisions of the Professional Boxing Safety
    Act of 1996, as amended (the act), cover

    these elements and determine whether selected state and tribal boxing
    commissions have

    documentation indicating compliance with the act*s provisions; (3)
    determine whether selected states and tribes have provisions that cover
    additional

    elements; and (4) identify federal actions taken under the act. www. gao.
    gov/ cgi- bin/ getrpt? GAO- 03- 699. To view the full product, including
    the scope and methodology, click on the link above. For more information,
    contact Bernard Ungar, (202) 512- 4232, ungarb@ gao. gov. Highlights of
    GAO- 03- 699, a report to the

    Chairman, Committee on Commerce, Science, and Transportation, U. S. Senate

    July 2003

    PROFESSIONAL BOXING

    Issues Related to the Protection of Boxers' Health, Safety, and Economic
    Interests

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    Contents

    Page ii GAO- 03- 699 Professional Boxing

    Contents

    Page iii GAO- 03- 699 Professional Boxing

    Page 1 GAO- 03- 699 Professional Boxing United States General Accounting
    Office Washington, D. C. 20548

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    A

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    Appendix I

    Appendix I Professional Boxing Events Held in the United States during
    Calendar Year 2001

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    Appendix II

    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix II Fundamental Elements to Address Health and Safety, Economic,
    and Integrity Problems in Professional Boxing

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    Appendix III

    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix III Selected Boxing Commissions* Documentation of Compliance with
    the Act*s Provisions

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    Appendix IV

    Appendix IV State and Tribal Provisions That Cover Additional Health,
    Safety, Economic, and Integrity Elements

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    Appendix IV State and Tribal Provisions That Cover Additional Health,
    Safety, Economic, and Integrity Elements

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    Appendix IV State and Tribal Provisions That Cover Additional Health,
    Safety, Economic, and Integrity Elements

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    Appendix IV State and Tribal Provisions That Cover Additional Health,
    Safety, Economic, and Integrity Elements

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    Appendix V

    Appendix V Objectives, Scope, and Methodology

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    Appendix V Objectives, Scope, and Methodology

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    Appendix VI

    Appendix VI Comments from the Association of Boxing Commissions Page 50
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    Appendix VII

    Appendix VII Comments from the Missouri Office of Athletics Page 52 GAO-
    03- 699 Professional Boxing

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    Appendix VIII

    Appendix VIII Comments from the Miccosukee Athletic Commission Page 54
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    Appendix VIII Comments from the Miccosukee Athletic Commission Page 55
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    Appendix VIII Comments from the Miccosukee Athletic Commission Page 56
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    Appendix VIII Comments from the Miccosukee Athletic Commission Page 57
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    Appendix VIII Comments from the Miccosukee Athletic Commission Page 58
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    Appendix IX

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    Appendix X

    Appendix X Comments from the Pennsylvania Athletic Commission Page 61 GAO-
    03- 699 Professional Boxing

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    Appendix XI

    Appendix XI Comments from the Texas Department of Licensing and
    Regulations Page 63 GAO- 03- 699 Professional Boxing

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    Appendix XII

    United States General Accounting Office Washington, D. C. 20548- 0001
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