This is the Spanish language highlights associated with GAO-26-107225. Conclusiones de la GAO En el 2021, el último año para el que la GAO obtuviera datos completos, hubo aproximadamente 2.200 beneficiarios del incentivo fiscal para inversionistas residentes en Puerto Rico. El análisis de la GAO constató una disminución marcada en el promedio de la renta imponible a nivel federal y en los impuestos federales que esta población pagó en el período entre 5 años antes y 5 años después del traslado a Puerto Rico (ver a la figura). El análisis de la GAO encontró que la disminución en los ingresos de los impuestos federales podría ascender a cientos de millones de dólares por año. Figura 1: Promedio del total de renta imponible a nivel federal y a los impuestos federales totales pagados por los contribuyentes que reciben el incentivo fiscal para inversionistas residentes en Puerto Rico Nota: Las sumas en dólares están ajustadas por inflación a valores de 2023. Además, entre 2012 y 2024, casi 4.000 contribuyentes recibieron el incentivo fiscal para la exportación de servicios desde Puerto Rico. El efecto de los incentivos para las inversionistas residentes y la exportación de servicios en la economía de Puerto Rico es difícil de aislar dado que los datos sobre los costos y beneficios son mixtos. En parte, esto se debe a que los beneficiarios representan una fracción pequeña de la población de Puerto Rico. Algunos estudios económicos realizados para el gobierno de Puerto Rico sugieren un aumento en la actividad económica y de empleo a raíz de los incentivos fiscales, mientras que las perspectivas locales y los datos de migración sugieren resultados mixtos. En 2021, el Servicio de Impuestos Internos (IRS, por sus siglas en inglés) anunció una iniciativa de cumplimiento, llamada una campaña, para abordar las inquietudes de que algunos beneficiarios del incentivo para inversionistas residentes en Puerto Rico no estarían cumpliendo sus obligaciones tributarias federales. La campaña solo comenzó a mostrar resultados hace poco tiempo, en parte, debido a la complejidad de las auditorías de ingresos altos y patrimonios elevados, la falta de priorización por parte del IRS de la iniciativa, y las brechas de comunicación entre el IRS y Puerto Rico. Hasta 2025, el IRS no pudo obtener datos completos sobre los contribuyentes que reclamaban el incentivo para inversionistas residentes en Puerto Rico con números del Seguro Social para garantizar el cumplimiento de las leyes tributarias federales. Asimismo, el IRS no cuenta con un plan documentado para obtener sistemáticamente los datos más actuales de Puerto Rico a futuro. La obtención de dichos datos de forma sistemática mejoraría la capacidad del IRS para garantizar el cumplimiento. Adicionalmente, el IRS no analizó referencias de funcionarios del gobierno de Puerto Rico que identificaron a contribuyentes estadounidenses cuyo cumplimiento del requisito de residencia en Puerto Rico no pudieron confirmar. El IRS tampoco tiene un plan para priorizar cualquier referencia futura. La GAO analizó estas referencias junto con los datos del IRS e identificó a los contribuyentes con indicadores de posible incumplimiento de la ley tributaria federal. La GAO compartió este análisis al IRS. El establecimiento de procedimientos para examinar casos de posible incumplimiento identificados por agencias gubernamentales de Puerto Rico podría ayudar al IRS a mejorar el cumplimiento tributario a nivel federal. Por qué la GAO hizo este estudio En el 2012, Puerto Rico promulgó incentivos tributarios para inversionistas residentes (Ley 22) y la exportación de servicios (Ley 20) para fomentar el traslado a Puerto Rico y la inversión en el país. En general, la ley federal exime a los residentes en Puerto Rico del impuesto federal sobre la renta de fuentes dentro de Puerto Rico. El IRS es responsable de asegurar que los contribuyentes que reclaman el incentivo para inversionistas residentes en Puerto Rico cumplan sus obligaciones tributarias federales. Se le solicitó a la GAO que examinara los incentivos tributarios para inversionistas residentes en Puerto Rico y la exportación de servicios. En este informe (1) se describe a la población que recibe los incentivos tributarios, (2) se describen algunos efectos económicos de estos incentivos fiscales en la economía de Puerto Rico, y (3) se evalúan los esfuerzos del IRS para asegurar el cumplimiento entre las personas estadounidenses que se trasladan a Puerto Rico y declaran la residencia. La GAO analizó la documentación y datos del IRS y Puerto Rico y entrevistó a funcionarios pertinentes. La GAO también entrevistó a funcionarios locales, empresas de desarrollo económico y grupos de partes interesadas.

Para la versión de esta página en español, ver a GAO-26-108642. What GAO Found In 2021, the most current year for which GAO had complete data, there were approximately 2,200 recipients of the Puerto Rico resident investor tax incentive. GAO’s analysis found a significant decrease in the average federal taxable income and federal taxes paid by this population between the 5 years prior to and up to 5 years after moving to Puerto Rico (see figure). GAO’s analysis found that the decrease in federal tax revenue in aggregate could amount to hundreds of millions of dollars per year. Figure: Average Total Federal Taxable Income and Total Federal Taxes Paid by Taxpayers Receiving the Puerto Rico Resident Investor Tax Incentive Note: Dollar amounts are inflation-adjusted 2023 dollars. Additionally, from 2012 through 2024, almost 4,000 taxpayers received Puerto Rico’s business export service tax incentive. The effect of the resident investor and business export service incentives on Puerto Rico’s economy is difficult to isolate as the evidence is mixed on the overall costs and benefits. This is, in part, due to recipients representing a small fraction of Puerto Rico’s population. Some economic studies undertaken for the Puerto Rico government suggest an increase in economic activity and employment related to the tax incentives while local perspectives and migration data suggest mixed results. In 2021, the Internal Revenue Service (IRS) announced a compliance initiative, called a campaign, to address concerns that some recipients of Puerto Rico’s resident investor incentive may not be meeting their federal tax obligations. The campaign only recently began showing results, in part, due to the complexity of high-income and high-wealth audits, IRS not prioritizing the effort, and communication gaps between IRS and Puerto Rico. Until 2025, IRS was unable to obtain complete data on taxpayers claiming Puerto Rico’s resident investor incentive with Social Security numbers to help ensure compliance with federal tax laws. Further, IRS has no documented plan to routinely acquire the most current data from Puerto Rico going forward. Obtaining such data regularly would improve IRS’s ability to ensure compliance. Additionally, IRS did not pursue referrals from Puerto Rico government officials who identified U.S. taxpayers whom officials could not confirm met Puerto Rico’s residency requirement. IRS also does not have a plan to prioritize any future referrals. GAO analyzed these referrals along with IRS data and identified taxpayers with indicators of potential noncompliance with federal tax law, which GAO shared with IRS. Establishing procedures to review cases of potential noncompliance identified by Puerto Rico government agencies could help IRS improve federal tax compliance. Why GAO Did This Study In 2012, Puerto Rico enacted the resident investor (Act 22) and export service business (Act 20) tax incentives to encourage relocation to and investment in Puerto Rico. Federal law generally exempts residents of Puerto Rico from federal income tax on income sourced from Puerto Rico. IRS is responsible for ensuring that taxpayers claiming Puerto Rico’s resident investor incentive are meeting their federal tax obligations. GAO was asked to review the Puerto Rico resident investor and export service business tax incentives. This report (1) describes the population receiving tax incentives, (2) describes selected economic effects of these tax incentives on Puerto Rico’s economy, and (3) assesses IRS efforts to ensure compliance among U.S. persons relocating to Puerto Rico and claiming residency. GAO analyzed IRS and Puerto Rico documentation and data and interviewed relevant officials. GAO also interviewed local officials, economic development firms, and stakeholder groups.

Why This Matters The Food and Drug Administration (FDA) oversees recalls of medical devices that may present a risk to the health of users. The ramifications of using recalled devices—such as defective ventilators or pacemakers—include the potential for serious injury or death. FDA’s oversight of medical products, including devices, has been on GAO’s high-risk list since 2009. GAO Key Takeaways From fiscal years 2020 to 2024, FDA oversaw the recall of 3,934 medical devices. All were voluntarily recalled by manufacturers. FDA can mandate a recall, although it rarely does so. Insufficient staff limit FDA’s ability to conduct oversight activities, according to officials. For example, from fiscal years 2020 to 2024, FDA couldn’t meet its 3-month goal of terminating recalls (meaning FDA determines all reasonable efforts were made by the manufacturer to remove or correct the device) due to resource constraints. Some stakeholders said delays can affect patient care. The Department of Health and Human Services (HHS) oversees FDA and is currently undergoing reforms. Conducting workforce planning to determine the staffing and skills FDA needs for oversight would help HHS keep unsafe devices from continued use. According to officials, FDA cannot require manufacturers to adopt its recommendations for how to carry out certain recalls. Some stakeholders said manufacturers and FDA communicating different information can be confusing. FDA officials said it can also result in inefficient use of resources. By working with FDA to assess if additional authorities are needed, and seeking them if beneficial, HHS may be better positioned to address current recall process inefficiencies. Medical Device Recalls that Exceeded FDA’s 3-Month Termination Goal Note: Termination means FDA determines all reasonable efforts were made by the manufacturer to remove or correct the device. How GAO Did This Study We reviewed FDA policies and guidance on the recall process and analyzed data from FDA’s Recall Enterprise System. We also interviewed FDA officials and 10 stakeholder groups representing providers, patients, and the medical device industry to get their perspectives on challenges FDA faces in overseeing recalls.

What GAO Found After three unsuccessful attempts over two decades, the Department of Veterans Affairs (VA) undertook a fourth effort in 2017—the Electronic Health Record Modernization (EHRM) program—to modernize its legacy health information system. GAO has previously reported on the challenges VA has experienced with this effort. In these reports, GAO made 18 recommendations to improve cost estimating, schedule, program management, user adoption and satisfaction, and operational testing. GAO deemed 12 of these as priority recommendations because of their criticality to successful future deployments. VA has not yet fully implemented 16 of the 18 recommendations. Implementation Status of GAO Electronic Health Record System-Related Recommendations to the Department of Veterans Affairs as of December 2025 Report Total number of recommendations Number of priority recommendations Implementation status of recommendations GAO-25-106874 (March 2025) 3 2 2 priority open (not implemented) 1 closed (implemented) GAO-23-106731 (May 2023) 10 10 9 priority open (not implemented) 1 priority open (partially implemented) GAO-22-103718 (February 2022) 2 0 1 open (not implemented) 1 closed (implemented) GAO-21-224 (February 2021) 2 0 2 open (not implemented) GAO-20-473 (June 2020) 1 0 1 open (not implemented) Source: GAO reports. I GAO-26-108812 In March 2025, GAO reported that VA had made improvements at five initial sites but noted that the department’s actions to address challenges had impacted the program’s total cost estimate and schedule. Accordingly, GAO made two priority recommendations to update the cost estimate and schedule. Senate and House Authorizing and Appropriations Committees subsequently sent a letter to VA requesting a detailed cost estimate and schedule before September 30, 2025. While VA has delivered a notional schedule to congressional committees, it has not provided a cost estimate or detailed documentation of its schedule necessary to determine the extent to which it is consistent with leading practices. In May 2023, GAO reported that users expressed dissatisfaction with the new system and VA did not adequately identify and address system issues. GAO made 10 priority recommendations to address change management, user satisfaction, system trouble ticket, and independent operational assessment deficiencies. VA has not yet fully implemented the 10 recommendations. Until VA fully implements the priority recommendations, future deployments risk prolonging management challenges like those experienced in the initial deployments and users will likely not be positioned to achieve optimal usage of the new electronic health record (EHR) system. Why GAO Did This Study VA depends on its EHR system to manage health care for its patients. Since 2017, the department’s EHRM program has undertaken efforts to replace its legacy EHR system with a modernized, commercial system. VA first deployed its new EHR system in October 2020 and followed up with further deployments to four additional sites in 2022. However, in 2023, it halted future system deployments due to feedback from veterans and clinicians that the new system was not meeting expectations. In December 2024, VA announced plans to restart deployments beginning with four facilities in Michigan. The department plans for nine additional site deployments in 2026. VA plans to accelerate deployments to complete approximately 170 sites by 2031. GAO has previously designated VA health care as a high-risk area for the federal government, in part due to its challenges implementing EHRM initiatives. GAO was asked to testify on its key prior reports and related recommendations to improve VA’s EHRM program. GAO summarized the results of five prior reports and followed up with VA on actions to implement recommendations.

What GAO Found The Marine Corps and Air Force had higher rates of the most serious accidents in the last 2 fiscal years (2023 and 2024) with its Osprey aircraft compared with the average serious accident rate for the previous 8 years, based on available Department of Defense (DOD) data. In fiscal years 2023 and 2024, 18 serious, non-combat accidents occured involving death; permanent disability; extensive hospitalization; property damage of $600,000 or more; or a destroyed aircraft. Rates of serious accidents were between 36 percent and 88 percent higher than each service’s average rate for the prior 8 fiscal years. Percent Difference of Serious Osprey Accident Rates in Fiscal Years 2023 and 2024 Compared to Service Average for Fiscal Years 2015–2022 Note: The accident rate equals the number of accidents per year divided by the number of flight hours per year and then multiplied by 100,000. Serious accidents refer to combined Class A and B accidents which are those accidents that involved death; permanent disability; extensive hospitalization; property damages of $600,000 or more; or a destroyed aircraft. The Navy had not experienced a Class A or Class B accident with its Osprey variant since it began operational use in fiscal year 2021 through fiscal year 2024. Rates of serious accidents with the Osprey aircraft generally exceeded those of the Departments of the Navy and Air Force fixed wing and rotary wing aircraft fleets for fiscal year 2015 through fiscal year 2024. Serious Accident Rate Comparisons for Marine Corps and Air Force Osprey with Departments of the Navy and Air Force Fixed Wing and Rotary Wing Fleets, Fiscal Years 2015–2024 Note: Serious accidents refer to combined Class A and B accidents which are those accidents that involved death; permanent disability; extensive hospitalization; property damages of $600,000 or more; or a destroyed aircraft. Most reported causes for serious accidents related to materiel failure of airframe or engine components and human error during aircraft operations or maintenance, according to GAO’s analysis of safety data. Osprey program stakeholders have not fully identified, analyzed, or responded with procedural or materiel mitigations to all safety risks. For example, program stakeholders, which include the Osprey Joint Program Office and military services that operate the aircraft, had closed 45 risk assessments at the time of our review, but had not fully responded to 34 known system-related risks related to the potential failure of airframe and engine components. Stakeholders also had not identified actions to respond to non-system safety risks associated with aircraft maintenance and operations, such as mismatches in maintenance skill levels and limited training time to build aircrew experience. Without refining the joint program’s process for identifying, analyzing, and responding to Osprey safety risks to incorporate and prioritize system and non-system safety risks, program stakeholders cannot adequately mitigate risks that can contribute to death, injury, or loss of mission capability and resources. Program stakeholders described factors that affected their ability to fully resolve Osprey safety risks, including challenges with how program stakeholders developed priorities and plans for addressing safety issues. These stakeholders identified costly, long-term engineering solutions and safety improvements that were required across a joint program with varied fleet sizes, which created longer risk mitigation timelines. GAO found that the median age for 28 unresolved serious and medium system risks was about 9 years, and over half (17 of 28) had been unresolved for between 6 and 14 years. Summary and Median Age of Unresolved Osprey System Safety Risk Assessments, by Assessment Type as of June 2025 Note: The Department of Defense (DOD) designates risk assessments as serious and medium based on their assessment of the severity (e.g., catatsrophic) and frequency (e.g., remote). The figure does not include six additional risk assessments for general military aviation risks (e.g., bird strikes) that are not specific to the Osprey and have been accepted for the life of the program. New initiatives established in 2024 are intended to address several of these factors, but these efforts did not comprehensively address non-system safety risks or include information for each service’s Osprey variant. Without determining an oversight structure with clearly defined roles and responsibilities for resolving known safety risks or conducting periodic reviews of efforts to resolve them, DOD cannot have reasonable assurance that program stakeholders will fully resolve the interrelated system and non-system safety risks affecting the Osprey. GAO found that the Osprey program stakeholders have not routinely shared information in three areas to promote the safe operation of the aircraft. Hazard and accident reporting. Program stakeholders have not proactively shared hazard and accident reporting information with Osprey units and unit safety personnel in the other services that operate the aircraft. Determining a process to proactively share relevant safety information with these personnel would provide greater assurance that Osprey units have the information needed to update their safety procedures. Aircraft knowledge and emergency procedures. Program stakeholders did not convene a multi-service conference or other forum to share Osprey aircraft knowledge and emergency procedures for 5 years (from 2020 to 2025). Service-specific changes to operational practices included safety related information, but these changes were not readily shared among the services, according to unit personnel with whom GAO spoke. The military services that operate the aircraft held a conference in May 2025, but they had not formalized plans to continue to do so. Without such a routine method, Osprey units have missed out on opportunities to share information that would enhance the safe operations of the aircraft. Maintenance data for common aircraft components and parts. Program stakeholders have taken steps to address maintenance data integrity issues for the hundreds of common Osprey aircraft components and parts that are shared across the services, but they have yet to confirm that all implementation steps have been completed. Without conducting a comprehensive review of Osprey maintenance guidance and inspection procedures, program stakeholders do not have assurance that efforts to improve maintenance information sharing have resolved data integrity issues, including for critical life-limited Osprey components, which has hindered their ability to ensure the safe operation of the aircraft. Why GAO Did This Study The Marine Corps, Air Force, and Navy use the Osprey tiltrotor aircraft, which combines the capabilities of a helicopter with those of a turboprop aircraft. The Osprey experienced four fatal accidents since 2022 resulting in the deaths of 20 service members, based on reported DOD data. GAO was asked to review Osprey accidents. This report (1) describes the trends in reported Osprey accidents; (2) evaluates the extent to which the Program Office and the military services have taken steps to identify and resolve Osprey safety issues; and (3) discusses how the military services share relevant Osprey safety information. GAO analyzed DOD data on Osprey accidents through fiscal year 2024 and visited a non-generalizable sample of seven Marine Corps, Air Force, and Navy Osprey units to interview officials that GAO selected based on factors such as where accidents occurred.