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    Results:

    Subject Term: "Information and referral services"

    4 publications with a total of 19 open recommendations including 1 priority recommendation
    Director: Debra A. Draper
    Phone: (202) 512-7114

    3 open recommendations
    Recommendation: To help ensure that the WTC Health Program quality assurance (QA) program addresses required QA elements, including the three elements mandated in the Zadroga Act, the Director of NIOSH should develop and implement procedures for conducting systematic reviews of each clinic's QA plan (recommendation 1).

    Agency: Department of Health and Human Services: Public Health Service: Centers for Disease Control and Prevention: National Institute for Occupational Safety and Health
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that the WTC Health Program QA program addresses required QA elements, including the three elements mandated in the Zadroga Act, the Director of NIOSH should develop and disseminate guidance that clearly specifies how the clinics should address mandated elements in their QA plans (recommendation 2).

    Agency: Department of Health and Human Services: Public Health Service: Centers for Disease Control and Prevention: National Institute for Occupational Safety and Health
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that the WTC Health Program QA program addresses required QA elements, including the three elements mandated in the Zadroga Act, the Director of NIOSH should develop uniform performance measures that clinics are required to use to consistently evaluate mandated elements through their audits every quarter (recommendation 3).

    Agency: Department of Health and Human Services: Public Health Service: Centers for Disease Control and Prevention: National Institute for Occupational Safety and Health
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Jessica Lucas-Judy
    Phone: (202) 512-9110

    7 open recommendations
    including 1 priority recommendation
    Recommendation: The Commissioner of Internal Revenue should establish, document, and implement an organizational structure identifying responsibility for defining objectives with an appropriate line of reporting for measuring costs and results for information referrals.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open

    Comments: As of January 2017, IRS has taken some action to implement this recommendation. IRS told us it established a cross-functional team in February 2016 to conduct a comprehensive review of IRS's referral programs, including the information referral process. IRS completed its review and plan for the organizational structure in December 2016. The Wage and Investment division will retain the intake and screening responsibilities. The Small Business and Self-Employed division will be responsible for defining objectives and monitoring results for information referrals. We continue to monitor IRS implementation of the planned cost and results measurement and reporting.
    Recommendation: The Commissioner of Internal Revenue should ensure that the IRM has internal controls for processing information referrals by establishing, documenting, and implementing supervisory review and segregation of duties for inventory management reporting procedures.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open

    Comments: As of January 2017, IRS has taken some action on this recommendation. IRS told us it established a cross-functional team in February 2016 to conduct a comprehensive review of IRS's referral programs, including the information referral process. IRS completed its review and plan for the organizational structure in December 2016. Once IRS approves the organizational structure, IRS will document new and updated screening and routing procedures in the Internal Revenue Manual as well as guidance for the Image Control Team and other IRS units receiving information referrals. IRS plans to implement this recommendation by September 2017.
    Recommendation: The Commissioner of Internal Revenue should ensure that the IRM has internal controls for processing information referrals by establishing, documenting, and implementing ongoing monitoring of information referrals retained for destruction, including a mechanism for tracking the reasons referrals were retained prior to destruction.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open

    Comments: As of January 2017, IRS has taken some action to implement this recommendation. IRS told us it established a cross-functional team in February 2016 to conduct a comprehensive review of IRS's referral programs, including the information referral process. IRS completed its review and plan for the organizational structure in December 2016. Once IRS approves the organizational structure, IRS will establish and document Internal Revenue Manual procedures, including criteria for retaining information referrals for destruction. IRS plans to implement this recommendation by September 2017.
    Recommendation: The Commissioner of Internal Revenue should ensure that the IRM has internal controls for processing information referrals by establishing, documenting, and implementing procedures for each IRS operating unit receiving information referrals to provide feedback on the number and types of referrals misrouted and on their disposition, and a mechanism to analyze patterns of misroute errors.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open

    Comments: As of January 2017, IRS has taken some action to implement this recommendation. IRS told us it established a cross-functional team in February 2016 to conduct a comprehensive review of IRS's referral programs, including the information referral process. IRS completed its review and plan for the organizational structure in December 2016. Once IRS approves the organizational structure, IRS will establish and document Internal Revenue Manual procedures, including guidelines for IRS units receiving information referrals. IRS plans to implement this recommendation by September 2017.
    Recommendation: The Commissioner of Internal Revenue should establish a coordination mechanism to facilitate communication and information sharing across IRS referral programs on crosscutting tax issues and ways to improve efficiency in the mechanisms for public reporting of possible tax violations.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open

    Comments: As of March 2017, IRS had taken some action to establish a coordination mechanism to help IRS referral programs communicate and share information, as GAO recommended in its February 2016 report. IRS established a cross-functional team in February 2016 to comprehensively review IRS's referral programs. Among other things, this team is to explore aligning all IRS referral programs within an organizational structure to more efficiently coordinate, communicate, and share information across the referral programs by December 2017. As of March 2017, the Deputy Commissioner of Services and Enforcement directed the largest recipient of referrals to facilitate quarterly meetings in order to improve communication and information sharing across multiple IRS referral programs. The meetings are scheduled to begin by summer 2017.
    Recommendation: The Commissioner of Internal Revenue should direct the referral programs to establish a mechanism to coordinate on a plan and timeline for developing a consolidated, online referral submission in order to better position IRS to leverage specialized expertise while exploring options to further consolidate the initial screening operations.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open
    Priority recommendation

    Comments: As of March 2017, IRS had taken some action to establish a mechanism to coordinate on a plan and timeline for developing a consolidated, online referral submission, as GAO recommended in its February 2016 report. IRS established a cross-functional team in February 2016 to comprehensively review IRS's referral programs. Among other things, the team has explored options to consolidate the initial screening operations and determine the scope and complexity for moving the referral process to an online format. According to IRS, an electronic submission process is expected to provide better access to the program and reduce the burden associated with making a written report or referral. In November 2016, the cross-functional team requested information technology resources for fiscal year 2019 to develop an online system which could potentially replace four separate referral forms, filter out incomplete referrals, and electronically route referrals for further IRS action. IRS assessed options for consolidating all forms for the various referral programs and determined that consolidating them to a single form was not feasible due to the technical nature and complexity of the various referral types. As of March 2017, the cross-functional team has worked with IRS On Line Services to develop an online application prototype and is also considering the cost-effectiveness of a commercial off-the-shelf product. According to the IRS, the online application will make it easier for the public to report possible tax violations. Also, the online system will improve efficiency in coordination and provide reports that will be incorporated into the quarterly coordination meetings, to achieve a broader collaborative mechanism across the multiple referral programs. IRS has said it will consider further consolidating the referral programs once the online application is in place.
    Recommendation: The Commissioner of Internal Revenue should ensure that the Internal Revenue Manual (IRM) has internal controls for processing information referrals by establishing, documenting, and implementing procedures for maintaining and communicating the information referral screening and routing guidelines to the Image Control Team (ICT) and IRS units receiving information referrals as well as procedures for ICT screening and routing operations.

    Agency: Department of the Treasury: Internal Revenue Service
    Status: Open

    Comments: As of January 2017, IRS has taken some action on this recommendation. IRS told us it established a cross-functional team in February 2016 to conduct a comprehensive review of IRS's referral programs, including the information referral process. IRS completed its review and plan for the organizational structure in December 2016. Once IRS approves the organizational structure, IRS will document new and updated screening and routing procedures in the Internal Revenue Manual as well as guidance for the Image Control Team and other IRS units receiving information referrals. IRS plans to implement this recommendation by September 2017.
    Director: David J.Wise
    Phone: (202) 512-2834

    6 open recommendations
    Recommendation: To ensure that properties determined as suitable and available are more likely to be practical for homeless assistance and that Federal Register reporting is not redundant, Congress should revisit the scope of properties to be reported to HUD with respect to the types of properties that may be less likely to be useful to assist the homeless and the frequency of Federal Register reporting.

    Agency: Congress
    Status: Open

    Comments: Two companion bills were introduced in the 114th Congress that address this matter. S. 2375 and HR 4465, "The Federal Asset Sale and Transfer Act of 2015/16" would require the list of available properties to assist the homeless be available on HUD and GSA websites rather than in the Federal Register. In addition, the bills would enable buildings not optimal for homeless assistance to be listed for sale more quickly. Both bills have been reported by their respective committees and placed on the Senate Legislative Calendar. When we confirm what additional actions the US Congress has taken in response to the this matter, we will provide updated information.
    Recommendation: To improve HUD's database on Title V homeless assistance properties, HUD should modify its existing database or create an electronic, searchable database to meet reporting needs to the extent that the benefits outweigh the costs.

    Agency: Department of Housing and Urban Development
    Status: Open

    Comments: When we confirm what actions HUD has taken in response to this recommendation, we will provide updated information.
    Recommendation: HUD, General Services Administration, HHS, and USICH should work together to address the challenges that homeless assistance providers face with the Title V homeless assistance program by (1) identifying what kinds of properties are most practical for homeless assistance, and (2) developing a web-based source of information on the program for homeless assistance providers.

    Agency: Department of Housing and Urban Development
    Status: Open

    Comments: When we confirm what actions HUD has taken in response to this recommendation, we will provide updated information.
    Recommendation: HUD, General Services Administration, HHS, and USICH should work together to address the challenges that homeless assistance providers face with the Title V homeless assistance program by (1) identifying what kinds of properties are most practical for homeless assistance, and (2) developing a web-based source of information on the program for homeless assistance providers.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: When we confirm what actions HHS has taken in response to this recommendation, we will provide updated information.
    Recommendation: HUD, General Services Administration, HHS, and USICH should work together to address the challenges that homeless assistance providers face with the Title V homeless assistance program by (1) identifying what kinds of properties are most practical for homeless assistance, and (2) developing a web-based source of information on the program for homeless assistance providers.

    Agency: General Services Administration
    Status: Open

    Comments: GSA has made several minor changes to its McKinney-Vento Homeless Assistance website (a module of www.disposal.gsa.gov) during the two years since the report was issued. Specifically, GSA added a link to USICH and repaired some other links that were non-functional, but GSA has not made any other substantive changes to the site. The agencies have not yet worked together to develop a web-based source of information on the program.
    Recommendation: HUD, General Services Administration, HHS, and USICH should work together to address the challenges that homeless assistance providers face with the Title V homeless assistance program by (1) identifying what kinds of properties are most practical for homeless assistance, and (2) developing a web-based source of information on the program for homeless assistance providers.

    Agency: United States Interagency Council on Homelessness
    Status: Open

    Comments: When we confirm what actions USICH has taken in response to this recommendation, we will provide updated information.
    Director: Cosgrove, James C
    Phone: (202) 512-7114

    3 open recommendations
    Recommendation: In order to improve CMS's ability to identify self-referred anatomic pathology services and help CMS avoid unnecessary increases in these services, the Administrator of CMS should insert a self-referral flag on Medicare Part B claim forms and require providers to indicate whether the anatomic pathology services for which the provider bills Medicare are self-referred or not.

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

    Comments: In June 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) insert a self-referral flag on Medicare Part B claim forms and require providers to indicate whether the anatomic pathology services for which the provider bills Medicare are self-referred or not. The Department of Health and Human Services (HHS) did not concur with this recommendation, noting that CMS does not believe that this recommendation will address overutilization that occurs as a result of self-referral. We continue to believe that such a flag on Part B claims would likely be the easiest and most cost-effective way for CMS to identify self-referred anatomic pathology services and monitor the behavior of those providers who self-refer these services. As of June 2017, CMS has not provided any additional information about actions to address this recommendation.
    Recommendation: In order to improve CMS's ability to identify self-referred anatomic pathology services and help CMS avoid unnecessary increases in these services, the Administrator of CMS should determine and implement an approach to ensure the appropriateness of biopsy procedures performed by self-referring providers.

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

    Comments: In June 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) implement an approach to ensure the appropriateness of biopsy procedures performed by self-referring providers. The Department of Health and Human Services (HHS) does not concur with this recommendation and does not believe it would address overutilization that occurs as a result of self-referral. HHS noted that it would be difficult to make recommendations regarding whether anatomic pathology services are appropriate without reviewing a large number of claims. We continue to believe that it is important for CMS to monitor the self-referral of anatomic pathology services on an ongoing basis and determine if those services are inappropriate or unnecessary. We also continue to believe this can be achieved without reviewing a large number of claims. CMS could, for example, consider performing targeted audits of providers that perform a higher average number of biopsy procedures compared to providers of the same specialty treating similar numbers of Medicare beneficiaries. As of June 2017, CMS has not provided any additional information about actions to address this recommendation.
    Recommendation: In order to improve CMS's ability to identify self-referred anatomic pathology services and help CMS avoid unnecessary increases in these services, the Administrator of CMS should develop and implement a payment approach for anatomic pathology services that would limit the financial incentives associated with referring a higher number of specimens--or anatomic pathology services--per biopsy procedure.

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

    Comments: In June 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) develop and implement a payment approach for anatomic pathology services under the Physician Fee Schedule that would limit the financial incentives associated with referring a higher number of specimens--anatomic pathology services--per biopsy procedure. Although health care providers have discretion in determining the number of tissue samples from biopsy procedures that become specimens (anatomic pathology services), CMS's current payment system under the Physician Fee Schedule provides a financial incentive for providers to refer more specimens per biopsy procedure. Specifically, CMS pays for each specimen that a provider submits to be analyzed. HHS indicated that it concurred with our recommendation and that it had addressed this recommendation by reducing payment for the most commonly furnished anatomic pathology service (Current Procedural Terminology [CPT] code 88305) by approximately 30 percent in calendar year 2013. However, CMS's payment reduction did not change the financial incentive providers have to refer more specimens per biopsy procedure because they will still be paid separately for each specimen submitted. We continue to believe that CMS should develop a payment approach that addresses this incentive. As of June 2017, CMS had not provided any additional information about actions it has taken to address this recommendation.