CDHA CAAR

October 16, 2018

CAAR – Center for Retirement Research at Boston College Issue Brief – October 16, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:19 pm

An Update on Medicare’s Finances,” by Alicia H. Munnell and Anqi Chen (IB No. 18-19, October 2018, .pdf and Excel format, 9p.).

An Update on Medicare’s Finances

CAAR – Kaiser Family Foundation Issue Brief – October 16, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:18 pm

Medicare Part D: A First Look at Prescription Drug Plans in 2019,” by Juliette Cubanski, Anthony Damico, and Tricia Neuman (October 2018, .pdf format, 12p.).

www.kff.org/medicare/issue-brief/medicare-part-d-a-first-look-at-prescription-drug-plans-in-2019/

October 11, 2018

CAAR – Medicare Payment Advisory Commission Hearing Transcript – October 11, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:11 pm

An agenda and transcript of the October 4-5, 2018 meeting is available.

medpac.gov/-public-meetings-/meeting-details/october-2018-public-meeting

Transcript (.pdf format, 347p.):

medpac.gov/docs/default-source/default-document-library/medpac-october-2018-transcriptscc2e12adfa9c665e80adff00009edf9c.pdf?sfvrsn=0

CAAR – National Academy of Social Insurance Brief – October 11, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:10 pm

Changing Medicare Eligibility: Program Design Challenges,” by Paul N. Van de Water (October 2018, .pdf format, 14p.).

www.nasi.org/research/2018/changing-medicare-eligibility-program-design-challenges

October 5, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Report – October 5, 2018

Filed under: Reports and Articles — Tags: — admin @ 12:43 pm

Many Inpatient Rehabilitation Facility Stays Did Not Meet Medicare Coverage and Documentation Requirements,” (A-01-15-00500, September 2018, .pdf format, 32p.).

oig.hhs.gov/oas/reports/region1/11500500.asp

September 27, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Report – September 27, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:22 pm

Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials,” (OEI-09-16-00410, September 2018, .pdf format, 31p.).

oig.hhs.gov/oei/reports/oei-09-16-00410.asp

September 18, 2018

CAAR – Commonwealth Fund Issue Brief – September 18, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:40 pm

A Policy Option to Enhance Access and Affordability for Medicare’s Low-Income Beneficiaries,” by Cathy Schoen, Karen Davis, Amber Willink, and Christine Buttorff (September 2018, .pdf format, 14p.).

www.commonwealthfund.org/publications/issue-briefs/2018/sep/medicare-low-income-beneficiaries

September 14, 2018

CAAR – Medicare Payment Advisory Commission Hearing Transcript – September 14, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:06 pm

An agenda and transcript of the September 6-7, 2018 meeting is available.

www.medpac.gov/-public-meetings-/meeting-details/september-2018-public-meeting

Transcript (.pdf format, 272p.):

www.medpac.gov/docs/default-source/default-document-library/medpac-meeting-transcripts-9-2018.pdf

September 13, 2018

CAAR – Journal of the American Medical Association Article Abstracts – September 13, 2018

Filed under: Reports and Articles — Tags: , — admin @ 5:05 pm

A. “Association of Hospital Participation in a Medicare Bundled Payment Program With Volume and Case Mix of Lower Extremity Joint Replacement Episodes,” by Amol S. Navathe, Joshua M. Liao, Sarah E. Dykstra, Erkuan Wang, Zoe M. Lyon, Yash Shah, Joseph Martinez, Dylan S. Small, Rachel M. Werner, Claire Dinh, Xinshuo Ma, and Ezekiel J. Emanuel (Vol. 320, No. 9, September 4, 2018, p. 901-910).

jamanetwork.com/journals/jama/article-abstract/2698926

B. “Mandatory Medicare Bundled Payment Program for Lower Extremity Joint Replacement and Discharge to Institutional Postacute Care: Interim Analysis of the First Year of a 5-Year Randomized Trial,” by Amy Finkelstein, Yunan Ji, Neale Mahoney, and Jonathan Skinner (Vol. 320, No. 9, September 4, 2018, p. 892-900).

jamanetwork.com/journals/jama/article-abstract/2698927

CAAR – National Academy of Social Insurance Report – September 13, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:00 pm

Changing Medicare Eligibility: Program Design Challenges,” by Paul N. Van de Water (No. 15, September 2018, .pdf format, 16p.).

www.nasi.org/research/2018/changing-medicare-eligibility-program-design-challenges

September 10, 2018

CAAR – US Government Accountability Office Report – September 10, 2018

Filed under: Reports and Articles — Tags: — admin @ 2:24 pm

Medicare Advantage: Benefits and Challenges of Payment Adjustments Based on Beneficiaries’ Ability to Perform Daily Tasks,” (GAO-18-588, September 2018, .pdf format, 29p.).

www.gao.gov/products/GAO-18-588

August 27, 2018

CAAR – US Government Accountability Office Report – August 27, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:51 pm

Medicare Fee-For-Service: Information on the First Year of Nationwide Reduced Payment Rates for Durable Medical Equipment,” (GAO-18-534, July 2018, .pdf format, 54p.).

www.gao.gov/products/GAO-18-534

CAAR – National Bureau of Economic Research Working Paper – August 27, 2018

Filed under: Working Papers — Tags: , — admin @ 5:49 pm

Links to an abstract are available. For full text availability check your organization’s library. “Long-Term Care Hospitals: A Case Study in Waste,” by Liran Einav, Amy Finkelstein, and Neale Mahoney (w24946, August 2018, .pdf format, 60p.).

www.nber.org/papers/w24946

August 22, 2018

CAAR – Kaiser Family Foundation Note – August 22, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:03 pm

Closing the Medicare Part D Coverage Gap: Trends, Recent Changes, and What’s Ahead,” by Juliette Cubanski, Tricia Neuman, and Anthony Damico (August 2018, .pdf format, 6p.).

www.kff.org/medicare/issue-brief/closing-the-medicare-part-d-coverage-gap-trends-recent-changes-and-whats-ahead/

August 21, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Report – August 21, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:02 pm

Medicare Made Improper and Potentially Improper Payments for Emergency Ambulance Transports to Destinations Other Than Hospitals or Skilled Nursing Facilities,” (A-09-17-03017, August 2018, .pdf format, 20p.).

oig.hhs.gov/oas/reports/region9/91703017.asp

CAAR – Journal of the American Medical Association Article Abstracts – August 21, 2018

A. “Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents,” by Chana A. Sacks, ChangWon C. Lee, Aaron S. Kesselheim, and Jerry Avorn (Vol. 320, No. 7, August 21, 2018, p. 650-656).

jamanetwork.com/journals/jama/article-abstract/2697695

B. “Association of Cardiovascular Health Level in Older Age With Cognitive Decline and Incident Dementia,” by Cécilia Samieri, Marie-Cécile Perier, Bamba Gaye, Cécile Proust-Lima, Catherine Helmer, Jean-François Dartigues, Claudine Berr, Christophe Tzourio, and Jean-Philippe Empana (Vol. 320, No. 7, August 21, 2018, p. 657-664).

jamanetwork.com/journals/jama/article-abstract/2697696

August 14, 2018

CAAR – US Centers for Medicare and Medicaid Services Fact Sheet – August 14, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:09 pm

Medicare Advantage Prior Authorization and Step Therapy for Part B Drugs,” (August 2018).

www.cms.gov/newsroom/fact-sheets/medicare-advantage-prior-authorization-and-step-therapy-part-b-drugs

August 9, 2018

CAAR – US Department of Health and Human Services, Office of the Inspector General Report – August 9, 2018

Filed under: Reports and Articles — Tags: , — admin @ 5:28 pm

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2016 Average Sales Prices,” (OEI-03-18-00120, August 2018, .pdf format, 12p.).

oig.hhs.gov/oei/reports/oei-03-18-00120.asp

August 8, 2018

CAAR – Tables of Contents – August 8, 2018

Filed under: Journal Table of Contents — Tags: , , — admin @ 5:05 pm

Health Affairs (Vol. 37, No. 8, August 2018).

www.healthaffairs.org/toc/hlthaff/37/8

Journal of Alzheimer’s Disease (Vol. 64, No. 4, 2018).

content.iospress.com/journals/journal-of-alzheimers-disease/64/4

Journal of Elder Abuse and Neglect (Vol. 30, No. 4, 2018).

www.tandfonline.com/toc/wean20/30/4?nav=tocList&

August 1, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Report – August 1, 2018

Filed under: Reports and Articles — Tags: , — admin @ 4:55 pm

Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio,” (OEI-02-16-00570, July 2018, .pdf format, 40p.).

oig.hhs.gov/oei/reports/oei-02-16-00570.asp

CAAR – US Government Accountability Office Correspondence – August 1, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:54 pm

Medicare: Status of HHS’s Implementation of Required Prior Authorization Medical Reviews and Provider Education for Chiropractic Services,” (GAO-18-624R, July 2018, .pdf format, 7p.).

www.gao.gov/products/GAO-18-624R

July 30, 2018

CAAR – Medicare Payment Advisory Commission Report – July 30, 2018

Filed under: Reports and Articles — Tags: , — admin @ 5:01 pm

Health Care Spending and the Medicare Program,” (June 2018, .pdf format, 203p.).

www.medpac.gov/docs/default-source/data-book/jun18_databookentirereport_sec.pdf

July 23, 2018

CAAR – New England Journal of Medicine Article Abstract – July 23, 2018

Filed under: Reports and Articles — Tags: , — admin @ 5:25 pm

Evaluation of Medicare’s Bundled Payments Initiative for Medical Conditions,” by Karen E. Joynt Maddox, E. John Orav, Jie Zheng, and Arnold M. Epstein (Vol. 379, No. 3, July 19, 2018, p. 260-269).

www.nejm.org/doi/full/10.1056/NEJMsa1801569

July 19, 2018

CAAR – US Department of Health and Human Services, Office of the Inspector General Report – July 19, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:10 pm

Medicare Improperly Paid Providers for Nonemergency Ambulance Transports to Destinations Not Covered by Medicare,” (A-09-17-03018, July 2018, .pdf format, 14p.).

oig.hhs.gov/oas/reports/region9/91703018.asp

 

July 18, 2018

CAAR – US House Committee on Ways and Means, Subcommittee on Health Hearing Testimony – July 18, 2018

Filed under: Legislation Information Updates — Tags: — admin @ 5:11 pm

Hearing on Modernizing Stark Law to Ensure the Successful Transition from Volume to Value in the Medicare Program,” a hearing held July 17, 2018 (witness statement available in .pdf format, video of the full hearing available at the site, running time 1 hour 58 minutes). Note: Hearing begins at the 18:41 mark and ends at the 2:16:52 mark.

waysandmeans.house.gov/event/hearing-on-modernizing-stark-law-to-ensure-the-successful-transition-from-volume-to-value-in-the-medicare-program/

July 17, 2018

CAAR – US House Committee on Ways and Means, Subcommittee on Oversight Hearing Testimony – July 17, 2018

Filed under: Legislation Information Updates — Tags: — admin @ 4:55 pm

Hearing on Combating Fraud in Medicare: A Strategy for Success,” a hearing held July 17, 2018 (witness statement available in .pdf format, video of the full hearing available at the site, running time hour minutes). Note: Hearing begins at the 1:28 mark.

waysandmeans.house.gov/event/hearing-on-combating-fraud-in-medicare-a-strategy-for-success/

July 10, 2018

CAAR – US Government Accountability Office Report – July 10, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:06 pm

Medicare: Small and Rural Practices’ Experiences in Previous Programs and Expected Performance in the Merit-based Incentive Payment System,” (GAO-18-428, May 2018, .pdf format, 49p.).

www.gao.gov/products/GAO-18-428

July 9, 2018

CAAR – Medicare Payment Advisory Commission Report – July 9, 2018

Filed under: Reports and Articles — Tags: , — admin @ 5:28 pm

Report to the Congress: Medicare and the Health Care Delivery System,” (June 2018, .pdf format, 383p.).

www.medpac.gov/docs/default-source/reports/jun18_medpacreporttocongress_sec.pdf

June 29, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Report – June 29, 2018

Filed under: Reports and Articles — Tags: , — admin @ 3:40 pm

Opioid Use in Medicare Part D Remains Concerning,” (OEI-02-18-00220, June 2018, .pdf format, 23p.).

oig.hhs.gov/oei/reports/oei-02-18-00220.asp

June 28, 2018

CAAR – Commonwealth Fund Issue Brief – June 28, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:52 pm

Designing a Medicare Help at Home Benefit: Lessons from Maryland’s Community First Choice Program,” by Karen Davis, Amber Willink, Ian Stockwell, Kaitlyn Whiton, Julia Burgdorf, and Cynthia Woodcock (June 2018, .pdf and HTML format, 9p.).

www.commonwealthfund.org/publications/issue-briefs/2018/jun/designing-medicare-help-home-benefit-lessons-marylands-community

June 27, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Report – June 27, 2018

Filed under: Reports and Articles — Tags: , — admin @ 5:08 pm

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2018,” (OEI-05-18-00240, June 2018, .pdf format, 32p.).

oig.hhs.gov/oei/reports/oei-05-18-00240.asp

June 25, 2018

CAAR – Kaiser Family Foundation Issue Brief – June 25, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:24 pm

The Facts on Medicare Spending and Financing,” by Juliette Cubanski and Tricia Neuman (June 2018, .pdf format, 8p.)

www.kff.org/medicare/issue-brief/the-facts-on-medicare-spending-and-financing/

June 21, 2018

CAAR – Kaiser Family Foundation Issue Brief – June 21, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:43 pm

What’s in the Administration’s 5-Part Plan for Medicare Part D and What Would it Mean for Beneficiaries and Program Savings?” by Juliette Cubanski (June 2018, .pdf format, 6p.).

www.kff.org/medicare/issue-brief/whats-in-the-administrations-5-part-plan-for-medicare-part-d-and-what-would-it-mean-for-beneficiaries-and-program-savings/

June 14, 2018

CAAR – US Social Security Administration, Research, Statistics, and Policy Analysis Reports, Periodicals – June 14, 2018

Filed under: Reports and Articles — Tags: , , — admin @ 4:50 pm

A. “Earnings and Employment Data for Workers Covered Under Social Security and Medicare, by State and County, 2015,” (May 2018, .pdf, Excel, and HTML format, 455p.).

www.ssa.gov/policy/docs/statcomps/eedata_sc/2015/index.html

B. “SSI Recipients by State and County, 2017,” (June 2018, .pdf, Excel, and HTML format, 115p.).

www.ssa.gov/policy/docs/statcomps/ssi_sc/2017/index.html

C. SSI Monthly Statistics, April 2018 (May 2018, .pdf and HTML format).

www.ssa.gov/policy/docs/statcomps/ssi_monthly/2018-04/index.html

D. International Update, May 2018, (May 2018, .pdf format, 3p.).

www.ssa.gov/policy/docs/progdesc/intl_update/2018-05/index.html

June 11, 2018

CAAR – Urban Institute Report – June 11, 2018

Filed under: Reports and Articles — Tags: , — admin @ 4:49 pm

Social Security and Medicare Lifetime Benefits and Taxes: 2017 Update,” by C. Eugene Steuerle and Caleb Quakenbush (June 2018, .pdf format, 25p.).

www.urban.org/research/publication/social-security-and-medicare-lifetime-benefits-and-taxes-2017-update

June 7, 2018

CAAR – US Centers for Medicare and Medicaid Services Report – June 7, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:09 pm

2018 Annual Report of The Boards of Trustees of The Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds,” (June 2018, .pdf format, 254p.).

www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ReportsTrustFunds/index.html

June 4, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Brief – June 4, 2018

Filed under: Reports and Articles — Tags: , — admin @ 4:25 pm

Increases in Reimbursement for Brand-Name Drugs in Part D,” (OEI 03 15 00080, June 2018, .pdf format, 15p.).

oig.hhs.gov/oei/reports/oei-03-15-00080.asp

 

May 30, 2018

CAAR – US Senate Committe on Finance, Subcommittee on Health Hearing Testimony – May 30, 2018

Filed under: Legislation Information Updates — Tags: , , — admin @ 5:10 pm

Examining Efforts to Prevent Opioid Overutilization and Misuse in Medicare and Medicaid,” a hearing held May 29, 2018 (witness statements available in .pdf format, video of the full hearing available at the site, running time hour minutes).

www.finance.senate.gov/hearings/examining-efforts-to-prevent-opioid-overutilization-and-misuse-in-medicare-and-medicaid

May 24, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Reports – May 24, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:10 pm

A. “Round 2 Competitive Bidding for Oxygen: Continued Access for Vast Majority of Beneficiaries,” (OEI-01-15-00041, May 2018, .pdf format, 29p.).

oig.hhs.gov/oei/reports/oei-01-15-00041.asp

B. “Round 2 Competitive Bidding For Enteral Nutrition: Continued Access For Vast Majority Of Beneficiaries,” (OEI-01-15-00042, May 2018, .pdf format, 22p.).

oig.hhs.gov/oei/reports/oei-01-15-00042.asp

 

CAAR – Nature Letter Abstract – May 24, 2018

Filed under: Reports and Articles — Tags: , , — admin @ 5:09 pm

Cellular milieu imparts distinct pathological {alpha}-synuclein strains in {alpha}-synucleinopathies,” by Chao Peng, Ronald J. Gathagan, Dustin J. Covell, Coraima Medellin, Anna Stieber, John L. Robinson, Bin Zhang, Rose M. Pitkin, Modupe F. Olufemi, Kelvin C. Luk, John Q. Trojanowski & Virginia M.-Y. Lee (Vol. 557, No. 7706, May 24, 2018, p. 558-563).

www.nature.com/articles/s41586-018-0104-4

May 21, 2018

CAAR – US Government Accountability Office Report – May 21, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:54 pm

Medicare: CMS Should Take Actions to Continue Prior Authorization Efforts to Reduce Spending,” (GAO-18-341, April 2018, .pdf format, 49p.).

www.gao.gov/products/GAO-18-341

May 17, 2018

CAAR – Kaiser Family Foundation Issue Brief – May 17, 2018

Filed under: Reports and Articles — Tags: — admin @ 5:01 pm

Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing,” by Juliette Cubanski, Anthony Damico, and Tricia Neuman (May 2018, .pdf format, 13p.).

www.kff.org/medicare/issue-brief/medicare-part-d-in-2018-the-latest-on-enrollment-premiums-and-cost-sharing/

May 11, 2018

CAAR – Brookings Institution Report – May 11, 2018

Filed under: uncategorized — Tags: — admin @ 3:48 pm

A Proposal to Enhance Competition and Reform Bidding in the Medicare Advantage Program,” by Steven M. Lieberman, Loren Adler, Erin Trish, Joseph Antos, John Bertko, and Paul Ginsburg (May 2018, .pdf format, 25p.).

www.brookings.edu/research/a-proposal-to-enhance-competition-and-reform-bidding-in-the-medicare-advantage-program/

May 8, 2018

CAAR – US Senate Special Committee on Aging Hearing Testimony – May 8, 2018

Filed under: Legislation Information Updates — Tags: , — admin @ 4:54 pm

Insulin Access and Affordability: The Rising Cost of Treatment,” a hearing held May 8, 2018 (witness statements available in .pdf format, video of the full hearing available at the site, running time 1 hour 41 minutes). Hearing begins at the 18:46 mark.

www.aging.senate.gov/hearings/insulin-access-and-affordability-the-rising-cost-of-treatment

CAAR – US House Committee on Ways and Means, Health Subcommittee Hearing Testimony – May 8, 2018

Filed under: Legislation Information Updates — Tags: — admin @ 4:53 pm

Hearing on the Medicare Advantage Program,” a hearing held May 8, 2018 (witness statements available in .pdf format, video of the full hearing available at the site, running time 1 hour 46 minutes). Note: The hearing begins at the 1:58 mark.

waysandmeans.house.gov/event/hearing-on-the-medicare-advantage-program/

April 27, 2018

CAAR – Kaiser Family Foundation Issue Brief – April 27, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:52 pm

Searching for Savings in Medicare Drug Price Negotiations,” by Juliette Cubanski and Tricia Neuman (April 2018, .pdf format, 5p.).Kaiser Family Foundation Issue Brief: “Searching for Savings in Medicare Drug Price Negotiations,” by Juliette Cubanski and Tricia Neuman (April 2018, .pdf format, 5p.).

www.kff.org/medicare/issue-brief/searching-for-savings-in-medicare-drug-price-negotiations/

April 18, 2018

CAAR – US Department of Health and Human Services, Office of Inspector General Reports – April 18, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:49 pm

A. “CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements,” (A-05-16-00058, April 2018, .pdf format, 20p.).

oig.hhs.gov/oas/reports/region5/51600058.asp

B. “CMS’s Policies and Procedures Were Generally Effective in Ensuring That Prescription Drug Coverage Capitation Payments Were Not Made After the Beneficiaries’ Dates of Death,” (A-07-16-05088, April 2018, .pdf format, 12p.).

oig.hhs.gov/oas/reports/region7/71605088.asp

April 10, 2018

CAAR – Medicare Payment Advisory Commission Hearing Transcript – April 10, 2018

Filed under: Reports and Articles — Tags: — admin @ 4:56 pm

A transcript of the March 1-2, 2018 meeting is available.

www.medpac.gov/-public-meetings-/meeting-details/march-2018-public-meeting

View transcript (.pdf format, 413p.):

www.medpac.gov/docs/default-source/default-document-library/april-2018-meeting-transcript.pdf?sfvrsn=0

April 9, 2018

CAAR – National Bureau of Economic Research Working Paper – April 9, 2018

Filed under: Working Papers — Tags: — admin @ 5:01 pm

Links to an abstract are available. For full text availability check your organization’s library.
Multimarket Contact in Health Insurance: Evidence from Medicare Advantage,” by Haizhen Lin and Ian M. McCarthy (w24486, April 2018, .pdf format, 42p.).

www.nber.org/papers/w24486

April 5, 2018

CAAR – US Government Accountability Office Report – April 5, 2018

Filed under: Reports and Articles — Tags: , — admin @ 4:42 pm

Electronic Health Information: CMS Oversight of Medicare Beneficiary Data Security Needs Improvement,” (GAO-18-210, March 2018, .pdf format, 42p.).

www.gao.gov/products/GAO-18-210

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