Health, Education, Employment, Social Security, Welfare, and Veterans
Reports (Letter Report, 12/01/95, GAO/HEHS-96-69W).
GAO presented a listing and selected summaries of reports and
testimonies issued in November 1995 and a listing of reports and
testimonies issued in December 1994 through November 1995 relating to
such issues as: (1) health care services and financing; (2) Medicare and
Medicaid; (3) early childhood, elementary, secondary, and higher
education; (4) training and employment; (5) pensions; (6) social
security, disability, and welfare benefits; and (7) veterans and
military health care and benefits.
--------------------------- Indexing Terms -----------------------------
REPORTNUM: HEHS-96-69W
TITLE: Health, Education, Employment, Social Security, Welfare,
and Veterans Reports
DATE: 12/01/95
SUBJECT: Health care services
Health care programs
Educational programs
Employment or training programs
Social security benefits
Welfare benefits
Veterans benefits
IDENTIFIER: Bibliographies
Medicaid Program
Medicare Program
Pell Grant
Dept. of Education Stafford Student Loan Program
ETA Senior Community Service Employment Program
******************************************************************
** This file contains an ASCII representation of the text of a **
** GAO report. Delineations within the text indicating chapter **
** titles, headings, and bullets are preserved. Major **
** divisions and subdivisions of the text, such as Chapters, **
** Sections, and Appendixes, are identified by double and **
** single lines. The numbers on the right end of these lines **
** indicate the position of each of the subsections in the **
** document outline. These numbers do NOT correspond with the **
** page numbers of the printed product. **
** **
** No attempt has been made to display graphic images, although **
** figure captions are reproduced. Tables are included, but **
** may not resemble those in the printed version. **
** **
** Please see the PDF (Portable Document Format) file, when **
** available, for a complete electronic file of the printed **
** document's contents. **
** **
** A printed copy of this report may be obtained from the GAO **
** Document Distribution Center. For further details, please **
** send an e-mail message to: **
** **
** **
** **
** with the message 'info' in the body. **
******************************************************************
Cover
================================================================ COVER
Health, Education, and Human
Services Division Reports
December 1995
HEALTH
EDUCATION
EMPLOYMENT
SOCIAL SECURITY
WELFARE
VETERANS
GAO/HEHS-96-69W
Abbreviations
=============================================================== ABBREV
AFDC - Aid to Families With Dependent Children
COLA - Cost of living allowance
CSRS - Civil Service Retirement System
DC - District of Columbia
DOD - Department of Defense
DODDS - Department of Defense Dependents Schools
DOE - Department of Energy
DOL - Department of Labor
EEO - Equal Employment Opportunity
EEOC - Equal Employment Opportunity Commission
EMA - eligible metropolitan area
ERISA - Employee Retirement Income Security Act of 1974
ESRD - end stage renal disease
GAO - General Accounting Office
GSA - General Services Administration
HCFA - Health Care Financing Administration
HEHS - Health, Education, and Human Services Division, GAO
HHS - Department of Health and Human Services
HMO - health maintenance organization
HRD - Human Resources Division, GAO
JOBS - Job Opportunities and Basic Skills program
NAFTA - North American Free Trade Agreement
NASA - National Aeronautics and Space Administration
NHSC - National Health Service Corps
NIH - National Institutes of Health
NPR - National Performance Review
NRC - Nuclear Regulatory Commission
OAA - Older Americans Act
OFCCP - Office of Federal Contract Compliance Programs, DOL
OHA - Office of Hearings and Appeals, Social Security
Administration
OSHA - Occupational Safety and Health Administration, DOL
PBGC - Pension Benefit Guarantee Corporation
PBM - pharmacy benefit manager
SAA - state approved agency
SSA - Social Security Administration
SSI - Supplemental Security Income
T&A - time and attendance
TRICARE - DOD nationwide managed health care program
VA - Department of Veterans Affairs
PREFACE
============================================================ Chapter 0
The General Accounting Office (GAO), an arm of the Congress, was
established to independently audit government agencies. GAO's
Health, Education, and Human Services (HEHS) Division reviews the
government's health, education, employment, social security,
disability, welfare, and veterans programs administered in the
Departments of Health and Human Services, Labor, Education, Veterans
Affairs, and some other agencies.
This booklet lists the GAO products issued on these programs. It is
divided into two major sections:
Most Recent GAO Products: This section identifies reports and
testimonies issued during the past month and provides summaries
for selected key products.
Comprehensive 1-Year Listings: This section lists all products
published in the last year, organized chronologically by subject
as shown in the table of contents. When appropriate, products
may be included in more than one subject area.
You may obtain single copies of the products free of charge, by
telephoning your request to (202) 512-6000 or faxing it to (301)
258-4066. Additional ordering details appear at the end of this
booklet. Instructions for getting on GAO's mailing list appear on
page 43 of this booklet.
You may access the Most Recent GAO Products section of this booklet
on Internet. Instructions appear on the last two pages of this
booklet.
Janet L. Shikles
Assistant Comptroller General
MOST RECENT GAO PRODUCTS
(NOVEMBER 1995)
============================================================ Chapter 1
HEALTH
---------------------------------------------------------- Chapter 1:1
SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:1.1
National Health Service Corps: Opportunities to Stretch Scarce
Dollars and Improve Provider Placement (Report, 11/24/95, GAO/HEHS-
96-28).
Overall, compared with the scholarship program, the National Health
Service Corps (NHSC) loan repayment program offers a better long-term
investment of scarce federal resources to address shortages of
primary care providers. Neither program appears to outweigh the
other in terms of how well it directs resources to those areas
identified as having the severest shortages. Technically, the
scholarship program offers a better guarantee that providers will
serve in the neediest shortage areas because it gives the recipients
less freedom of choice in deciding where to serve. However, the
available evidence suggests that generally little difference exists
in the priority of the sites where scholarship and loan repayment
recipients practice. Regardless of which approach is used, NHSC does
not distribute provider resources as effectively as it could to
alleviate health care needs in the greatest number of eligible
shortage areas.
For more information, contact Frank C. Pasquier at (206) 287- 4861.
Medicare: Enrollment Growth and Payment Practices for Kidney
Dialysis Services (Report, 11/22/95, GAO/HEHS-96-33).
Medicare's costs for the end stage renal disease (ESRD) program have
increased, primarily because the number of beneficiaries being
enrolled in the program increased substantially. The annual rate of
increase averaged 11.6 percent between 1978 and 1991. In addition to
the increase in enrollment, the mortality rate for new ESRD patients
decreased. Since the program began in 1973, technological
improvements and a greater availability of dialysis machines have
meant that persons who were not considered good candidates for
dialysis in 1973--primarily those 65 years old or older and those
whose kidney failure was caused by diabetes and hypertension--are now
routinely placed on dialysis. GAO's review of medical services and
supplies provided to all Medicare ESRD patients in 1991 indicates
that no separately billable service or supply was provided frequently
enough to make it a good candidate to be considered part of the
standard dialysis treatment and thus included in a future composite
rate.
For more information, contact Thomas G. Dowdal at (202) 512- 7119.
Ryan White Care Act of 1990: Opportunities to Enhance Funding Equity
(Report, 11/13/95, GAO/HEHS-96-26). Testimony on same topic (4/5/95,
GAO/T-HEHS-95-126, and 2/22/95, GAO/T-HEHS-95-91). Correspondence on
same topic (2/14/95, GAO/HEHS-95-79R, and 3/31/95, GAO/HEHS-95-119R).
Established by the Ryan White Comprehensive AIDS Resources Emergency
(CARE) Act of 1990, the Ryan White program distributed more than $579
million in fiscal year 1994 to eligible metropolitan areas (EMA)
through title I of the act and to states through title II. The title
I and II funding formulas result in variations in per-case funding
for several reasons. The most important is that EMAs' AIDS cases are
counted in both formulas. In addition, the indicators needed to
target funds to states and EMAs are absent or inadequate. For
example, GAO found evidence of large geographic differences in the
cost of serving AIDS patients, yet neither the title I nor the title
II formula takes these differences into account. Also, the title I
formula targets funding to EMAs on the basis of their cumulative
number of reported AIDS cases, yet over 60 percent of these reported
cases have since died. As a result, the oldest EMAs receive the most
generous funding, and newly emerging EMAs with more recent growth in
AIDS cases receive less funding. Both title I and title II have a
factor for targeting funds to states and EMAs based on their
resources; however, the indicators used in these formulas are
incomplete.
For more information, contact Jerry C. Fastrup at (202) 512- 7211.
Pharmacy Benefit Managers: Early Results on Ventures With Drug
Manufacturers (Report, 11/9/95, GAO/HEHS-96-45).
Some of the largest pharmaceutical manufacturers have recently merged
or formed alliances with some of the largest companies that manage
prescription drug benefits for health plans, called pharmacy benefit
managers (PBM). They have merged or allied with PBMs because they
believe that the PBMs' market power will help maintain the
manufacturers' profits at a time when their drugs face increased
competition. The role of PBMs in health care has evolved from simply
administering prescription drug benefits for health plan sponsors to
helping them contain their overall drug costs. Critics of the
mergers and alliances have focused on how PBMs may help their drug
manufacturer partners increase market share. GAO's review of changes
in the formularies managed by Medco and Diversified Pharmaceutical
Services, Inc., showed differences in the extent to which these PBMs
have given preference to their respective partners' drugs. The
changes in Medco's formulary that favor Merck drugs do not
necessarily demonstrate that Medco automatically gave preference to
Merck drugs without considering competitors' products.
For more information, contact John C. Hansen at (202) 512-7105.
Medicaid Section 1115 Waivers: Flexible Approach to Approving
Demonstrations Could Increase Federal Costs (Report, 11/8/95,
GAO/HEHS-96-44).
Contrary to the administration's assertion, the approved spending
limits for demonstration waivers in Oregon, Hawaii, and Florida are
not budget-neutral and could increase federal Medicaid expenditures.
Only Tennessee's 1115 waiver agreement should cost no more than the
continuation of its smaller, prewaiver program and, in fact, should
result in savings. Overall, the net additional federal funding is
small in relation to demonstration spending allowed under federal
expenditure caps--likely fewer than 3 percent. However, federal
Medicaid expenditures could grow significantly if the administration
continues to show a similar flexibility in reviewing state 1115
financing strategies. Five waivers have been approved since
Florida's in late 1994, and the large backlog of pending waivers
includes three states with large Medicaid programs--New York,
Illinois, and Texas. Additional federal dollars are available along
with other funding sources identified in state waiver applications.
For more information, contact Michael F. Gutowski at (202) 512-
7128.
Medicare Managed Care: Growing Enrollment Adds Urgency to Fixing HMO
Payment Problem (Report, 11/8/95, GAO/HEHS-96-21).
Recently, enrollment of Medicare beneficiaries in health maintenance
organizations (HMO) has grown rapidly and is concentrated in certain
states and areas. Although Medicare HMOs have enrolled less than
one- tenth of beneficiaries nationwide, since 1994 enrollment growth
has exceeded 20 percent annually. As GAO has reported, for 10 years
Medicare has used an HMO rate-setting method with several flaws.
Specifically, because HMO payment rates are fixed--linked to the
average cost of Medicare fee-for-service care--Medicare cannot lower
rates through competition among HMOs or negotiate a share in any
savings that HMOs achieve through greater efficiency. Also, HMO
payment rates are not adequately "risk adjusted" to reflect cost
differences deriving from beneficiaries health status. Although HMO
enrollees typically have been healthier (and therefore less costly to
care for) than average beneficiaries, Medicare has paid HMOs more
than it would have for the same patients' care under fee for service.
GAO has identified three promising strategies that Medicare with new
legislative authority could use concurrently, tailoring strategies to
market conditions prevailing in an area.
For more information, contact Scott L. Smith at (202) 512-5713.
Fraud and Abuse: Medicare Continues to Be Vulnerable to Exploitation
by Unscrupulous Providers (Testimony, 11/2/95, GAO/T- HEHS-96-7).
Medicare is the nation's largest health payer. In 1994, the program
spent $162 billion on behalf of about 37 million elderly and disabled
people. GAO estimates that fraud and abuse may account for as much
as 10 percent of health care costs. The vast majority of Medicare
providers seek to abide by program rules and strive to meet
beneficiaries' needs. Nevertheless, Medicare is overwhelmed in its
efforts to keep pace with, much less stay ahead of, those bent on
cheating the system. GAO's recent investigations of Medicare fraud
and abuse have implicated home health agencies, medical suppliers,
pharmacists, rehabilitation therapy companies, and clinical
laboratories, among others. They are attracted by high reimbursement
levels for some supplies and services and few barriers to entry.
Once engaged in profitable activities, they too often escape
detection because of inadequate claims scrutiny, elude pursuit
because of law enforcement authorities' limited resources and
fragmented responsibilities, and face little risk of speedy or
appropriate punishment.
For more information, contact Jonathan Ratner at (202) 512-7107.
OTHER HEALTH PRODUCTS
-------------------------------------------------------- Chapter 1:1.2
Medicare Transaction System: Strengthened Management and Sound
Development Approach Critical to Success (Testimony, 11/16/95,
GAO/T-AIMD-96-12).
Health Care Task Force (Letter, 11/9/95, GAO/GGD-96-45R).
EDUCATION
---------------------------------------------------------- Chapter 1:2
SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:2.1
Higher Education: Selected Information on Student Financial Aid
Received by Legal Immigrants (Report, 11/24/95, GAO/HEHS-96-7).
According to Department of Education records, about 390,000 legal
immigrant student received Pell grant aid in academic year 1992-93.
This was about 10 percent of all students receiving Pell grants. In
total, immigrants received $662 million, or about 11 percent, of Pell
grant aid in that year. GAO was unable to determine the total number
of legal immigrants who received Stafford loans because citizenship
data are not maintained in the Department of Education's loan files.
However, some immigrants who received Pell grants also received
Stafford loans that totaled $257 million. About 82 percent of the
immigrants who received student financial aid lived in seven states,
led by California with 31 percent and New York with 25 percent.
Sixty-one percent attended public colleges, 19 percent attended
private colleges, and 21 percent attended proprietary (for-profit
vocational) schools. The 100 schools with the most immigrant Pell
grant recipients accounted for about 50 percent of all such students,
and 91 of these schools were located in the seven states with the
highest concentration of immigrant students.
For more information, contact Joseph J. Eglin, Jr., at (202) 512-
7009.
EMPLOYMENT
---------------------------------------------------------- Chapter 1:3
SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:3.1
Department of Labor: Senior Community Service Employment Program
Delivery Could Be Improved Through Legislative and Administrative
Actions (Report, 11/2/95, GAO/HEHS-96-4). Testimony on same topic
(11/2/95, GAO/T-HEHS-96-57).
The Older Americans Act (OAA) requires the Department of Labor to
award grants to national sponsors sufficient to maintain their 1978
level of activities. This requirement is commonly known as the hold
harmless provision. Of the $410.5 million appropriation for program
year 1994, $234.5 million was distributed under this provision. In
applying this provision, Labor uses 1978 state-by state position
allocation patterns. The remaining funds are distributed in
accordance with current age and per capita income data to state
governments and national sponsors. These allocation patterns limit
Labor's ability to achieve equitable distribution among the states on
the basis of actual need. Appropriations' statutes also affect
equitable distribution. These statutes have required that no more
than 22 percent of Labor's Senior Community Service Employment
Program appropriation be allocated to state governments. Under
Labor's regulations, expenditures that GAO believes to be
administrative in nature may be charged to another cost
category--other enrollee costs-- thereby allowing the statutory
15-percent limit on administrative expenses to be exceeded. As a
result, grant funds have been improperly allocated.
For more information, contact Lawrence J. Horinko at (202) 512-
7001.
OTHER EMPLOYMENT PRODUCTS
-------------------------------------------------------- Chapter 1:3.2
Federal Employee Redress: An Opportunity for Reform (Testimony,
11/29/95, GAO/T-GGD-96-42).
Military Equal Opportunity: Certain Trends in Racial and Gender Data
May Warrant Further Analysis (Report, 11/17/95, GAO/NSIAD-96- 17).
Job Corps Program (Letter, 11/9/95, GAO/HEHS-96-61R).
Federal Job Classification: Comparison of Job Content with Grades
Assigned in Selected Occupations (Report, 11/6/95, GAO/GGD-96-20).
SOCIAL SECURITY, DISABILITY,
AND WELFARE
---------------------------------------------------------- Chapter 1:4
SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:4.1
Child Support Enforcement: States and Localities Move to Privatized
Services (Report, 11/20/95, GAO/HEHS-96-43FS).
Facing budgetary and staffing constraints and increasing federal
performance standards, state child support enforcement programs are
struggling to serve their ever-increasing caseloads. As states
confront the need to improve their services to the public, many are
turning to the private sector to augment their child support
enforcement programs. GAO presents in this report an inventory of
ongoing and planned state contracts for locations services,
collections, payment processing, and full-service programs as of
October 1995. GAO found that one or more child support services are
privatized statewide in 20 states and at the local office level in 18
states. GAO identified 21 contracts for full-service child support
operations, about half of which are served by one of two major
contractors. GAO also identified 40 other contracts for collections
and related location services; four major contractors provide most of
these services. Finally, nine contracts exist for payment processing
services and eight contracts exist for location services only.
For more information, contact David P. Bixler at (202) 512-7201.
OTHER SOCIAL SECURITY,
DISABILITY, AND WELFARE
PRODUCTS
-------------------------------------------------------- Chapter 1:4.2
Thrift Savings Plan (Letter, 11/14/95, GAO/HEHS-96-66R).
Federal Grants to New Jersey (Letter, 11/8/95, GAO/AIMD-96-8R).
VETERANS AFFAIRS AND MILITARY
HEALTH
---------------------------------------------------------- Chapter 1:5
SELECTED SUMMARIES
-------------------------------------------------------- Chapter 1:5.1
VA Health Care: Effects of Facility Realignment on Construction
Needs Are Unknown (Report, 11/17/95, GAO/HEHS-96-19).
As part of the fiscal year 1996 budget, the President requested that
the Congress appropriate $514 million for Department of Veterans
Affairs (VA) major construction projects. These projects include the
construction of two new VA medical facilities and major renovations
at seven existing facilities. These projects would enhance VA's
inpatient care capacity for veterans within designated target areas.
The renovation projects would not, however, correct all deficiencies
at the seven medical centers; these centers estimate that they need
an additional $308 million to correct the deficiencies. VA officials
did not rigorously consider available alternatives to construction.
GAO's analysis of project construction documents indicates that VA's
construction contract award dates and costs would likely be
significantly affected if funding for the construction of the
projects is delayed until fiscal year 1997. According to medical
center officials, veterans will continue receiving health care
regardless of how long project funding is delayed.
For more information, contact Paul R. Reynolds at (202) 512- 7109.
OTHER VETERANS AFFAIRS AND
MILITARY HEALTH PRODUCTS
-------------------------------------------------------- Chapter 1:5.2
Fiscal Year 1996 VA Certification (Letter, 11/14/95, GAO/HEHS-
96-67R).
Hispanic Veterans (Letter, 11/2/95, GAO/HEHS-96-25R).
HEALTH
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 2
ACCESS AND INFRASTRUCTURE
---------------------------------------------------------- Chapter 2:1
For more information, contact Sarah F. Jaggar at (202) 512-7119.
Mammography Services: Initial Impact of New Federal Law Has Been
Positive (Report, 10/27/95, GAO/HEHS-96-17).
Ryan White Care Act: Access to Services by Minorities, Women, and
Substance Abusers (Testimony, 7/17/95, GAO/T-HEHS-95-212). Report on
same topic (1/13/95, GAO/HEHS-95-49).
EMPLOYEE AND RETIREE HEALTH
BENEFITS
---------------------------------------------------------- Chapter 2:2
For more information, contact Michael F. Gutowski at (202) 512-
7119.
Employer-Based Health Plans: Issues, Trends, and Challenges Posed by
ERISA (Report, 7/25/95, GAO/HEHS-95-167). Testimony on same topic
(7/25/95, GAO/T-HEHS-95-223).
FINANCING
---------------------------------------------------------- Chapter 2:3
For more information, contact Jonathan Ratner or William J. Scanlon
at (202) 512-7119.
Ryan White Care Act of 1990: Opportunities to Enhance Funding Equity
(Report, 11/13/95, GAO/HEHS-96-26). Testimony on same topic (4/5/95,
GAO/T-HEHS-95-126, and 2/22/95, GAO/T-HEHS-95-91). Correspondence on
same topic (2/14/95, GAO/HEHS-95-79R, and 3/31/95, GAO/HEHS-95-119R).
Community Health Center Grants (Letter, 10/11/95, GAO/HEHS-96- 13R).
Medigrant: Florida (Letter, 10/2/95, GAO/HEHS-96-11R).
Medical Liability: Impact on Hospital and Physician Costs Extends
Beyond Insurance (Report, 9/29/95, GAO/AIMD-95-169).
Health Insurance Portability: Reform Could Ensure Continued Coverage
for up to 25 Million Americans (Report, 9/19/95, GAO/HEHS- 95-257).
Cost Factors in CARE Act Formula (Letter, 9/15/95, GAO/HEHS-95-
256R).
Medigap Insurance: Insurers' Compliance With Federal Minimum Loss
Ratio Standards, 1988-93 (Report, 8/23/95, GAO/HEHS-95-151).
Health Insurance For Children: Many Remain Uninsured Despite
Medicaid Expansion (Report, 7/19/95, GAO/HEHS-95-175).
Health Insurance Regulation: National Portability Standards Would
Facilitate Changing Health Plans (Testimony, 7/18/95, GAO/T-HEHS-
95-205).
Health Insurance Regulation: Variation in Recent State Small
Employer Health Insurance Reforms (Report, 6/12/95, GAO/HEHS-95-
161FS).
German Health Reforms: Changes Result in Lower Health Costs in 1993
(Report, 12/16/94, GAO/HEHS-95-27).
Biotech R & D, Reform, and Market Change (Letter, 12/15/94,
GAO/HEHS-95-34R).
Hospital Costs: Cost Control Efforts at 17 Texas Hospitals (Report,
12/9/94, GAO/AIMD-95-21).
HEALTH CARE REFORM RELATED
ISSUES
---------------------------------------------------------- Chapter 2:4
For more information, contact Michael F. Gutowski, Rosamond Katz, or
Scott L. Smith at (202) 512-7119.
Health Care Task Force (Letter, 11/9/95, GAO/GGD-96-45R).
Cost of Health Care Task Force Related Activities (Testimony,
3/14/95, GAO/T-GGD-95-114).
HHS PUBLIC HEALTH SERVICE
AGENCIES
---------------------------------------------------------- Chapter 2:5
For more information, contact Bruce D. Layton, James O. McClyde, or
Sarah F. Jaggar at (202) 512-7119.
Medical Devices: FDA Review Time (Letter Report, 10/30/95,
GAO/PEMD-96-2).
FDA Drug Approval: Review Time Has Decreased in Recent Years
(Report, 10/20/95, GAO/PEMD-96-1).
FDA Import Automation: Serious Management and Systems Development
Problems Persist (Report, 9/28/95, GAO/AIMD-95-188).
Cancer Drug Research: Contrary to Allegation, NIH Hydrazine Sulfate
Studies Were Not Flawed (Report, 9/13/95, GAO/HEHS-95-141).
Health Care Shortage Areas: Designations Not a Useful Tool for
Directing Resources to the Underserved (Report, 9/8/95, GAO/HEHS-
95-200).
Health Research Misconduct: HHS' Handling of Cases is Appropriate,
but Timeliness Remains a Concern (Report, 8/3/95, GAO/HEHS-95-134).
Practice Guidelines: Overview of Agency for Health Care Policy and
Research Efforts (Testimony, 7/25/95, GAO/T-HEHS-95-221).
Reassignment of Two NIH Employees (Letter, 7/5/95, GAO/OSI-95- 14R).
Immunization: HHS Could Do More to Increase Vaccination Among Older
Adults (Report, 6/8/95, GAO/PEMD-95-14).
Health and Human Services: Opportunities to Realize Savings
(Testimony, 1/12/95, GAO/T-HEHS-95-57).
LONG-TERM CARE AND AGING
---------------------------------------------------------- Chapter 2:6
For more information, contact James C. Musselwhite or William J.
Scanlon at (202) 512-7119.
Immunization: HHS Could Do More to Increase Vaccination Among Older
Adults (Report, 6/8/95, GAO/PEMD-95-14).
Long-Term Care: Current Issues and Future Directions (Report,
4/13/95, GAO/HEHS-95-109).
Aging Issues: Related GAO Reports and Activities in Fiscal Year 1994
(Report, 12/29/94, GAO/HEHS-95-44).
Long-Term Care: Diverse, Growing Population Includes Millions of
Americans of All Ages (Report, 11/7/94, GAO/HEHS-95-26).
MANAGED CARE
---------------------------------------------------------- Chapter 2:7
For more information, contact Sarah F. Jaggar, Jonathan Ratner, or
William J. Scanlon at (202) 512-7119.
Medicare Managed Care Growth (Letter, 10/18/95, GAO/HEHS-96- 47R).
Medicare Managed Care: Enrollment Growth Underscores Need to Revamp
HMO Payment Methods (Testimony, 7/12/95, GAO/T-HEHS-95-207).
Medicare Managed Care: Program Growth Highlights Need to Fix HMO
Payment Problems (Testimony, 5/24/95, GAO/T-HEHS-95-174).
Community Health Centers: Challenges in Transitioning to Prepaid
Managed Care (Report, 5/4/95, GAO/HEHS-95-138). Testimony on same
topic (5/4/95, GAO/T-HEHS-95-143).
Defense Health Care: DOD's Managed Care Program Continues to Face
Challenges (Testimony, 3/28/95, GAO/T-HEHS-95-117).
MEDICARE AND MEDICAID
---------------------------------------------------------- Chapter 2:8
For more information, contact Kathryn G. Allen, Thomas G. Dowdal,
or Barry D. Tice at (202) 512-7119.
Medicare: Enrollment Growth and Payment Practices for Kidney
Dialysis Services (Report, 11/22/95, GAO/HEHS-96-33).
Medicare Transaction System: Strengthened Management and Sound
Development Approach Critical to Success (Testimony, 11/16/95,
GAO/T-AIMD-96-12).
Medicaid Section 1115 Waivers: Flexible Approach to Approving
Demonstrations Could Increase Federal Costs (Report, 11/8/95,
GAO/HEHS-96-44).
Medicare Managed Care: Growing Enrollment Adds Urgency to Fixing HMO
Payment Problem (Report, 11/8/95, GAO/HEHS-96-21).
Fraud and Abuse: Medicare Continues to Be Vulnerable to Exploitation
by Unscrupulous Providers (Testimony, 11/2/95, GAO/T- HEHS-96-7).
Medicaid and Children's Insurance (Letter, 10/20/95, GAO/HEHS-
96-50R).
Medicare Managed Care Growth (Letter, 10/18/95, GAO/HEHS-96- 47R).
Fraud and Abuse Provisions in H.R. 2425 (Letter, 10/7/95,
GAO/HEHS-96-37R).
Arizona Medicaid: Competition Among Managed Care Plans Lowers
Program Costs (Report, 10/4/95, GAO/HEHS-96-2).
Medicare Spending: Modern Management Strategies Needed to Curb
Billions in Unnecessary Payments (Report, 9/19/95, GAO/HEHS-95- 210).
Durable Medical Equipment: Regional Carriers' Coverage Criteria Are
Consistent With Medicare Law (Report, 9/19/95, GAO/HEHS-95-185).
Preventing Abusive Medicare Billing (Letter, 9/5/95, GAO/HEHS-
95-260R).
Medicaid: Tennessee's Program Broadens Coverage but Faces Uncertain
Future (Report, 9/1/95, GAO/HEHS-95-186).
Medicare: Antifraud Technology Offers Significant Opportunity to
Reduce Health Care Fraud (Report, 8/11/95, GAO/AIMD-95-77).
Medicare Competitive Bidding (Letter, 8/11/95, GAO/HEHS-95- 238R).
Medicare: Excessive Payments for Medical Supplies Continue Despite
Improvements (Report, 8/8/95, GAO/HEHS-95-171).
Medicare: Increased HMO Oversight Could Improve Quality and Access
to Care (Report, 8/3/95, GAO/HEHS-95-155). Testimony on same topic
(8/3/95, GAO/T-HEHS-95-229).
Medicare: Modern Management Strategies Could Curb Fraud, Waste, and
Abuse (Testimony, 7/31/95, GAO/T-HEHS-95-227).
Medicaid: Local Contributions (Letter, 7/28/95, GAO/HEHS-95- 215R).
Medicare: Enhancing Health Care Quality Assurance (Testimony,
7/27/95, GAO/T-HEHS-95-224).
Medicaid: Matching Formula's Performance and Potential Modifications
(Testimony, 7/27/95, GAO/T-HEHS-95-226).
Medicare: Adapting Private Sector Techniques Could Curb Losses to
Fraud and Abuse (Testimony, 7/19/95, GAO/T-HEHS-95-211).
Health Insurance For Children: Many Remain Uninsured Despite
Medicaid Expansion (Report, 7/19/95, GAO/HEHS-95-175).
Medicare: Allegations Against ABC Home Health Care (Testimony,
7/19/95, GAO/T-OSI-95-18). Report on same topic (7/19/95,
GAO/OSI-95- 17).
Medicare Providers' Legal Expenses (Letter, 7/18/95, GAO/HEHS-
95-214R).
Medicare Managed Care: Enrollment Growth Underscores Need to Revamp
HMO Payment Methods (Testimony, 7/12/95, GAO/T-HEHS-95-207).
Medicaid: State Flexibility in Implementing Managed Care Programs
Requires Appropriate Oversight (Testimony, 7/12/95, GAO/T-HEHS-95-
206).
Medicare: Rapid Spending Growth Calls for More Prudent Purchasing
(Testimony, 6/28/95, GAO/T-HEHS-95-193).
Medicaid: Statewide Section 1115 Demonstrations' Impact on
Eligibility, Service Delivery, and Program Cost (Testimony, 6/21/95,
GAO/T-HEHS-95-182).
Medicare: Modern Management Strategies Needed to Curb Program
Exploitation (Testimony, 6/15/95, GAO/T-HEHS-95-183).
Medicare Managed Care: Program Growth Highlights Need to Fix HMO
Payment Problems (Testimony, 5/24/95, GAO/T-HEHS-95-174).
Medicare: Reducing Fraud and Abuse Can Save Billions (Testimony,
5/16/95, GAO/T-HEHS-95-157).
Medicare Claims: Commercial Technology Could Save Billions Lost to
Billing Abuse (Report, 5/5/95, GAO/AIMD-95-135).
Medicaid Managed Care: More Competition and Oversight Would Improve
California's Expansion Plan (Report, 4/28/95, GAO/HEHS-95-87).
Medicaid: Spending Pressures Drive States Toward Program Reinvention
(Report, 4/4/95, GAO/HEHS-95-122). Testimony on same topic
(GAO/T-HEHS-95-129).
Medicaid: Restructuring Approaches Leave Many Questions (Report,
4/4/95, GAO/HEHS-95-103).
Medicare: Tighter Rules Needed to Curtail Overcharges for Therapy in
Nursing Homes (Report, 3/30/95, GAO/HEHS-95-23).
Medicaid: Experience With State Waivers to Promote Cost Control and
Access to Care (Testimony, 3/23/95, GAO/T-HEHS-95-115).
Medicare and Medicaid: Opportunities to Save Program Dollars by
Reducing Fraud and Abuse (Testimony, 3/22/95, GAO/T-HEHS-95-110).
Medicare Secondary Payer Program (Letter, 3/6/95, GAO/HEHS-95- 101R).
GAO's 1995 High Risk Reports: Medicare Claims (Report, 2/95,
GAO/HR-95-8).
Medicare Secondary Payer Program: Actions Needed to Realize Savings
(Testimony, 2/23/95, GAO/T-HEHS-95-92).
Uninsured and Children on Medicaid (Letter, 2/14/95, GAO/HEHS-
95-83R).
Medicare: Opportunities Are Available to Apply Managed Care
Strategies (Testimony, 2/10/95, GAO/T-HEHS-95-81).
Medicare: High Spending Growth Calls for Aggressive Action
(Testimony, 2/6/95, GAO/T-HEHS-95-75).
Medicare Part B: Regional Variation in Denial Rates for Medical
Necessity (Report, 12/19/94, GAO/PEMD-95-10). Testimony on same
topic (12/19/94, GAO/T-PEMD-95-11).
PRESCRIPTION DRUGS
---------------------------------------------------------- Chapter 2:9
For more information, contact John C. Hansen at (202) 512-7119.
Pharmacy Benefit Managers: Early Results on Ventures With Drug
Manufacturers (Report, 11/9/95, GAO/HEHS-96-45).
Nonprescription Drugs: Value of a Pharmacist-Controlled Class Has
Yet to Be Demonstrated (Report, 8/24/95, GAO/PEMD-95-12).
Prescription Drugs and the Elderly: Many Still Receive Potentially
Harmful Drugs Despite Recent Improvements (Report, 7/24/95,
GAO/HEHS-95-152).
Prescription Drug Prices: Official Index Overstates Producer Price
Inflation (Report, 4/28/95, GAO/HEHS-95-90).
PROVIDER ISSUES
--------------------------------------------------------- Chapter 2:10
For more information, contact Sarah F. Jaggar at (202) 512-7119.
National Health Service Corps: Opportunities to Stretch Scarce
Dollars and Improve Provider Placement (Report, 11/24/95, GAO/HEHS-
96-28).
Indian Health Service: Improvements Needed in Credentialing
Temporary Physicians (Report, 4/21/95, GAO/HEHS-95-46).
Medical Education: Curriculum and Financing Strategies Need to
Encourage Primary Care Training (Report, 10/21/94, GAO/HEHS-95-9).
PUBLIC HEALTH AND EDUCATION
--------------------------------------------------------- Chapter 2:11
For more information, contact Sarah F. Jaggar at (202) 512-7119.
Community Health Center Grants (Letter, 10/11/95, GAO/HEHS-96- 13R).
Montana's Medical Assistance Facilities (Letter, 10/2/95,
GAO/HEHS-96-12R).
Planned Parenthood (Letter, 8/9/95, GAO/HEHS-95-216R).
Hospital-Based Home Health Agencies (Letter, 7/19/95, GAO/HEHS-
95-209R).
Vaccines for Children: Reexamination of Program Goals and
Implementation Needed to Ensure Vaccination (Report, 6/22/95,
GAO/PEMD-95-22).
Immunization: HHS Could Do More to Increase Vaccination Among Older
Adults (Report, 6/8/95, GAO/PEMD-95-14).
Vaccines for Children: Barriers to Immunization (Testimony, 5/4/95,
GAO/T-PEMD-95-21).
Community Health Centers: Challenges in Transitioning to Prepaid
Managed Care (Report, 5/4/95, GAO/HEHS-95-138). Testimony on same
topic (5/4/95, GAO/T-HEHS-95-143).
Tuberculosis: Costly and Preventable Cases Continue in Five Cities
(Report, 3/16/95, GAO/HEHS-95-11).
Health Care: School-Based Health Centers Can Expand Access for
Children (Report, 12/22/94, GAO/HEHS-95-35).
QUALITY AND PRACTICE STANDARDS
--------------------------------------------------------- Chapter 2:12
For more information, contact Sandra K. Isaacson at (202) 512-7174
or George F. Poindexter at (202) 512-7213.
Mammography Services: Initial Impact of New Federal Law Has Been
Positive (Report, 10/27/95, GAO/HEHS-96-17).
Health Care: Employers and Individual Consumers Want Additional
Information on Quality (Report, 9/29/95, GAO/HEHS-95-201).
Patient Self-Determination Act: Providers Offer Information on
Advance Directives but Effectiveness Uncertain (Report, 8/28/95,
GAO/HEHS-95-135).
Impact of Organ Allocation Variances (Letter, 7/31/95, GAO/HEHS-
95-203R).
Medicare: Enhancing Health Care Quality Assurance (Testimony,
7/27/95, GAO/T-HEHS-95-224).
Maine Practice Guidelines (Letter, 4/4/95, GAO/HEHS-95-118R).
Electromagnetic Interference with Medical Devices (Letter, 3/17/95,
GAO/RCED-95-96R).
Cholesterol Measurement: Variability in Methods and Test Results
(Testimony, 2/13/95, GAO/T-PEMD-95-17). Report on same topic
(12/30/94, GAO/PEMD-95-8).
SUBSTANCE ABUSE AND DRUG
TREATMENT
--------------------------------------------------------- Chapter 2:13
For more information, contact Sarah F. Jaggar at (202) 512-7119.
Treatment of Hardcore Cocaine Users (Letter, 7/31/95, GAO/HEHS-
95-179R).
OTHER HEALTH ISSUES
--------------------------------------------------------- Chapter 2:14
For more information, contact Sarah F. Jaggar at (202) 512-7119.
ENVIRONMENTAL IMPACT ON
HEALTH
------------------------------------------------------- Chapter 2:14.1
Superfund: Information on Current Health Risks (Report, 7/19/95,
GAO/RCED-95-205).
Health and Safety: DOE's Epidemiological Data Base Has Limited Value
for Research (Report, 6/6/95, GAO/RCED-95-126).
Health and Safety: Status of Federal Efforts to Disclose Cold War
Radiation Experiments Involving Humans (Testimony, 12/01/94, GAO/T-
RCED-95-40).
MISCELLANEOUS
------------------------------------------------------- Chapter 2:14.2
Financial Audit: U.S. Senate Health Promotion Revolving Fund for
the Periods Ended 9/30/93 and 12/31/92 (Report, 5/3/95, GAO/AIMD-
95-105).
EDUCATION
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 3
DEPARTMENT OF EDUCATION
---------------------------------------------------------- Chapter 3:1
For more information, contact Joseph J. Eglin, Jr., at (202) 512-
7009, Wayne B. Upshaw at (202) 512-7006, Beatrice F. Birman at
(202) 512-7008, or Eleanor L. Johnson at (202) 512-7209.
Adult Education: Measuring Program Results Has Been Challenging
(Report, 9/6/95, GAO/HEHS-95-153).
Student Financial Aid: Data Not Fully Utilized to Identify
Inappropriately Awarded Loans and Grants (Report, 7/11/95,
GAO/HEHS-95-89).
Federal Family Education Loan Information System: Weak Computer
Controls Increase Risk of Unauthorized Access to Sensitive Data
(Report, 6/12/95, GAO/AIMD-95-117).
Department of Education: Information on Consolidation Opportunities
and Student Aid (Testimony, 4/6/95, GAO/T-HEHS-95-130).
Adult Education Act (Letter, 2/16/95, GAO/HEHS-95-65R).
Department of Education: Opportunities to Realize Savings
(Testimony, 1/18/95, GAO/T-HEHS-95-56).
EARLY CHILDHOOD DEVELOPMENT
---------------------------------------------------------- Chapter 3:2
For more information, contact Beatrice F. Birman at (202) 512-7008
or Eleanor L. Johnson at (202) 512-7209.
Early Childhood Centers: Services to Prepare Children for School
Often Limited (Report, 3/21/95, GAO/HEHS-95-21).
Early Childhood Programs: Promoting the Development of Young
Children in Denmark, France, and Italy (Report, 2/22/95, GAO/HEHS-
95-45BR).
Early Childhood Programs: Parent Education and Income Best Predict
Participation (Report, 12/28/94, GAO/HEHS-95-47).
Early Childhood Programs: Local Perspectives on Barriers to
Providing Head Start Services (Report, 12/21/94, GAO/HEHS-95-8).
ELEMENTARY AND SECONDARY
EDUCATION
---------------------------------------------------------- Chapter 3:3
For more information, contact Beatrice F. Birman at (202) 512-7008,
Eleanor L. Johnson at (202) 512-7209, or Fred E. Yohey, Jr., at
(202) 512-7218.
School Finance: Trends in U.S. Education Spending (Report, 9/15/95,
GAO/HEHS-95-235).
DOD Dependents Schools: Enrollment Categories, Numbers, and
Locations(Report, 9/18/95, GAO/HEHS-95-149).
Schools and Workplaces: An Overview of Successful and Unsuccessful
Practices (Report, 8/31/95, GAO/PEMD-95-28).
D.C. Public School Enrollment (Letter, 8/28/95, GAO/AIMD-95- 229R).
Vocational Education: Changes at High School Level After Amendments
to Perkins Act (Report, 7/12/95, GAO/HEHS-95-144).
District of Columbia: Weaknesses in Personnel Records and Public
Schools' Management Information and Controls (Testimony, 6/14/95,
GAO/T-AIMD-95-170).
School Safety: Promising Initiatives for Addressing School Violence
(Report, 4/25/95, GAO/HEHS-95-106).
School Facilities: America's Schools Not Designed or Equipped for
21st Century (Report, 4/4/95, GAO/HEHS-95-95). Testimony on same
topic (4/4/95, GAO/T-HEHS-95-127).
School Facilities: Condition of America's Schools (Report, 2/1/95,
GAO/HEHS-95-61).
Multiple Youth Programs (Letter, 1/19/95, GAO/HEHS-95-60R).
Charter Schools: New Model for Public Schools Provides Opportunities
and Challenges (Report, 1/18/95, GAO/HEHS-95-42). Testimony on same
topic (1/19/95, GAO/T-HEHS-95-52).
Health Care: School-Based Health Centers Can Expand Access for
Children (Report, 12/22/94, GAO/HEHS-95-35).
HIGHER EDUCATION
---------------------------------------------------------- Chapter 3:4
For more information, contact Josepth J. Eglin, Jr., at (202) 512-
7009 or Wayne B. Upshaw at (202) 512-7006.
Higher Education: Selected Information on Student Financial Aid
Received by Legal Immigrants (Report, 11/24/95, GAO/HEHS-96-7).
National Service Programs AmeriCorps*USA--Early Program Resource and
Benefit Information (Testimony, 10/17/95, GAO/T-HEHS-96-14). Report
on same topic (8/29/95, GAO/HEHS-95-222).
Land-Grant College Revenues (Letter, 10/20/95, GAO/HEHS-96-10R).
AmeriCorps*USA Clarifications (Letter, 9/11/95, GAO/HEHS-95- 267R).
AmeriCorps*USA Benefit-Cost Study (Letter, 9/7/95, GAO/HEHS-95-
255R).
Direct Student Loans (Letter, 8/25/95, GAO/HEHS-95-225R).
College Savings: Information on State Tuition Prepayment Programs
(Report, 8/3/95, GAO/HEHS-95-131).
Vocational Education: 2-Year Colleges Improve Programs, Maintain
Access for Special Populations (Report, 7/26/95, GAO/HEHS-95-163).
Teacher Training: Status and Participants' Views of Delta Teachers
Academy (Report, 6/29/95, GAO/RCED-95-208).
Student Loan Defaults: Department of Education Limitations in
Sanctioning Problem Schools (Report, 6/19/95, GAO/HEHS-95-99).
Direct Student Loans: Selected Characteristics of Participating
Schools (Testimony, 3/30/95, GAO/T-HEHS-95-123).
Higher Education: Restructuring Student Aid Could Reduce Low-Income
Student Dropout Rate (Report, 3/23/95, GAO/HEHS-95-48).
GAO's 1995 High Risk Reports: Student Financial Aid (Report, 2/95,
GAO/HR-95-10).
Guaranteed Student Loans: Actions to Ensure Continued Student Access
to Subsidized Loans (Report, 2/24/95, GAO/HEHS-95-64).
Multiple Teacher Training Programs: Information on Budgets,
Services, and Target Groups (Report, 2/22/95, GAO/HEHS-95-71FS).
Adult Education Act (Letter, 2/16/95, GAO/HEHS-95-65R).
GAO Education Reports (Letter, 2/3/95, GAO/HEHS-72R).
NCAA Student Athlete Pell Grants (Letter, 1/10/95, GAO/OSI-95- 13R).
Women's Educational Equity Act: A Review of Program Goals and
Strategies Needed (Report, 12/27/94, GAO/PEMD-95-6).
EMPLOYMENT
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 4
EQUAL EMPLOYMENT OPPORTUNITIES
---------------------------------------------------------- Chapter 4:1
For more information, contact Lawrence J. Horinko at (202) 512-
7001.
Military Equal Opportunity: Certain Trends in Racial and Gender Data
May Warrant Further Analysis (Report, 11/17/95, GAO/NSIAD-96- 17).
Equal Employment Opportunity: Women and Minority Representation at
Interior, Agriculture, Navy, and State (Report, 9/29/95, GAO/GGD-
95-211).
Equal Employment Opportunity: DOL Contract Compliance Reviews Could
Better Target Federal Contractors (Report, 9/28/95, GAO/HEHS-95-
177).
Employment Discrimination: Most Private-Sector Employers Use
Alternative Dispute Resolution (Report, 7/5/95, GAO/HEHS-95-150).
Federal Affirmative Employment: Progress of Women and Minority
Criminal Investigators at Selected Agencies (Report, 4/25/95,
GAO/GGD-95-85).
Equal Employment Opportunity: Group Representation in Key Jobs at
the National Institutes of Health (Report, 3/16/95, GAO/GGD-95-83).
Equal Opportunity: DOD Studies on Discrimination in the Military
(Report, 3/95, GAO/NSIAD-95-103).
Discrimination Complaints: Monetary Awards in Federal EEO Cases
(Report, 1/3/95, GAO/GGD-95-28FS).
Managing DOE: Further Review Needed of Suspensions of Security
Clearances for Minority Employees (Report, 12/8/94, GAO/RCED-95- 15).
LABOR AND MANAGEMENT RELATIONS
---------------------------------------------------------- Chapter 4:2
For more information, contact Charles A. Jeszeck at (202) 512-7036
or Sigurd R. Nilsen at (202) 512-7003.
Federal Employee Redress: An Opportunity for Reform (Testimony,
11/29/95, GAO/T-GGD-96-42).
Worker Protection: Federal Contractors and Violations of Labor Law
(Report, 10/24/95, GAO/HEHS-96-8).
Federal Personnel Management: Views on Selected NPR Human Resource
Recommendations (Report, 9/18/95, GAO/GGD-95-221BR).
TRAINING AND EMPLOYMENT
ASSISTANCE
---------------------------------------------------------- Chapter 4:3
For more information, contact Charles A. Jeszeck at (202) 512-7036,
Sigurd R. Nilsen at (202) 512-7003, or Wayne B. Upshaw at (202)
512- 7006, .
Job Corps Program (Letter, 11/9/95, GAO/HEHS-96-61R).
Department of Labor: Senior Community Service Employment Program
Delivery Could Be Improved Through Legislative and Administrative
Actions (Report, 11/2/95, GAO/HEHS-96-4). Testimony on same topic
(11/2/95, GAO/T-HEHS-96-57).
Job Corps: High Costs and Mixed Results Raise Questions About
Program's Effectiveness (Report, 6/30/95, GAO/HEHS-95-180).
Department of Labor: Rethinking the Federal Role in Worker
Protection and Workforce Development (Testimony, 4/4/95, GAO/T-
HEHS-95-125).
Multiple Employment Training Programs: Information Crosswalk on 163
Employment Training Programs (Report, 2/14/95, GAO/HEHS-95-85FS).
Multiple Employment Training Programs: Major Overhaul Needed to
Create a More Efficient, Customer-Driven System (Testimony, 2/6/95).
Multiple Employment Training Programs: Major Overhaul Needed to
Reduce Costs, Streamline the Bureaucracy, and Improve Results
(Testimony, 1/10/95, GAO/T-HEHS-95-53).
WORKPLACE QUALITY
---------------------------------------------------------- Chapter 4:4
For more information, contact Lawrence J. Horinko at (202) 512-
7001, Charles A. Jeszeck at (202) 512-7036, or Sigurd R. Nilsen at
(202) 512-7003.
OSHA: Potential to Reform Regulatory Enforcement (Testimony,
10/17/95, GAO/T-HEHS-96-42).
Schools and Workplaces: An Overview of Successful and Unsuccessful
Practices (Report, 8/31/95, GAO/PEMD-95-28).
Department of Labor: Rethinking the Federal Role in Worker
Protection and Workforce Development (Testimony, 4/4/95, GAO/T-
HEHS-95-125).
OTHER EMPLOYMENT ISSUES
---------------------------------------------------------- Chapter 4:5
For more information, contact Lawrence J. Horinko at (202) 512-
7001, Charles A. Jeszeck at (202) 512-7036, or Sigurd R. Nilsen at
(202) 512-7003.
Federal Job Classification: Comparison of Job Content with Grades
Assigned in Selected Occupations (Report, 11/6/95, GAO/GGD-96-20).
Review of Compensation Comparability Report (Letter, 10/30/95,
GAO/GGD-96-34R).
Defense Contractors: Pay, Benefits, and Restructuring During Defense
Downsizing (Report, 10/10/95, GAO/NSIAD-96-19BR).
Federal Reorganization: Congressional Proposal to Merge Education,
Labor, and EEOC (Report, 6/7/95, GAO/HEHS-95-140). Testimony on same
topic (6/29/95, GAO/T-HEHS-95-188).
Personnel Practices: Selected Characteristics of Recent Ramspeck Act
Appointments (Testimony, 5/24/95, GAO/T-GGD-95-173).
Title 6 T&A Data (NASA) (Letter, 5/23/95, GAO/AIMD-95-140R).
Title 6 T&A Data (NRC) (Letter, 5/23/95, GAO/AIMD-95-139R).
Administratively Uncontrollable Overtime (Letter, 4/14/95,
GAO/GGD-95-129R).
Federal Quality Management: Strategies for Involving Employees
(Report, 4/18/95, GAO/GGD-95-79).
Federal Downsizing: The Administration's Management of Workforce
Reductions (Testimony, 3/2/95, GAO/T-GGD-95-108).
Labor's Regional Structure and Trust Funds (Letter, 2/10/95,
GAO/HEHS-95-82R).
Block Grants: Characteristics, Experience, and Lessons Learned
(Report, 2/9/95, GAO/HEHS-95-74). Testimony on same topic (2/9/95,
GAO/T-HEHS-95-80).
GAO Labor Products (1990-1995) (Letter, 2/3/95, GAO/HEHS-95- 73R).
Department of Labor: Opportunities to Realize Savings (Testimony,
1/18/95, GAO/T-HEHS-95-55).
Federal Personnel: Federal/Private Sector Pay Comparisons (Report,
12/14/94, GAO/OCE-95-1).
SOCIAL SECURITY, DISABILITY, AND
WELFARE
(COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 5
CHILDREN'S ISSUES
---------------------------------------------------------- Chapter 5:1
For more information, contact David P. Bixler at (202) 512-7201,
Diana S. Eisenstat at (202) 512-5562, or Robert L. MacLafferty at
(415) 904-2123.
CHILD SUPPORT
-------------------------------------------------------- Chapter 5:1.1
Child Support Enforcement: States and Localities Move to Privatized
Services (Report, 11/20/95, GAO/HEHS-96-43FS).
Child Support Enforcement: Families Could Benefit From Stronger
Enforcement Program (Report, 12/27/94, GAO/HEHS-95-24).
OTHER CHILDREN'S ISSUES
-------------------------------------------------------- Chapter 5:1.2
Child Welfare: Complex Needs Strain Capacity to Provide Services
(Report, 9/26/95, GAO/HEHS-95-208).
Children and Families Services Programs (Letter, 9/1/95,
GAO/HEHS-95-191R).
Federal Reimbursement for Foster Care (Letter, 8/11/95,
GAO/HEHS-95-197R).
Child Welfare: Opportunities to Further Enhance Family Preservation
and Support Activities (Report, 6/15/95, GAO/HEHS-95-112).
Child Support Enforcement: Opportunity to Reduce Federal and State
Costs (Testimony, 6/13/95, GAO/T-HEHS-95-181).
Foster Care: Health Needs of Many Young Children Are Unknown and
Unmet (Report, 5/26/95, GAO/HEHS-95-114).
Child Care: Recipients Face Service Gaps and Supply Shortages
(Testimony, 3/1/95, GAO/T-HEHS-95-96).
Child Care: Narrow Subsidy Programs Create Problems for Mothers
Trying to Work (Testimony, 1/31/95, GAO/T-HEHS-95-69).
Low-Income Families: Comparison of Incomes of AFDC and Working Poor
Families (Testimony, 1/25/95, GAO/T-HEHS-95-63).
Child Care: Child Care Subsidies Increase Likelihood That Low-
Income Mothers Will Work (Report, 12/30/94, GAO/HEHS-95-20).
Child Care: Promoting Quality in Family Child Care (Report, 12/7/94,
GAO/HEHS-95-36). Testimony on same topic (12/9/94, GAO/T-
HEHS-95-43).
PENSIONS
---------------------------------------------------------- Chapter 5:2
For more information, contact Michael D. Packard at (202) 512-7250
or Donald C. Snyder at (202) 512-7204.
PENSION BENNEFIT GUARANTY
CORPORATION
-------------------------------------------------------- Chapter 5:2.1
PBGC (Letter, 8/24/95, GAO/AIMD-95-225R).
PUBLIC AND PRIVATE PENSION
ISSUES
-------------------------------------------------------- Chapter 5:2.2
Proposed Pension Reversion (Letter, 10/24/95, GAO/HEHS-96-54R).
Federal Pensions: Thrift Savings Plan Has Key Role in Retirement
Benefits (Report, 10/19/95, GAO/HEHS-96-1).
Private Pension Plans: Efforts to Encourage Infrastructure
Investment (Report, 9/8/95, GAO/HEHS-95-173).
Penson COLAs (Letter, 8/11/95, GAO/HEHS-95-219R).
Combined Fund Analysis (Letter, 8/7/95, GAO/HEHS-95-230R).
Federal Retirement System Financing (Testimony, 6/28/95, GAO/T-
GGD-95-197).
Overview of Federal Retirement Programs (Testimony, 5/22/95,
GAO/T-GGD-95-172).
Federal Retirement: Benefits for Members of Congress, Congressional
Staff, and Other Employees (Report, 5/15/95, GAO/GGD-95-78).
Testimony on same topic (5/15/95, GAO/T-GGD-95-165).
CSRS Funding (Letter, 4/3/95, GAO/GGD-95-200R).
Federal Retirement Issues (Testimony, 3/10/95, GAO/T-GGD-95- 111).
District Pensions: Federal Options for Sharing Burden to Finance
Unfunded Liability (Report, 12/28/94, GAO/HEHS-95-40).
SOCIAL SECURITY AND DISABILITY
---------------------------------------------------------- Chapter 5:3
For more information, contact Cynthia A. Bascetta at (202) 512-
7207, Michael T. Blair at (404) 679-1944, Christopher C. Crissman
at (202) 512-7051, Cynthia M. Fagnoni at (202) 512-7202, or Rolland
H. Miller at (202) 512-7246.
DISABILITY
-------------------------------------------------------- Chapter 5:3.1
Disability Insurance: Broader Management Focus Needed to Better
Control Caseload (Testimony, 5/23/95, GAO/T-HEHS-95-164).
D.C. Disability Retirement Rate (Report, 3/31/95, GAO/GGD-95- 133).
Supplemental Security Income: Recipient Population Has Changed as
Caseloads Have Burgeoned (Testimony, 3/27/95, GAO/T-HEHS-95-120).
Social Security: New Functional Assessments for Children Raise
Eligibility Questions (Report, 3/10/95, GAO/HEHS-95-66).
Social Security: Federal Disability Programs Face Major Issues
(Testimony, 3/2/95, GAO/T-HEHS-95-97).
Supplemental Security Income: Recent Growth in the Rolls Raises
Fundamental Program Concerns (Testimony, 1/27/95, GAO/T-HEHS-95- 67).
SOCIAL SECURITY
ADMINISTRATION
-------------------------------------------------------- Chapter 5:3.2
Supplemental Security Income: Disability Program Vulnerable to
Applicant Fraud When Middlemen Are Used (Report, 8/31/95, GAO/HEHS-
95-116).
OHA Backlogs (Letter, 7/28/95, GAO/HEHS-95-228R).
Supplemental Security Income: Growth and Changes in Recipient
Population Call for Reexamining Program (Report, 7/7/95, GAO/HEHS-
95-137).
Social Security Administration: Leadership Challenges Accompany
Transition to an Independent Agency (Report, 2/15/95, GAO/HEHS-95-
59).
SSA Services to Employers (Letter, 12/6/94, GAO/HEHS-95-38R).
OTHER SOCIAL SECURITY
PROGRAMS
-------------------------------------------------------- Chapter 5:3.3
SSA's Rehabilitation Programs (Letter, 9/7/95, GAO/HEHS-95- 253R).
WELFARE
---------------------------------------------------------- Chapter 5:4
For more information, contact David P. Bixler at (202) 512-7201.
Welfare To Work: Approaches That Help Teenage Mothers Complete High
School (Report, 9/29/95, GAO/HEHS/PEMD-95-202).
Welfare To Work: Child Care Assistance Limited; Welfare Reform May
Expand Needs (Report, 9/21/95, GAO/HEHS-95-220).
Welfare to Work: State Programs Have Tested Some of the Proposed
Reforms (Report, 7/14/95, GAO/PEMD-95-26).
Low-Income Families (Letter, 6/28/95, GAO/HEHS-95-162R).
Welfare Benefits: Potential to Recover Hundreds of Millions More in
Overpayments (Report, 6/20/95, GAO/HEHS-95-111).
Welfare Programs: Opportunities to Consolidate and Increase Program
Efficiencies (Report, 5/31/95, GAO/HEHS-95-139).
Welfare to Work: Most AFDC Training Programs Not Emphasizing Job
Placement (Report, 5/19/95, GAO/HEHS-95-113).
Welfare to Work: Measuring Outcomes for JOBS Participants (Report,
4/17/95, GAO/HEHS-95-86).
Means-Tested Programs (Letter, 2/24/95, GAO/HEHS-95-94R).
Welfare Reform: Implications of Proposals on Legal Immigrants'
Benefits (Report, 2/2/95, GAO/HEHS-95-58).
Welfare to Work: AFDC Training Program Spends Billions, but Not Well
Focused on Employment (Testimony, 1/10/95, GAO/T-HEHS-95-51). Report
on same topic (12/19/94, GAO/HEHS-95-28).
OTHER PRODUCTS RELATED TO
SOCIAL SECURITY, DISABILITY,
AND WELFARE
---------------------------------------------------------- Chapter 5:5
For more information, contact Diana S. Eisenstat at (202) 512- 5562.
Thrift Savings Plan (Letter, 11/14/95, GAO/HEHS-96-66R).
Federal Grants to New Jersey (Letter, 11/8/95, GAO/AIMD-96-8R).
Block Grants: Issues in Designing Accountability Provisions (Report,
9/1/95, GAO/AIMD-95-226).
Illegal Aliens: National Net Cost Estimates Vary Widely (Report,
7/25/95, GAO/HEHS-95-133).
Health and Human Services: Opportunities to Realize Savings
(Testimony, 1/12/95, GAO/T-HEHS-95-57).
VETERANS AFFAIRS AND MILITARY
HEALTH (COMPREHENSIVE
1-YEAR LISTING)
============================================================ Chapter 6
MILITARY HEALTH CARE
---------------------------------------------------------- Chapter 6:1
For more information, contact Daniel M. Brier at (202) 512-6803 or
George F. Poindexter at (202) 512-7213.
Military Physicians: DOD's Medical School and Scholarship Program
(Report, 9/29/95, GAO/HEHS-95-244).
Defense Health Care: Despite TRICARE Procurement Improvements,
Problems Remain (Report, 8/3/95, GAO/HEHS-95-142).
Defense Health Care: Problems With Medical Care Overseas Are Being
Addressed (Report, 7/12/95, GAO/HEHS-95-156).
Operation Desert Storm: Health Concerns of Selected Indiana Persian
Gulf War Veterans (Report, 5/16/95, GAO/HEHS-95-102).
Wartime Medical Care: Aligning Sound Requirements with New Combat
Care Approaches Is Key to Restructuring Force (Testimony, 3/30/95,
GAO/T-NSIAD-95-129).
Defense Health Care: DOD's Managed Care Program Continues to Face
Challenges (Testimony, 3/28/95, GAO/T-HEHS-95-117).
Defense Health Care: Issues and Challenges Confronting Military
Medicine (Report, 3/22/95, GAO/HEHS-95-104).
VETERANS' BENEFITS
---------------------------------------------------------- Chapter 6:2
For more information, contact Irene P. Chu at (202) 512-7102.
Hispanic Veterans (Letter, 11/2/95, GAO/HEHS-96-25R).
VA Student Financial Aid: Opportunity to Reduce Overlap in Approving
Education and Training Programs (Report, 10/30/95, GAO/HEHS-96-22).
Veterans' Benefits: Effective Interaction Needed Within VA to
Address Appeals Backlog (Report, 9/27/95, GAO/HEHS-95-190).
Veterans Benefits Modernization: Further Service Improvement Depends
on Coordinated Approach (Testimony, 6/22/95, GAO/T-AIMD-95- 184).
Veterans' Benefits: VA Can Prevent Millions in Compensation and
Pension Overpayments (Report, 4/28/95, GAO/HEHS-95-88).
Concurrent Receipt (Letter, 4/27/95, GAO/HEHS-95-136R).
Veterans Compensation: Offset of DOD Separation Pay and VA
Disability Compensation (Report, 4/3/95, GAO/NSIAD-95-123).
Veterans' Benefits: Basing Survivors' Compensation on Veterans'
Disability Is a Viable Option (Report, 3/6/95, GAO/HEHS-95-30).
Veterans' Benefits: Better Assessments Needed to Guide Claims
Processing Improvements (Report, 1/13/95, GAO/HEHS-95-25).
VETERANS' HEALTH CARE
---------------------------------------------------------- Chapter 6:3
For more information, contact James R. Linz at (202) 512-7110 or
Paul R. Reynolds at (202) 512-7109.
VA Health Care: Effects of Facility Realignment on Construction
Needs Are Unknown (Report, 11/17/95, GAO/HEHS-96-19).
Fiscal Year 1996 VA Certification (Letter, 11/14/95, GAO/HEHS-
96-67R).
VA Health Care: Efforts to Increase Sharing With DOD and the Private
Sector (Testimony, 10/18/95, GAO/T-HEHS-96-41).
VA Health Care Delivery: Top Management Leadership Critical to
Success of Decision Support Systems (Report, 9/29/95, GAO/AIMD-95-
182).
VA Clinic Funding (Letter, 9/19/95, GAO/HEHS-95-273R).
Proposed VA Hospital at Travis Air Force Base (Letter, 9/19/95,
GAO/HEHS-95-268R).
VA Medical Resources Allocation (Letter, 9/12/95, GAO/HEHS-95- 252R).
Medical Care Budget Alternatives (Letter, 9/12/95, GAO/HEHS-95-
247R).
VA Health Care: Need for Brevard Hospital Not Justified (Report,
8/29/95, GAO/HEHS-95-192).
VA Construction Contract Award Delays (Letter, 8/25/95,
GAO/HEHS-95-240R).
VA Health Care: Issues Affecting Eligibility Reform (Testimony,
7/19/95, GAO-T-HEHS-95-213).
VA Health Care: Physician Peer Review Identifies Quality of Care
Problems but Actions to Address Them Are Limited (Report, 7/7/95,
GAO/HEHS-95-121).
Brockton Substance Abuse (Letter, 6/2/95, GAO/HEHS-95-172R).
VA Savings Options (Letter, 5/18/95, GAO/HEHS-95-165R).
VA's Florida Network Planning (Letter, 5/16/95, GAO/HEHS-95- 160R).
Operation Desert Storm: Health Concerns of Selected Indiana Persian
Gulf War Veterans (Report, 5/16/95, GAO/HEHS-95-102).
VA Health Care: Challenges and Options for the Future (Testimony,
5/9/95, GAO/T-HEHS-95-147).
VA Health Care: Retargeting Needed to Better Meet Veterans' Changing
Needs (Report, 4/21/95, GAO/HEHS-95-39).
Barriers to VA Managed Care (Letter, 4/20/95, GAO/HEHS-95-84R).
VA Health Care: Albuquerque Medical Center Not Recovering Full Costs
of Lithotripsy Services (Report, 12/28/94, GAO/HEHS-95-19).
Veterans' Health Care: Veterans' Perceptions of VA Services and VA's
Role in Health Care Reform (Report, 12/23/94, GAO/HEHS-95-14).
VA Health Care: Inadequate Planning in the Chesapeake Network
(Report, 12/22/94, GAO/HEHS-95-6).
MAJOR CONTRIBUTORS
============================================================ Chapter 7
Jessie L. Battle
David W. Bieritz
Susan Y. Higgins
James L. Kirkman
Stephen F. Palincsar
ORDER FORM
============================================================ Chapter 8
MAILING LIST REQUEST FORM
============================================================ Chapter 9
CHANGE OF ADDRESS NOTIFICATION
FORM
=========================================================== Chapter 10
REQUESTING CHANGES
----------------------------------------------------- Chapter 10:0.0.1
Please complete the following information.
To change name, organization, or address, enter appropriate changes
below.
Old Information
.
(Customer Number on Mailing Label above Name)
Name:
Organization:
Address:
.
.
New Information
Name:
Organization:
Address:
.
.
FAX OR MAIL TO:
----------------------------------------------------- Chapter 10:0.0.2
Janet Shikles, Assistant Comptroller General
U.S. General Accounting Office
Fax (202) 512-5806
(12/95)
----------------------------------------------------- Chapter 10:0.0.3
Turn this page over, fold on the dotted lines, and affix stamp.
INTERNET INSTRUCTIONS
=========================================================== Chapter 11
To access this publication as a FULL TEXT ASCII or PDF (Portable
Document Format) electronic file from the Government Printing Office
(GPO) , follow these steps: (Note: PDF files are available only via
World Wide Web (WWW) or a Wide Area Information Server (WAIS)
client.).
Via WWW via UCSD:
1) Go to: \http://ssdc.ucsd.edu/gpo/gao.html.
2) Perform search for "Health Education Employment Social Security
Welfare Veterans".
3) Mail the file(s) to yourself.
Via WWW via Perdue:
1) Go to: \http://thorplus.lib.purdue.edu/gpo/.
2) Select GAO database (near bottom of 2nd screen).
3) Perform search for "Health Education Employment Social Security
Welfare Veterans". <(MUST use quotes in searches).
4) Use the "m" command to mail the file to yourself.
Via TELNET:
1) TELNET to: .
2) Login as > gao < (MUST be lower case).
3) Follow steps #3 & #4 above for Via WWW via Perdue.
Via WAIS (for PDF files, also):
1) Obtain source file information through anonymous FTP at
\eids04.eids.gpo.gov.
2) Login as "anonymous".
3) Use your own e-mail address as PASSWORD.
4) Follow steps #3 & #4 listed above for Via WWW via Perdue.
Via Dial-in:
1) Modem settings: VT-100 emulation (8,N,1).
2) Dial (202) 512-1661.
3) Type "SWAIS".
4) Login as > gao < (MUST be lower case).
5) Follow step #3 listed above for VIA WWW via Perdue.
6) For downloading files, follow your modem software guidelines.
Via CapAccess: .
1) Type GO GAO at any CapAccess prompt.
2) Select WAIS menu item - #5.
3) Follow steps #3 & #4 listed above for VIA WWW via Perdue.
See "Helpful Hints" and "WAIS Manual" files for more information on
searching techniques. For additional access options or questions on
using the GPO system, contact GPO at or
(202) 512-1530. Please do NOT use this GAO e-mail address for
questions about the GPO system or for ordering reports.
Electronic access information is also available via GAO's FaxBack
system. The automated voice menu number is (301) 258-4097.
Select option #4 to receive INTERNET access info via FAX.
*** End of document. ***