What GAO Found The Office of Management and Budget annually designates a list of programs considered high-priority for improper payments. The Department of Veterans Affairs (VA) Community Care program and the Centers for Medicare & Medicaid Services’ (CMS) Medicare Advantage program are two of the 30 programs designated as high priority for fiscal year 2025. VA reported a Community Care improper payment estimate of $608 million for fiscal year 2025, or 2.4 percent of the program’s outlays. CMS reported a Medicare Advantage improper payment estimate of $23.7 billion for fiscal year 2025, or 6.1 percent of the program’s outlays. GAO found gaps in the agencies’ efforts to reduce improper payment and fraud risks. Agency Efforts to Reduce Improper Payments and Fraud Risks   Community Care Program Medicare Advantage Program Developed and implemented a process to identify and assess the root causes of improper payments ● ● Developed, implemented, and monitored corrective action plans that adequately address the identified root causes of improper payments ● ◐ Conducted a fraud risk assessment that identifies inherent fraud risks, assesses their likelihood and impact, determines risk tolerance, evaluates controls, and documents a fraud risk profile ○ ○ Legend: ● Met; ◐ Partially met; ○ Not met. Source: GAO. | GAO-26-107946 Note: Analysis based on the results of GAO work completed from November 2024 through June 2026. For the fiscal years included in GAO’s review, VA developed and implemented a process to identify and assess the root causes of improper payments in the Community Care program. VA also developed, implemented, and monitored corrective action plans that adequately address the identified root causes. While VA has taken steps to identify and assess fraud risks, these efforts do not meet the key elements of a fraud risk assessment and have not resulted in a comprehensive fraud risk assessment for the program, leaving it vulnerable to fraud. For the fiscal years included in GAO’s review, CMS developed and implemented a process to identify and assess the root causes of improper payments in the Medicare Advantage program. However, its estimated improper payment rate has not decreased but remained steady. CMS’s corrective action plans are not sufficiently detailed and do not adequately monitor progress. Specifically, CMS does not have a detailed plan for expediting Risk Adjustment Data Validation (RADV) audits. These audits are CMS’s primary corrective action for identifying and recovering improper payments. CMS’s backlog of RADV audits contributes to significant delays in its recovery efforts. Furthermore, CMS has not conducted a comprehensive fraud risk assessment for the program. CMS’s efforts to reduce improper payments and fraud in the Medicare Advantage program will be inadequate without comprehensive corrective action plans and fraud risk assessments. Why GAO Did This Study Reducing improper payments and fraud is critical to safeguarding federal funds and could help achieve cost savings and improve the government’s fiscal position. GAO was asked to assess agency efforts to identify and address root causes of improper payments and fraud. In this report, GAO examines to what extent (1) VA has taken steps to identify and address the root causes of improper payments and mitigate fraud risks in the Community Care program and (2) CMS has taken steps to identify and address the root causes of improper payments and mitigate fraud risks in the Medicare Advantage program. GAO examined documentation from VA, CMS, PaymentAccuracy.gov, and prior reports from agency Offices of Inspector General (OIG). GAO also interviewed agency officials, OIG staff, and trade association representatives.

What GAO Found The size of passenger vehicles on U.S. roads has grown over the past 30 years. Selected studies that GAO reviewed generally found that larger vehicles, certain design features (see figure), and turning maneuvers may limit a driver’s visibility and pose greater risks to pedestrians and cyclists. Data on driver visibility, such as the size of blind zones around a vehicle, are not readily available. As such, GAO used turning maneuvers to analyze the potential relationship between vehicle type and involvement in fatal pedestrian crashes. GAO found that larger vehicles had higher odds of turning compared with going straight in fatal pedestrian crashes than cars in the same scenarios. For example, heavy-duty trucks (e.g., semi-trucks) had at least 12 times the odds compared with cars. Vehicle Design Features and Their Potential Relationship to Driver Visibility Auto and truck manufacturers that GAO interviewed have developed technologies to help mitigate limited driver visibility, such as side bicyclist alerts and pedestrian automatic emergency braking. Manufacturers have also conducted testing and benchmarking of their vehicles to assess driver visibility. Two selected foreign jurisdictions—the European Union (EU) and London, England—have taken steps to reduce risks to pedestrians and cyclists related to limited driver visibility. The EU has adopted driver visibility standards that auto and truck manufacturers must meet. While similar regulations also apply in the United Kingdom, London has developed a driver visibility standard that requires some commercial truck operators to install additional safety equipment. The Department of Transportation (DOT) has recognized risks to pedestrians and cyclists related to driver visibility but has not fully analyzed those risks or developed responses. DOT has conducted some research and begun to collect data that could be useful in conducting such an analysis. However, it has not analyzed specific risks that limited driver visibility may pose to pedestrians and cyclists, such as those related to turning maneuvers or vehicle design features. DOT has not done so because, in part, it has not determined a method to measure driver visibility in cars and trucks. Such a method could provide data on the size of blind zones and enable DOT to fully analyze the extent to which they pose risks to pedestrians and cyclists. Fully analyzing specific risks would also provide DOT with the information it needs to respond to them, and would better position DOT to meet its goal of reducing roadway fatalities Why GAO Did This Study In 2024, about 9,200 pedestrians and cyclists were killed on U.S. roadways—an increase of about 65 percent since 2010. A range of factors can contribute to increased pedestrian and cyclist fatalities, including larger vehicles, which make up an increasing share of vehicles on U.S. roadways and may limit driver visibility. GAO was asked to review issues related to driver visibility. This report examines (1) what studies and federal data show about the relationship between vehicle characteristics, driver visibility, and pedestrian and cyclist fatalities; (2) actions selected auto and truck manufacturers have taken related to driver visibility; (3) approaches selected foreign jurisdictions have used to reduce driver visibility–related risks to pedestrians and cyclists; and (4) the extent to which DOT has analyzed and responded to potential driver visibility–related risks to pedestrians and cyclists. GAO reviewed selected studies published from 2015 to 2025, analyzed DOT pedestrian fatality data, and selected and interviewed five auto and five truck manufacturers. GAO also reviewed driver visibility standards adopted by the EU and London and interviewed officials about their approaches. Finally, GAO reviewed DOT studies and planning documents and interviewed DOT officials.

GAO’s work regularly finds that federal programs are unable to assess their performance to determine if they are solving the problem they were created to fix. By defining goals and collecting and using relevant data, agencies could make informed decisions to improve their programs’ results. The Big Picture Each year, the federal government spends trillions of dollars on programs that Americans depend on, such as health care, public safety, and disaster support. Our recent reports have found that many federal programs do not have clearly defined goals to identify what they seek to achieve or relevant data to assess progress. Without this information, Congress and agency leaders cannot determine if federal programs funded by taxpayer dollars are delivering intended results and supporting the American people. What GAO’s Work Shows Through a three-step process, federal agencies can monitor and manage the results of their programs. The program performance management process Federal programs do not consistently manage their performance. Our work often finds programs are focused on inputs (such as money to spend) and outputs (such as number of individuals who received benefits). By contrast, outcomes are the results of a program (such as number of individuals whose lives improved in an intended way). Programs often lack information on outcomes because they operate without clear, measurable goals or data to assess their results. Agency leaders and Congress need this information to determine if programs are solving the problems they were created to fix, and in turn, if they are a good return on investment for taxpayer money. Selected Federal Programs that GAO Previously Found Had Incomplete Performance Management Processes Moreover, federal programs rarely work in isolation. Our work often identifies sets of related programs—within an agency or across multiple agencies—that seek to achieve the same outcomes and may create overlapping efforts. We also find these related programs have not always defined goals or collected data to manage their performance. This creates the potential for waste and inefficiency. It limits decision-makers’ abilities to (1) assess relative performance across programs and (2) make informed decisions to streamline efforts or provide resources to more effective programs. Most Programs that Solely Support Pregnant Women, Young Children, and Their Families Had Established Performance Management Processes Many pregnant women, children through age 5, and their families use support services like food assistance or childcare. In 2026, we identified 15 federal programs at five agencies that provide direct services only to this population. Twelve of these 15 programs had performance management processes that set goals, collect data, and use the information to assess whether the programs are meeting goals. We recommended that the remaining three programs without these processes—one each at the Departments of Agriculture, Health and Human Services, and Veterans Affairs—fully develop them to ensure programs are meeting goals, identifying potential improvements, and targeting resources appropriately. Source: GAO. | GAO-26-109130 When we have identified opportunities to improve program performance by developing goals and collecting and using data, agencies have taken action to implement our recommendations. Actions to Improve Performance Management for the Securing the Cities Program The Department of Homeland Security’s (DHS) Securing the Cities program seeks to help state and local governments detect and deter nuclear terrorism. In 2019, we found that DHS did not collect information to fully track cities' use of the program’s funds or assess performance. We recommended DHS do so. Subsequently, we found in 2024 that the program had established goals, performance measures, and milestones, and conducted quarterly financial assessments. DHS is now better positioned to monitor the program’s performance and identify any needed actions to improve results. Source: GAO. | GAO-26-109130 Additional evidence is needed to determine program effectiveness. Because of its ongoing nature, performance management can serve as an early-warning system to identify the need for real-time improvements. Collecting evidence beyond performance data can help determine whether a program is working and why. This includes robust studies known as program evaluations, which can provide valuable insights on program performance. Types of Program Evaluations and Insights Process evaluations assess the extent to which a program is being implemented as intended. Outcome evaluations assess whether (1) program activities are aligned with desired outcomes and (2) changes in outcomes are consistent with program goals. Impact evaluations assess the effect of a program by comparing results to what would have happened in its absence. Source: GAO. | GAO-26-109130 When we asked federal managers in a 2020 survey about these robust evaluations, about one-third of respondents reported having access to them to help manage their programs. Challenges and Opportunities Statutory requirements provide a solid foundation for effective federal performance management. They have also increased agencies’ use of performance data in decision-making, such as identifying program problems to address and developing new strategies. In contrast, Congress and the administration often do not have the performance data and evidence they need to make informed improvements and target resources to individual programs or across related programs. Our work has identified approaches to help ensure decision makers have sufficient information, including practices to help individual or sets of related programs manage performance and build evidence; practices to effectively coordinate, and a guide to evaluate and manage, related programs; and a guide to design program evaluations. Consistently using these approaches could help agencies manage and assess their programs and provide policymakers and the public with vital information about federal program performance. For more information, contact Lori Atkinson at atkinsonl@gao.gov.

What GAO Found The Federal Home Loan Bank (FHLBank) System is a government-sponsored enterprise that consists of 11 federally chartered FHLBanks that support liquidity in the financial system by making loans—known as advances—to member financial institutions, including banks. These advances offer member institutions a low-cost source of funding to make mortgage loans or manage the risk of not meeting financial obligations in a timely and cost-efficient manner (liquidity risk). A December 2025 GAO report found that as of June 2025, 93 percent of banks were FHLBank members and more than three-quarters had taken out at least one advance from June 2015 through June 2025. GAO’s analysis of banks’ quarterly Call Report data found that large banks—those with more than $10 billion in total assets—were responsible for a majority of banks’ FHLBank borrowing in this period. These banks represented approximately 3 percent of active FHLBanks members and held, on average, nearly 74 percent of all outstanding FHLBank borrowing during the period. A March 2024 GAO report found that Silicon Valley Bank and Signature Bank had borrowed substantial advances before their failures in spring 2023. Silicon Valley Bank increased the balance of its outstanding advances by 50 percent in the first week of March 2023 before its failure on March 10. Signature Bank increased its outstanding advances by 37 percent in March 2023 before its failure on March 12. The two FHLBanks continued to assess risk and provide advances to the two banks before they failed. FHLBanks generally lend to members if the requested amount is within the member’s available borrowing capacity based on its pledged collateral or credit limit. FHLBanks may limit or deny advances based on supervisory information from the member’s primary regulator. The FHLBanks and federal banking regulators increased their frequency of communication in March 2023, but the banks’ relatively fast decline limited further action. Timely coordination between FHLBanks and Federal Reserve Banks is critical when a bank is at risk. This coordination must negotiate overlap in membership between the two systems. The March 2023 bank failures revealed such coordination challenges. After March 2023, the FHLBanks and Federal Reserve System initiated two efforts to improve coordination during periods of stress: (1) increasing engagement between FHLBanks and Federal Reserve Banks and (2) establishing a working group to improve interoperability. These efforts are intended to address the coordination challenges experienced during the March 2023 bank failures and are consistent with federal internal control standards related to control activities and information and communication. At the time of GAO’s December 2025 report, these efforts were in the early stages. Continued commitment to these coordination efforts will be important to help ensure that the FHLBanks and Federal Reserve Banks are prepared to respond quickly to member liquidity needs during future periods of financial stress. Why GAO Did This Study The failures of Silicon Valley Bank and Signature Bank in March 2023 renewed questions about the FHLBanks’ role in providing liquidity during periods of financial stress. In the weeks leading up to the failures, these banks had borrowed large sums from their FHLBanks. That same month, total advances outstanding to all members reached about $1 trillion, exceeding levels reached during previous financial market disruptions. This statement discusses (1) the FHLBank System's role in providing financial system liquidity through advances, (2) banks’ use of advances during the March 2023 bank failures, and (3) efforts to improve emergency coordination between FHLBanks and Federal Reserve Banks. This statement is based on reports GAO issued from April 2023 to December 2025. For those reports, GAO reviewed relevant legislation, regulations, policies, and agency reports, and interviewed federal officials, representatives of FHLBanks and member banks, and other stakeholders. For more information, contact Jill Naamane at NaamaneJ@gao.gov.