Law Firms Representing Purdue Pharma Agree to Relinquish $1 Million in Settlement with U.S. Trustee Program

The Department of Justice’s U.S. Trustee Program (USTP) has entered into a settlement with three law firms representing Purdue Pharma (Purdue) in its ongoing bankruptcy cases. The firms are Skadden, Arps, Slate, Meagher & Flom LLP; Wilmer Cutler Pickering Hale and Dorr LLP; and Dechert LLP (the Firms). 

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    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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    Banks and credit unions collect, use, and share consumers' personal information—such as income level and credit card transactions—to conduct everyday business and market products and services. They share this information with a variety of third parties, such as service providers and retailers. The Gramm-Leach-Bliley Act (GLBA) requires financial institutions to provide consumers with a privacy notice describing their information-sharing practices. Many banks and credit unions elect to use a model form—issued by regulators in 2009—which provides a safe harbor for complying with the law (see figure). GAO found the form gives a limited view of what information is collected and with whom it is shared. Consumer and privacy groups GAO interviewed cited similar limitations. The model form was issued over 10 years ago. The proliferation of data-sharing since then suggests a reassessment of the form is warranted. Federal guidance states that notices about information collection and usage are central to providing privacy protections and transparency. Since Congress transferred authority to the Consumer Financial Protection Bureau (CFPB) for implementing GLBA privacy provisions, the agency has not reassessed if the form meets consumer expectations for disclosures of information-sharing. CFPB officials said they had not considered a reevaluation because they had not heard concerns from industry or consumer groups about privacy notices. Improvements to the model form could help ensure that consumers are better informed about all the ways banks and credit unions collect and share personal information. Excerpts of the Gramm-Leach-Bliley Act Model Privacy Form Showing Reasons Institutions Share Personal Information Federal regulators examine institutions for compliance with GLBA privacy requirements, but did not do so routinely in 2014–2018 because they found most institutions did not have an elevated privacy risk. Before examinations, regulators assess noncompliance risks in areas such as relationships with third parties and sharing practices to help determine if compliance with privacy requirements needs to be examined. The violations of privacy provisions that the examinations identified were mostly minor, such as technical errors, and regulators reported relatively few consumer complaints. Banks and credit unions maintain a large amount of personal information about consumers. Federal law requires that they have processes to protect this information, including data shared with certain third parties. GAO was asked to review how banks and credit unions collect, use, and share such information and federal oversight of these activities. This report examines, among other things, (1) what personal information banks and credit unions collect, and how they use and share the information; (2) the extent to which they make consumers aware of the personal information they collect and share; and (3) how regulatory agencies oversee such collection, use, and sharing. GAO reviewed privacy notices from a nongeneralizable sample of 60 banks and credit unions with a mix of institutions with asset sizes above and below $10 billion. GAO also reviewed federal privacy laws and regulations, regulators' examinations in 2014–2018 (the last 5 years available), procedures for assessing compliance with federal privacy requirements, and data on violations. GAO interviewed officials from banks, industry and consumer groups, academia, and federal regulators. GAO recommends that CFPB update the model privacy form and consider including more information about third-party sharing. CFPB did not agree or disagree with the recommendation but said they would consider it, noting that it would require a joint rulemaking with other agencies. For more information, contact Alicia Puente Cackley at (202) 512-8678 or CackleyA@gao.gov or Nick Marinos at (202) 512-9342 or MarinosN@gao.gov.
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    What GAO Found The Department of Homeland Security (DHS) initially expected to implement the entire Homeland Advanced Recognition Technology (HART) by 2021; however, no segments of the program have been deployed to date. Currently estimated to cost $4.3 billion in total, DHS plans to deploy increment 1 of the program in December 2021 and expects to implement later increments in 2022 and 2024. Increment 1 is expected to replace the functionality of the existing system. Although the multi-billion dollar HART program had suffered continuing delays, until the end of last year, the DHS Chief Information Officer (CIO) had reported the program as low risk on the IT Dashboard, a website showing, among other things, the performance and risks of agency information technology (IT) investments. In May 2020, the Office of the CIO began developing a new assessment process which led to the CIO accurately elevating HART's rating from low to high risk and reporting this rating to the IT Dashboard in November 2020. In addition, consistent with OMB guidance, the CIO fulfilled applicable oversight requirements for high-risk IT programs by, among other things, conducting a review of the program known as a TechStat review. While the CIO complied with applicable oversight requirements in conducting the TechStat review, GAO noted that DHS's associated policy was outdated. Specifically, the 2017 policy does not reflect the revised process DHS started using in 2020. As such, until the guidance is updated, other departmental IT programs deemed high risk would likely not be readily aware of the specific process requirements. Concurrent with the CIO's actions to conduct oversight, HART program management has also acted to implement important risk management practices. Specifically, GAO found that HART had fully implemented four of seven risk management best practices and partially implemented the remaining three (see table). For example, as of February 2021, the program had identified 49 active risks, including 15 related to cost and schedule and 17 related to technical issues. While DHS has plans under way to fully implement two of the partially implemented practices, until it fully implements the remaining practice its efforts to effectively monitor the status of risks and mitigation plans may be hampered. Summary of the Homeland Advanced Recognition Technology Program's Implementation of the Seven Risk Management Practices Practice GAO assessment 1. Determine risk sources and categories ● 2. Define parameters to analyze and categorize risks ● 3. Establish and maintain a risk management strategy ◑ 4. Identify and document risks ● 5. Evaluate and categorize each identified risk using defined risk categories and parameters, and determine its relative priority ● 6. Develop a risk mitigation plan in accordance with the risk management strategy ◑ 7. Monitor the status of each risk periodically and implement the risk mitigation plan as appropriate ◑ Legend: ● = Fully implemented ◑ = Partially implemented ○ = Not implemented Source: GAO analysis of agency data. | GAO-21-386 Why GAO Did This Study DHS currently uses an outdated system, implemented over 27 years ago, for providing biometric identity management services (i.e., fingerprint matching and facial recognition technology services), known as the Automated Biometric Identification System, or IDENT. In 2016, DHS initiated a multi-billion dollar program known as HART, which is intended to replace the existing system. GAO was asked to evaluate the HART program. Its specific objectives, among others, were to (1) determine the status of the program, (2) assess the extent to which the DHS CIO was accurately reporting risk and meeting applicable oversight requirements, and (3) assess the extent to which the program was identifying and managing its risks. To accomplish these objectives, GAO identified the program's schedule and cost estimates, assessed the CIO's risk ratings and HART oversight documentation and related evidence against OMB guidance, and compared the program's risk management practices to best practices that are essential to identifying and mitigating potential problems. In addition, GAO interviewed appropriate officials.
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    Genetic counselors and medical geneticists are two groups who typically work together to provide genetic services, such as genetic testing and counseling. Genetic counselors have at least a master's degree in genetic counseling and assess individuals or families with or at risk for genetic conditions, and provide counseling and education on test results. Medical geneticists are typically physicians who specialize in medical genetics and genomics, and provide comprehensive genetic services, ranging from diagnosis and interpretation of test results to the management and treatment of genetic conditions. GAO's analysis of data from the professional organizations representing this workforce shows the number of genetic counselors certified to provide genetic counseling services has nearly doubled since 2009, and is projected to continue growing. The data show there were approximately 4,700 certified genetics counselors in the United States in 2019. The data also show the number of new medical geneticists has increased modestly since 2009, and the total number certified in the United States was approximately 1,240 as of April 2020. There is no widely accepted measure for how many genetic counselors and medical geneticists should be available; however, representatives from professional organizations GAO interviewed stated that demand for genetic services is rising. Data from the professional organizations representing the genetic counselor and medical geneticist workforces, as well as data from the Census Bureau, also show the number of genetic counselors and medical geneticists varied across states. States averaged seven genetic counselors per 500,000 people in 2019 and two medical geneticists per 500,000 people in 2020. Genetic counselors and medical geneticists primarily practice in hospital settings. Distribution of Genetic Counselors by State, 2019 Advances in genetic technology and research have increased the amount of information available to individuals and providers, and may have increased the demand for genetic services. The medical genetics workforce—which includes genetic counselors and medical geneticists—plays an essential role in providing access to genetic services. Some studies have identified concerns with the size of the medical genetics workforce and its ability to meet the current and future demand for genetic services. A House Committee on Appropriations report included a provision for GAO to conduct an analysis of the medical genetics workforce. This report describes, among other objectives, what is known about changes in the size of the genetic counselor and medical geneticist workforces; and what is known about the geographic distribution of these workforces. GAO reviewed relevant studies of the genetic counselor and medical geneticist workforces; interviewed agency officials and professional organizations representing each workforce; and analyzed the most recent available data on the size and distribution of each workforce in the United States, as well as population data from the Census Bureau. GAO provided a draft of this report to the Department of Health and Human Services and the Department of Labor. The Department of Health and Human Services provided technical comments, which GAO incorporated as appropriate. For more information, contact James Cosgrove at (202) 512-7114 or CosgroveJ@gao.gov.
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    From 2016 through 2019, the Department of Defense (DOD) conducted or sponsored at least 11 classified or sensitive studies on contested mobility— the ability of the U.S. military to transport equipment and personnel in a contested operational environment. The studies resulted in more than 50 recommendations, and DOD officials stated they believed that some of the recommendations had been implemented. However, officials did not know the exact disposition of the recommendations, as they are not actively tracking implementation activities. Further, no single DOD oversight entity evaluated the studies' recommendations and tracked implementation across the department. As a result, DOD may be missing an opportunity to leverage existing knowledge on mobility in contested environments across organizations, and strengthen its mobility efforts for major conflicts as envisioned in the National Defense Strategy. DOD has updated aspects of wargame exercises and mobility training to prepare for a contested environment, but has not updated training for the surge sealift fleet—ships owned by DOD and the Department of Transportation's Maritime Administration (MARAD) and crewed by contracted mariners. These crews are primarily trained and qualified to operate the ship, but receive limited contested mobility training. While DOD has updated air mobility training and other aspects of mobility training, sealift crew training requirements have not been updated by DOD and MARAD to reflect contested environment concerns because DOD has not conducted an evaluation of such training. Since sealift is the means by which the majority of military equipment would be transported during a major conflict, it is important that crews be trained appropriately for contested mobility to help ensure that ships safely reach their destinations and complete their missions. C-17 Performing Defense Maneuvers DOD has begun to mitigate contested environment challenges through improved technology and related initiatives. The Navy is acquiring improved technologies to deploy on surge sealift ships and replacement ships. The Air Force is equipping current mobility aircraft (see photo above) with additional defensive technologies and planning for the development of future replacement aircraft. According to U.S. Transportation Command, the command is revising its contracts with commercial partners to address cyber threats, and funding research and development projects that address contested mobility concerns. Many of these efforts are nascent and will take years to be put in place. China and Russia are strengthening their militaries to neutralize U.S. strengths, including mobility—the ability of U.S. military airlift and air refueling aircraft and sealift ships to rapidly move equipment and personnel from the United States to locations abroad to support DOD missions. Senate Report 116-48 included a provision for GAO to review DOD's ability to operate in a contested mobility environment. This report assesses the extent to which DOD has studied contested mobility and tracked the implementation of study recommendations, assesses the extent to which DOD has revised its training to incorporate contested mobility challenges, and describes the technologies that DOD uses to mitigate contested mobility challenges. GAO identified contested mobility studies conducted or sponsored by DOD; evaluated DOD's processes for monitoring implementation of study recommendations; analyzed training and exercise documents from DOD combatant commands, the Air Force, and the Navy; and reviewed DOD plans for technological improvements to its mobility forces. GAO recommends that DOD designate an oversight entity to track the implementation of study recommendations, and that DOD and MARAD evaluate and update sealift training. DOD and the Department of Transportation concurred or partially concurred with each recommendation. GAO believes each recommendation should be fully implemented, as discussed in the report. For more information, contact Cary Russell at (202) 512-5431 or RussellC@gao.gov.
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