According to our review of congressional testimonies and national studies on professional boxing dating from 1994 through 2002, 15 fundamental elements are considered important in helping address the sport’s major problems. Six elements could help to protect the health and safety of professional boxers, four could help to protect their economic interests, and five could help to correct problems affecting the integrity of the sport. The six elements that could help to protect the health and safety of boxers would provide medical examinations, including neurological testing; monitoring of training injuries; assessments of medical risks; health and life insurance; the presence of appropriate medical personnel and equipment; and enforcement of suspensions for injuries. According to the testimonies and studies, these elements are important because, although the overall rate of injury is lower in professional boxing than in many other sports, the risk of severe or permanent brain injury is greater. Neurological testing may be needed to detect such injury. Furthermore, because injuries may occur during training and sparring as well as during boxing events, monitoring during training was recommended, and health and life insurance may be needed before and after as well as during events. In some instances, the treatment a fighter receives in the initial minutes after an injury determines whether the fighter recovers or sustains permanent damage or death. Having an ambulance and qualified medical personnel on-site, rather than on call, can be critical. Enforcement of suspensions imposed by boxing commissions in other states is important to prevent injured boxers from trying to fight outside the states in which they are registered before their injuries have healed. The four elements that could help to protect boxers’ economic interests would require pension plans for boxers, require full disclosure of purses and payments, require minimum uniform contractual terms between boxers and prohibit conflicts of interest. Without a union to represent their economic interests, boxers have often been exploited, and although the sport has generated enormous wealth for others, many professional boxers have been left penniless. Comprehensive pension plans for boxers are almost nonexistent, and boxers have sometimes been left to pay trainers out of their share of the fight purse when the financial responsibilities of promoters and managers were not disclosed in advance. Conflicts of interest between promoters and managers and long-term contracts with promoters have also disadvantaged boxers. The 5 elements that could help to correct problems affecting the integrity of the sport would require registration and training for judges, referees, and others; prevent sanctioning organizations from exercising undue influence in the selection of judges; establish uniform boxing and scoring rules; require reviews of sanctioning organizations’ rankings of boxers; and require knowledge of the sport for commission officials. Reports of unqualified officials, last-minute changes in the procedures for selecting judges, nonstandard boxing and scoring rules, fraudulent rankings that have resulted in injury and even death for weaker boxers, and political appointments to boxing commissions have undermined the integrity of the sport. Table 1 sets forth the 15 elements we identified. For more detailed information on the problems discussed in the testimonies and studies and the recommendations made to address these problems, see appendix II. The act’s provisions fully or partially cover 10 of the elements that we identified as important to address the health and safety, economic, and integrity problems facing professional boxing. Our analysis shows that one of the act’s provisions fully covers the element that requires evaluations of medical information on boxers and assessments of the risks involved in allowing them to fight before each match. The act’s provisions partially cover 9 elements. For example, one provision partially covers the element requiring medical examinations, including neurological testing, before and after a fight. (The provision requires prefight, but not postfight, examinations and no neurological testing.) Another provision partially covers the element requiring the presence of medical personnel and equipment at fights and the filing of postfight medical reports. (It requires the presence of medical personnel and equipment, but not the filing of postfight medical reports.) Table 2 sets forth our analysis of the extent to which the act’s provisions cover the fundamental elements we identified. On March 13, 2003, the Senate Committee on Commerce, Science, and Transportation approved S. 275, a bill that would further amend the act. If enacted, the proposed legislation would expand the act’s coverage of four fundamental elements—those dealing with the evaluation of medical information, minimum contractual terms, the selection of judges, and reviews of rankings. In addition, the proposed legislation would establish the United States Boxing Administration (USBA) within the Department of Labor and empower it to consider other fundamental elements in addressing professional boxers’ health, safety, and other concerns. USBA would be responsible for providing oversight, administering the federal boxing laws, and issuing minimum standards to protect the health, safety, and general interests of professional boxers. Its responsibilities would also include licensing boxers, promoters, managers, and sanctioning organizations and maintaining a registry of medical records and medical suspension information on all boxers. USBA would also be authorized to conduct investigations and to suspend or revoke licenses for misconduct after providing notice and hearing. The 8 state and 2 tribal boxing commissions that we reviewed varied in the extent to which they had documentation indicating compliance with the 10 provisions of the act related to the fundamental elements we identified. The act does not require the commissions to document their compliance. However, because documentation constituted the only verifiable evidence of compliance, we reviewed all available documentation in the commissions’ event files, including pre- and post-fight medical examination check sheets, insurance coverage forms, copies of contracts between boxers and promoters, event sheets identifying boxers’ registration numbers, promoters’ revenue reports to commissions, and statements of independence signed by ring officials. All 10 commissions had documentation indicating compliance at least 75 percent of the time for three provisions—those that require prefight medical examinations, disclosure of amounts paid to promoters, and registration of boxers—but only 2 commissions had documentation at least 75 percent of the time for the provision prohibiting conflicts of interest. (See fig. 1.) Five of the commissions said they usually complied with this provision but did not document their compliance. The 10 commissions’ documentation for the remaining six provisions varied within this range. (See table 4 in app. 3 for the results of our analysis of the commissions’ documentation.) When asked why they did not always document their compliance with the provisions, the commissions often did not provide a reason, but when they did, they generally pointed to privacy or liability concerns, said they were unaware of the federal provisions, or said they thought documentation was not needed. For details on the reasons the commissions provided for not documenting compliance, see appendix III. The eight states and two tribes that we reviewed vary in the extent to which their provisions cover health and safety and economic elements in addition to those covered in the act. Each of these states and tribes has some provisions that cover additional fundamental elements or portions of fundamental elements. The number of such provisions enacted by an individual Commission ranges from 10 (California) to 4 (Missouri). All 10 states and tribes have provisions fully covering the additional element that requires uniform boxing and scoring rules, and eight states or tribes have provisions fully covering the additional element that requires the filing of postfight medical reports. California was the only state with provisions fully covering 3 other additional elements—for monitoring injuries sustained during training, enforcing suspensions for debilitating training injuries, and providing pension plans for boxers. Four states or tribes have provisions that go beyond the act in requiring postfight medical examinations, but none of these states or tribes requires neurological testing. Similarly, three states or tribes have provisions that go beyond the act in requiring that boxers be provided with health insurance before and after, as well as during, each match, but none of these states or tribes requires life insurance. Figure 2 summarizes the results of our analysis. The primary reason provided by the states and tribes for not having provisions covering additional elements was that the provisions would be too costly to implement. For more details, see appendix IV. Actions taken by the Department of Justice under the act have been limited. Justice officials said the department does not prosecute cases unless they are referred to it by federal law enforcement agencies. There were no records of cases brought by U.S. Attorneys under the federal boxing legislation during fiscal years 1996 through 2002, and there were no referrals from law enforcement agencies. Because the act provides for state and civil remedies in addition to federal criminal prosecution, Justice officials said that cases could be referred to state authorities rather than to U.S. Attorneys. Furthermore, the officials said, violations of the act are misdemeanors, and U.S. Attorneys generally pursue only felony cases, although they would prosecute a misdemeanor if circumstances warranted. In commenting on a draft of this report, the president of ABC said that ABC had made two referrals to U.S. Attorneys’ offices. The first, made in October 2002, concerned the World Boxing Association’s ratings of a boxer. According to the ABC president, the referral was dismissed because the World Boxing Association provided the U.S. Attorney with a copy of its rating criteria and the boxers were well known. The ABC president said that the other referral, made to the Arkansas U.S. Attorney in 2001, reported that professional boxing was occurring in bars without the supervision of the Arkansas boxing commission. The ABC president said that ABC had not received a response to the referral and the case had not been prosecuted. The Federal Trade Commission’s (FTC) responsibility under the act is limited to making available to the public the information it receives from sanctioning organizations. FTC has no responsibility for enforcing compliance or verifying the accuracy of the information. FTC officials said they periodically check the sanctioning organizations’ Web sites to assess whether the required information has been made available to the public and has found the Web sites to be adequate. Our review of the Web sites of 14 sanctioning organizations found that this information was posted on the Internet. FTC officials also said they had not received any consumer complaints related to the boxing industry.