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    Subject Term: "Deceased persons"

    2 publications with a total of 3 open recommendations
    Director: Seto J. Bagdoyan
    Phone: (202) 512-6722

    1 open recommendations
    Recommendation: To further improve efforts to limit improper payments, including fraud, in the Medicaid program, the Acting Administrator of CMS should provide guidance to states on the availability of automated information through Medicare's enrollment database--the Provider Enrollment, Chain and Ownership System (PECOS)--and full access to all pertinent PECOS information, such as ownership information, to help screen Medicaid providers more efficiently and effectively.

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

    Comments: HHS considers this recommendation closed because they provide states with training and direct access to PECOS on an ongoing basis. Additionally, CMS also makes Medicare Enrollment data available to states through custom data extracts. We do not consider this action sufficient to close the recommendation, to provide states information on the availability of automated information through PECOS. For example, custom extracts do not constitute automated information containing all information in PECOS states need to screen providers in Medicaid. Additionally, the states the we interviewed for our study were not aware that custom extracts were available. CMS should provide guidance to state Medicaid programs that this information is available until fully automated access to PECOS is available. We reached out to CMS about the status of this recommendation. As of May 2017, we have not received a response. We will continue to monitor progress on this recommendation.
    Director: Bertoni, Daniel
    Phone: (202) 512-7215

    2 open recommendations
    Recommendation: In order to enhance the accuracy of and ensure appropriate agency access to SSA's death data, and to clarify how SSA applies the eligibility requirements of the Social Security Act and enhance agencies' awareness of how to obtain access, the Social Security Administration's Acting Commissioner should direct the Deputy Commissioner of Operations to develop and publicize guidance it will use to determine whether agencies are eligible to receive SSA's full death file.

    Agency: Social Security Administration
    Status: Open

    Comments: The Social Security Administration (SSA) disagreed with this recommendation, stating that each request to obtain the full death file is unique, and that officials must review them on a case-by-case basis to ensure compliance with various legal requirements. It also expressed concern that developing this guidance as we recommended would require agency expenditures unrelated to its mission in an already fiscally constrained environment. SSA noted that any federal agency that would like to explore accessing the full death master file (which includes state death records) should submit a request to SSA. SSA will review the file and, if satisfactory, enter into an Information Exchange Agreement covering terms, conditions and reimbursement for the exchange. As of April 2017, SSA reports that it is continuing its efforts and there is no change in status. GAO appreciates that agencies may base their request for the full death file on different intended uses, and supports SSA's efforts to ensure compliance with all applicable legal requirements. However, developing such guidance could help to ensure consistency in SSA's future decision making by the new Office of Data Exchange, and enhance agencies' ability to obtain the data in a timely and efficient manner.
    Recommendation: In order to enhance the accuracy of and ensure appropriate agency access to SSA's death data, and to increase transparency among recipient agencies, the Social Security Administration's Acting Commissioner should direct the Deputy Commissioner of Operations to share a more detailed explanation of how it determines reimbursement amounts for providing agencies with death information.

    Agency: Social Security Administration
    Status: Open

    Comments: The Social Security Administration (SSA) reported that it has implemented improvements in its estimating procedures for future reimbursable agreements to ensure consistent estimates for all customers. It reviews all reimbursable requests on a case-by-case basis to determine full costs (including direct and indirect expenses) to provide goods, resources, or services. However, the agency stated that it is not a typical government business practice to share these detailed costs for reimbursable agreements. As of April 2017, SSA reports that it is continuing its efforts and there is no change in status. We are encouraged that SSA has made efforts to standardize the estimates it shares with its federal partners. While we recognize that there may be limitations on the type of cost details SSA can provide to recipient agencies, we continue to believe that more transparency in conveying the factors that lead to the estimated and final reimbursement amounts recipient agencies are charged could help them make more informed decisions.