September 27, 2021

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Three charged in conspiracy to purchase $500,000 in weapons for cartel

11 min read
Three men are now facing federal charges for their roles in a conspiracy on behalf of Cartel del Noreste (CDN)

Read full article at: https://www.justice.gov July 29, 2021

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    Kaiser Foundation Health Plan of Washington, formerly known as Group Health Cooperative (GHC), agreed to pay $6,375,000 to resolve allegations that it submitted invalid diagnoses to Medicare for Medicare Advantage beneficiaries and received inflated payments from Medicare as a result, the Justice Department announced today.  Kaiser Foundation Health Plan is headquartered in Oakland, California.    
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  • Defense Health Care: Oversight of Military Services’ Post-Deployment Health Reassessment Completion Rates Is Limited
    In U.S GAO News
    Military servicemembers engaged in combat tours in Afghanistan and Iraq are at risk of developing combat-related mental health conditions, including post-traumatic stress disorder (PTSD). In many cases, signs of potential mental health conditions do not surface until months after servicemembers return from deployment. In 2004, Army researchers published a series of articles that indicated a significant increase in the number of servicemembers reporting mental health concerns 90 to 120 days after returning from deployment, compared with mental health concerns reported before or soon after deployment. These findings led the Department of Defense (DOD) in March 2005 to develop requirements and policies for the post-deployment health reassessment (PDHRA) as part of its continuum of deployment health assessments for servicemembers. PDHRA is a screening tool for military servicemembers; it is designed to identify and address their health concerns--including mental health concerns--90 to 180 days after return from deployment. Servicemembers answer a set of questions about their physical and mental health conditions and concerns, and health care providers review the answers and refer servicemembers for further evaluation and treatment if necessary. A November 2007 study showed that a larger number of servicemembers indicated mental health concerns on their PDHRAs than on assessments earlier in their deployment cycles. Although DOD established PDHRA requirements and policies, it gave the military services discretion to implement them to meet their unique needs as long as the services adhere to the requirements and policies. DOD oversees the military services' compliance with PDHRA requirements through its deployment health assessment quality assurance program and is required to report on the quality assurance program annually to the Armed Services Committees of the House of Representatives and Senate. In June 2007, we reported that DOD's oversight of its deployment health assessments does not provide DOD or Congress with the information needed to evaluate DOD and the military services' compliance with deployment health assessment requirements. That report is part of a body of work in which we identified weaknesses in DOD's quality assurance program. The Senate Committee on Armed Services directed us to review DOD's oversight of PDHRA, and the House Committee on Armed Services and 11 senators also expressed interest in this work. In this report, we focus on how DOD ensures that servicemembers complete the PDHRA. Specifically, we discuss how well DOD's quality assurance program oversees the military services' compliance with the requirement that they ensure that servicemembers complete the PDHRA.DOD's quality assurance program has limitations and does not allow the department to accurately assess whether the military services ensure that servicemembers complete the PDHRA. DOD's quality assurance program relies on quarterly reports from each military service, monthly reports from AFHSC, and site visits to military installations to oversee the military services' compliance with deployment health assessment requirements, including completion of PDHRA. Each of these sources of information has limitations. The military services' quarterly reports and the monthly reports from AFHSC do not provide the information DOD needs to accurately assess the military services' PDHRA completion rates, which would allow DOD to determine if the military services have ensured that servicemembers completed the PDHRA. These reports do not allow DOD to calculate a completion rate because they do not provide essential information, such as the total number of servicemembers who returned from deployment and should have completed the PDHRA in that quarter or month. Furthermore, DOD cannot use information collected from site visits to validate the services' quarterly reports because the small number of site visits constitutes an insufficient sample for validation purposes. In our 2007 report, we recommended that DOD make enhancements to its quality assurance program, which would allow the department to better evaluate compliance with deployment health requirements. Although DOD concurred with the recommendation included in the 2007 report, as of June 2008, the department had not implemented the recommendation. As a result, DOD's quality assurance program cannot provide decision makers with reasonable assurance that servicemembers complete PDHRA. Overall, DOD concurred with our report's findings and conclusions; however, DOD identified several items in the report that it addressed in written comments. DOD suggested that the function of oversight is beyond the scope of the quality assurance program. Additionally, DOD commented that the department is taking steps that it believes will resolve some of the issues we note in this report. However, DOD did not provide us with relevant details or evidence pertaining to these efforts. We believe that oversight is an essential function of the quality assurance program and that the program currently does not receive the information necessary to perform this function.
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  • Stabilization and Reconstruction: Actions Needed to Improve Governmentwide Planning and Capabilities for Future Operations
    In U.S GAO News
    The United States has become increasingly involved in stabilization and reconstruction operations as evidenced in the Balkans, Haiti, Somalia, Iraq, and Afghanistan. In December 2005, the President issued National Security Presidential Directive 44, establishing governmentwide policy for coordinating, planning, and implementing U.S. stabilization and reconstruction assistance to affected foreign entities. This testimony addresses stabilization and reconstruction issues related to (1) State Department (State) efforts to improve interagency planning and coordination, (2) Department of Defense (DOD) efforts to enhance its capabilities and planning, and (3) State efforts to develop civilian capabilities. GAO's statement is based on its May 2007 report on DOD stability operations and preliminary observations related to State's interagency planning framework and civilian response capabilities.State and DOD have begun to take steps to better coordinate stabilization and reconstruction activities, but several significant challenges may hinder their ability to integrate planning for potential operations and strengthen military and civilian capabilities to conduct them. State's Office of the Coordinator for Reconstruction and Stabilization is developing a framework for U.S. agencies to use when planning stabilization and reconstruction operations, but the framework has yet to be fully applied to any operation. The National Security Council has not approved the entire framework, guidance related to the framework is unclear, and some interagency partners have not accepted it. For example, some interagency partners stated that the framework's planning process is cumbersome and too time consuming for the results it produces. While steps have been taken to address concerns and strengthen the framework's effectiveness, differences in planning capacities and procedures among U.S. government agencies may pose obstacles to effective coordination. DOD has taken several positive steps to improve its ability to conduct stability operations but faces challenges in developing capabilities and measures of effectiveness, integrating the contributions of non-DOD agencies into military contingency plans, and incorporating lessons learned from past operations into future plans. These challenges, if not addressed, may hinder DOD's ability to fully coordinate and integrate stabilization and reconstruction activities with other agencies or to develop the full range of capabilities those operations may require. Among its many efforts, DOD has developed a new policy, planning construct and joint operating concept with a greater focus on stability operations, and each service is pursuing efforts to improve capabilities. However, inadequate guidance, practices that inhibit sharing of planning information with non-DOD organizations, and differences in the planning capabilities and capacities of DOD and non-DOD organizations hinder the effectiveness of these improvement efforts. Since 2005, State has been developing three civilian corps to deploy rapidly to international crises, but significant challenges must be addressed before they will be fully capable. State and other agencies face challenges in establishing two of these units--the Active Response Corps and Standby Response Corps--because of staffing and resource constraints and concerns that stabilization and reconstruction operations are not core missions for each parent organization. Congress has not yet enacted legislation necessary for State to obligate funds for the third unit, the Civilian Reserve Corps, staffed solely with non-federal volunteers. Further, State has not fully defined the types of missions these personnel would be deployed to support.
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    What GAO Found GAO’s 2021 annual report identifies 112 new actions for Congress or executive branch agencies to improve the efficiency and effectiveness of government. For example: The Office of Management and Budget should improve how agencies buy common goods and services—such as medical supplies and computers—by addressing data management challenges and establishing performance metrics to help save the federal government billions of dollars over the next 5 years, as well as potentially eliminate duplicative contracts. The National Nuclear Security Administration could implement cost savings programs to operate more effectively at its nuclear laboratory and production sites to potentially save hundreds of millions of dollars over approximately a five year period. The Department of Health and Human Services could improve coordination of its infectious disease modeling efforts to better identify any duplication and overlap among agencies, which could help them to better plan for and more efficiently respond to disease outbreaks. The Internal Revenue Service (IRS) could enhance third-party information reporting to increase compliance with tax laws and raise revenue. GAO has also previously suggested (1) providing IRS with authority to correct certain errors—with appropriate safeguards—in tax returns and (2) establishing requirements for paid tax return preparers to help improve the accuracy of tax returns. From 2011 to 2021, GAO has identified more than 1,100 actions to reduce costs, increase revenues, and improve agencies' operating effectiveness. GAO’s last report in May 2020 said progress made in addressing many of the actions identified from 2011 to 2019 had resulted in approximately $429 billion in financial benefits, including $393 billion that accrued through 2019 and $36 billion that was projected to accrue in future years. Since May 2020, at least tens of billions of dollars in additional financial benefits have been achieved. GAO estimates that tens of billions of additional dollars could be saved should Congress and executive branch agencies fully address open actions, including those that have potential financial benefits of $1 billion or more. Why GAO Did This Study The federal government has made an unprecedented financial response to the COVID-19 pandemic. Once the pandemic recedes and the economy substantially recovers, Congress and the administration will need to develop and swiftly implement an approach to place the government on a sustainable long-term fiscal path. In the short term, opportunities exist for achieving billions of dollars in financial savings and improving the efficiency and effectiveness of a wide range of federal programs in other areas. GAO has responded with annual reports to a statutory provision for it to identify and report on federal programs, agencies, offices, and initiatives—either within departments or government-wide—that have duplicative goals or activities. GAO also identifies areas that are fragmented or overlapping, as well as additional opportunities to achieve cost savings or enhance revenue collection. This statement discusses: the new areas identified in GAO’s 2021 annual report; and examples of open actions recommended to Congress or executive branch agencies with potential financial benefits of $1 billion or more. To identify what actions exist to address these issues, GAO reviewed and updated select prior work, including matters for congressional consideration and recommendations for executive action. For more information, contact Jessica Lucas-Judy at (202) 512-6806 or lucasjudyj@gao.gov or Michelle Sager at (202) 512-6806 or sagerm@gao.gov.
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  • Weapon System Sustainment: Aircraft Mission Capable Rates Generally Did Not Meet Goals and Cost of Sustaining Selected Weapon Systems Varied Widely
    In U.S GAO News
    Mission Capable Rates for Selected Department of Defense Aircraft GAO examined 46 types of aircraft and found that only three met their annual mission capable goals in a majority of the years for fiscal years 2011 through 2019 and 24 did not meet their annual mission capable goals in any fiscal year as shown below. The mission capable rate—the percentage of total time when the aircraft can fly and perform at least one mission—is used to assess the health and readiness of an aircraft fleet. Number of Times Selected Aircraft Met Their Annual Mission Capable Goal, Fiscal years 2011 through 2019 aThe military departments did not provide mission capable goals for all nine years for these aircraft. Aggregating the trends at the military service level, the average annual mission capable rate for the selected Air Force, Navy, and Marine Corps aircraft decreased since fiscal year 2011, while the average annual mission capable rate for the selected Army aircraft slightly increased. While the average mission capable rate for the F-35 Lightning II Joint Strike Fighter showed an increase from fiscal year 2012 to 2019, it trended downward from fiscal year 2015 through fiscal year 2018 before improving slightly in fiscal year 2019. For fiscal year 2019, GAO found only three of the 46 types of aircraft examined met the service-established mission capable goal. Furthermore, for fiscal year 2019: six aircraft were 5 percentage points or fewer below the goal; 18 were from 15 to 6 percentage points below the goal; and 19 were more than 15 percentage points below the goal, including 11 that were 25 or more percentage points below the goal. Program officials provided various reasons for the overall decline in mission capable rates, including aging aircraft, maintenance challenges, and supply support issues as shown below. Sustainment Challenges Affecting Some of the Selected Department of Defense Aircraft aA service life extension refers to a modification to extend the service life of an aircraft beyond what was planned. bDiminishing manufacturing sources refers to a loss or impending loss of manufacturers or suppliers of items. cObsolescence refers to a lack of availability of a part due to its lack of usefulness or its no longer being current or available for production. Operating and Support Costs for Selected Department of Defense Aircraft Operating and support (O&S) costs, such as the costs of maintenance and supply support, totaled over $49 billion in fiscal year 2018 for the aircraft GAO reviewed and ranged from a low of $118.03 million for the KC-130T Hercules (Navy) to a high of $4.24 billion for the KC-135 Stratotanker (Air Force). The trends in O&S costs varied by aircraft from fiscal year 2011 to 2018. For example, total O&S costs for the F/A-18E/F Super Hornet (Navy) increased $1.13 billion due in part to extensive maintenance needs. In contrast, the F-15C/D Eagle (Air Force) costs decreased by $490 million due in part to a reduction in the size of the fleet. Maintenance-specific costs for the aircraft types we examined also varied widely. Why This Matters The Department of Defense (DOD) spends tens of billions of dollars annually to sustain its weapon systems in an effort to ensure that these systems are available to simultaneously support today's military operations and maintain the capability to meet future defense requirements. This report provides observations on mission capable rates and costs to operate and sustain 46 fixed- and rotary-wing aircraft in the Departments of the Army, Navy, and Air Force. How GAO Did This Study GAO was asked to report on the condition and costs of sustaining DOD's aircraft. GAO collected and analyzed data on mission capable rates and O&S costs from the Departments of the Army, Navy, and Air Force for fiscal years 2011 through 2019. GAO reviewed documentation and interviewed program office officials to identify reasons for the trends in mission capability rates and O&S costs as well as any challenges in sustaining the aircraft. This is a public version of a sensitive report issued in August 2020. Information on mission capable and aircraft availability rates were deemed to be sensitive and has been omitted from this report. For more information, contact Director Diana Maurer at (202) 512-9627 or maurerd@gao.gov.
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  • Firearm Injuries: Health Care Service Needs and Costs
    In U.S GAO News
    What GAO Found There is no complete information on the health care costs of firearm injuries. National data allow for estimates of the costs of initial hospital treatment and some first-year costs, but less is known about costs the more time passes from the injury. Examining available data and information, GAO found the following: Initial hospital costs: Using hospital data from 2016 and 2017—the most recent that were available—GAO estimated that the initial hospital costs of firearm injuries were just over $1 billion annually. However, physician costs not captured in the data could add around 20 percent to that total. GAO also found that each year there were about 30,000 inpatient stays and about 50,000 emergency department visits to initially treat firearm injuries, and that patients with Medicaid and other public coverage accounted for over 60 percent of the costs of this care. First-year costs: Findings from studies on health care costs within the first year of hospital discharge after a firearm injury suggest that those costs can be significant. For example, studies estimating first-year hospital readmissions costs found that up to 16 percent of firearm injury survivors with an initial inpatient stay were readmitted at least once for their injury, with average costs of $8,000 to $11,000 per patient. Long-term costs: Less is known about the costs of health care for firearm injuries beyond the first year after hospital discharge. GAO identified studies that estimated lifetime costs of these injuries, but the estimates relied on data from over 20 years ago, making them no longer a reliable indicator of costs. Clinical experts GAO met with described a wide range in both physical and behavioral health care needs for firearm injury survivors after hospital discharge, with some survivors needing lifelong care. These experts also told GAO that survivors often face barriers to receiving needed care, such as being denied care when it is not covered by their insurance. While not receiving needed services may minimize costs initially, the consequences of unmet health needs for firearm injury survivors may ultimately result in greater costs. Range of Physical Health Care Needs for Firearm Injuries after Hospital Discharge Why GAO Did This Study In 2019, close to 40,000 people died from a firearm injury in the U.S., and around twice that number sustained non-fatal injuries. Over 100 organizations representing health care providers consider the number of firearm injuries that occur each day to be a public health epidemic. Health care costs associated with firearm injuries—both those for services provided during initial hospital treatment and those for services provided long-term—are paid for, at least in part, by public payers, such as Medicaid and Medicare. GAO was asked to review the health care costs of firearm injuries. This report describes the initial hospital costs of firearm injuries in the U.S. and what is known about the costs of subsequent care, as well as the post-discharge services that may be needed to treat these injuries. GAO analyzed hospital data for 2016 and 2017 collected by the Agency for Healthcare Research and Quality related to the initial costs of treating firearm injuries, and conducted a literature review on the health care costs of these injuries following discharge. In addition, GAO moderated meetings with 12 experts, representing clinicians, economists, and others—selected with assistance from the National Academies of Sciences, Engineering, and Medicine—to discuss the post-discharge health care service needs and costs of firearm injuries. The Department of Health and Human Services provided technical comments on a draft of this report, which GAO incorporated as appropriate. For more information, contact Carolyn L. Yocom at (202) 512-7114 or yocomc@gao.gov.
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