Internal controls (11 - 20 of 42 items) in Past Year
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...
Skilled Nursing Facilities: CMS Should Improve Accessibility and Reliability of Expenditure Data
GAO-16-700: Published: Sep 7, 2016. Publicly Released: Oct 6, 2016.
The Centers for Medicare & Medicaid Services (CMS)—the agency within the Department of Health and Human Services (HHS) that administers Medicare—collects and reports expenditure data from skilled nursing facilities (SNF), but it has not taken key steps to make the data readily accessible to public stakeholders or to ensure their reliability. SNFs are required to self-report their expenditures...
NIH Biomedical Research: Agencies Involved in the Indirect Cost Rate-Setting Process Need to Improve Controls
GAO-16-616: Published: Sep 7, 2016. Publicly Released: Sep 28, 2016.
Research organizations that apply for National Institutes of Health (NIH) funding participate in an indirect cost rate-setting process, which involves submitting a rate proposal; reviewing the proposal and having it audited by a third-party agency at the cognizant agency's request; and finalizing (negotiating) the rate for the organization. The Office of Management and Budget (OMB) and the Departm...
High-Containment Laboratories: Improved Oversight of Dangerous Pathogens Needed to Mitigate Risk
GAO-16-642: Published: Aug 30, 2016. Publicly Released: Sep 21, 2016.
The total number of incidents involving incomplete inactivation—a process to destroy the hazardous effects of pathogens while retaining characteristics for future use—that occurred from 2003 through 2015 is unknown for several reasons. One key reason is that the Select Agent Program—operated by the Departments of Health and Human Services (HHS) and Agriculture (USDA) to oversee certain dange...
Veterans' Health Care: Improved Oversight of Community Care Physicians' Credentials Needed
GAO-16-795: Published: Sep 19, 2016. Publicly Released: Sep 19, 2016.
GAO found that the Department of Veterans Affairs' (VA) contractors—Health Net Federal Services (Health Net) and TriWest Healthcare Alliance (TriWest)—complied with contractual requirements to verify the credentials of physicians under one community care program, but were deficient in doing so under another program. Based on GAO's review of selected physicians, GAO found that the contractors a...
Patient Protection and Affordable Care Act: Final Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015
GAO-16-792: Published: Sep 9, 2016. Publicly Released: Sep 12, 2016.
Under the Patient Protection and Affordable Care Act (PPACA), health-insurance marketplaces are required to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies or Medicaid. Verification steps include reviewing and validating an applicant's Social Security number, if one is provided; citizenship, status as a U.S...
Female Genital Mutilation/Cutting: Existing Federal Efforts to Increase Awareness Should Be Improved
GAO-16-645: Published: Jun 30, 2016. Publicly Released: Aug 1, 2016.
The Centers for Disease Control and Prevention (CDC) estimated that 513,000 women and girls in the United States were at risk of or had been subjected to female genital mutilation/cutting (FGM/C) in 2012, a threefold increase from its 1990 estimate. CDC attributes this change primarily to increased immigration from countries where FGM/C is practiced, rather than an increase in the occurrence of FG...