Information Technology and Cybersecurity: Significant Attention Is Needed to Address High-Risk Areas

What GAO Found

In its March 2021 high-risk series update, GAO reported that significant attention was needed to improve the federal government’s management of information technology (IT) acquisitions and operations, and ensure the nation’s cybersecurity. Regarding management of IT, overall progress in addressing this area has remained unchanged. Since 2019, GAO has emphasized that the Office of Management and Budget (OMB) and covered federal agencies need to continue to fully implement critical requirements of federal IT acquisition reform legislation, known as the Federal Information Technology Acquisition Reform Act (FITARA), to better manage tens of billions of dollars in IT investments. For example:

  • OMB continued to demonstrate leadership commitment by issuing guidance to implement FITARA statutory provisions, but sustained leadership and expanded capacity were needed to improve agencies’ management of IT.
  • Agencies continued to make progress with reporting FITARA milestones and plans to modernize or replace obsolete IT investments, but significant work remained to complete these efforts.
  • Agencies improved the involvement of their agency Chief Information Officers in the acquisition process, but greater cost savings could be achieved if IT acquisition shortcomings, such as reducing duplicative IT contracts, were addressed.

In March 2021, GAO reiterated the need for agencies to address four major cybersecurity challenges facing the nation: (1) establishing a comprehensive cybersecurity strategy and performing effective oversight, (2) securing federal systems and information, (3) protecting cyber critical infrastructure, and (4) protecting privacy and sensitive data. GAO identified 10 actions for agencies to take to address these challenges. However, since 2019, progress in this area has regressed—GAO’s 2021 rating of leadership commitment declined from met to partially met. To help address the leadership vacuum, in January 2021, Congress enacted a statute establishing the Office of the National Cyber Director. Although the director position has not yet been filled, on April 12 the President announced his intended nominee. Overall, the federal government needs to move with a greater sense of urgency to fully address cybersecurity challenges. In particular:

  • Develop and execute a more comprehensive federal strategy for national cybersecurity and global cyberspace. In September 2020, GAO reported that the cyber strategy and implementation plan addressed some, but not all, of the desirable characteristics of national strategies, such as goals and resources needed.
  • Mitigate global supply chain risks. In December 2020, GAO reported that few of the 23 civilian federal agencies it reviewed implemented foundational practices for managing information and communication technology supply chain risks.
  • Enhance the federal response to cyber incidents. In July 2019, GAO reported that most of 16 selected federal agencies had deficiencies in at least one of the activities associated with incident response processes.

Why GAO Did This Study

The effective management and protection of IT has been a longstanding challenge in the federal government. Each year, the federal government spends more than $100 billion on IT and cyber-related investments; however, many of these investments have failed or performed poorly and often have suffered from ineffective management.

Accordingly, GAO added improving the management of IT acquisitions and operations as a high-risk area in February 2015. Information security has been on the high-risk area since 1997. In its March 2021 high-risk update, GAO reported that significant actions were required to address IT acquisitions and operations. Further, GAO noted the urgent need for agencies to take 10 specific actions on four major cybersecurity challenges.

GAO was asked to testify on federal agencies’ efforts to address the management of IT and cybersecurity. For this testimony, GAO relied primarily on its March 2021 high-risk update and selected prior work across IT and cybersecurity topics.

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    Most commercial aircraft undergo voluntary inspections to ensure that galleys and lavatories are constructed and assembled to meet the Food and Drug Administration's (FDA) sanitation standards, according to industry representatives. Twenty-seven percent of the inspections FDA conducted between fiscal years 2015 and 2019 found objectionable conditions. But in nearly all of these instances, the conditions identified, such as the need for additional sealant in areas where there was a gap or seam, were corrected by the airline or aircraft manufacturer during the inspection. However, some regional airline representatives told GAO that their aircraft do not receive these construction inspections, either because larger airlines with which they have contracts told them the inspections were unnecessary or because they did not believe the inspections were relevant to them. FDA provides these inspections free of charge, upon request of aircraft manufacturers or airlines, and aircraft passing inspection receive a certificate of sanitary construction. Representatives of one aircraft manufacturer said they view the certificate as beneficial because their customers see it as a guarantee that the aircraft was constructed in a way that decreases the likelihood of microbial contamination, pests, and insects. While the construction inspections are important, they are not required, and FDA does not proactively encourage airlines to request them. By developing a process for communicating directly to all U.S.-based commercial airlines, including regional airlines, to encourage them to receive construction inspections, FDA could better ensure that aircraft meet FDA sanitation standards to protect passenger health. An Airline Representative Applying Additional Sealant in Response to an FDA Inspection FDA faces several challenges in providing construction inspections and is taking steps to address these challenges. For example, the demand for inspections by manufacturers and airlines is unpredictable, and FDA inspectors are responsible for inspections at multiple locations. To help mitigate these challenges, officials we interviewed from four FDA field offices said they usually request advance notice from industry to allow the agency time to allocate the necessary resources for construction inspections. Voluntary construction inspections are the primary mechanism by which FDA oversees compliance with its required sanitation standards for the construction of aircraft galleys and lavatories. A report accompanying the House 2019 Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations bill included a provision for GAO to review FDA's process for ensuring proper sanitation in aircraft galleys and lavatories. This report (1) examines the extent to which aircraft are inspected to ensure compliance with FDA's sanitation standards, and (2) discusses challenges FDA faces in providing aircraft inspections and how FDA is addressing such challenges. GAO reviewed FDA guidance, interviewed FDA officials in headquarters and four selected field offices with high volumes of construction inspections, conducted site visits to meet with FDA inspectors, and interviewed representatives of selected aircraft manufacturers and airlines. GAO recommends that FDA develop a process for communicating directly with all U.S.-based commercial airlines to encourage them to request construction inspections. FDA generally agreed with our recommendation. For more information, contact Steve Morris (202) 512-3841 MorrisS@gao.gov.
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  • F-35 Sustainment: DOD Needs to Address Key Uncertainties as It Re-Designs the Aircraft’s Logistics System
    In U.S GAO News
    The Autonomic Logistics Information System (ALIS) is integral to supporting F-35 aircraft operations and maintenance. However, F-35 personnel at 5 locations GAO visited for its March 2020 report cited several challenges. For example, users at all 5 locations we visited stated that electronic records of F-35 parts in ALIS are frequently incorrect, corrupt, or missing, resulting in the system signaling that an aircraft should be grounded in cases where personnel know that parts have been correctly installed and are safe for flight. At times, F-35 squadron leaders have decided to fly an aircraft when ALIS has signaled not to, thus assuming operational risk to meet mission requirements. GAO found that DOD had not (1) developed a performance-measurement process for ALIS to define how the system should perform or (2) determined how ALIS issues were affecting overall F-35 fleet readiness, which remains below warfighter requirements. DOD recognizes that ALIS needs improvement and plans to leverage ongoing re-design efforts to eventually replace ALIS with a new logistics system. However, as DOD embarks on this effort, it faces key technical and programmatic uncertainties (see figure). Uncertainties about the Future F-35 Logistics Information System These uncertainties are complicated and will require significant planning and coordination with the F-35 program office, military services, international partners, and the prime contractor. For example, GAO reported in March 2020 that DOD had not determined the roles of DOD and the prime contractor in future system development and management. DOD had also not made decisions about the extent to which the new system will be hosted in the cloud as opposed to onsite servers at the squadron level. More broadly, DOD has experienced significant challenges sustaining a growing F-35 fleet. GAO has made over 20 recommendations to address problems associated with ALIS, spare parts shortages, limited repair capabilities, and inadequate planning. DOD has an opportunity to re-imagine the F-35's logistics system and improve operations, but it must approach this planning deliberately and thoroughly. Continued attention to these challenges will help ensure that DOD can effectively sustain the F-35 and meet warfighter requirements. The F-35 Lightning II is DOD's most ambitious and costly weapon system in history, with total acquisition and sustainment costs for the three U.S. military services who fly the aircraft estimated at over $1.6 trillion. Central to F-35 sustainment is ALIS—a complex system that supports operations, mission planning, supply-chain management, maintenance, and other processes. A fully functional ALIS is critical to the more than 3,300 F-35 aircraft that the U.S. military services and foreign nations plan to purchase. Earlier this year, DOD stated that it intends to replace ALIS with a new logistics system. This statement highlights (1) current user challenges with ALIS and (2) key technical and programmatic uncertainties facing DOD as it re-designs the F-35's logistics system. This statement is largely based on GAO's March 2020 report on ALIS ( GAO-20-316 ), as well as previous F-35 sustainment work. GAO previously recommended that DOD develop a performance-measurement process for ALIS, track how ALIS is affecting F-35 fleet readiness, and develop a strategy for re-designing the F-35's logistics system. GAO also suggested that Congress consider requiring DOD to develop a performance-measurement process for its logistics system. DOD concurred with GAO's recommendations and is taking actions to address them. For more information, contact Diana C. Maurer at (202) 512-9627 or maurerd@gao.gov.
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    In Crime News
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  • DOD Health Care: DOD Should Monitor Implementation of Its Clinical Practice Guidelines
    In U.S GAO News
    As of October 2020, the Departments of Defense (DOD) and Veterans Affairs (VA) had jointly developed 22 clinical practice guidelines (VA/DOD CPG) that address specific health conditions, including those related to chronic diseases, mental health issues, pain management, and rehabilitation. Such guidelines are important as military and veteran populations may have different health care needs than civilians due to involvement in combat or occupational exposures (e.g., fumes from burn pits) that may amplify physical and psychological stresses. GAO found that DOD and VA considered the health care needs of these populations throughout the guideline development process and that the guidelines include information about these health care needs in different sections. In some cases, the guidelines include treatment recommendations that specifically address the health care needs of the military and veteran populations. In other instances, they may include information about the prevalence of a specific condition for these populations, among other information. Each of the military services (Army, Air Force, and Navy) has its own process for distributing VA/DOD CPGs to providers at their military treatment facilities (MTF). However, DOD's Defense Health Agency (DHA) is in the process of assuming administrative operations—to include distributing guidelines—for all of the military services' MTFs through an incremental transition process that is to be completed by the end of September 2021. While DHA officials acknowledged that they need to develop a uniform distribution process for the guidelines once they complete the transition, MTF providers can currently access the guidelines through VA's designated website and DOD's electronic health record systems. Congress directed DOD to implement VA/DOD CPGs, using means such as providing education and training, and to monitor MTFs' implementation of them. However, GAO found that DHA and the military services are not systematically monitoring MTFs' implementation of these guidelines. While the Army tracks VA/DOD CPG education and training at its MTFs, officials with DHA, the Navy, and the Air Force explained that they have not been monitoring MTF implementation of these guidelines. DHA officials acknowledged that they need to develop a monitoring process as they assume administrative and oversight responsibilities for the military services' MTFs, but have not yet developed a plan to do so. Without a systematic process to monitor MTF implementation of these guidelines, DHA does not know the extent to which MTF providers may be using VA/DOD CPGs to reduce the variability and improve the quality of health care services provided—factors that may contribute to better health outcomes across the military health system. Through DOD's TRICARE program, eligible beneficiaries may receive care from providers at MTFs or from civilian providers. The National Defense Authorization Act for Fiscal Year 2017 required DOD to establish a program to develop, implement, update, and monitor clinical practice guidelines, which are evidence-based treatment recommendations to improve the consistency and quality of care delivered by MTF providers. The Act also included a provision for GAO to assess issues related to the military health system, including the process of ensuring that providers adhere to clinical practice guidelines, and to report annually for 4 years. This is GAO's fourth report based on the Act. This report describes (1) how the process for developing the guidelines considers the health care needs of the military and veteran populations, (2) how they are distributed by the military services to their providers and how providers access them, and (3) the extent to which DHA and the military services monitor MTF implementation of them, among other things. GAO reviewed relevant policies and guidance; analyzed each of the 22 CPGs; and interviewed officials with DOD, the military services, and VA. GAO recommends that DHA work with the military services to develop and implement a systematic process to monitor MTFs' implementation of VA/DOD CPGs. DOD concurred with this recommendation. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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  • Federal Rulemaking: Selected EPA and HHS Regulatory Analyses Met Several Best Practices, but CMS Should Take Steps to Strengthen Its Analyses
    In U.S GAO News
    GAO reviewed 11 Executive Order (EO) 13771 rules—five significant Environmental Protection Agency (EPA) rules and six economically significant Department of Health and Human Services (HHS) rules. Seven of the 11 rules modified (i.e. repealed, amended, or delayed) existing rules (see table). GAO found that analyses for most of the seven rules monetized the same types of benefits and costs as analyses for the rules they modified, an indicator of consistency in the regulatory analyses. For example, one EPA rule modified an earlier rule that had established requirements for chemical risk management programs. EPA monetized anticipated changes to industry compliance costs for both rules. Where agencies monetized similar types of benefits and costs for both reviewed rules and modified rules, the value of some estimates differed, in part, because agencies had updated analytical assumptions, such as the number of entities subject to requirements or relevant wage data. Topics and Characteristics of 11 Environmental Protection Agency (EPA) and Department of Health and Human Services (HHS) Rules Selected for Review Agency Topics Modified existing rule(s) Monetized costs exceeded benefits EPA Risk management programs ● ○   Railroad ties as non-waste fuels ● ○   Chemical data reporting ● ●   Mercury reporting ○ ●   Effluent from dental offices ○ ● HHS, FDA Food labeling ● ○   Agricultural water requirements ● ● HHS, CMS End-stage renal disease treatment ● ●   Home health quality reporting ● ●   Patient discharge planning ○ ●   Diabetes prevention and appropriate use of imaging services ○ ● Legend: ● = Yes; ○ = No Source: GAO analysis of EPA, Food and Drug Administration (FDA), and Centers for Medicare & Medicaid Services (CMS) data. | GAO-21-151 Regulatory analyses for eight of the 11 rules GAO reviewed projected that monetized costs would exceed monetized benefits, though each identified other factors that may have led decision makers to determine that the total benefits justified the total costs, such as important, non-quantified effects. These eight analyses met about half of the selected best practices for economic analysis. However, some analyses developed by HHS's Centers for Medicare & Medicaid Services (CMS) did not fully meet best practices associated with analyzing regulatory alternatives, assessing important effects, and providing transparency. It is particularly important that agencies develop quality analyses for economically significant rules, such as those finalized by CMS. By meeting these best practices, CMS could help the public and other parts of government provide effective feedback and mitigate potential conflict with entities affected by rules. It could also help CMS assess whether a rule's benefits justify the costs. EO 13771 generally requires executive agencies to identify two rules for repeal for each new rule issued. Since EO 13771 went into effect in 2017, executive agencies have taken regulatory actions expected to generate over $50 billion in savings to society. Quality regulatory analysis provides agency decision makers and the public with a thorough assessment of the benefits and costs of different regulatory options. GAO was asked to review regulatory analyses for rules finalized under EO 13771. For selected agencies, this report examines (1) how the calculated economic effects of selected rules differed, if at all, from those of rules they modified; and (2) the extent to which agencies met best practices in analyzing the economic effects of selected rules for which monetized costs exceed monetized benefits. GAO reviewed analyses for 11 rules—and the rules they modified— finalized by EPA and HHS, the two agencies that finalized the most economically significant EO 13771 rules through fiscal year 2019. GAO compared analyses to selected best practices in GAO's Assessment Methodology for Economic Analysis . GAO recommends that CMS take steps to ensure its future regulatory analyses are consistent with best practices for analyzing alternatives, assessing important effects, and providing transparency. EPA said it appreciated GAO's findings. HHS generally agreed with the report, and CMS agreed with the recommendation directed to it. For more information, contact Yvonne D. Jones at (202) 512-6806 or jonesy@gao.gov.
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    In U.S Courts
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  • Prescription Drugs: Department of Veterans Affairs Paid About Half as Much as Medicare Part D for Selected Drugs in 2017
    In U.S GAO News
    GAO found that the Department of Veterans Affairs (VA) paid, on average, 54 percent less per unit for a sample of 399 brand-name and generic prescription drugs in 2017 as did Medicare Part D, even after accounting for applicable rebates and price concessions in the Part D program. GAO also found that 233 of the 399 drugs in the sample were at least 50 percent cheaper in VA than in Medicare, and 106 drugs were at least 75 percent cheaper. Only 43 drugs were cheaper in Medicare than in VA. The percent difference in price between the two programs was greater on average for generic drugs. Specifically, VA's prices were 68 percent lower than Medicare prices for the 203 generic drugs (an average difference of $0.19 per unit) and 49 percent lower for the 196 brand-name drugs (an average difference of $4.11 per unit). Average Per-Unit Net Prices Paid by Department of Veterans Affairs and Medicare Part D for Selected Drugs, 2017 Note: GAO's sample of 399 drugs included the top 100 brand-name and generic drugs in Medicare Part D in 2017, by: (1) highest expenditures; (2) highest utilization (by quantities dispensed); and (3) highest cost-per use. Per-unit prices are weighted to reflect differences in utilization in the two programs. Medicare prices reflect expenditures after accounting for rebates and other price concessions. While there are many factors that impact prices in the complex drug market, GAO identified several key program features that may contribute to the consistent price differential between VA and Medicare Part D. For example, Medicare's beneficiaries are divided among numerous prescription drug plans, which each negotiate drug prices with manufacturers. In contrast, VA is a single integrated health system with a unified list of covered drugs—thereby possibly strengthening its bargaining position when negotiating. In addition, VA has access to significant discounts defined by law, and can then negotiate further for lower prices. These discount prices are not available to Medicare Part D plans. GAO provided a draft of this product to HHS and VA for comment. Both agencies provided technical comments, which GAO incorporated as appropriate. In 2017, combined, Medicare Part D and VA accounted for approximately $105 billion in prescription drug sales—nearly one-third of total U.S. expenditures—and covered nearly 52 million individuals. The two programs use different methods to pay for prescription drugs. Medicare reimburses Part D plan sponsors, which in turn pay pharmacies to dispense drugs. VA primarily uses a direct purchase approach to acquire drugs from manufacturers. GAO was asked to examine differences in the amounts major federal programs paid for prescription drugs. This report: (1) compares average unit prices for prescription drugs in Medicare Part D to those in the VA; and (2) describes factors affecting prices in the two programs. GAO analyzed (1) CMS data for Medicare Part D payments to retail pharmacies as well as rebates and other price concessions Part D plans received and (2) VA drug purchasing data. These data were from 2017, the most recent data available at the time of GAO's analysis. To select a sample of drugs GAO identified the top 100 brand-name and 100 generic drugs in Medicare Part D in 2017 for three categories: (1) highest expenditure, (2) highest utilization, and (3) highest cost-per use. In total, this yielded 399 non-duplicate drugs (203 generic and 196 brand-name), which represented 44 percent of Medicare Part D spending in 2017. GAO compared weighted average unit prices for these drugs. GAO interviewed CMS and VA officials, and reviewed academic and government reports to understand factors that may affect prices in the two programs. For more information, contact John Dicken at (202) 512-7114 or dickenj@gao.gov.
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