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Carbon Capture Tax Credit: Actions Needed to Improve Federal Administration and Evaluation of Tax Expenditure
WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report:
* * *
Carbon Capture Tax Credit: Actions Needed to Improve Federal Administration and Evaluation of Tax Expenditure
*
#Fast Facts
Carbon capture technology can reduce carbon in the atmosphere by storing it underground or using it to make products like concrete or jet fuel.
The 45Q tax credit was created to incentivize development of this technology. But some taxpayers have difficulty claiming it. Those who use captured carbon to make products face the biggest hurdles-long delays for approval ... Show Full Article WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * Carbon Capture Tax Credit: Actions Needed to Improve Federal Administration and Evaluation of Tax Expenditure * #Fast Facts Carbon capture technology can reduce carbon in the atmosphere by storing it underground or using it to make products like concrete or jet fuel. The 45Q tax credit was created to incentivize development of this technology. But some taxpayers have difficulty claiming it. Those who use captured carbon to make products face the biggest hurdles-long delays for approvaland a high rejection rate, for example.
No agency is tasked with measuring results and the law didn't set clear goals, so it's hard to know if the 45Q tax credit is working.
We made recommendations to Congress and agencies to improve oversight and administration of the tax credit.
Industrial carbon capture and storage facility with tall metal towers, and pipes.
#Highlights
#What GAO Found
The Carbon Oxide Sequestration Credit (45Q) is a tax credit provided for certain carbon oxides that are captured at emission sources or directly from the air and either stored underground or used to produce products. The credit has been amended multiple times, including by the 2022 Inflation Reduction Act (IRA), which added new credit features. More recently, the One Big Beautiful Bill Act created parity in credit values across uses of captured carbon. As of March 2026, there were 33 carbon capture facilities in the U.S., with additional facilities planned. The number of 45Q credit claims more than tripled from 2019 to 2023, according to IRS data.
The Internal Revenue Service (IRS) has taken several actions to administer the 45Q credit and mitigate potential noncompliance. However, taxpayers using carbon to produce products face compliance burdens, delays, and uncertainty in claiming the credit. GAO identified areas in the approval process for carbon utilization where IRS and the Department of Energy (DOE) could potentially minimize compliance burden and improve certainty for taxpayers. Pursuing such opportunities-for example, streamlining certain processes, or clarifying acceptable datasets that can be used to calculate carbon displaced-could improve the process and help minimize delays for both agencies and taxpayers.
Multiple potential goals, the lack of a designated agency to evaluate the effectiveness of the credit, and data limitations complicate Congress's ability to understand the performance of the 45Q credit. Even so, periodic reviews of tax expenditures are crucial for informed oversight. GAO has previously recommended various actions Congress and agencies could take to improve oversight for other tax expenditures, such as identifying what should be analyzed and by whom. In this report, GAO identified key questions for Congress to consider directing agencies to analyze to help determine the performance of the credit. These key questions are: (1) how well the credit is working to achieve its goals, (2) how efficiently the credit is performing and (3) how the credit compares to other policy tools.
#Why GAO Did This Study
The 45Q credit was created in 2008 to incentivize the development of carbon capture technology and reduce carbon emissions. Carbon capture involves complex and novel technology, and the 45Q credit could result in potentially substantial revenue expenditures.
The IRA includes a provision for GAO to review the distribution and use of IRA funds. This report assesses (1) IRS's administration of the 45Q credit, and (2) the challenges in evaluating the effectiveness of the credit. GAO reviewed agency policies and procedures and interviewed officials from IRS, DOE, and the Environmental Protection Agency. GAO also interviewed selected external stakeholders knowledgeable about the 45Q credit, representing advocacy, research, and industry. GAO also conducted two site visits to carbon capture sites in Houston, Texas.
#Recommendations
GAO is recommending that Congress consider directing agencies to collect and analyze data to answer key questions about the performance of the 45Q credit, such as how well it is working to achieve its goals, how efficiently it is performing, and how it compares to other policy tools.
GAO is making four recommendations to IRS and two recommendations to DOE to improve the review process for carbon utilization, by reducing taxpayers' burden while still mitigating potential noncompliance. These include determining a time period of carbon capture data needed to begin claiming the credit, and clarifying datasets acceptable for calculating carbon displaced. IRS partially agreed with one recommendation; IRS and DOE disagreed with the remaining five. GAO maintains the recommendations are warranted as discussed in the report.
#Matter for Congressional Consideration
Matter Status Comments
Congress should consider directing agencies to collect and analyze data to answer key questions about the performance of the 45Q credit, such as how well it is working to achieve specific goals, how efficiently it is performing, and how it compares to other policy tools. (Matter for Congressional Consideration 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
#Recommendations for Executive Action
Agency Affected Recommendation Status
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should determine the minimum time period of production system direct data needed to determine the displacement factor in the LCA pre-approval, and update guidance to allow for taxpayers that meet that minimum to submit an LCA for pre-approval prior to the end of the tax year. (Recommendation 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should continue creating additional comparison product system technology baselines, including by implementing a process for taxpayers to request specific technology baselines, similar to the process for requesting provisional emissions rates for the 45V and 45Z credits. (Recommendation 2)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should determine the feasibility, including the costs and benefits, of developing a Greenhouse gases, Regulated Emissions, and Energy use in Technologies (GREET) model for common 45Q utilization pathways, allowing an LCA process that can be submitted upon tax return filing without prior review, similar to the 45V and 45Z credits. (Recommendation 3)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Energy The Secretary of Energy, in coordination with IRS, should adjust the 45Q credit guidance on LCAs to clarify which GREET model data are acceptable for use with a 45Q credit LCA and how and when they can be used. (Recommendation 4)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should modify the IRS/DOE memorandum of understanding (MOU) to provide taxpayers, with appropriate limitations, an opportunity to modify elements of their LCAs prior to rejection, rather than having to resubmit their LCAs and restart the process. (Recommendation 5)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Energy The Secretary of Energy, in coordination with IRS, should modify the IRS/DOE MOU to provide taxpayers, with appropriate limitations, an opportunity to modify elements of their LCA prior to rejection, rather than having to resubmit their LCAs and restart the DOE review process. (Recommendation 6)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
See All 6 Recommendations
***
Original text here: https://www.gao.gov/products/gao-26-107711
* * *
Carbon Capture Tax Credit: Actions Needed to Improve Federal Administration and Evaluation of Tax Expenditure
*
#Fast Facts
Carbon capture technology can reduce carbon in the atmosphere by storing it underground or using it to make products like concrete or jet fuel.
The 45Q tax credit was created to incentivize development of this technology. But some taxpayers have difficulty claiming it. Those who use captured carbon to make products face the biggest hurdles-long delays for approval ... Show Full Article WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * Carbon Capture Tax Credit: Actions Needed to Improve Federal Administration and Evaluation of Tax Expenditure * #Fast Facts Carbon capture technology can reduce carbon in the atmosphere by storing it underground or using it to make products like concrete or jet fuel. The 45Q tax credit was created to incentivize development of this technology. But some taxpayers have difficulty claiming it. Those who use captured carbon to make products face the biggest hurdles-long delays for approvaland a high rejection rate, for example.
No agency is tasked with measuring results and the law didn't set clear goals, so it's hard to know if the 45Q tax credit is working.
We made recommendations to Congress and agencies to improve oversight and administration of the tax credit.
Industrial carbon capture and storage facility with tall metal towers, and pipes.
#Highlights
#What GAO Found
The Carbon Oxide Sequestration Credit (45Q) is a tax credit provided for certain carbon oxides that are captured at emission sources or directly from the air and either stored underground or used to produce products. The credit has been amended multiple times, including by the 2022 Inflation Reduction Act (IRA), which added new credit features. More recently, the One Big Beautiful Bill Act created parity in credit values across uses of captured carbon. As of March 2026, there were 33 carbon capture facilities in the U.S., with additional facilities planned. The number of 45Q credit claims more than tripled from 2019 to 2023, according to IRS data.
The Internal Revenue Service (IRS) has taken several actions to administer the 45Q credit and mitigate potential noncompliance. However, taxpayers using carbon to produce products face compliance burdens, delays, and uncertainty in claiming the credit. GAO identified areas in the approval process for carbon utilization where IRS and the Department of Energy (DOE) could potentially minimize compliance burden and improve certainty for taxpayers. Pursuing such opportunities-for example, streamlining certain processes, or clarifying acceptable datasets that can be used to calculate carbon displaced-could improve the process and help minimize delays for both agencies and taxpayers.
Multiple potential goals, the lack of a designated agency to evaluate the effectiveness of the credit, and data limitations complicate Congress's ability to understand the performance of the 45Q credit. Even so, periodic reviews of tax expenditures are crucial for informed oversight. GAO has previously recommended various actions Congress and agencies could take to improve oversight for other tax expenditures, such as identifying what should be analyzed and by whom. In this report, GAO identified key questions for Congress to consider directing agencies to analyze to help determine the performance of the credit. These key questions are: (1) how well the credit is working to achieve its goals, (2) how efficiently the credit is performing and (3) how the credit compares to other policy tools.
#Why GAO Did This Study
The 45Q credit was created in 2008 to incentivize the development of carbon capture technology and reduce carbon emissions. Carbon capture involves complex and novel technology, and the 45Q credit could result in potentially substantial revenue expenditures.
The IRA includes a provision for GAO to review the distribution and use of IRA funds. This report assesses (1) IRS's administration of the 45Q credit, and (2) the challenges in evaluating the effectiveness of the credit. GAO reviewed agency policies and procedures and interviewed officials from IRS, DOE, and the Environmental Protection Agency. GAO also interviewed selected external stakeholders knowledgeable about the 45Q credit, representing advocacy, research, and industry. GAO also conducted two site visits to carbon capture sites in Houston, Texas.
#Recommendations
GAO is recommending that Congress consider directing agencies to collect and analyze data to answer key questions about the performance of the 45Q credit, such as how well it is working to achieve its goals, how efficiently it is performing, and how it compares to other policy tools.
GAO is making four recommendations to IRS and two recommendations to DOE to improve the review process for carbon utilization, by reducing taxpayers' burden while still mitigating potential noncompliance. These include determining a time period of carbon capture data needed to begin claiming the credit, and clarifying datasets acceptable for calculating carbon displaced. IRS partially agreed with one recommendation; IRS and DOE disagreed with the remaining five. GAO maintains the recommendations are warranted as discussed in the report.
#Matter for Congressional Consideration
Matter Status Comments
Congress should consider directing agencies to collect and analyze data to answer key questions about the performance of the 45Q credit, such as how well it is working to achieve specific goals, how efficiently it is performing, and how it compares to other policy tools. (Matter for Congressional Consideration 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
#Recommendations for Executive Action
Agency Affected Recommendation Status
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should determine the minimum time period of production system direct data needed to determine the displacement factor in the LCA pre-approval, and update guidance to allow for taxpayers that meet that minimum to submit an LCA for pre-approval prior to the end of the tax year. (Recommendation 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should continue creating additional comparison product system technology baselines, including by implementing a process for taxpayers to request specific technology baselines, similar to the process for requesting provisional emissions rates for the 45V and 45Z credits. (Recommendation 2)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should determine the feasibility, including the costs and benefits, of developing a Greenhouse gases, Regulated Emissions, and Energy use in Technologies (GREET) model for common 45Q utilization pathways, allowing an LCA process that can be submitted upon tax return filing without prior review, similar to the 45V and 45Z credits. (Recommendation 3)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Energy The Secretary of Energy, in coordination with IRS, should adjust the 45Q credit guidance on LCAs to clarify which GREET model data are acceptable for use with a 45Q credit LCA and how and when they can be used. (Recommendation 4)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Internal Revenue Service The Commissioner of Internal Revenue, in coordination with DOE, should modify the IRS/DOE memorandum of understanding (MOU) to provide taxpayers, with appropriate limitations, an opportunity to modify elements of their LCAs prior to rejection, rather than having to resubmit their LCAs and restart the process. (Recommendation 5)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Energy The Secretary of Energy, in coordination with IRS, should modify the IRS/DOE MOU to provide taxpayers, with appropriate limitations, an opportunity to modify elements of their LCA prior to rejection, rather than having to resubmit their LCAs and restart the DOE review process. (Recommendation 6)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
See All 6 Recommendations
***
Original text here: https://www.gao.gov/products/gao-26-107711
Wearable Technologies: Potential Benefits and Challenges in Clinical Decision-Making
WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report:
* * *
Wearable Technologies: Potential Benefits and Challenges in Clinical Decision-Making
*
#Fast Facts
Wearable devices with health-related features, such as glucose monitors and smartwatches, are growing in popularity. In this technology assessment, we reviewed how clinicians can use data from wearables to help diagnose and treat patients-and how AI might expand what such devices can achieve.
Wearables rely on sensors to collect data on users. This data may allow clinicians to give patients ... Show Full Article WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * Wearable Technologies: Potential Benefits and Challenges in Clinical Decision-Making * #Fast Facts Wearable devices with health-related features, such as glucose monitors and smartwatches, are growing in popularity. In this technology assessment, we reviewed how clinicians can use data from wearables to help diagnose and treat patients-and how AI might expand what such devices can achieve. Wearables rely on sensors to collect data on users. This data may allow clinicians to give patientsmore timely and personalized treatment. Wearables may also help underserved populations by expanding remote patient care.
But devices vary in reliability and can be difficult to integrate into clinical work. We offer three policy options that could help.
A closeup of a smartwatch on someone's wrist displaying heartrate and other data.
#Highlights
#What GAO Found
Wearable devices (wearables) with health-related features have the potential to be used in clinical decision-making (see figure). Wearables can be either medical or wellness devices, and their features can be augmented by artificial intelligence (AI). Wearables use sensors to track vital signs and establish patient health baselines; alert users, caregivers, or clinicians of medical events or suggested lifestyle changes; and provide additional assessments of user data that can be sent to a clinician for interpretation. Clinicians could use such data as a source of information when diagnosing and treating patients.
Examples of wearables that could be used in clinical decision-making
Wearables increase the amount of information considered during clinical decision-making, which may allow for quicker diagnoses by clinicians, more personalized care plans, and improved patient compliance. Wearables may also benefit underserved populations by expanding remote patient monitoring. However, wearables vary in accuracy and reliability.
AI has the potential to increase the capabilities of wearables by, for example, improving autonomous decision-making. However, the extent to which wearables will be able to make clinical decisions autonomously is unclear at this time.
GAO identified challenges to using wearables for clinical decision-making, including challenges related to ensuring wearables benefit patients as intended, integrating wearables into clinical workflows, and navigating the health technology market.
GAO developed three policy options that could help address the challenges and enhance the benefits of using wearables in clinical decision-making. The first is the status quo, whereby policymakers would continue with current efforts and activities in the field. The other two policy options identify possible new actions by policymakers, which may include legislative bodies, government agencies, standards-setting organizations, industry, and other groups. See below for details of the policy options and relevant opportunities and considerations.
Policy Options Help Address Challenges with Use of Wearables in Clinical Decision-Making
Continue the status quo (report page 24)
Policymakers could continue ongoing digital health technology activities, and policymakers outside of government could continue voluntarily testing the use of wearables for clinical purposes.
Opportunities
* Monitoring and assessing recent and ongoing activities related to digital health technologies, including wearables, may help address some of the challenges GAO identified. Such challenges include ensuring patient health benefits, integrating wearables into clinical workflows, and navigating the health technology market.
Considerations
* Some of the challenges GAO identified may remain unaddressed by recent or ongoing activities, and some activities may worsen some challenges.
Integration of wearables into clinical workflows (report page 26)
Policymakers could refine the clinical workflows and technology infrastructure of medical facilities to support the integration of wearables into clinical decision-making.
Opportunities
* Improving clinical workflow integration could help establish common practices for receiving, responding to, and protecting patient health data, which could protect privacy and improve patient outcomes.
* It could also help clarify clinician responsibilities surrounding the use of wearables data in clinical decision-making, which could ease liability concerns.
Considerations
* Resource requirements for wearables integration could shift resources away from other priorities.
* Patients and clinicians may experience variable results according to the local implementation strategy.
* If administrators improve the integration of selected wearables, the use of wearables not selected may decline.
Improvements to wearables performance (report page 27)
Policymakers could incentivize manufacturers to improve the performance of wearables by building and maintaining a comprehensive public database of recommended wearables that have completed a selected, independent certification process. Clinicians and patients could then use the database to help find certified devices.
Opportunities
* Testing and disclosure of wearables performance could help medical facility administrators, clinicians, and patients make more informed decisions about the benefits and risks of selecting specific wearables.
* Encouraging companies to maintain a certification may increase manufacturer testing of wearables' effect on patient health and safety.
Considerations
* Incentivizing participation in a certification process that is separate from the Food and Drug Administration's review process may create confusion for wearables manufacturers, clinicians, and patients, with potential effects on patient safety.
* Research and development costs may rise significantly, hindering the market for new wearables and potentially advantaging larger, established manufacturers.
Source: GAO. | GAO-26-107847
#Why GAO Did This Study
Because wearables may facilitate more timely and personalized patient care, manufacturers and medical association representatives have suggested increasing their integration into clinical decision-making. In addition, in 2025 leaders at the Department of Health and Human Services announced support for increasing the use of wearables in health care.
GAO was asked to review the potential role of wearables in clinical decision-making. This report examines (1) the potential benefits and challenges of using wearables in clinical decision-making, (2) the potential benefits and challenges of using AI to augment the decision-making capabilities of such wearables, and (3) what policy options might help address challenges and enhance benefits associated with the use of wearables in clinical decision-making.
To conduct this engagement, GAO reviewed scientific literature, federal agency guidance, and other documents; interviewed a wide range of stakeholders and agency representatives; and conducted site visits to laboratories, medical and research centers, and manufacturers to better understand these technologies.
For more information, contact Sarah Harvey at HarveyS@gao.gov.
***
Original text here: https://www.gao.gov/products/gao-26-107847
* * *
Wearable Technologies: Potential Benefits and Challenges in Clinical Decision-Making
*
#Fast Facts
Wearable devices with health-related features, such as glucose monitors and smartwatches, are growing in popularity. In this technology assessment, we reviewed how clinicians can use data from wearables to help diagnose and treat patients-and how AI might expand what such devices can achieve.
Wearables rely on sensors to collect data on users. This data may allow clinicians to give patients ... Show Full Article WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * Wearable Technologies: Potential Benefits and Challenges in Clinical Decision-Making * #Fast Facts Wearable devices with health-related features, such as glucose monitors and smartwatches, are growing in popularity. In this technology assessment, we reviewed how clinicians can use data from wearables to help diagnose and treat patients-and how AI might expand what such devices can achieve. Wearables rely on sensors to collect data on users. This data may allow clinicians to give patientsmore timely and personalized treatment. Wearables may also help underserved populations by expanding remote patient care.
But devices vary in reliability and can be difficult to integrate into clinical work. We offer three policy options that could help.
A closeup of a smartwatch on someone's wrist displaying heartrate and other data.
#Highlights
#What GAO Found
Wearable devices (wearables) with health-related features have the potential to be used in clinical decision-making (see figure). Wearables can be either medical or wellness devices, and their features can be augmented by artificial intelligence (AI). Wearables use sensors to track vital signs and establish patient health baselines; alert users, caregivers, or clinicians of medical events or suggested lifestyle changes; and provide additional assessments of user data that can be sent to a clinician for interpretation. Clinicians could use such data as a source of information when diagnosing and treating patients.
Examples of wearables that could be used in clinical decision-making
Wearables increase the amount of information considered during clinical decision-making, which may allow for quicker diagnoses by clinicians, more personalized care plans, and improved patient compliance. Wearables may also benefit underserved populations by expanding remote patient monitoring. However, wearables vary in accuracy and reliability.
AI has the potential to increase the capabilities of wearables by, for example, improving autonomous decision-making. However, the extent to which wearables will be able to make clinical decisions autonomously is unclear at this time.
GAO identified challenges to using wearables for clinical decision-making, including challenges related to ensuring wearables benefit patients as intended, integrating wearables into clinical workflows, and navigating the health technology market.
GAO developed three policy options that could help address the challenges and enhance the benefits of using wearables in clinical decision-making. The first is the status quo, whereby policymakers would continue with current efforts and activities in the field. The other two policy options identify possible new actions by policymakers, which may include legislative bodies, government agencies, standards-setting organizations, industry, and other groups. See below for details of the policy options and relevant opportunities and considerations.
Policy Options Help Address Challenges with Use of Wearables in Clinical Decision-Making
Continue the status quo (report page 24)
Policymakers could continue ongoing digital health technology activities, and policymakers outside of government could continue voluntarily testing the use of wearables for clinical purposes.
Opportunities
* Monitoring and assessing recent and ongoing activities related to digital health technologies, including wearables, may help address some of the challenges GAO identified. Such challenges include ensuring patient health benefits, integrating wearables into clinical workflows, and navigating the health technology market.
Considerations
* Some of the challenges GAO identified may remain unaddressed by recent or ongoing activities, and some activities may worsen some challenges.
Integration of wearables into clinical workflows (report page 26)
Policymakers could refine the clinical workflows and technology infrastructure of medical facilities to support the integration of wearables into clinical decision-making.
Opportunities
* Improving clinical workflow integration could help establish common practices for receiving, responding to, and protecting patient health data, which could protect privacy and improve patient outcomes.
* It could also help clarify clinician responsibilities surrounding the use of wearables data in clinical decision-making, which could ease liability concerns.
Considerations
* Resource requirements for wearables integration could shift resources away from other priorities.
* Patients and clinicians may experience variable results according to the local implementation strategy.
* If administrators improve the integration of selected wearables, the use of wearables not selected may decline.
Improvements to wearables performance (report page 27)
Policymakers could incentivize manufacturers to improve the performance of wearables by building and maintaining a comprehensive public database of recommended wearables that have completed a selected, independent certification process. Clinicians and patients could then use the database to help find certified devices.
Opportunities
* Testing and disclosure of wearables performance could help medical facility administrators, clinicians, and patients make more informed decisions about the benefits and risks of selecting specific wearables.
* Encouraging companies to maintain a certification may increase manufacturer testing of wearables' effect on patient health and safety.
Considerations
* Incentivizing participation in a certification process that is separate from the Food and Drug Administration's review process may create confusion for wearables manufacturers, clinicians, and patients, with potential effects on patient safety.
* Research and development costs may rise significantly, hindering the market for new wearables and potentially advantaging larger, established manufacturers.
Source: GAO. | GAO-26-107847
#Why GAO Did This Study
Because wearables may facilitate more timely and personalized patient care, manufacturers and medical association representatives have suggested increasing their integration into clinical decision-making. In addition, in 2025 leaders at the Department of Health and Human Services announced support for increasing the use of wearables in health care.
GAO was asked to review the potential role of wearables in clinical decision-making. This report examines (1) the potential benefits and challenges of using wearables in clinical decision-making, (2) the potential benefits and challenges of using AI to augment the decision-making capabilities of such wearables, and (3) what policy options might help address challenges and enhance benefits associated with the use of wearables in clinical decision-making.
To conduct this engagement, GAO reviewed scientific literature, federal agency guidance, and other documents; interviewed a wide range of stakeholders and agency representatives; and conducted site visits to laboratories, medical and research centers, and manufacturers to better understand these technologies.
For more information, contact Sarah Harvey at HarveyS@gao.gov.
***
Original text here: https://www.gao.gov/products/gao-26-107847
International Agreements: DOD Has Opportunities to Improve Internal Communication and Oversight
WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report:
* * *
International Agreements: DOD Has Opportunities to Improve Internal Communication and Oversight
*
#Fast Facts
Through international arrangements, DOD leverages foreign partners to cooperatively develop weapon systems and ensure access to parts and other resources.
Although DOD established hundreds of arrangements worth $64 billion from FYs 2021 to 2025, the total number and dollar value of them declined during these years. One factor in the decline is that DOD is taking longer to review ... Show Full Article WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * International Agreements: DOD Has Opportunities to Improve Internal Communication and Oversight * #Fast Facts Through international arrangements, DOD leverages foreign partners to cooperatively develop weapon systems and ensure access to parts and other resources. Although DOD established hundreds of arrangements worth $64 billion from FYs 2021 to 2025, the total number and dollar value of them declined during these years. One factor in the decline is that DOD is taking longer to reviewand approve the arrangements, which at times has caused significant delays.
DOD has yet to take a systematic or proactive approach to managing the challenges it faces in establishing these arrangements.
We recommended that it do so.
Handshake in front of American flag
#Highlights
#What GAO Found
The Department of Defense (DOD) uses international agreements and arrangements to achieve political, economic, and military objectives. For example, these could include cooperatively developing and producing a military system with a foreign partner. From fiscal years 2021 through 2025, DOD established 303 acquisition-related international arrangements with an associated dollar value of $64 billion. However, both the number and dollar value of these arrangements declined over this period. DOD officials said that factors like personnel shortages and lengthy review and approval timelines contributed to this decline.
Decline in DOD International Arrangements, Fiscal Years (FY) 2021-2025
DOD's internal coordination and communication for international arrangements varied. Apart from occasional difficulties, officials said that coordination between the Under Secretary of Defense (USD)-level offices-Acquisition and Sustainment (A&S), Office of General Counsel, and Policy-is working relatively well. However, communication between USD-level offices and the military departments about some key changes has not been timely. For example, changes to the application of cost-sharing requirements were not broadly communicated when they occurred and were instead shared on an agreement-by-agreement basis. According to military department officials, they subsequently had to adjust and renegotiate multiple arrangements, and some foreign partners opted out of arrangements entirely.
DOD has not yet fully identified or responded to the challenges it faces in establishing these arrangements, and its approach to managing these challenges has at times been ad hoc and reactive. Using a tailored version of GAO's enterprise risk management framework, GAO identified benefits that DOD could realize by implementing a more systematic approach for managing challenges. For example, USD(A&S) could use available data to better leverage resources and pinpoint and monitor challenges to improve oversight. Ultimately, a more systematic approach could help ensure that DOD is better positioned to meet strategic goals for cost-sharing and defense industrial base improvements, while also reducing rework, wasted effort, and costs.
#Why GAO Did This Study
DOD relies on international arrangements to achieve various purposes, including for acquisition activities like increasing access to needed parts, technologies, and resources. Responsibilities for developing these arrangements are dispersed throughout DOD, with the military departments developing and negotiating them, and USD offices reviewing and approving them.
A Senate report includes a provision for GAO to review DOD's coordination for international arrangements. GAO's report examines (1) data trends for selected arrangements for fiscal years 2021-2025; and (2) the extent to which DOD offices coordinate and communicate regarding these arrangements; and (3) assesses DOD's approach to identifying and addressing challenges for these arrangements.
To conduct this work, GAO analyzed military department data for selected arrangements established during fiscal years 2021-2025; reviewed relevant statutes, regulations, and DOD policies; and interviewed DOD officials.
#Recommendations
GAO is recommending that DOD establish a mechanism to ensure timely communication about key changes; and implement a systematic, proactive approach for managing the challenges it faces with acquisition-related international arrangements. DOD concurred with both recommendations and identified actions to improve internal communication and oversight.
#Recommendations for Executive Action
Agency Affected Recommendation Status
Department of Defense The Secretary of Defense should require the Under Secretary of Defense for Acquisition and Sustainment and the Department of Defense Office of General Counsel to establish a mechanism to ensure timely communication with the military departments and other stakeholders of key policy and procedure changes for acquisition-related international arrangements. (Recommendation 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should require the Under Secretary of Defense for Acquisition and Sustainment to implement a systematic, proactive approach-that considers the six essential elements of GAO's tailored framework-for managing its challenges with acquisition-related international arrangements. (Recommendation 2)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
***
Original text here: https://www.gao.gov/products/gao-26-108249
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International Agreements: DOD Has Opportunities to Improve Internal Communication and Oversight
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#Fast Facts
Through international arrangements, DOD leverages foreign partners to cooperatively develop weapon systems and ensure access to parts and other resources.
Although DOD established hundreds of arrangements worth $64 billion from FYs 2021 to 2025, the total number and dollar value of them declined during these years. One factor in the decline is that DOD is taking longer to review ... Show Full Article WASHINGTON, Aug. 6 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * International Agreements: DOD Has Opportunities to Improve Internal Communication and Oversight * #Fast Facts Through international arrangements, DOD leverages foreign partners to cooperatively develop weapon systems and ensure access to parts and other resources. Although DOD established hundreds of arrangements worth $64 billion from FYs 2021 to 2025, the total number and dollar value of them declined during these years. One factor in the decline is that DOD is taking longer to reviewand approve the arrangements, which at times has caused significant delays.
DOD has yet to take a systematic or proactive approach to managing the challenges it faces in establishing these arrangements.
We recommended that it do so.
Handshake in front of American flag
#Highlights
#What GAO Found
The Department of Defense (DOD) uses international agreements and arrangements to achieve political, economic, and military objectives. For example, these could include cooperatively developing and producing a military system with a foreign partner. From fiscal years 2021 through 2025, DOD established 303 acquisition-related international arrangements with an associated dollar value of $64 billion. However, both the number and dollar value of these arrangements declined over this period. DOD officials said that factors like personnel shortages and lengthy review and approval timelines contributed to this decline.
Decline in DOD International Arrangements, Fiscal Years (FY) 2021-2025
DOD's internal coordination and communication for international arrangements varied. Apart from occasional difficulties, officials said that coordination between the Under Secretary of Defense (USD)-level offices-Acquisition and Sustainment (A&S), Office of General Counsel, and Policy-is working relatively well. However, communication between USD-level offices and the military departments about some key changes has not been timely. For example, changes to the application of cost-sharing requirements were not broadly communicated when they occurred and were instead shared on an agreement-by-agreement basis. According to military department officials, they subsequently had to adjust and renegotiate multiple arrangements, and some foreign partners opted out of arrangements entirely.
DOD has not yet fully identified or responded to the challenges it faces in establishing these arrangements, and its approach to managing these challenges has at times been ad hoc and reactive. Using a tailored version of GAO's enterprise risk management framework, GAO identified benefits that DOD could realize by implementing a more systematic approach for managing challenges. For example, USD(A&S) could use available data to better leverage resources and pinpoint and monitor challenges to improve oversight. Ultimately, a more systematic approach could help ensure that DOD is better positioned to meet strategic goals for cost-sharing and defense industrial base improvements, while also reducing rework, wasted effort, and costs.
#Why GAO Did This Study
DOD relies on international arrangements to achieve various purposes, including for acquisition activities like increasing access to needed parts, technologies, and resources. Responsibilities for developing these arrangements are dispersed throughout DOD, with the military departments developing and negotiating them, and USD offices reviewing and approving them.
A Senate report includes a provision for GAO to review DOD's coordination for international arrangements. GAO's report examines (1) data trends for selected arrangements for fiscal years 2021-2025; and (2) the extent to which DOD offices coordinate and communicate regarding these arrangements; and (3) assesses DOD's approach to identifying and addressing challenges for these arrangements.
To conduct this work, GAO analyzed military department data for selected arrangements established during fiscal years 2021-2025; reviewed relevant statutes, regulations, and DOD policies; and interviewed DOD officials.
#Recommendations
GAO is recommending that DOD establish a mechanism to ensure timely communication about key changes; and implement a systematic, proactive approach for managing the challenges it faces with acquisition-related international arrangements. DOD concurred with both recommendations and identified actions to improve internal communication and oversight.
#Recommendations for Executive Action
Agency Affected Recommendation Status
Department of Defense The Secretary of Defense should require the Under Secretary of Defense for Acquisition and Sustainment and the Department of Defense Office of General Counsel to establish a mechanism to ensure timely communication with the military departments and other stakeholders of key policy and procedure changes for acquisition-related international arrangements. (Recommendation 1)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Defense The Secretary of Defense should require the Under Secretary of Defense for Acquisition and Sustainment to implement a systematic, proactive approach-that considers the six essential elements of GAO's tailored framework-for managing its challenges with acquisition-related international arrangements. (Recommendation 2)
Open Actions to satisfy the intent of the recommendation have not been taken or are being planned.
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
***
Original text here: https://www.gao.gov/products/gao-26-108249
DOGE: Information on Personnel and Ethics Activities
WASHINGTON, Aug. 5 (TNSLrpt) -- The Government Accountability Office issued the following report:
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DOGE: Information on Personnel and Ethics Activities
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#Fast Facts
The Department of Government Efficiency was established in January 2025 to reform the federal government.
We identified 206 DOGE personnel who held positions from January 2025 through January 2026. Of these, 27 were described as special government employees-personnel who may continue their private employment while performing temporary duties for the government. Such roles can raise difficult ethics questions.
Officials ... Show Full Article WASHINGTON, Aug. 5 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * DOGE: Information on Personnel and Ethics Activities * #Fast Facts The Department of Government Efficiency was established in January 2025 to reform the federal government. We identified 206 DOGE personnel who held positions from January 2025 through January 2026. Of these, 27 were described as special government employees-personnel who may continue their private employment while performing temporary duties for the government. Such roles can raise difficult ethics questions. Officialsat the Executive Office of the President told us that DOGE personnel receive the same training on ethics as other staff in their office. However, they didn't provide records to confirm this.
DOGE an official website of the United States government displayed on screen.
#Highlights
#What GAO Found
GAO identified 206 Department of Government Efficiency (DOGE) personnel who held positions in the Executive Office of the President (EOP) from January 20, 2025, through January 31, 2026. These individuals held positions at the U.S. DOGE Service (USDS), White House Office, and Office of Management and Budget (OMB). Some of these DOGE personnel were also detailed to other executive agencies outside of EOP. USDS is responsible for coordinating with executive agencies to advance DOGE's initiatives.
Coordination Between U.S. DOGE Service and Other Federal Entities
Of the 206 personnel GAO identified, administration officials characterized four as DOGE leaders. The other 202 personnel held positions at either USDS or the White House Office. These personnel held positions as employees, as detailees to these components from other federal agencies, and as volunteers. Twenty-seven of the 206 were special government employees (SGE). At least 128, including one SGE, had separated from their EOP positions by January 31, 2026.
EOP officials told GAO that DOGE personnel within EOP receive the same ethics and records management training as other EOP personnel. However, EOP did not respond to GAO's requests for access to training records and financial disclosures for DOGE personnel. As a result, GAO could not determine all DOGE personnel who received training or completed financial disclosures with EOP.
Nine executive agencies provided information on ethics and records management activities for 64 DOGE personnel who held positions at those agencies and also within EOP. According to this information, 49 completed ethics training, 18 completed records management training, and 38 filed financial disclosures with those agencies during the time frame of GAO's review. Officials from the nine agencies told GAO that some of the 28 personnel they identified as detailees should have completed these activities with their home agencies. Officials from six agencies told GAO that no individuals at those agencies met GAO's scoping criteria. Ten did not provide requested information timely or at all. As a result, GAO could not determine all DOGE personnel who held positions, received training, or completed financial disclosures with these 10 agencies.
Officials from the Office of Government Ethics, the supervising ethics office for the executive branch, told GAO that they have limited responsibilities concerning the activities of DOGE personnel and do not oversee executive branch employees. Officials said their office has not reviewed an EOP ethics program since 2023 and has no plans to review USDS's program in the next 4 years because the temporary organization within USDS terminated on July 4, 2026.
#Why GAO Did This Study
In January and February 2025, several executive orders directed DOGE to implement a series of government reform initiatives, including to reform the federal workforce and reduce spending. DOGE personnel include SGEs. SGEs may have substantial financial interests outside the federal government that can conflict with their federal responsibilities. Appropriate ethics and records management practices can help support ethical behavior.
GAO was asked to review the employment status of selected DOGE personnel and their activities. This report examines information about (1) the federal positions of EOP DOGE personnel, and (2) their completion of ethics and records management training and their filing of financial disclosures.
For this review, GAO defined EOP DOGE personnel as those who held positions (1) as USDS personnel from January 20, 2025, through January 31, 2026; or (2) as personnel at other EOP components (White House Office or OMB) who assisted USDS or federal agencies in advancing DOGE's initiatives during this time frame. This included individuals who were detailed from EOP to other agencies or from other agencies to EOP. GAO reviewed information from court filings, the administration, and executive agencies about identified personnel's federal positions. GAO also reviewed information from these sources about identified personnel's ethics and records management training and their filing of financial disclosures. In addition, GAO interviewed Office of Government Ethics and National Archives and Records Administration officials about their efforts to support EOP ethics and records management activities for DOGE personnel. GAO requested interviews with EOP, but EOP did not respond to these requests.
For more information, contact Jessica Lucas-Judy at lucasjudyj@gao.gov.
***
Original text here: https://www.gao.gov/products/gao-26-108403
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DOGE: Information on Personnel and Ethics Activities
*
#Fast Facts
The Department of Government Efficiency was established in January 2025 to reform the federal government.
We identified 206 DOGE personnel who held positions from January 2025 through January 2026. Of these, 27 were described as special government employees-personnel who may continue their private employment while performing temporary duties for the government. Such roles can raise difficult ethics questions.
Officials ... Show Full Article WASHINGTON, Aug. 5 (TNSLrpt) -- The Government Accountability Office issued the following report: * * * DOGE: Information on Personnel and Ethics Activities * #Fast Facts The Department of Government Efficiency was established in January 2025 to reform the federal government. We identified 206 DOGE personnel who held positions from January 2025 through January 2026. Of these, 27 were described as special government employees-personnel who may continue their private employment while performing temporary duties for the government. Such roles can raise difficult ethics questions. Officialsat the Executive Office of the President told us that DOGE personnel receive the same training on ethics as other staff in their office. However, they didn't provide records to confirm this.
DOGE an official website of the United States government displayed on screen.
#Highlights
#What GAO Found
GAO identified 206 Department of Government Efficiency (DOGE) personnel who held positions in the Executive Office of the President (EOP) from January 20, 2025, through January 31, 2026. These individuals held positions at the U.S. DOGE Service (USDS), White House Office, and Office of Management and Budget (OMB). Some of these DOGE personnel were also detailed to other executive agencies outside of EOP. USDS is responsible for coordinating with executive agencies to advance DOGE's initiatives.
Coordination Between U.S. DOGE Service and Other Federal Entities
Of the 206 personnel GAO identified, administration officials characterized four as DOGE leaders. The other 202 personnel held positions at either USDS or the White House Office. These personnel held positions as employees, as detailees to these components from other federal agencies, and as volunteers. Twenty-seven of the 206 were special government employees (SGE). At least 128, including one SGE, had separated from their EOP positions by January 31, 2026.
EOP officials told GAO that DOGE personnel within EOP receive the same ethics and records management training as other EOP personnel. However, EOP did not respond to GAO's requests for access to training records and financial disclosures for DOGE personnel. As a result, GAO could not determine all DOGE personnel who received training or completed financial disclosures with EOP.
Nine executive agencies provided information on ethics and records management activities for 64 DOGE personnel who held positions at those agencies and also within EOP. According to this information, 49 completed ethics training, 18 completed records management training, and 38 filed financial disclosures with those agencies during the time frame of GAO's review. Officials from the nine agencies told GAO that some of the 28 personnel they identified as detailees should have completed these activities with their home agencies. Officials from six agencies told GAO that no individuals at those agencies met GAO's scoping criteria. Ten did not provide requested information timely or at all. As a result, GAO could not determine all DOGE personnel who held positions, received training, or completed financial disclosures with these 10 agencies.
Officials from the Office of Government Ethics, the supervising ethics office for the executive branch, told GAO that they have limited responsibilities concerning the activities of DOGE personnel and do not oversee executive branch employees. Officials said their office has not reviewed an EOP ethics program since 2023 and has no plans to review USDS's program in the next 4 years because the temporary organization within USDS terminated on July 4, 2026.
#Why GAO Did This Study
In January and February 2025, several executive orders directed DOGE to implement a series of government reform initiatives, including to reform the federal workforce and reduce spending. DOGE personnel include SGEs. SGEs may have substantial financial interests outside the federal government that can conflict with their federal responsibilities. Appropriate ethics and records management practices can help support ethical behavior.
GAO was asked to review the employment status of selected DOGE personnel and their activities. This report examines information about (1) the federal positions of EOP DOGE personnel, and (2) their completion of ethics and records management training and their filing of financial disclosures.
For this review, GAO defined EOP DOGE personnel as those who held positions (1) as USDS personnel from January 20, 2025, through January 31, 2026; or (2) as personnel at other EOP components (White House Office or OMB) who assisted USDS or federal agencies in advancing DOGE's initiatives during this time frame. This included individuals who were detailed from EOP to other agencies or from other agencies to EOP. GAO reviewed information from court filings, the administration, and executive agencies about identified personnel's federal positions. GAO also reviewed information from these sources about identified personnel's ethics and records management training and their filing of financial disclosures. In addition, GAO interviewed Office of Government Ethics and National Archives and Records Administration officials about their efforts to support EOP ethics and records management activities for DOGE personnel. GAO requested interviews with EOP, but EOP did not respond to these requests.
For more information, contact Jessica Lucas-Judy at lucasjudyj@gao.gov.
***
Original text here: https://www.gao.gov/products/gao-26-108403