Global Entry for UK Citizens

How to Apply for Global Entry:Citizens of the United Kingdom are eligible for Global Entry. Applications must be submitted through CBP’s Trusted Traveler Programs (TTP) website. The non-refundable application fee for a five-year Global Entry…

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  • Texas Heart Hospital and Wholly-Owned Subsidiary THHBP Management Company LLC to Pay $48 Million to Settle False Claims Act Allegations Related to Alleged Kickbacks
    In Crime News
    Texas Heart Hospital of the Southwest LLP, a partially physician-owned hospital in Plano, Texas, and its wholly owned subsidiary, THHBP Management Company, LLC (collectively, the “Heart Hospital”) have agreed to pay the United States $48 million to resolve claims that the Heart Hospital violated the False Claims Act by knowingly submitting claims to the Medicare program that resulted from violations of the Physician Self-Referral Law and the Anti Kickback Statute, the Justice Department announced today.
    [Read More…]
  • Justice Department Settles Claims Against City of Meriden, Connecticut, Involving Denial of Mosque
    In Crime News
    The Justice Department and the U.S. Attorney’s Office for the District of Connecticut today announced an agreement with the City of Meriden, Connecticut to resolve allegations that the city violated the Religious Land Use and Institutionalized Persons Act of 2000 (RLUIPA) by denying the application of the Omar Islamic Center to establish a mosque in March 2019, and by maintaining a zoning code that treats religious assemblies and institutions on less than equal terms with nonreligious assemblies and institutions in nine zoning districts.
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  • Fair Labor Standards Act: Observations on the Effects of the Home Care Rule
    In U.S GAO News
    In response to the Department of Labor's Home Care Rule—which extended Fair Labor Standards Act (FLSA) minimum wage and overtime protections to more home care workers—some states made changes in their Medicaid programs, according to studies and GAO interviews with stakeholders and selected state officials. Many stakeholders said the rule led some states to limit home care workers' hours in their Medicaid programs to avoid overtime costs. For example, in Oregon, newly hired home care workers provided through Medicaid were generally limited to 40 hours per week, according to state documentation. Some states also budgeted additional funds for overtime pay. In addition, according to a few stakeholder groups, some states changed service delivery in their Medicaid programs, for example, by discontinuing services such as live-in care. In contrast, several stakeholders said some states did not make any major changes to their Medicaid programs' home care services. Provider agencies, workers, and consumers experienced changes after the Home Care Rule took effect. Specifically, some provider agencies restricted workers' hours to limit overtime costs, though this can result in the need to hire more workers, leading to increased costs of recruiting, training, and scheduling, according to several stakeholders. GAO's analysis of national survey data found that home care workers, when compared to occupations with similar education and training requirements, were more likely to work full-time but did not earn significantly higher earnings following the Home Care Rule (see figure). Many stakeholders GAO spoke with described ongoing challenges consumers face in obtaining home care services, such as difficulty finding workers to hire. Estimated Median Weekly Earnings of Employed Workers, 2010 through 2019 Note: The margins of error at the 95 percent confidence level are within plus or minus 7.2 percent of the estimate itself. Employment in home care is projected to grow nearly 40 percent over the next decade to meet demand from an increasing population of older adults and people with disabilities. Home care workers help those who need assistance with activities of daily living such as dressing, eating, or bathing. State Medicaid programs may allow home care for eligible individuals as an alternative to institutional care. The Department of Labor's (DOL) Home Care Rule, which went into effect in 2015, extended FLSA protections to more home care workers. GAO was asked to review the implementation and effects of the Home Care Rule. This report examines what is known about (1) changes states made to their Medicaid programs in response to the Home Care Rule; and (2) the Home Care Rule's effect on home care provider agencies, workers, and consumers. To address these objectives, GAO analyzed 2010 through 2019 national survey data on workers' hours and wages; interviewed stakeholders from 15 organizations that represent the different groups affected, DOL officials, and home care program officials from three states selected based on variation in their Medicaid programs and minimum wage levels; and reviewed studies on state strategies to implement the Home Care Rule. For more information, contact Melissa Emrey-Arras at (617) 788-0534 or emreyarrasm@gao.gov.
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  • Counselor Brechbuhl’s Travel to Mexico, Panama, and Uruguay
    In Crime Control and Security News
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  • Whistleblower Protection: Actions Needed to Strengthen Selected Intelligence Community Offices of Inspector General Programs
    In U.S GAO News
    The six Intelligence Community (IC)-element Offices of Inspectors General (OIG) that GAO reviewed collectively received 5,794 complaints from October 1, 2016, through September 30, 2018, and opened 960 investigations based on those complaints. Of the 960 investigations, IC-element OIGs had closed 873 (about 91 percent) as of August 2019, with an average case time ranging from 113 to 410 days to complete. Eighty-seven cases remained open as of August 2019, with the average open case time being 589 days. The number of investigations at each IC-element OIG varied widely based on factors such as the number of complaints received and each OIG's determination on when to convert a complaint into an investigation. An OIG may decide not to convert a complaint into an investigation if the complaint lacks credibility or sufficient detail, or may refer the complainant to IC-element management or to another OIG if the complaint involves matters that are outside the OIG's authority to investigate. Four of the IC-element OIGs—the Central Intelligence Agency (CIA) OIG, the Defense Intelligence Agency (DIA) OIG, the National Reconnaissance Office (NRO) OIG, and the National Security Agency (NSA) OIG—have a 180-days or fewer timeliness objective for their investigations. The procedures for the remaining two OIGs—the Inspector General of the Intelligence Community (ICIG) and the National Geospatial-Intelligence Agency (NGA) OIG—state that investigations should be conducted and reported in a timely manner. Other than those prescribed by statute, the ICIG and NGA OIG have not established timeliness objectives for their investigations. Establishing timeliness objectives could improve the OIGs' ability to efficiently manage investigation time frames and to inform potential whistleblowers of these time frames. All of the selected IC-element OIG investigations units have implemented some quality assurance standards and processes, such as including codes of conduct and ethical and professional standards in their guidance. However, the extent to which they have implemented processes to maintain guidance, conduct routine quality assurance reviews, and plan investigations varies (see table). Implementation of Quality Assurance Standards and Practices by Selected IC-element OIG Investigations Units   ICIG CIA OIG DIA OIG NGA OIG NRO OIG NSA OIG Regular updates of investigation guidance or procedures — — — ✓ — ✓ Internal quality assurance review routinely conducted — — ✓ — — — External quality assurance review routinely conducted — ✓ — — — — Required use of documented investigative plans ✓ ✓ ✓ ✓ — ✓ Legend: ✓ = standard or practice implemented; — = standard or practice not implemented. Source: GAO analysis of IC-element OIG investigative policies and procedures. | GAO-20-699 The Council of Inspectors General on Integrity and Efficiency's (CIGIE) Quality Standards for Investigations states that organizations should facilitate due professional care by establishing written investigative policies and procedures via handbooks, manuals, or similar mechanisms that are revised regularly according to evolving laws, regulations, and executive orders. By establishing processes to regularly update their procedures, the ICIG, CIA OIG, DIA OIG, and NRO OIG could better ensure that their policies and procedures will remain consistent with evolving laws, regulations, Executive Orders, and CIGIE standards. Additionally, CIGIE's Quality Standards for Federal Offices of Inspector General requires OIGs to establish and maintain a quality assurance program. The standards further state that internal and external quality assurance reviews are the two components of an OIG's quality assurance program, which is an evaluative effort conducted by reviewers independent of the unit being reviewed to ensure that the overall work of the OIG meets appropriate standards. Developing quality assurance programs that incorporate both types of reviews, as appropriate, could help ensure that the IC-element OIGs adhere to OIG procedures and prescribed standards, regulations, and legislation, as well as identify any areas in need of improvement. Further, CIGIE Quality Standards for Investigations states that case-specific priorities must be established and objectives developed to ensure that tasks are performed efficiently and effectively. CIGIE's standards state that this may best be achieved, in part, by preparing case-specific plans and strategies. Establishing a requirement that investigators use documented investigative plans for all investigations could facilitate NRO OIG management's oversight of investigations and help ensure that investigative steps are prioritized and performed efficiently and effectively. CIA OIG, DIA OIG, and NGA OIG have training plans or approaches that are consistent with CIGIE's quality standards for investigator training. However, while ICIG, NRO OIG, and NSA OIG have basic training requirements and tools to manage training, those OIGs have not established training requirements for their investigators that are linked to the requisite knowledge, skills, and abilities, appropriate to their career progression, and part of a documented training plan. Doing so would help the ICIG, NRO OIG, and NSA OIG ensure that their investigators collectively possess a consistent set of professional proficiencies aligned with CIGIE's quality standards throughout their entire career progression. Most of the IC-element OIGs GAO reviewed consistently met congressional reporting requirements for the investigations and semiannual reports GAO reviewed. The ICIG did not fully meet one reporting requirement in seven of the eight semiannual reports that GAO reviewed. However, its most recent report, which covers April through September 2019, met this reporting requirement by including statistics on the total number and type of investigations it conducted. Further, three of the six selected IC-element OIGs—the DIA, NGA, and NRO OIGs—did not consistently document notifications to complainants in the reprisal investigation case files GAO reviewed. Taking steps to ensure that notifications to complainants in such cases occur and are documented in the case files would provide these OIGs with greater assurance that they consistently inform complainants of the status of their investigations and their rights as whistleblowers. Whistleblowers play an important role in safeguarding the federal government against waste, fraud, and abuse. The OIGs across the government oversee investigations of whistleblower complaints, which can include protecting whistleblowers from reprisal. Whistleblowers in the IC face unique challenges due to the sensitive and classified nature of their work. GAO was asked to review whistleblower protection programs managed by selected IC-element OIGs. This report examines (1) the number and time frames of investigations into complaints that selected IC-element OIGs received in fiscal years 2017 and 2018, and the extent to which selected IC-element OIGs have established timeliness objectives for these investigations; (2) the extent to which selected IC-element OIGs have implemented quality standards and processes for their investigation programs; (3) the extent to which selected IC-element OIGs have established training requirements for investigators; and (4) the extent to which selected IC-element OIGs have met notification and reporting requirements for investigative activities. This is a public version of a sensitive report that GAO issued in June 2020. Information that the IC elements deemed sensitive has been omitted. GAO selected the ICIG and the OIGs of five of the largest IC elements for review. GAO analyzed time frames for all closed investigations of complaints received in fiscal years 2017 and 2018; reviewed OIG policies, procedures, training requirements, and semiannual reports to Congress; conducted interviews with 39 OIG investigators; and reviewed a selection of case files for senior leaders and reprisal cases from October 1, 2016, through March 31, 2018. GAO is making 23 recommendations, including that selected IC-element OIGs establish timeliness objectives for investigations, implement or enhance quality assurance programs, establish training plans, and take steps to ensure that notifications to complainants in reprisal cases occur. The selected IC-element OIGs concurred with the recommendations and discussed steps they planned to take to implement them. For more information, contact Brenda S. Farrell at (202) 512-3604, farrellb@gao.gov or Brian M. Mazanec at (202) 512-5130, mazanecb@gao.gov.
    [Read More…]
  • Native American Youth: Agencies Incorporated Almost All Leading Practices When Assessing Grant Programs That Could Prevent or Address Delinquency [Reissued with revisions on Aug. 27, 2020.]
    In U.S GAO News
    The Departments of Justice (DOJ), Health and Human Services (HHS), the Interior (Interior), and Education (Education) administered at least 38 grant programs from fiscal years 2015 through 2018 that could have helped prevent or address delinquency among Native American youth. These agencies made about $1.9 billion in awards to grantees through these programs during this period. These agencies incorporated almost all of the leading practices GAO identified for performance measurement or program evaluation when assessing the performance of selected grant programs. For example, HHS's Administration for Children and Families (ACF) incorporated 13 of the 14 leading practices for performance measurement but did not fully assess grantee data reliability for one of its programs. By developing a process to assess the reliability of grantee data contained in the annual performance reports that tribal recipients submit, ACF could obtain further assurance that it has an accurate representation of grantee performance. GAO also found that Interior's Bureau of Indian Education (BIE) did not conduct formal data reliability checks on performance data that grantees report and did not always collect performance reports from grantees in a timely manner for one of its programs. By developing a process to assess the reliability of a sample of grantee performance data and taking steps to alert grantees when they are late in submitting performance reports, BIE could better ensure that grantees are complying with the terms and conditions of the grant program and better understand how the program and its grantees are performing. Officials in all 12 interviews with tribes or tribal consortia GAO interviewed cited risk factors that contribute to juvenile delinquency in their communities. Number of Interviews in Which Tribal Officials Cited Risk Factors Contributing to Juvenile Delinquency Note: The figure includes the most common risk factors tribal officials cited for juvenile delinquency. While tribal officials cited restrictions placed on federal grant funding, difficulty communicating with program staff, and challenges hiring and retaining staff as barriers to implementing federal programs, they also identified promising practices, such as executing culturally relevant programs, for preventing or addressing juvenile delinquency. Federal and other studies have noted that exposure to violence and substance abuse make Native American youth susceptible to becoming involved with the justice system. GAO was asked to examine federal and tribal efforts to address juvenile delinquency and the barriers tribes face in doing so. This report examines (1) federal financial assistance targeting tribes that could prevent or address juvenile delinquency; (2) the extent to which federal agencies assess the performance of selected grant programs and incorporate leading practices; and (3) the juvenile delinquency challenges tribes report facing. GAO identified relevant grant programs during fiscal years 2015 through 2018—the most recent data available when GAO began the review. GAO analyzed documents and interviewed agency officials to determine how they assessed grant program performance and conducted interviews with 10 tribes and two tribal consortia to discuss challenges with delinquency. GAO is making three recommendations, including that relevant HHS and Interior offices develop a process to assess the reliability of tribal grantee performance information and that an Interior office take steps to alert grantees that are late in submitting progress reports. Interior concurred with the two recommendations. HHS disagreed with GAO's recommendation. GAO clarified the recommendation to HHS and continues to believe it is warranted. For more information, contact Gretta L. Goodwin, (202) 512-8777, or GoodwinG@gao.gov.
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  • Secretary Pompeo’s Call with Bolivian President-elect Arce
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  • Aviation Safety: Actions Needed to Evaluate Changes to FAA’s Enforcement Policy on Safety Standards
    In U.S GAO News
    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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  • Lesotho National Day
    In Crime Control and Security News
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  • Department Of Justice And U.S. Patent And Trademark Office To Host Public Workshop On Promoting Innovation In The Life Science Sector
    In Crime News
    The Justice Department’s Antitrust Division (DOJ) and the U.S. Patent and Trademark Office (USPTO) will host a virtual public workshop on Sept. 23rd and 24th, 2020 to discuss the importance of intellectual property rights and pro-competitive collaborations for life sciences companies, research institutions, and American consumers. 
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  • Justice Department Settles Sexual Harassment and Retaliation Lawsuit Securing $342,500 for Two Female Firefighters and Changes to the Houston Fire Department’s Training Practices
    In Crime News
    The Justice Department announced today that it has reached a settlement with the City of Houston resolving allegations that personnel at Houston Fire Department (HFD) Station 54 discriminated and retaliated against former firefighter Jane Draycott in violation of Title VII of the Civil Rights Act of 1964. Title VII is a federal statute that prohibits employment discrimination on the basis of race, color, national origin, sex and religion.   
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  • Justice Department Sues Monopolist Google For Violating Antitrust Laws
    In Crime News
    Today, the Department of Justice — along with eleven state Attorneys General — filed a civil antitrust lawsuit in the U.S. District Court for the District of Columbia to stop Google from unlawfully maintaining monopolies through anticompetitive and exclusionary practices in the search and search advertising markets and to remedy the competitive harms. The participating state Attorneys General offices represent Arkansas, Florida, Georgia, Indiana, Kentucky, Louisiana, Mississippi, Missouri, Montana, South Carolina, and Texas.
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  • Former Resident of Stockton, California Sentenced to More Than 15 Years in Prison for Human Trafficking Convictions Related to Forced Labor of Foreign Nationals
    In Crime News
    Sharmistha Barai, 40, formerly of Stockton, California, was sentenced Friday, Oct. 2 to 15 years and eight months in prison for forced labor violations.
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  • Federal Courts Participate in Audio Livestream Pilot
    In U.S Courts
    Thirteen district courts around the country will livestream audio of select proceedings in civil cases of public interest next year as part of a two-year pilot program.
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  • Sussex County Woman Charged with Concealing Terrorist Financing to Syrian Al-Nusra Front, a Foreign Terrorist Organization
    In Crime News
    A Sussex County, New Jersey, woman, Maria Bell, a/k/a “Maria Sue Bell,” 53, of Hopatcong, New Jersey, was arrested at her home today and charged with one count of knowingly concealing the provision of material support and resources to a Foreign Terrorist Organization Assistant Attorney General for National Security John C. Demers and U.S. Attorney Craig Carpenito for the District of New Jersey announced.
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  • Elder Justice: HHS Could Do More to Encourage State Reporting on the Costs of Financial Exploitation
    In U.S GAO News
    Most state Adult Protective Services (APS) agencies have been providing data on reports of abuse to the Department of Health and Human Services (HHS), including data on financial exploitation, although some faced challenges collecting and submitting these data. Since states began providing data to HHS's National Adult Maltreatment Reporting System (NAMRS) in 2017, they have been voluntarily submitting more detailed data on financial exploitation and perpetrators each year (see figure). However, some APS officials GAO interviewed in selected states said collecting data is difficult, in part, because victims are reluctant to implicate others, especially family members or other caregivers. APS officials also said submitting data to NAMRS was challenging initially because their data systems often did not align with NAMRS, and caseworkers may not have entered data in the system correctly. HHS has provided technical assistance and grant funding to help states address some of these challenges and help provide a better picture of the prevalence of the various types of financial exploitation and its perpetrators nationwide. Number of States That Provide Data on Financial Exploitation and Perpetrators to NAMRS Studies estimate some of the costs of financial exploitation to be in the billions, but comprehensive data on total costs do not exist and NAMRS does not currently collect cost data from APS agencies. The Consumer Financial Protection Bureau found actual losses and attempts at elder financial exploitation reported by financial institutions nationwide were $1.7 billion in 2017. Also, studies published from 2016 to 2020 from three states—New York, Pennsylvania, and Virginia—estimated the costs of financial exploitation could be more than $1 billion in each state alone. HHS does not currently ask states to submit cost data from APS casefiles to NAMRS, though officials said they have begun to reevaluate NAMRS with state APS agencies and other interested parties, including researchers, and may consider asking states to submit cost data moving forward. Adding cost data to NAMRS could make a valuable contribution to the national picture of the cost of financial exploitation. Recognizing the importance of these data, some APS officials GAO interviewed said their states have developed new data fields or other tools to help caseworkers collect and track cost data more systematically. HHS officials said they plan to share this information with other states to make them aware of practices that could help them collect cost data, but they have not established a timeframe for doing so. Elder financial exploitation—the fraudulent or illegal use of an older adult's funds or property—has far-reaching effects on victims and society. Understanding the scope of the problem has thus far been hindered by a lack of nationwide data. In 2013, HHS worked with states to create NAMRS, a voluntary system for collecting APS data on elder abuse, including financial exploitation. GAO was asked to study the extent to which NAMRS provides information on elder financial exploitation. This report examines (1) the status of HHS's efforts to compile nationwide data through NAMRS on the extent of financial exploitation and the challenges involved, and (2) what is known about the costs of financial exploitation to victims and others. GAO analyzed NAMRS data from fiscal year 2016 through 2019 (the most recent available); reviewed relevant federal laws; and interviewed officials from HHS, other federal agencies, elder abuse prevention organizations, and researchers. GAO also reviewed APS documents and spoke with officials in eight states, selected based on their efforts to study, collect, and report cost data; and reviewed studies on financial exploitation. GAO recommends that HHS (1) work with state APS agencies to collect and submit cost data to NAMRS, and (2) develop a timeframe to share states' tools to help collect cost data. HHS did not agree with the first recommendation, but GAO maintains that it is warranted, as discussed in the report. HHS agreed with the second recommendation. For more information, contact Kathryn A. Larin at (202) 512-7215 or larink@gao.gov.
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  • Syria Sanctions Designations on the Anniversary of Assad’s Attack Against the People of Douma, Syria
    In Crime Control and Security News
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  • Japanese Shipping Company Fined $1.5 Million for Concealing Illegal Discharges of Oily Water
    In Crime News
    Misuga Kaiun Co. Ltd. (MISUGA), a Japanese-based company engaged in international shipping, was sentenced yesterday in federal court before U.S. District Court Judge Paul G. Byron in Orlando, Florida.
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  • Colorado Man Convicted of Production, Transportation, and Possession of Child Pornography
    In Crime News
    An Englewood, Colorado, resident was convicted today after a three-day jury trial on six child exploitation offenses, announced Acting Assistant Attorney General Brian C. Rabbitt of the Justice Department’s Criminal Division and U.S. Attorney Gregg Sofer of the Western District of Texas.
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  • Justice Department and FTC Announce First Enforcement Actions for Violations of the Better Online Ticket Sales Act
    In Crime News
    The Department of Justice, together with the Federal Trade Commission (FTC), today announced three settlements resolving alleged violations of the Better Online Ticket Sales (BOTS) Act. These are the first enforcement actions that the department and the FTC have brought under the BOTS Act.
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  • Unaccompanied Children: Actions Needed to Improve Grant Application Reviews and Oversight of Care Facilities
    In U.S GAO News
    The Office of Refugee Resettlement's (ORR) grant announcements soliciting care providers for unaccompanied children—those without lawful immigration status and without a parent or guardian in the U.S. available to provide care and physical custody for them—lack clarity about what state licensing information is required. Further, ORR does not systematically confirm the information submitted by applicants or document a review of their past performance on ORR grants, when applicable, according to GAO's analysis of ORR documents and interviews with ORR officials. The grant announcements do not specify how applicants without a state license should show license eligibility—a criterion for receiving an ORR grant—or specify what past licensing allegations and concerns they must report. In addition, the extent to which ORR staff verify applicants' licensing information is unclear. In fiscal years 2018 and 2019, ORR awarded grants to approximately 14 facilities that were unable to serve children for 12 or more months because they remained unlicensed. In addition, ORR did not provide any documentation that staff conducted a review of past performance for the nearly 70 percent of applicants that previously held ORR grants. Without addressing these issues, ORR risks awarding grants to organizations that cannot obtain a state license or that have a history of poor performance. State licensing agencies regularly monitor ORR-funded facilities, but according to GAO's survey of these agencies, their information sharing with ORR is limited (see figure). State licensing agencies and ORR staff both said that improved information sharing would benefit their monitoring of facilities. Without such improvements, ORR may lack information about ongoing issues at its facilities. Key Survey Responses on Information-Sharing with the Office of Refugee Resettlement (ORR) by the 23 State Agencies That Licensed ORR-Funded Facilities in Fall 2019 ORR requires grantees to take corrective action to address noncompliance it identifies through monitoring, but ORR has not met some of its monitoring goals or notified grantees of the need for corrective actions in a timely manner. For example, under ORR regulations, each facility is to be audited for compliance with standards to prevent and respond to sexual abuse and harassment of children by February 22, 2019, but by April 2020, only 67 of 133 facilities had been audited. In fiscal years 2018 and 2019, ORR also did not meet its policy goals to visit each facility at least every 2 years, or to submit a report to facilities on any corrective actions identified within 30 days of a visit. Without further action, ORR will continue to not meet its own monitoring goals, which are designed to ensure the safety and well-being of children in its care. ORR is responsible for the care and placement of unaccompanied children in its custody, which it provides through grants to state-licensed care provider facilities. ORR was appropriated $1.3 billion for this program in fiscal year 2020. GAO was asked to review ORR's grant making process and oversight of its grantees. This report examines (1) how ORR considers state licensing issues and past performance in its review of grant applications; (2) state licensing agencies' oversight of ORR grantees, and how ORR and states share information; and (3) how ORR addresses grantee noncompliance. GAO reviewed ORR grant announcements and applications for fiscal years 2018 and 2019. GAO conducted a survey of 29 state licensing agencies in states with ORR facilities, and reviewed ORR monitoring documentation and corrective action reports. GAO also reviewed ORR guidance and policies, as well as relevant federal laws and regulations, and interviewed ORR officials. GAO is making eight recommendations to ORR on improving clarity in its grant announcements, communication with state licensing agencies, and monitoring of its grantees. ORR agreed with all eight recommendations. For more information, contact Kathryn A. Larin at (202) 512-7215 or larink@gao.gov.
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  • Private Health Coverage: Results of Covert Testing for Selected Offerings
    In U.S GAO News
    GAO performed 31 covert tests to selected sales representatives and stated that we had pre-existing conditions, such as diabetes or heart disease, and we requested coverage for these conditions to see if the sales representative directed GAO's undercover agents to a comprehensive Patient Protection and Affordable Care Act (PPACA)-compliant plan, or a PPACA-exempt plan that does not cover what we requested. As part of these tests, GAO gauged whether sales representatives engaged in potentially deceptive practices, such as making false or misleading statements about coverage or omitting material information about coverage. The results of the covert tests ranged from sales representatives appropriately explaining to GAO's undercover agents that a PPACA-exempt plan would not cover the pre-existing condition the undercover agents stated that they had, to engaging in potentially deceptive marketing practices that misrepresented or omitted information about the products they were selling. Specifically, in 21 of 31 covert tests, the sales representative appropriately referred undercover agents to a PPACA-compliant plan. In two of 31 covert tests, the sales representatives did not appear to engage in deceptive marketing practices but were not always consistent or clear in their explanation of the type of coverage and plans they were selling. In the remaining eight of 31 covert tests, the sales representatives engaged in potentially deceptive marketing practices, such as claiming the pre-existing condition was covered when the health plan documents GAO received after purchase said otherwise. GAO plans to refer these eight cases of potential deceptive marketing practices to the Federal Trade Commission (FTC) and corresponding state insurance commissioners' offices for follow-up as appropriate. Millions of Americans obtain health insurance coverage in the individual market, which consists mainly of private plans sold directly to consumers without access to group coverage. While generally regulated by states, starting in 2014, PPACA established a number of new federal requirements for the individual health insurance market. For example, PPACA prohibited insurers from excluding coverage or charging higher premiums for pre-existing conditions and required that individual market plans cover a set of essential health benefits, including coverage for mental health and substance abuse disorder services, prescription drugs, and maternity and newborn care. Certain types of health coverage arrangements that can be sold directly to consumers do not have to comply with some or all of PPACA's individual market requirements and, as a result, may be less expensive, but also offer more limited benefits compared to PPACA-compliant plans. Recent changes to federal law and regulations could result in the increased use of PPACA-exempt health coverage arrangements as alternatives to PPACA-compliant plans in the individual market. For example, in 2018, federal regulations expanded the availability of short term, limited duration insurance (STLDI) plans, a type of PPACA-exempt arrangement. In addition, starting January 1, 2019, individuals who fail to maintain "minimum essential coverage," as required by PPACA, no longer face a tax penalty. Further, the devastating economic effects of the Coronavirus Disease 2019 (COVID-19) pandemic could create additional demand for affordable health coverage, including PPACA-exempt plans.  With these changes, and because of their lower relative costs, PPACA-exempt health coverage arrangements may be attractive to consumers, particularly those who find it difficult to afford PPACA-compliant plans. However, such arrangements generally do not need to follow PPACA's requirement that plans in the individual market be presented to consumers in defined categories outlining the extent to which they are expected to cover medical care. As a result, depending on how they are marketed and sold, PPACA-exempt arrangements could present risks for consumers, if, for example, they buy them mistakenly believing that coverage is as comprehensive as for PPACA-compliant plans. GAO was asked to obtain insights on the marketing and sales practices of insurance sales representatives who sell PPACA-exempt plans. In this report, GAO describes the results of covert tests we conducted involving selected sales representatives, when contacted by individuals stating that they had pre-existing conditions. In this regard, GAO agents performed a number of covert tests (i.e., undercover phone calls) from November 2019 through January 2020 posing as individuals needing to purchase health insurance to cover pre-existing conditions. GAO also discussed the marketing and oversight of PPACA-exempt arrangements with senior officials from federal agencies, including the FTC, and Centers of Medicare and Medicaid Services (CMS) within the Department of Health and Human Services (HHS), as well as the National Association of Insurance Commissioners (NAIC)5. GAO provided a draft of this product to FTC, HHS, and NAIC for review and comment. FTC, HHS, and NAIC provided technical comments, which GAO incorporated as appropriate. HHS provided additional written comments on a draft of this report. For more information, contact Seto Bagdoyan at (202)-6722 or bagdoyans@gao.gov.
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    The Small Business Administration (SBA) develops its subsidy cost estimates for the 7(a) loan guarantee program—that is, estimates of the program's net long-term cost to the government—using a cash flow model. The model uses historical data, econometric equations, and macroeconomic projections to estimate cash flows—such as guarantee fees, SBA purchases of defaulted loans, and recoveries on those loans—for the loans SBA expects to guarantee in the next fiscal year. The net present value of the cash flows (value in current dollars) is the subsidy cost estimate. SBA generally incorporated key elements of subsidy cost estimation into its estimates for the 7(a) program for the fiscal year 2020 budget. Specifically, GAO found that SBA's estimation process was largely consistent with eight key elements GAO previously identified that help ensure subsidy estimates are supported, reliable, and reasonable. For example, SBA generally validated historical data, documented the cash flow model and key assumptions, analyzed the sensitivity of estimates to alternative assumptions, and had documented policies and procedures. SBA made changes in its estimation process that collectively increased the 7(a) program's subsidy cost to $99 million for fiscal year 2020 (a 0.33 percent subsidy rate when expressed as the cost per dollar of credit assistance) from $0 for fiscal year 2019 (0 percent subsidy rate). Some of these changes were routine updates to data and economic assumptions used in the cash flow model, while others were revisions to the estimation process. Additionally, some individual changes increased the subsidy costs, while others decreased it. Some of the changes that had the largest impact on the subsidy rate included the following: Incorporating the President's economic assumptions for fiscal year 2020 decreased the rate by 0.27 percentage points. Updating the basis for the size and composition of the loan cohort SBA expected to guarantee in fiscal year 2020 increased the rate by 0.21 percentage points. Revising the methodology for estimating purchase amounts for defaulted loans to better reflect the outstanding loan balance at the time of purchase increased the rate by 0.21 percentage points. The 7(a) program is SBA's largest loan guarantee program for small businesses, with about $95 billion in outstanding loan principal as of the end of fiscal year 2019. Federal agencies that provide credit assistance are generally required to estimate the net long-term cost to the government—known as the subsidy cost—for each annual cohort of loans. SBA initially estimated a zero subsidy cost for each cohort from fiscal years 2014 through 2019, but estimated that the fiscal year 2020 cohort would have a positive subsidy cost and require appropriations. GAO was asked to evaluate SBA's subsidy estimation process for the 7(a) program. This report examines (1) how SBA estimates 7(a) subsidy costs, (2) the extent to which SBA incorporated key elements of subsidy cost estimation into its estimation process for the fiscal year 2020 budget, and (3) the changes SBA made in its estimation process for the fiscal year 2020 budget. GAO reviewed SBA documentation on its estimation process, including information on SBA's cash flow model, and compared SBA's process to key elements that GAO previously identified ( GAO-16-269 ). GAO also interviewed officials from SBA, the Office of Management and Budget, and outside auditors and contractors that annually review SBA's process and model. For more information, contact William B. Shear at (202) 512-8678 or shearw@gao.gov.
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    Fifth-generation (5G) wireless networks promise to provide significantly greater speeds and higher capacity to accommodate more devices. In addition, 5G networks are expected to be more flexible, reliable, and secure than existing cellular networks. The figure compares 4G and 5G performance goals along three of several performance measures. Note: Megabits per second (Mbps) is a measure of the rate at which data is transmitted, milliseconds (ms) is a measure of time equal to one thousandth of a second, and square kilometer (km²) is a measure of area. As with previous generations of mobile wireless technology, the full performance of 5G will be achieved gradually as networks evolve over the next decade. Deployment of 5G network technologies in the U.S. began in late 2018, and these initial 5G networks focus on enhancing mobile broadband. These deployments are dependent on the existing 4G core network and, in many areas, produced only modest performance improvements. To reach the full potential of 5G, new technologies will need to be developed. International bodies that have been involved in defining 5G network specifications will need to develop additional 5G specifications and companies will need to develop, test, and deploy these technologies. GAO identified the following challenges that can hinder the performance or usage of 5G technologies in the U.S. GAO developed six policy options in response to these challenges, including the status quo. They are presented with associated opportunities and considerations in the following table. The policy options are directed toward the challenges detailed in this report: spectrum sharing, cybersecurity, privacy, and concern over possible health effects of 5G technology. Policy options to address challenges to the performance or usage of U.S. 5G wireless networks Policy Option Opportunities Considerations Spectrum-sharing technologies (report p. 47) Policymakers could support research and development of spectrum sharing technologies. Could allow for more efficient use of the limited spectrum available for 5G and future generations of wireless networks. It may be possible to leverage existing 5G testbeds for testing the spectrum sharing technologies developed through applied research. Research and development is costly, must be coordinated and administered, and its potential benefits are uncertain. Identifying a funding source, setting up the funding mechanism, or determining which existing funding streams to reallocate will require detailed analysis. Coordinated cybersecurity monitoring (report p. 48) Policymakers could support nationwide, coordinated cybersecurity monitoring of 5G networks. A coordinated monitoring program would help ensure the entire wireless ecosystem stays knowledgeable about evolving threats, in close to real time; identify cybersecurity risks; and allow stakeholders to act rapidly in response to emerging threats or actual network attacks. Carriers may not be comfortable reporting incidents or vulnerabilities, and determinations would need to be made about what information is disclosed and how the information will be used and reported. Cybersecurity requirements (report p. 49) Policymakers could adopt cybersecurity requirements for 5G networks. Taking these steps could produce a more secure network. Without a baseline set of security requirements the implementation of network security practices is likely to be piecemeal and inconsistent. Using existing protocols or best practices may decrease the time and cost of developing and implementing requirements. Adopting network security requirements would be challenging, in part because defining and implementing the requirements would have to be done on an application-specific basis rather than as a one-size-fits-all approach. Designing a system to certify network components would be costly and would require a centralized entity, be it industry-led or government-led. Privacy practices (report p. 50) Policymakers could adopt uniform practices for 5G user data. Development and adoption of uniform privacy practices would benefit from existing privacy practices that have been implemented by states, other countries, or that have been developed by federal agencies or other organizations. Privacy practices come with costs, and policymakers would need to balance the need for privacy with the direct and indirect costs of implementing privacy requirements. Imposing requirements can be burdensome, especially for smaller entities. High-band research (report p. 51) Policymakers could promote R&D for high-band technology. Could result in improved statistical modeling of antenna characteristics and more accurately representing propagation characteristics. Could result in improved understanding of any possible health effects from long-term radio frequency exposure to high-band emissions. Research and development is costly and must be coordinated and administered, and its potential benefits are uncertain. Policymakers will need to identify a funding source or determine which existing funding streams to reallocate. Status quo (report p. 52) Some challenges described in this report may be addressed through current efforts. Some challenges described in this report may remain unresolved, be exacerbated, or take longer to resolve than with intervention. GAO was asked to assess the technologies associated with 5G and their implications. This report discusses (1) how the performance goals and expected uses are to be realized in U.S. 5G wireless networks, (2) the challenges that could affect the performance or usage of 5G wireless networks in the U.S., and (3) policy options to address these challenges. To address these objectives, GAO interviewed government officials, industry representatives, and researchers about the performance and usage of 5G wireless networks. This included officials from seven federal agencies; the four largest U.S. wireless carriers; an industry trade organization; two standards bodies; two policy organizations; nine other companies; four university research programs; the World Health Organization; the National Council on Radiation Protection and Measurements; and the chairman of the Defense Science Board's 5G task force. GAO reviewed technical studies, industry white papers, and policy papers identified through a literature review. GAO discussed the challenges to the performance or usage of 5G in the U.S. during its interviews and convened a one-and-a-half day meeting of 17 experts from academia, industry, and consumer groups with assistance from the National Academies of Sciences, Engineering, and Medicine. GAO received technical comments on a draft of this report from six federal agencies and nine participants at its expert meeting, which it incorporated as appropriate. For more information, contact Hai Tran at (202) 512-6888, tranh@gao.gov or Vijay A. D’Souza at (202) 512-6240, dsouzav@gao.gov.
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    Federal entities have a variety of roles and responsibilities for supporting efforts to enhance the cybersecurity of the nation. Among other things, 23 federal entities have roles and responsibilities for developing policies, monitoring critical infrastructure protection efforts, sharing information to enhance cybersecurity across the nation, responding to cyber incidents, investigating cyberattacks, and conducting cybersecurity-related research. To fulfill their roles and responsibilities, federal entities identified activities undertaken in support of the nation's cybersecurity. For example, National Security Council (NSC) staff, on behalf of the President, and the National Institute of Standards and Technology, have developed policies, strategies, standards, and plans to guide cybersecurity efforts. The Department of Homeland Security has helped secure the nation's critical infrastructure through developing security policy and coordinating security initiatives, among other efforts. Other agencies have established initiatives to gather intelligence and share actual or possible cyberattack information. Multiple agencies have mechanisms in place to assist in responding to cyberattacks, and law enforcement components, including the Federal Bureau of Investigation, are responsible for investigating them. The White House's September 2018 National Cyber Strategy and the NSC's accompanying June 2019 Implementation Plan detail the executive branch's approach to managing the nation's cybersecurity. When evaluated together, these documents addressed several of the desirable characteristics of national strategies, but lacked certain key elements for addressing others. National Cyber Strategy and Implementation Plan are Missing Desirable Characteristics of a National Strategy Characteristic Cyber Strategy and Plan Coverage of Issue Purpose, scope, and methodology Addressed Organizational roles, responsibilities, and coordination Addressed Integration and implementation Addressed Problem definition and risk assessment Did not fully address Goals, subordinate objectives, activities, and performance measures Did not fully address Resources, investments, and risk management Did not fully address Source: GAO analysis of 2018 National Cyber Strategy and 2019 Implementation Plan . | GAO-20-629 For example, the Implementation Plan details 191 activities that federal entities are to undertake to execute the priority actions outlined in the National Cyber Strategy. These activities are assigned a level, or tier, based on the coordination efforts required to execute the activity and the extent to which NSC staff is expected to be involved. Thirty-five of these activities are designated as the highest level (tier 1), and are coordinated by a functional entity within the NSC . Ten entities are assigned to lead or co-lead these critical activities while also tasked to lead or co-lead lower tier activities. Leadership Roles for Federal Entities Assigned as Leads or Co-Leads for National Cyber Strategy Implementation Plan Activities Entity Tier 1 Activities Tier 2 Activities Tier 3 Activities National Security Council 15 7 3 Department of Homeland Security 14 19 15 Office of Management and Budget 7 6 5 Department of Commerce 5 9 35 Department of State 2 5 11 Department of Defense 1 6 17 Department of Justice 1 10 5 Department of Transportation 1 0 5 Executive Office of the President 1 0 0 General Services Administration 1 2 1 Source: GAO analysis of 2018 National Cyber Strategy and 2019 Implementation Plan . | GAO-20-629 Although the Implementation Plan defined the entities responsible for leading each of the activities; it did not include goals and timelines for 46 of the activities or identify the resources needed to execute 160 activities. Additionally, discussion of risk in the National Cyber Strategy and Implementation Plan was not based on an analysis of threats and vulnerabilities. Further, the documents did not specify a process for monitoring agency progress in executing Implementation Plan activities. Instead, NSC staff stated that they performed periodic check-ins with responsible entities, but did not provide an explanation or definition of specific level of NSC staff involvement for each of the three tier designations. Without a consistent approach to engaging with responsible entities and a comprehensive understanding of what is needed to implement all 191 activities, the NSC will face challenges in ensuring that the National Cyber Strategy is efficiently executed. GAO and others have reported on the urgency and necessity of clearly defining a central leadership role in order to coordinate the government's efforts to overcome the nation's cyber-related threats and challenges. The White House identified the NSC staff as responsible for coordinating the implementation of the National Cyber Strategy . However, in light of the elimination of the White House Cybersecurity Coordinator position in May 2018, it remains unclear which official ultimately maintains responsibility for not only coordinating execution of the Implementation Plan , but also holding federal agencies accountable once activities are implemented. NSC staff stated responsibility for duties previously attributed to the White House Cyber Coordinator were passed to the senior director of NSC's Cyber directorate; however, the staff did not provide a description of what those responsibilities include. NSC staff also stated that federal entities are ultimately responsible for determining the status of the activities that they lead or support and for communicating implementation status to relevant NSC staff. However, without a clear central leader to coordinate activities, as well as a process for monitoring performance of the Implementation Plan activities, the White House cannot ensure that entities are effectively executing their assigned activities intended to support the nation's cybersecurity strategy and ultimately overcome this urgent challenge. Increasingly sophisticated cyber threats have underscored the need to manage and bolster the cybersecurity of key government systems and the nation's cybersecurity. The risks to these systems are increasing as security threats evolve and become more sophisticated. GAO first designated information security as a government-wide high-risk area in 1997. This was expanded to include protecting cyber critical infrastructure in 2003 and protecting the privacy of personally identifiable information in 2015. In 2018, GAO noted that the need to establish a national cybersecurity strategy with effective oversight was a major challenge facing the federal government. GAO was requested to review efforts to protect the nation's cyber critical infrastructure. The objectives of this report were to (1) describe roles and responsibilities of federal entities tasked with supporting national cybersecurity, and (2) determine the extent to which the executive branch has developed a national strategy and a plan to manage its implementation. To do so, GAO identified 23 federal entities responsible for enhancing the nation's cybersecurity. Specifically, GAO selected 13 federal agencies based on their specialized or support functions regarding critical infrastructure security and resilience, and 10 additional entities based on analysis of its prior reviews of national cybersecurity, relevant executive policy, and national strategy documents. GAO also analyzed the National Cyber Strategy and Implementation Plan to determine if they aligned with the desirable characteristics of a national strategy. GAO is making one matter for congressional consideration, that Congress should consider legislation to designate a leadership position in the White House with the commensurate authority to implement and encourage action in support of the nation's cybersecurity. GAO is also making one recommendation to the National Security Council to work with relevant federal entities to update cybersecurity strategy documents to include goals, performance measures, and resource information, among other things. The National Security Council neither agreed nor disagreed with GAO's recommendation. For more information, contact Nick Marinos at (202) 512-9342 or marinosn@gao.gov.
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