Five MS-13 Members Charged with Murder

Five local members of the violent Mara Salvatrucha (MS-13) international street gang are set to appear in court following charges of conspiracy and murder in aid of racketeering, announced Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division and U.S. Attorney Ryan K. Patrick of the Southern District of Texas.

Wilson Jose Ventura-Mejia, 24; Jimmy Villalobos-Gomez, 23; Angel Miguel Aguilar-Ochoa, 35; Walter Antonio Chicas-Garcia, 23; and Marlon Miranda-Moran, 21, appeared for their arraignments and detention hearings via video before U.S. Magistrate Judge Sam S. Sheldon. All are El Salvadorian nationals who illegally resided in Houston, Texas.  Also charged is Franklin Trejo-Chavarria, 23, who is currently in custody serving a sentence in El Salvador for charges there.  

A federal grand jury returned the indictment Nov. 12.  All are charged with conspiracy and murder in aid of racketeering.  

The indictment alleges the defendants committed a 2018 murder in furtherance of the MS-13 enterprise.

The FBI, U.S. Immigration and Customs Enforcement’s Homeland Security Investigations and Houston Police Department conducted the investigation.  Trial Attorneys Julie A. Finocchiaro, Gerald Collins and Matthew Hoff from the Criminal Division’s Organized Crime and Gang Section and Assistant U.S. Attorneys Britni Cooper and John Michael Lewis are prosecuting the case.

An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law. 

The year 2020 marks the 150th anniversary of the Department of Justice.  Learn more about the history of our agency at www.Justice.gov/Celebrating150Years.

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    The Federal Aviation Administration (FAA) directed individual offices to implement the Compliance Program, and FAA has increasingly used compliance actions rather than enforcement actions to address violations of safety standards since starting the Compliance Program. FAA revised agency-wide guidance in September 2015 to emphasize using compliance actions, such as counseling or changes to policies. Compliance actions are to be used when a regulated entity is willing and able to comply and enforcement action is not required or warranted, e.g., for repeated violations, according to FAA guidance. FAA then directed its offices—for example, Flight Standards Service and Drug Abatement Division—to implement the Compliance Program as appropriate, given their different responsibilities and existing processes. Under the Compliance Program, data show that selected FAA offices have made increasing use of compliance actions. Total Number of Federal Aviation Administration Enforcement Actions and Number of Compliance Actions Closed for Selected Program Offices, Fiscal Years 2012-2019 No specific FAA office or entity oversees the Compliance Program. FAA tasked a working group to lead some initial implementation efforts. However, the group no longer regularly discusses the Compliance Program, and no office or entity was then assigned oversight authority. As a result, FAA is not positioned to identify and share best practices or other valuable information across offices. FAA established goals for the Compliance Program—to promote the highest level of safety and compliance with standards and to foster an open, transparent exchange of data. FAA, however, has not taken steps to evaluate if or determine how the program accomplishes these goals. Key considerations for agency enforcement decisions state that an agency should establish an evaluation plan to determine if its enforcement policy achieves desired goals. Three of eight FAA offices have started to evaluate the effects of the Compliance Program, but two offices have not yet started. Three other offices do not plan to do so—in one case, because FAA has not told the office to. FAA officials generally believe the Compliance Program is achieving its safety goals based on examples of its use. However, without an evaluation, FAA will not know if the Compliance Program is improving safety or having other effects—intended or unintended. FAA supports the safety of the U.S. aviation system by ensuring air carriers, pilots, and other regulated entities comply with safety standards. In 2015, FAA announced a new enforcement policy with a more collaborative and problem-solving approach called the Compliance Program. Under the program, FAA emphasizes using compliance actions, for example, counseling or training, to address many violations more efficiently, according to FAA. Enforcement actions such as civil penalties are reserved for more serious violations, such as when a violation is reckless or intentional. The FAA Reauthorization Act of 2018 included a provision that GAO review FAA's Compliance Program. This report examines (1) how FAA implemented and used the Compliance Program and (2) how FAA evaluates the effectiveness of the program. GAO analyzed FAA data on enforcement actions agency-wide and on compliance actions for three selected offices for fiscal years 2012 to 2019 (4 years before and after program start).GAO also reviewed FAA guidance and interviewed FAA officials, including those from the eight offices that oversee compliance with safety standards. GAO is making three recommendations including that FAA assign authority to oversee the Compliance Program and evaluate the effectiveness of the program in meeting goals. FAA concurred with the recommendations. For more information, contact Heather Krause at (202) 512-2834 or krauseh@gao.gov.
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  • VA Health Care: Better Data Needed to Assess the Health Outcomes of Lesbian, Gay, Bisexual, and Transgender Veterans
    In U.S GAO News
    The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) analyzes national-level data by birth sex to assess health outcomes for women veterans. For example, it analyzes frequency data to identify their most common health conditions. However, VHA is limited in its assessment of health outcomes for the lesbian, gay, bisexual, and transgender (LGBT) veteran population because it does not consistently collect sexual orientation or self-identified gender identity (SIGI) data. VHA officials stated that providers may record veterans' sexual orientation—which can be used to identify lesbian, gay, and bisexual veterans—in non-standardized clinical notes in electronic health records. However, without a standardized field, providers may not be consistently collecting these data, and VHA does not know the total number of these veterans in its system. VHA officials recognize the importance of consistently collecting these data, but have yet to develop and implement a field for doing so. VHA collects SIGI data—which can be used in part to identify transgender veterans—in enrollment, administrative, and electronic health record systems. Although VHA has worked to improve the collection of these data, GAO found inconsistencies in how VHA records SIGI and, according to VA, 89 percent of veterans' records lack SIGI information. VHA added a field to collect this information in the administrative system; however, these data are not linked to electronic health records. As such, VHA providers cannot see the data during clinical visits when determining the appropriate services for transgender veterans, such as screening certain transgender men for breast and cervical cancers, as required by VHA policy. VHA's plan to link SIGI data across both systems has been postponed several times, and the data remain unlinked. VHA Sexual Orientation and Self-Identified Gender Identity (SIGI) Data Collection Limitations, Fiscal Year 2020 Until VHA can more consistently collect and analyze sexual orientation and SIGI data for the veteran population served, it will have a limited understanding of the health care needs of LGBT veterans, including any disparities they may face. VHA provides care to a diverse population of veterans, including women and LGBT veterans. These veterans may experience differences in health outcomes that are closely linked with social or economic disadvantage, and VA considers it important to analyze the services they receive as well as their health outcomes to improve health equity. House Report 115-188 included a provision for GAO to review VA's data collection and reporting procedures for information on veterans' gender and sexual orientation. This report describes how VHA assesses health outcomes for women veterans and examines the extent to which VHA assesses health outcomes for LGBT veterans. GAO reviewed VHA directives and VHA's Health Equity Action Plan. GAO interviewed officials from VHA's Women's Health Services and LGBT Health Program, VHA researchers who focus on women and LGBT veterans, and representatives from other health care systems with experience collecting gender and sexual orientation information. GAO is making four recommendations to VA to consistently collect sexual orientation and SIGI data, and analyze these data to assess health outcomes for LGBT veterans. VA concurred with GAO's recommendations and identified actions it is taking to address them. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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  • Public Health Preparedness: HHS Has Taken Some Steps to Implement New Authority to Speed Medical Countermeasure Innovation
    In U.S GAO News
    The Department of Health and Human Services' (HHS) Biomedical Advanced Research and Development Authority has taken steps towards implementing an authority provided by the 21st Century Cures Act to accelerate the development of medical countermeasures. Medical countermeasures are drugs, vaccines, and devices to diagnose, treat, prevent, or mitigate potential health effects of exposure to chemical, biological, radiological, and nuclear threats. However, as of June 2020, HHS had not selected a medical countermeasures innovation partner—an independent, nonprofit entity that the 21st Century Cures Act authorizes HHS to partner with to use venture capital practices and methods to invest in companies developing medical countermeasures. Towards implementing the authority, HHS has developed a vision for the innovation partner, staffed a division to manage HHS's medical innovation partnership and determined an initial amount of funding needed, solicited and considered feedback from venture capital and other stakeholders, and developed preliminary plans for structuring and overseeing the partnership. HHS officials explained this type of partnership approach was new to the agency and required due diligence to develop. According to agency officials, the innovation partner will allow HHS to invest in potentially transformative medical countermeasures that have the potential to benefit the government. For example, the innovation partner could invest in innovative wearable technologies to help early detection of viral infections. HHS officials told GAO that the partner, which is required by law to be a nonprofit entity, will be required to reinvest BARDA's revenues generated from government investments into further investments made through the partnership. BARDA's ultimate goal will be to use these revenues to fund new investments. According to a review of stakeholder comments submitted to HHS, potential venture capital partners identified concerns regarding aspects of the agency's plans for the innovation partner, which the stakeholders indicated could hinder HHS's implementation of the authority. For example, there is a statutory limit to the annual salary that can be paid to an individual from HHS's annual appropriation, which some stakeholders indicated was too low to attract an entity to manage the innovation partner funds. HHS officials told GAO they are assessing options to mitigate some of these concerns, but that plans will not be final until they select the partner. GAO provided a draft of this correspondence to HHS and the Department of Defense for review and comment. HHS did not provide comments on this report and DOD provided technical comments that we incorporated as appropriate. The COVID-19 pandemic and other public health emergencies caused by chemical, biological, radiological, and nuclear agents or emerging infectious diseases raise concern about the nation's vulnerability to, and capacity to prevent or mitigate, potential health effects from exposure to such threats. The 21st Century Cures Act authorized HHS to partner with a private, nonprofit entity that can use venture capital practices and methods to invest in companies developing promising, innovative, medical countermeasures. The 21st Century Cures Act included a provision for GAO to review activities conducted under the innovation partner authority. This report describes the status of HHS's implementation of the authority. GAO reviewed relevant statutes and HHS documentation regarding its plans and actions taken to implement the authority, reviewed responses HHS received to the two requests for information it used to collect information from venture capital and other stakeholders, interviewed HHS officials, and interviewed officials from the Department of Defense, which has partnered with a private, nonprofit entity to make investments using venture capital practices. For more information, contact Mary Denigan-Macauley at (202) 512-7114 or DeniganMacauleyM@gao.gov.
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  • Anesthesia Services: Differences between Private and Medicare Payments Likely Due to Providers’ Strong Negotiating Position
    In U.S GAO News
    Literature GAO reviewed indicated that private insurance payments for anesthesia services on average were more than 3-1/2 times those of Medicare payments. This payment difference increased from what GAO reported in 2007—average private insurance payments for certain anesthesia services in 2004 were about 3 times those of Medicare. While Medicare rates for anesthesia services are set by the Centers for Medicare & Medicaid Services (CMS), private insurance rates are set through negotiations between providers and private insurers. GAO identified three recent studies with analyses of private insurance and Medicare payments for anesthesia services: Researchers from Yale University calculated that private insurance payments were 3.67 times Medicare payments, on average, for services provided by anesthesiologists for one large private insurer in 2015 operating across all 50 states and the District of Columbia. The Health Care Cost Institute calculated that in 2017 private insurance payments ranged from 2 to 7 times Medicare payments, on average, across six common services provided by anesthesiologists in 33 states. Wide state-to-state variation within specific services was reported. The American Society of Anesthesiologists reported that private insurance payments were 3.46 times Medicare payments, on average, based on a survey of its members in 2019. According to studies GAO reviewed and stakeholders GAO interviewed, market factors likely enhanced anesthesia providers' negotiating position and allowed them to secure higher private payments. For example, several studies and stakeholders cited market concentration as a key factor that increased private payments for anesthesia services. In a market with high provider concentration—or relatively few providers in a given market—there is little competition between providers, enabling the providers within that market to negotiate for higher payments from private insurers. Studies also indicated that specialists, including anesthesia providers, could negotiate higher in-network payment rates because they were able to leave an insurer's network with little risk of losing patients or revenue. In addition, when anesthesia providers are not a part of a private insurer's network, they are typically able to bill for a higher amount than the insurer would pay for an in-network provider, known as out-of-network billing. This dynamic decreases providers' incentives to participate in insurer networks because it creates an attractive alternative to network participation. GAO's interviews with stakeholders, literature review, and review of agency data generally did not indicate that the supply of anesthesia providers was insufficient for Medicare beneficiaries. CMS data indicate that the number of active anesthesia providers per 100,000 Medicare beneficiaries increased from 2010 through 2018 and that a very small number of anesthesia providers opted out of the Medicare program. Furthermore, researchers and stakeholders GAO interviewed were not aware of any issues with access to anesthesia services for Medicare beneficiaries, including those in traditionally underserved rural areas. In 2018, Medicare paid over $2 billion for anesthesia services, such as general anesthesia administered to beneficiaries undergoing surgical or other invasive procedures. The joint explanatory statement for the Further Consolidated Appropriations Act, 2020 included a provision for GAO to update its 2007 report and examine how differences in payment rates for anesthesia services have changed since that time. In 2007, GAO reported that Medicare payments in 2004 for certain anesthesia services provided by anesthesiologists were on average 67 percent lower than private insurance payments in certain geographic areas—indicating that private payments were about 3 times more than Medicare payments at that time. This report describes what is known about (1) recent trends in differences between Medicare and private payments for anesthesia services, and (2) the sufficiency of the supply of anesthesia providers for Medicare beneficiaries. GAO reviewed literature and available published data on payment differences for anesthesia services, published in the United States since 2010. GAO also reviewed data from CMS on the number of anesthesia providers from 2010, 2018, and 2020. GAO also interviewed a nongeneralizable selection of three research groups, two beneficiary advocacy groups, and five stakeholder groups, including those representing anesthesiologists, nurse anesthetists, and hospitals, to obtain their perspectives on these issues. The Department of Health and Human Services provided no comments on this report. For more information, contact Jessica Farb at (202) 512-7114 or farbj@gao.gov.
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  • VA Disability Benefits: VA Should Continue to Improve Access to Quality Disability Medical Exams for Veterans Living Abroad
    In U.S GAO News
    The number of disability claims for veterans living abroad—in foreign countries or U.S. territories—increased 14 percent from fiscal years 2014 to 2019. During this time period, claims processing time frames improved. In fiscal year 2019, the Veterans Benefits Administration (VBA) of the Department of Veterans Affairs (VA) approved comparable percentages of disability claims for veterans living abroad and domestically—63 percent and 64 percent respectively. However, for a subset of these claims—those where veterans likely received a disability medical exam scheduled by Department of State (State) embassy staff—approval rates were often lower. Veterans' access to disability medical exams abroad improved as VBA has increasingly relied on contracted examiners, rather than embassy-referred examiners, to conduct these exams. According to VBA, this shift expanded the pool of trained examiners abroad and increased the frequency and depth of VBA's quality reviews for contract exams. These quality reviews help VBA and its contractor identify and address common errors, according to VBA and contractor officials. However, several factors continue to limit some veterans' ability to access quality disability medical exams (see figure). Factors That Impair the Access of Veterans Living Abroad to Quality Disability Medical Exams Unknown quality of certain exams: A subset of veterans living abroad receive disability medical exams from an embassy-referred provider. VBA does not systematically assess the quality of these exams. Without doing so, VBA cannot determine if such exams affect the approval rates of veterans who receive them or contribute to longer processing times and are unable to make informed decisions about their use. Travel reimbursement: Under current VA regulations, VA is not authorized to reimburse veterans for travel expenses for certain services incurred in foreign countries as it is for those incurred within the United States, including U.S. territories. Consequently, some veterans living in foreign countries may be unable to afford to travel to exams. Examiner reimbursement: The Veterans Health Administration's (VHA) Foreign Medical Program reimburses examiners referred by embassy staff via paper checks in U.S. currency. These checks may be slow to arrive and not accepted by foreign banks, according to State and other officials and staff we interviewed. Such payment issues can deter examiners from being willing to conduct disability medical exams and thus limit veterans' access to these exams in foreign countries. Of the roughly 1 million disability claims VBA processed in fiscal year 2019, 18,287 were for veterans living abroad. Veterans living abroad are entitled to the same disability benefits as those living domestically, but GAO previously reported that veterans living abroad may not be able to access disability medical exams as readily as their domestic counterparts. VBA uses medical exam reports to help determine if a veteran should receive disability benefits. GAO was asked to review the disability claims and exam processes for veterans living abroad. Among other things, this report examines disability claims trends for veterans living abroad and these veterans' ability to access quality disability medical exams. GAO analyzed VBA claims data for fiscal years 2014 to 2019; assessed data reliability; reviewed relevant federal laws, regulations, policies, and contract documents; and interviewed employees of VBA, State, and other stakeholders. GAO is making five recommendations, including that VBA assess the quality of embassy-referred exams, VBA and VHA assess whether to reimburse beneficiaries for travel to disability medical exams in foreign countries, and that VBA and VHA pay examiners located by embassy staff electronically. The Department of Veterans Affairs concurred with GAO's recommendations. For more information, contact Elizabeth Curda at (202) 512-7215 or curdae@gao.gov.
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  • Weapon System Sustainment: Aircraft Mission Capable Rates Generally Did Not Meet Goals and Cost of Sustaining Selected Weapon Systems Varied Widely
    In U.S GAO News
    Mission Capable Rates for Selected Department of Defense Aircraft GAO examined 46 types of aircraft and found that only three met their annual mission capable goals in a majority of the years for fiscal years 2011 through 2019 and 24 did not meet their annual mission capable goals in any fiscal year as shown below. The mission capable rate—the percentage of total time when the aircraft can fly and perform at least one mission—is used to assess the health and readiness of an aircraft fleet. Number of Times Selected Aircraft Met Their Annual Mission Capable Goal, Fiscal years 2011 through 2019 aThe military departments did not provide mission capable goals for all nine years for these aircraft. Aggregating the trends at the military service level, the average annual mission capable rate for the selected Air Force, Navy, and Marine Corps aircraft decreased since fiscal year 2011, while the average annual mission capable rate for the selected Army aircraft slightly increased. While the average mission capable rate for the F-35 Lightning II Joint Strike Fighter showed an increase from fiscal year 2012 to 2019, it trended downward from fiscal year 2015 through fiscal year 2018 before improving slightly in fiscal year 2019. For fiscal year 2019, GAO found only three of the 46 types of aircraft examined met the service-established mission capable goal. Furthermore, for fiscal year 2019: six aircraft were 5 percentage points or fewer below the goal; 18 were from 15 to 6 percentage points below the goal; and 19 were more than 15 percentage points below the goal, including 11 that were 25 or more percentage points below the goal. Program officials provided various reasons for the overall decline in mission capable rates, including aging aircraft, maintenance challenges, and supply support issues as shown below. Sustainment Challenges Affecting Some of the Selected Department of Defense Aircraft aA service life extension refers to a modification to extend the service life of an aircraft beyond what was planned. bDiminishing manufacturing sources refers to a loss or impending loss of manufacturers or suppliers of items. cObsolescence refers to a lack of availability of a part due to its lack of usefulness or its no longer being current or available for production. Operating and Support Costs for Selected Department of Defense Aircraft Operating and support (O&S) costs, such as the costs of maintenance and supply support, totaled over $49 billion in fiscal year 2018 for the aircraft GAO reviewed and ranged from a low of $118.03 million for the KC-130T Hercules (Navy) to a high of $4.24 billion for the KC-135 Stratotanker (Air Force). The trends in O&S costs varied by aircraft from fiscal year 2011 to 2018. For example, total O&S costs for the F/A-18E/F Super Hornet (Navy) increased $1.13 billion due in part to extensive maintenance needs. In contrast, the F-15C/D Eagle (Air Force) costs decreased by $490 million due in part to a reduction in the size of the fleet. Maintenance-specific costs for the aircraft types we examined also varied widely. Why This Matters The Department of Defense (DOD) spends tens of billions of dollars annually to sustain its weapon systems in an effort to ensure that these systems are available to simultaneously support today's military operations and maintain the capability to meet future defense requirements. This report provides observations on mission capable rates and costs to operate and sustain 46 fixed- and rotary-wing aircraft in the Departments of the Army, Navy, and Air Force. How GAO Did This Study GAO was asked to report on the condition and costs of sustaining DOD's aircraft. GAO collected and analyzed data on mission capable rates and O&S costs from the Departments of the Army, Navy, and Air Force for fiscal years 2011 through 2019. GAO reviewed documentation and interviewed program office officials to identify reasons for the trends in mission capability rates and O&S costs as well as any challenges in sustaining the aircraft. This is a public version of a sensitive report issued in August 2020. Information on mission capable and aircraft availability rates were deemed to be sensitive and has been omitted from this report. For more information, contact Director Diana Maurer at (202) 512-9627 or maurerd@gao.gov.
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