B-255639

spotlighting management problems and high-risk areas in the federal government that affect older Americans. These reports are shown in appendix V.

We have also provided information on GAO's employment of older Americans (see app. VI). As you are aware, our policies prohibit age discrimination. On September 30, 1993, about 59 percent of our work fo was 40 years of age and older. We continue to provide individual retirement counseling and group preretirement seminars.

As arranged with your office, we are sending copies of this report to interested congressional committees and subcommittees. Copies will al be made available to others on request.

This report was prepared under the direction of Joseph F. Delfico, Director, Income Security Issues, who may be reached at (202) 512-721 you have any questions. Other major contributors are listed in appendix VII.

Sincerely yours,

Janet L. Shilles

Janet L. Shikles

Assistant Comptroller General

Contents

Letter

Appendix I

Fiscal Year 1993 GAO

Reports on Issues

Primarily Affecting

Older Americans

Employment Issues

Federal Personnel: Employment Policy Challenges Created by an

Aging Workforce (GAO/GGD-93-138, Sept. 23, 1993)

Health Issues

Cataract Surgery: Patient-Reported Data on Appropriateness and

Outcomes (GAO/PEMD-93-14, Apr. 20, 1993)

Home Health Care: HCFA Properly Evaluated JCAHO's Ability to

Survey Home Health Agencies (GAO/HRD-93-33, Oct. 26, 1992)

Long-Term Care Insurance: High Percentage of Policyholders

Drop Policies (GAO/HRD-93-129, Aug. 25, 1993)

Long-Term Care Insurance: Tax Preferences Reduce Costs More

for Those in Higher Tax Brackets (GAO/GGD-93-110, June 22,

1993)

Medicaid Estate Planning (GAO/HRD-93-29R, July 20, 1993)

Medical Malpractice: Medicare/Medicaid Beneficiaries Account

for a Relatively Small Percentage of Malpractice Losses

(GAO/HRD-93-126, Aug. 11, 1993)

Medicare Part B: Reliability of Claims Processing Across Four

Carriers (GAO/PEMD-93-27, Aug. 11, 1993)

Medicare Physician Payment: Geographic Adjusters Appropriate

but Could Be Improved With New Data (GAO/HRD-93-93, July 20,

1993)

Retiree Health Plans: Health Benefits Not Secure Under

Employer-Based System (GAO/HRD-93-125, July 9, 1993)

Screening Mammography: Higher Medicare Payments Could

Increase Costs Without Increasing Use (GAO/HRD-93-50, Apr. 22,

1993)

Contents

Financial Audit: Pension Benefit Guaranty Corporation's 1992

and 1991 Financial Statements (GAO/AIMD-93-21, Sept. 29, 1993)

Financial Management: Estimate of Interest on Selected Benefits

Received by Postal Service Retirees (GAO/AIMD-93-11, July 29,

1993)

Long-Term-Care Case Management: State Experiences and

Implications for Federal Policy (GAO/HRD-93-52, Apr. 6, 1993)

Lump-Sum Retirements (GAO/GGD-93-2R, Oct. 20, 1992)

Older Americans Act: Eldercare Public-Private Partnerships

(GAO/PEMD-93-20, Apr. 16, 1993)

Pension Plans: Hidden Liabilities Increase Claims Against

Government Insurance Program (GAO/HRD-93-7, Dec. 30, 1992)

Pension Plans: Labor Should Not Ignore Some Small Plans That

Report Violations (GAO/HRD-93-45, Mar. 26, 1993)

Pension Restoration Act (GAO/HRD-93-7R, Dec. 18, 1992)

Private Pensions: Protections for Retirees' Insurance Annuities

Can Be Strengthened (GAO/HRD-93-29, Mar. 31, 1993)

Small Pension Plans: Concerns About the IRS Actuarial Audit

Program (GAO/HRD-93-64, June 30, 1993)

Social Security: IRS Tax Identity Data Can Help Improve SSA

Earnings Records (GAO/HRD-93-42, Mar. 29, 1993)

Social Security: Need to Improve Postentitlement Service to the

Public (GAO/HRD-93-21, May 7, 1993)

Social Security: Telephone Busy Signal Rates at Local SSA Field

Offices (GAO/HRD-93-49, Mar. 4, 1993)

Status of Agency Use of SSA Death Information

(GAO/HRD-93-31R, July 20, 1993)

Underfunded State and Local Pension Plans (GAO/HRD-93-9R,

Dec. 3, 1992)

Veterans Issues

Army Material Command: Factors Influencing Retirement

Decisions During 1990 Reduction in Force (GAO/NSIAD-93-28BR,

Dec. 31, 1992)

VA Health Care: Potential for Offsetting Long-Term Care Costs

Through Estate Recovery (GAO/HRD-93-68, July 27, 1993)

Other Issues

Tax Administration: Information on Tax Counseling for the

Elderly Program (GAO/GGD-93-90BR, Apr. 8, 1993)

i

Contents

ppendix II

iscal Year 1993 GAO

eports on Issues

ffecting Older

mericans and Others

Employment Issues

Americans With Disabilities Act: Initial Accessibility Good but

Important Barriers Remain (GAO/PEMD-93-16, May 19, 1993)

Information on EEO Discrimination Complaints

(GAO/GGD-93-6RS, Dec. 31, 1992)

Monetary Payments in Federal EEO Cases (GAO/GGD-93-45R,

May 25, 1993)

The Public Service: Issues Confronting the Federal Civilian

Workforce (GAO/GGD-93-53, Mar. 16, 1993)

Vocational Rehabilitation: Evidence for Federal Program's

Effectiveness Is Mixed (GAO/PEMD-93-19, Aug. 27, 1993)

Health Issues

Emergency Departments: Unevenly Affected by Growth and

Change in Patient Use (GAO/HRD-93-4, Jan. 4, 1993)

Family and Medical Leave Cost Estimate (GAO/HRD-93-14R,

Feb. 1, 1993)

Federal Health Care: Increased Information System Sharing

Could Improve Service, Reduce Costs (GAO/IMTEC-93-33BR,

June 29, 1993)

Health Care Access: Innovative Programs Using Nonphysicians

(GAO/HRD-93-128, Aug. 27, 1993)

Health Care: Rochester's Community Approach Yields Better

Access, Lower Costs (GAO/HRD-93-44, Jan. 29, 1993)

Health Information Systems: National Practitioner Data Bank

Continues to Experience Problems (GAO/IMTEC-93-1, Jan. 29,

1993)

Indian Health Service: Basic Services Mostly Available; Substance

Abuse Problems Need Attention (GAO/HRD-93-48, Apr. 9, 1993)

Medicaid: Changes in Drug Prices Paid by HMOs and Hospitals

Since Enactment of Rebate Provisions (GAO/HRD-93-43, Jan. 15,

1993)

Medicaid: Data Improvements Needed to Help Manage Health

Care Program (GAO/IMTEC-93-18, May 13, 1993)

Medicaid Drug Fraud: Federal Leadership Needed to Reduce

Program Vulnerabilities (GAO/HRD-93-118, Aug. 2, 1993)

Medicaid: Outpatient Drug Costs and Reimbursements for

Selected Pharmacies in Illinois and Maryland

(GAO/HRD-93-55FS, Mar. 18, 1993)

Contents

Medicare: Millions in End-Stage Renal Disease Expenditures Shifted to Employer Health Plans (GAO/HRD-93-31, Dec. 31, 1992)

Medicare: Renal Facility Cost Reports Probably Overstate Costs
of Patient Care (GAO/HRD-93-70, May 18, 1993)
Medicare: Separate Payment for Fitting Braces and Artificial
Limbs Is Not Needed (GAO/HRD-93-98, July 21, 1993)
Nonprofit Hospitals: For-Profit Ventures Pose Access and
Capacity Problems (GAO/HRD-93-124, July 22, 1993)
Organ Transplants: Increased Effort Needed to Boost Supply and
Ensure Equitable Distribution of Organs (GAO/HRD-93-56,
Apr. 22, 1993)

Prescription Drug Prices: Analysis of Canada's Patented Medicine
Prices Review Board (GAO/HRD-93-51, Feb. 17, 1993)

Psychiatric Fraud and Abuse: Increased Scrutiny of Hospital Stays Is Needed for Federal Health Programs (GAO/HRD-93-92, Sept. 17, 1993)

Utilization Review: Information on External Review

Organizations (GAO/HRD-93-22FS, Nov. 24, 1992)

Housing Issues

Assisted Housing: Evening Out the Growth of the Section 8
Program's Funding Needs (GAO/RCED-93-54, Aug. 5, 1993)
Homelessness: McKinney Act Programs and Funding Through
Fiscal Year 1991 (GAO/RCED-93-39, Dec. 21, 1992)
Public and Assisted Housing: Some Progress Made in
Implementing HUD's Family Self-Sufficiency Program
(GAO/RCED-93-78, Apr. 8, 1993)

Public Housing: Low-Income Housing Tax Credit as an

Alternative Development Method (GAO/RCED-93-31, July 16, 1993)

Rural Housing: FmHA's Home Loan Program Not Meeting the Needs of All Rural Residents (GAO/RCED-93-57, June 14, 1993) Income Security Issues

Legal Services Corporation: National Support Center Grantees' Activities (GAO/HRD-93-9, Feb. 5, 1993)

Long-Term Care Forum: Rethinking Service Delivery,

Accountability, and Cost Control (GAO/HRD-93-1SP, July 13, 1993)

Massachusetts Long-Term Care (GAO/HRD-93-22R, May 17, 1993) Social Security Disability: SSA Needs to Improve Continuing