Internal controls (1 - 10 of 15 items) in Past 6 Months
VA Health Care: Actions Needed to Ensure Medical Facility Controlled Substance Inspection Programs Meet Agency Requirements
GAO-17-242: Published: Feb 15, 2017. Publicly Released: Feb 15, 2017.
GAO found weaknesses in the way four selected Department of Veterans Affairs (VA) medical facilities were implementing their controlled substance inspection programs. Two of the four did not conduct monthly inspections of controlled substances as required by the Veterans Health Administration (VHA). For example, one facility missed 43 percent of monthly inspections in critical patient care areas a...
Medicaid: Program Oversight Hampered by Data Challenges, Underscoring Need for Continued Improvements
GAO-17-173: Published: Jan 6, 2017. Publicly Released: Feb 6, 2017.
GAO found that available Medicaid expenditure and utilization data do not provide CMS with sufficient information to consistently ensure that payments are proper or that beneficiaries have access to covered services. The Centers for Medicare & Medicaid Services (CMS), the agency within the Department of Health and Human Services (HHS) that administers the Medicaid program, relies on two key data s...
Veterans Health Administration: Management Attention Is Needed to Address Systemic, Long-standing Human Capital Challenges
GAO-17-30: Published: Dec 23, 2016. Publicly Released: Jan 23, 2017.
The Veterans Health Administration's (VHA) limited human resources (HR) capacity combined with weak internal control practices has undermined VHA's HR operations and its ability to improve delivery of health care services to veterans.Attrition of medical center HR staff increased between fiscal years 2013 and 2015, due to HR staff transferring to other federal agencies. VHA officials note a lack o...
Indian Health Service: Actions Needed to Improve Oversight of Quality of Care
GAO-17-181: Published: Jan 9, 2017. Publicly Released: Jan 9, 2017.
The Indian Health Service's (IHS) oversight of the quality of care provided in its federally operated facilities has been limited and inconsistent. While some oversight functions are performed at the headquarters level, the agency has delegated primary responsibility for the oversight of care to nine area offices. Area officials stated that the oversight they provide has included, for example, hol...
Public Health Emergencies: HHS Needs to Better Communicate Requirements and Revise Plans for Assessing Impact of Personnel Reassignment
GAO-17-187: Published: Jan 9, 2017. Publicly Released: Jan 9, 2017.
The Office of the Assistant Secretary for Preparedness and Response (ASPR), within the Department of Health and Human Services (HHS), has primary federal responsibility for overseeing medical and public health preparedness and response and coordinating the reassignment of personnel in a public health emergency. ASPR has developed processes to review and approve states' and tribes' requests for per...
Medicare: Initial Results of Revised Process to Screen Providers and Suppliers, and Need for Objectives and Performance Measures
GAO-17-42: Published: Nov 15, 2016. Publicly Released: Dec 15, 2016.
GAO's analysis of the Centers for Medicare & Medicaid Services' (CMS) Medicare enrollment data found that CMS used its revised enrollment screening process to screen and revalidate over 2.4 million unique new applications and existing enrollment records. GAO's analysis showed that the screening resulted in over 23,000 new applications being denied or rejected and over 703,000 existing enrollment r...
Veterans Health Care: Improvements Needed in Operationalizing Strategic Goals and Objectives
GAO-17-50: Published: Oct 21, 2016. Publicly Released: Nov 21, 2016.
The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) uses a multi-step strategic planning process to develop its strategic goals and objectives, which includes two key steps—(1) identifying and assessing factors that may affect health care delivery, which is referred to as environmental scanning, and (2) holding the annual National Leadership Council (NLC) Strategic Plan...
Emergency Funding for Ebola Response: Some USAID Reimbursements Did Not Comply with Legislative Requirements and Need to Be Reversed
GAO-17-35: Published: Nov 2, 2016. Publicly Released: Nov 2, 2016.
As of July 1, 2016, the U.S. Agency for International Development (USAID) and the Department of State (State) had obligated 58 percent and disbursed more than one-third of the $2.5 billion appropriated for Ebola activities. In the early stages of the U.S. response in West Africa, USAID obligated $883 million to control the outbreak, and State obligated $34 million for medical evacuations, among ot...
VA Health Care: Processes to Evaluate, Implement, and Monitor Organizational Structure Changes Needed
GAO-16-803: Published: Sep 27, 2016. Publicly Released: Oct 27, 2016.
Recent internal and external reviews of Veterans Health Administration (VHA) operations have identified deficiencies in its organizational structure and recommended changes that would require significant restructuring to address, including eliminating and consolidating program offices and reducing VHA central office staff. However, VHA does not have a process that ensures recommended organizationa...
Health Care Quality: HHS Should Set Priorities and Comprehensively Plan Its Efforts to Better Align Health Quality Measures
GAO-17-5: Published: Oct 13, 2016. Publicly Released: Oct 13, 2016.
While the full extent of misalignment among health care quality measures is unknown, it can have adverse effects on providers and efforts to improve quality of care. Misalignment occurs when health care payers require providers to report on measures that focus on different quality issues or define the measures using different specifications. GAO identified three studies that provided some informat...