Reports & Testimonies

  • GAO’s recommendations database contains report recommendations that still need to be addressed.

    GAO’s recommendations help congressional and agency leaders prepare for appropriations and oversight activities, as well as help improve government operations. Recommendations remain open until they are designated as Closed-implemented or Closed-not implemented. You can explore open recommendations by searching or browsing.

    GAO's priority recommendations are those that we believe warrant priority attention. We sent letters to the heads of key departments and agencies, urging them to continue focusing on these issues. These recommendations are labeled as such. You can find priority recommendations by searching or browsing our open recommendations below, or through our mobile app.

  • Browse Open Recommendations

    Explore priority recommendations by subject terms or browse by federal agency

    Search Open Recommendations

    Search for a specific priority recommendation by word or phrase



  • Governing on the go?

    Our Priorities for Policy Makers app makes it easier for leaders to search our recommendations on the go.

    See the November 10th Press Release


  • Have a Question about a Recommendation?

    • For questions about a specific recommendation, contact the person or office listed with the recommendation.
    • For general information about recommendations, contact GAO's Audit Policy and Quality Assurance office at (202) 512-6100 or apqa@gao.gov.
  • « Back to Results List Sort by   

    Results:

    Subject Term: "Child health services"

    3 publications with a total of 7 open recommendations including 1 priority recommendation
    Director: Kay E. Brown
    Phone: (202) 512-7215

    3 open recommendations
    including 1 priority recommendation
    Recommendation: The Secretary of the Department of Health and Human Services should direct the Office of Refugee Resettlement to develop a process to update its bed capacity framework on an annual basis to include the most recent data related to numbers of unaccompanied children who may be referred to its care and adjust its planning scenarios that guide its bed capacity as appropriate.

    Agency: Department of Health and Human Services
    Status: Open
    Priority recommendation

    Comments: The Office of Refugee Resettlement (ORR) developed a bed capacity framework for fiscal year 2016 and anticipated completing its fiscal year 2017 bed capacity framework by September 30, 2016. The framework includes bed capacity projections, including expected referrals and placement needs, based, in part, on data from the previous year. GAO will close this recommendation when HHS completes its 2017 bed capacity framework.
    Recommendation: The Secretary of the Department of Health and Human Services should direct the Office of Refugee Resettlement to review its monitoring program to ensure that onsite visits are conducted in a timely manner, case files are systematically reviewed as part of or separate from onsite visits, and that grantees properly document the services they provide to children.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: HHS agreed with our recommendation and ORR is in the process of reviewing its monitoring templates and tools and, according to HHS, has conducted a monitoring training for its Project Officers. In addition, ORR is sending additional Project Officers into the field to complete scheduled monitoring visits to its care provider facilities. HHS reports that ORR is on track to complete all scheduled monitoring visits for FY 2016. We will close this recommendation when ORR has completed its review of its monitoring templates and tools and demonstrates that it can complete its planned monitoring visits on schedule.
    Recommendation: The Secretary of the Department of Health and Human Services should direct the Office of Refugee Resettlement to develop a process to ensure all information collected through its existing post-release efforts are reliable and systematically collected so that they can be compiled in summary form and provide useful information to other entities internally and externally.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: The Office of Refugee Resettlement (ORR) created a new section in its unaccompanied children's policy guide that, among other things, includes case reporting, records management, retention, and information sharing requirements for post-release service providers. Post-release service providers are required to maintain this information in an ORR-provided database. Also, the section requires that all reports made to ORR's National Call Center be documented and reported in accordance with mandatory reporting laws, state licensing requirements, federal laws and regulations, and ORR policies and procedures. Lastly, in May 2016, ORR released data for the first quarter of fiscal year 2016 on Safety and Well-Being (SWB) follow-up calls that were made to children and their sponsors.
    Director: Iritani, Katherine M
    Phone: (206)287-4820

    2 open recommendations
    Recommendation: In light of the need for accurate and complete information on children's access to health services under Medicaid and CHIP, the requirement that states report information to CMS on certain aspects of their Medicaid and CHIP programs, and problems with accuracy and completeness in this state reporting, the Administrator of CMS should establish a plan, with goals and time frames, to review the accuracy and completeness of information reported on the CMS 416 and CHIP annual reports and ensure that identified problems are corrected.

    Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services
    Status: Open

    Comments: In September 2016, CMS said that it was taking new steps to review data on children's access and quality of care by reviewing required reports that evaluate states' Medicaid managed care plans; however, these reports do not represent a consistent set of measures used by all states that CMS can use for oversight purposes. Accurate, complete, and reliable data for both Medicaid and CHIP are necessary for CMS's oversight of children's access to services. GAO considers this recommendation open.
    Recommendation: In light of the need for accurate and complete information on children's access to health services under Medicaid and CHIP, the requirement that states report information to CMS on certain aspects of their Medicaid and CHIP programs, and problems with accuracy and completeness in this state reporting, the Administrator of CMS should work with states to identify additional improvements that could be made to the CMS 416 and CHIP annual reports, including options for reporting on the receipt of services separately for children in managed care and fee-for-service delivery models, while minimizing reporting burden, and for capturing information on the CMS 416 relating to children's receipt of treatment services for which they are referred.

    Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services
    Status: Open

    Comments: In September 2016, CMS said that it had changed the instructions for completing the CMS 416 to provide more detailed guidance for states on capturing required information on the total number of children who were referred for treatment services. However, CMS is not planning to require states to submit information on whether children received the treatment services for which they were referred. We maintain that having ability to monitor receipt of treatment services, receipt of services in managed care separate from fee-for-service, and having data from all states is important to CMS oversight. GAO considers this recommendation open.
    Director: Iritani, Katherine M
    Phone: (206)287-4820

    2 open recommendations
    Recommendation: To enhance the provision of dental care to children covered by Medicaid and CHIP, and to help ensure that HHS's Insure Kids Now Web site is a useful tool to help connect children covered by Medicaid and CHIP with participating dentists who will treat them, the Secretary of HHS should establish a process to periodically verify that the dentist lists posted by states on the Insure Kids Now Web site are complete, usable, and accurate, and ensure that states and participating dentists have a common understanding of what it means for a dentist to indicate he or she can treat children with special needs.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: HHS has reported taking steps to improve the data on the Insure Kids Now website, including establishing an ongoing system to check that data are in the correct format and conducting validation surveys. HHS has also reported that CMS will provide technical assistance to low performing States and develop mechanisms to better identify providers that serve children with special health care needs. As of September 2017, CMS has not indicated that it has communicated with states and providers on what it means for a dentist to indicate he or she can treat children with special needs. We will leave this recommendation open until the agency takes steps to ensure that states and participating dentists have a common understanding of what it means for a dentist to indicate he or she can treat children with special needs.
    Recommendation: To enhance the provision of dental care to children covered by Medicaid and CHIP, and to help ensure that HHS's Insure Kids Now Web site is a useful tool to help connect children covered by Medicaid and CHIP with participating dentists who will treat them, the Secretary of HHS should require states to verify that dentists listed on the Insure Kids Now Web site have not been excluded from Medicaid and CHIP by the HHS-OIG, and periodically verify that excluded providers are not included on the lists posted by the states.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: As of September 2017, CMS has not indicated the agency has required states to ensure that excluded providers are not listed on the Insure Kids Now website and has not indicated that the agency has taken steps to periodically verify that excluded providers are not listed. CMS has said that it relies on states to provide accurate lists of eligible dentists and that data issues prevent the agency from independently verifying that excluded providers are not included on the Insure Kids Now website. We continue to believe that CMS should require states to ensure that excluded providers are not listed on the website and periodically verify that excluded providers are not included on the lists posted by the states, so that the website does not present inaccurate information about providers available to serve Medicaid-covered children.