December 9, 2021

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Secretary Blinken’s Meeting with Muslim Frontline Workers on the Occasion of Eid al-Adha

14 min read

Office of the Spokesperson

The below is attributable to Spokesperson Ned Price:

Secretary of State Antony J. Blinken today virtually met with 11 Muslim frontline workers from diverse populations from around the world.  Secretary Blinken, joined by Under Secretary for Civilian Security, Democracy, and Human Rights Uzra Zeya, underscored the importance the United States places on engaging with these valued civil society partners, and expressed appreciation for the contributions and sacrifices these leaders have made working on the frontlines of the COVID-19 pandemic to keep people safe.  The Secretary emphasized that their selfless efforts to ensure the public good during a time of terrible loss and suffering was a clear and vibrant manifestation of the recent Eid al-Adha holiday spirit.

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    In U.S GAO News
    The Department of Defense (DOD) has a general expectation that its health care beneficiaries, upon receiving an urgent referral to see a specialist, will access that specialty care in 3 days or less. GAO's analysis of 16,754 urgent referrals at military treatment facilities (MTF) shows that DOD beneficiaries accessed specialty care services in 3 days or less for more than half of the urgent referrals. About 9 percent of the urgent referrals involved beneficiaries waiting 3 weeks or longer to be seen. According to DOD officials, some beneficiaries may have waited longer than 3 days due to factors such as patient preference, appointment availability, or waiting for lab results. Time to access care varied by specialty, with beneficiaries urgently referred to ophthalmology generally seeing a specialist the fastest, and those urgently referred to mental health and oncology generally waiting the longest. According to DOD officials, MTFs are responsible for monitoring beneficiaries' access to specialty care through urgent referrals. GAO found that the monitoring processes used varied by MTF and specialty care clinic at the five selected MTFs that GAO reviewed. For example, officials from one MTF told GAO they centrally manage all urgent referrals using a daily report to address any delays, while officials from another MTF told GAO that individual specialty care clinics are responsible for managing their own urgent referrals. DOD officials acknowledged such variation and MTFs have been directed to centralize their referral management and monitoring processes—an effort that is currently underway. GAO found that DOD monitors the rates at which beneficiaries receive timely and effective care, in part, through 10 outpatient health care quality measures. These measures allow DOD to make comparisons to civilian health care systems, and they are reviewed by various DOD groups at least quarterly. However, DOD officials told GAO that since October 2017, they have been unable to monitor nine of the 10 measures for MTFs using Military Health System (MHS) Genesis, DOD's new electronic health record system. According to the officials, DOD's current data warehouse—a system that stores some MHS Genesis data and can be used by MTFs to create reports on quality measures—is not capable of producing accurate reports for those measures. DOD officials told GAO they expect to implement a new data warehouse by the end of 2020. DOD officials also said they are importing data related to quality measures into another system used for quality monitoring; however, DOD does not have a targeted date for completing these data imports. Until these actions are fully implemented, groups responsible for monitoring quality care will continue to lack the data needed to offer assurance that the growing number of MTFs using MHS Genesis are providing beneficiaries with timely and effective care that will lead to better health outcomes. A draft of this report recommended that DOD establish a timeline to complete importing the quality measure-related data from MHS Genesis into DOD's system used for quality monitoring. In its review of the draft, DOD concurred with the recommendation and established a timeline for importing the data, to be available in DOD's system no later than May 2021. After reviewing the information DOD provided, GAO removed the recommendation from the final report. DOD is responsible for ensuring that beneficiaries have access to specialty care for conditions that, while not life-threatening, require immediate attention, as well as for ensuring that beneficiaries receive timely and effective care for certain routine or other services. A report accompanying the National Defense Authorization Act for Fiscal Year 2020 included a provision for GAO to review the quality of health care in the MHS. This report examines (1) the timeliness with which beneficiaries access specialty care at MTFs through urgent referrals and DOD's efforts to monitor access, and (2) DOD's use of quality measures to monitor and improve the rates of timely and effective care received by beneficiaries at MTFs. GAO examined relevant policies, national DOD referral data (a total of 16,754 urgent referrals) for a 1-year period ending August 2019, and the most recent available quality measure data (April 2020). GAO interviewed officials from five MTFs, selected for variation in military services, geography, provision of select specialty services, and use of the electronic health record system. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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    In U.S GAO News
    What GAO Found Congress needs to take action to break the impasse over a permanent solution for commercial spent nuclear fuel—used fuel removed from nuclear power reactors—according to experts GAO interviewed. Specifically, most experts said Congress should (1) amend the Nuclear Waste Policy Act of 1982 (NWPA) to authorize the Department of Energy (DOE) to implement a new consent-based process for siting consolidated interim storage and permanent geologic repository facilities, and (2) restructure the Nuclear Waste Fund to ensure reliable and sufficient funding. Experts highlighted concerns about the effect of the continuing impasse on environmental, health, and security risks; efforts to combat climate change; and taxpayer costs. For example, the amount the federal government will have to pay to owners to store spent nuclear fuel at reactor sites will continue to grow annually (see figure). Figure: Department of Energy Total Estimated Costs and Remaining Liabilities for Storing Commercial Spent Nuclear Fuel (SNF), in Billions of Dollars Note: For more details, see figure 4 in GAO-21-603. The United States currently has an ad hoc system for managing commercial spent nuclear fuel, which can affect future disposal decisions and costs. For example, spent fuel is stored using a variety of different technologies that will have implications for final disposal. Nearly all of the experts we interviewed said an integrated strategy is essential to developing a solution for commercial spent nuclear fuel and potentially reducing programmatic costs. However, DOE cannot fully develop and implement such a strategy without congressional action. In 2015, DOE began efforts to engage the public and develop a draft consent-based siting process, but it has not finalized this process. The draft includes elements that nearly all experts agreed are critical for an effective siting process. Finalizing the draft could help position DOE to implement a consent-based process for consolidated interim storage facilities and/or permanent geologic repositories if Congress amends the NWPA to allow for storage and disposal options other than, or in addition to, the Yucca Mountain repository. Why GAO Did This Study Commercial spent nuclear fuel is extremely dangerous if not managed properly. About 86,000 metric tons of this fuel is stored on-site at 75 operating or shutdown nuclear power plants in 33 states, an amount that grows by about 2,000 metric tons each year. The NWPA, as amended, requires DOE to dispose of spent nuclear fuel and specifies that the only site that may be considered for the permanent disposal of commercial spent nuclear fuel is a geologic repository at Yucca Mountain, Nevada. However, in 2010, DOE terminated its efforts to license a repository at Yucca Mountain, and Congress stopped funding activities related to the site. Since then, policymakers have been at an impasse on how to meet the federal disposal obligation, with significant financial consequences for taxpayers. This report examines actions that experts identified as necessary to develop a solution for spent nuclear fuel disposal. GAO reviewed DOE and other agency documents and interviewed 20 experts and 25 stakeholders from industry, nongovernmental organizations, and tribal and state groups.
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    In U.S GAO News
    Enrollment in private health insurance plans in the individual (coverage sold directly to individuals), small group (coverage offered by small employers), and large group (coverage offered by large employers) markets has historically been highly concentrated among a small number of issuers. GAO found that this pattern continued in 2017 and 2018. For example: For each market in 2018, at least 43 states (including the District of Columbia) were highly concentrated. Overall individual and small group markets have become more concentrated in recent years. The national median market share of the top three issuers increased by approximately 8 and 5 percentage points, respectively, from 2015 through 2018. With these increases, the median concentration was at least 94 percent in both markets in 2018. Number of States and District of Columbia Where the Three Largest Issuers Had at Least 80 Percent of Enrollment, by Market, 2011-2018 GAO found similar patterns of high concentration across the 39 states in 2018 that used federal infrastructure to operate individual market exchanges— marketplaces where consumers can compare and select among insurance plans sold by participating issuers—established in 2014 by the Patient Protection and Affordable Care Act (PPACA) and known as federally facilitated exchanges. From 2015 through 2018, states that were already highly concentrated became even more concentrated, often because the number of issuers decreased or the existing issuers accrued the entirety of the market share within a state. In 2017 and 2018 all 39 states were highly concentrated. GAO received technical comments on a draft of this report from the Department of Health and Human Services and incorporated them as appropriate. GAO previously reported that, from 2011 through 2016, enrollment in the individual, small group, and large group health insurance markets was concentrated among a few issuers in most states (GAO-19-306). GAO considered states' markets or exchanges to be highly concentrated if three or fewer issuers held at least 80 percent of the market share. GAO also found similar concentration on the health insurance exchanges established in 2014 by PPACA. A highly concentrated health insurance market may indicate less issuer competition and could affect consumers' choice of issuers and the premiums they pay for coverage. PPACA included a provision for GAO to periodically study market concentration. This report describes changes in the concentration of enrollment among issuers in the overall individual, small group, and large group markets; and individual market federally facilitated exchanges. GAO determined market share in the overall markets using enrollment data from 2017 and 2018 that issuers are required to report annually to the Centers for Medicare & Medicaid Services (CMS). GAO determined market share in the individual market federally facilitated exchanges in 2018 using enrollment data from CMS. For all analyses, GAO used the latest data available. For more information, contact John Dicken at (202) 512-7114 or dickenj@gao.gov.
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    In U.S GAO News
    The number of financial attaches that the Department of the Treasury (Treasury) deploys overseas dropped from approximately 30 in 1981 to 7 at the beginning of fiscal year 2005. Treasury has traditionally used financial attaches to monitor and gather information on international economic and financial developments to help shape U.S. international economic policy and to promote U.S. national interests. These attaches are part of the U.S. mission overseas and are typically stationed in U.S. embassies in key countries. Since at least 1981, however, the number of financial attaches placed overseas has been declining in response to changing conditions. Due to congressional interest in these financial attaches, this report describes (1) the role of financial attaches and (2) the process Treasury uses to determine attache placement. In commenting on this report, Treasury considered our report to be fair and accurate. Both Treasury and the Department of State provided technical comments, which we incorporated where appropriate.Financial attaches represent Treasury overseas and cover economic and financial issues relevant to U.S. international economic policies and U.S. national interests, although the role and need for financial attaches have evolved. Specifically, financial attaches conduct monitoring and analysis of macroeconomic and financial issues, including those affecting the private sector. Typically, financial attaches interact with host government financial agencies such as the ministries of finance and central banks, as well as with private sector financial entities. Financial attaches typically work in conjunction with the Economic Section of the U.S. mission and usually share the information they collect with other U.S. agencies. In Afghanistan and Iraq, financial attaches are primarily involved in coordinating economic reconstruction efforts. In general, the role of attaches has evolved over time due to changing Treasury priorities, as well as factors such as technological advances in communications. To some extent, these changes have reduced the necessity for some financial attache posts overseas. Treasury has recently begun to formalize its process for determining attache placement. Previously, the placement of Treasury's attaches was accomplished through an informal process, according to Treasury officials. More recently, Treasury has taken steps to formalize its process by specifying placement criteria it will take into consideration relative to overall Treasury priorities. These criteria include whether the United States has major financial interest in a country or whether there is significant U.S. engagement in a country. However, Treasury officials stated that budget constraints have been a primary factor in determining the number of attaches in recent years. Furthermore, projected rising costs are likely to constrain the number of attaches in the future.
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    In Crime News
    The Department of Justice announced today that the Madoff Victim Fund (MVF) began its seventh distribution of approximately $568 million in funds forfeited to the U.S. government in connection with the Bernard L. Madoff Investment Securities LLC (BLMIS) fraud scheme, bringing the total distributed to over $3.7 billion to nearly 40,000 victims worldwide.
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    In U.S GAO News
    This letter provides GAO's response to the American Institute of Certified Public Accountants' (AICPA) Auditing Standards Board's (ASB) exposure draft, Proposed Statement on Auditing Standards – Inquiries of the Predecessor Auditor Regarding Fraud and Noncompliance With Laws and Regulations. GAO provides standards for performing high-quality audits of governmental organizations, programs, activities, and functions and of government assistance received by contractors, nonprofit organizations, and other nongovernmental organizations with competence, integrity, objectivity, and independence. These standards, often referred to as generally accepted government auditing standards (GAGAS), are to be followed when required by law, regulation, agreement, contract, or policy. For financial audits, GAGAS incorporates by reference the AICPA's Statements on Auditing Standards (SAS).
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    Opioid manufacturer Purdue Pharma LP (Purdue) pleaded guilty today in federal court in Newark, New Jersey, to conspiracies to defraud the United States and violate the anti-kickback statute.
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