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    Subject Term: "Quality improvement"

    9 publications with a total of 30 open recommendations including 1 priority recommendation
    Director: Carolyn L. Yocom
    Phone: (202) 512-7114

    1 open recommendations
    including 1 priority recommendation
    Recommendation: The Administrator of CMS should take immediate steps to assess and improve the data available for Medicaid program oversight, including, but not limited to, T-MSIS. Such steps could include (1) refining the overall data priority areas in T-MSIS to better identify those variables that are most critical for reducing improper payments, and (2) expediting efforts to assess and ensure the quality of these T-MSIS data.

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

    Comments: As of September 2017, CMS has begun targeted efforts to assess and improve T-MSIS data available for Medicaid program oversight, including initiating a pilot study with four states to identify data anomalies and obtaining input from external experts on data quality. However, because these initiatives are ongoing and further efforts to improve T-MSIS data are still evolving, this recommendation remains open.
    Director: Frank Rusco
    Phone: (202) 512-3841

    7 open recommendations
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to develop a consistent definition of patent quality, and clearly articulate this definition in agency documents and other guidance.

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will update relevant agency guidance, conduct training, and take other actions in response to this recommendation by March 2017.
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to further develop measurable, quantifiable goals and performance indicators related to patent quality as part of the agency's strategic plan.

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will update existing indicators and, as appropriate, develop new measures by October 2016.
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to analyze the time examiners need to perform a thorough patent examination. This action could be taken in conjunction with the recommendation in our report on USPTO's prior art search capabilities (GAO-16-479).

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will complete an examination of expectancy by April 2017.
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to analyze how current performance incentives affect the extent to which examiners perform thorough examinations of patent applications.

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will complete an assessment of examination quality across current incentive award tiers by September 2017.
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to establish a process to provide data on the results of the Patent Trial and Appeal Board (PTAB) proceedings to managers and staff in the USPTO's Technology Centers, and analyze PTAB data for trends in patent quality issues to identify whether additional training, guidance, or other actions are needed to address trends.

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will establish a process to provide examiners with information on various PTAB proceedings by September 2016.
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to evaluate the effects of compact prosecution and other agency application and examination policies on patent quality. In doing so, USPTO should determine if any changes are needed to ensure that the policies are not adversely affecting patent quality.

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will complete an assessment of various policies on patent quality by September 2017.
    Recommendation: To help improve patent quality, the Secretary of Commerce should direct the Director of the USPTO to consider whether to require patent applicants to include claim clarity tools--such as a glossary of terms, a check box to signal functional claim language, or claim charts--in each patent application.

    Agency: Department of Commerce
    Status: Open

    Comments: According to the agency's action plan, USPTO will issue a request for comments on additional claim clarity tools by September 2017 and determine any new requirements by January 2018.
    Director: John Neumann
    Phone: (202) 512-3841

    7 open recommendations
    Recommendation: To ensure that USPTO's collaborative efforts on classification help examiners find relevant prior art, USPTO should work with the European Patent Office (EPO) to identify a target level of consistency of Cooperative Patent Classification decisions between USPTO and EPO and develop a plan to monitor consistency to achieve the target.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO has begun ongoing meetings with EPO on quality assurance. USPTO aims to agree to a target level, develop and deploy any needed IT, and begin monitoring and implementing corrective actions by first quarter of 2019.
    Recommendation: To ensure that USPTO is able to take full advantage of its investment in new information technology tools and capabilities, USPTO should develop and periodically update a documented strategy to identify key sources of nonpatent literature for individual technology centers and to assess the optimal means of providing access to these sources, such as including them in USPTO's search system.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO will begin assessing nonpatent literature usage and develop a strategy for optimizing its usage by November 2017.
    Recommendation: To improve its monitoring of prior art searches and provide USPTO the ability to examine and address trends in prior art search quality at the technology center level, USPTO should develop written guidance on what constitutes a thorough prior art search within each technology field (i.e., mechanical, chemical, electrical), technology center, art area, or art unit, as appropriate, and establish goals and indicators for improving prior art searches.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO will establish goals and indicators for prior art searches by December 2017.
    Recommendation: To improve its monitoring of prior art searches and provide USPTO the ability to examine and address trends in prior art search quality at the technology center level, USPTO should ensure that sufficient information is collected in reviews of prior art searches to assess the quality of searches at the technology center level, including how often examiners search for U.S. patents, foreign patents, and nonpatent literature.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO will complete an evaluation of the master review form used to collect information on prior art search by April 2017 and will have performed a sufficient number of reviews by September 2017 to assess search quality at the technology center level.
    Recommendation: To improve its monitoring of prior art searches and provide USPTO the ability to examine and address trends in prior art search quality at the technology center level, USPTO should use the audits and supervisory reviews to monitor the thoroughness of examiners' prior art searches and improvements over time.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO will develop metrics for prior art search quality and processes to incorporate information learned from these metrics by June 2017.
    Recommendation: To ensure that examiners have sufficient time to conduct a thorough prior art search, USPTO should, in conjunction with implementing the recommendation from our patent quality report to analyze the time examiners need to perform a thorough examination, specifically assess the time examiners need to conduct a thorough prior art search for different technologies.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO will complete analyses of examiner's required duties and current time expectancies and determine what, if any, additional time should be given by September 2017.
    Recommendation: To ensure that examiners have the technical competence needed to complete thorough prior art searches, USPTO should assess whether the technical competencies of examiners in each technology center match those necessary; develop strategies to address any gaps identified, such as a technical training strategy; and establish measures to monitor progress toward closing any gaps.

    Agency: Department of Commerce: Patent and Trademark Office
    Status: Open

    Comments: According to the agency's action plan, USPTO will develop assessment tools and plans to address any gaps identified, as well as measure progress towards closing any gaps by December 2017.
    Director: David Powner
    Phone: (202) 512-9286

    8 open recommendations
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to ensure that all IT investments are assessed for suitability for migration to a cloud computing service.

    Agency: Department of Agriculture
    Status: Open

    Comments: We are in the process of reviewing agency documentation and waiting for additional supporting documentation.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to ensure that all IT investments are assessed for suitability for migration to a cloud computing service.

    Agency: Department of the Treasury
    Status: Open

    Comments: We contacted the agency and are awaiting its response on the status of efforts to implement this recommendation.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to ensure that all IT investments are assessed for suitability for migration to a cloud computing service.

    Agency: Department of State
    Status: Open

    Comments: The Department of State established a requirement for completing a cloud computing service alternatives analysis for all new projects, and that existing IT projects be evaluated for the viability to migrate to a cloud computing environment. Further, the department established key factors for consideration when selecting applications for migration to a cloud environment. However, State has not yet evaluated a majority of its IT investments for cloud alternatives. The department said it plans to complete evaluations for some of these investments by the end of FY2017, but has not yet established plans to evaluate over a third of its investments.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to ensure that all IT investments are assessed for suitability for migration to a cloud computing service.

    Agency: Small Business Administration
    Status: Open

    Comments: We are waiting for a response from SBA on the status of efforts to implement this recommendation.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to establish evaluation dates for those investments identified in this report that have not been assessed for migration to the cloud.

    Agency: Department of Agriculture
    Status: Open

    Comments: We are in the process of waiting for additional department documentation.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to establish evaluation dates for those investments identified in this report that have not been assessed for migration to the cloud.

    Agency: Department of the Treasury
    Status: Open

    Comments: We are waiting for a response from the department on the status of efforts to implement this recommendation.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to establish evaluation dates for those investments identified in this report that have not been assessed for migration to the cloud.

    Agency: Department of State
    Status: Open

    Comments: The Department of State established a requirement for completing a cloud computing service alternatives analysis for all new projects, and that existing IT projects be evaluated for viability to migrate to a cloud computing environment. Further, the department established key factors for consideration when selecting applications for migration to a cloud environment. However, the department has not yet established evaluation dates for the vast majority of the investments that have not been assessed for migration to the cloud. Specifically, the department plans to complete evaluations for some of these investments by the end of fiscal year 2017, but does not plan to do so for most of them.
    Recommendation: To help ensure continued progress in the implementation of cloud computing services, the Secretaries of Agriculture, Health and Human Services, Homeland Security, State, and the Treasury; and the Administrators of the General Services Administration and Small Business Administration should direct their respective Chief Information Officers to establish evaluation dates for those investments identified in this report that have not been assessed for migration to the cloud.

    Agency: Small Business Administration
    Status: Open

    Comments: We are waiting for a response from the department on the status of efforts to implement this recommendation.
    Director: Fennell, Anne-marie Lasowski
    Phone: (202) 512-3841

    1 open recommendations
    Recommendation: To enhance the overall sustainability of the Forest Service's trail system, consistent with the vision articulated in A Framework for Sustainable Recreation, and to reduce the trail maintenance backlog, the Secretary of Agriculture should direct the Chief of the Forest Service to take several actions to improve the agency's trail maintenance approach in both the short and long terms. To improve the agency's ability to keep up with its maintenance goals in the short term and reduce its maintenance backlog, the agency should, recognizing the importance of volunteers for trail maintenance, take steps to improve management of volunteers, including by ensuring that collaboration with and management of volunteers are clear expectations of trails staff and offering relevant training.

    Agency: Department of Agriculture
    Status: Open

    Comments: The Forest Service reported that it has taken and continues to take steps to improve management of volunteers. In particular, the agency has taken steps to reduce barriers to volunteering, such as its fiscal year 2014 implementation of a revised approach to funding volunteer worker's compensation costs from a national funding pool rather than allocating funds locally. In addition, the December 2016 national trail strategy identifies some additional key actions, such as developing and providing efficiency tools to support active partnering. The Forest Service also reported that it is developing training materials that address volunteer and partnership program management skills. The Forest Service has not, however, taken steps to ensure that collaboration with and management of volunteers are clear expectations of trails staff.
    Director: White, James R
    Phone: (202)512-5594

    1 open recommendations
    Recommendation: To increase the effectiveness of IRS's examinations individual tax returns, the Commissioner of Internal Revenue should transcribe data from paper-filed Form 1040 Schedules C and E that are not currently transcribed and make that data available to SB/SE examiners for classification. If IRS has evidence that the costs related to transcribing all such data on Schedules C and E are prohibitive, IRS could do one or both of the following actions: (1) transcribe less data by transcribing only the missing data for selected line items, such as certain, large expense line items, or (2) develop a budget proposal to fund an initiative for transcribing Schedule C and E.

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

    Comments: As of March 2017, IRS had completed its study on whether to transcribe more data from paper-filed returns by comparing the benefits to classifying tax returns for audit from doing this transcription. They said the benefits to be derived from additional transcription are not significant and would not outweigh the added cost. However, IRS has not provided specific information about the costs and benefits from transcribing information from Schedules C and E that we mentioned in our recommendation. Having more data transcribed and electronically available from these areas likely will improve the classification of audits as well as the quality of the audits, according to examiners we spoke with for the report.
    Director: Cosgrove, James C
    Phone: (202)512-7029

    2 open recommendations
    Recommendation: To help ensure that Medicare beneficiaries have access to high-quality dialysis care, the Administrator of CMS should assess the extent to which the bundled payment for dialysis care will be sufficient to cover an efficient dialysis organization's costs to provide such care when the bundled payment expands to cover oral-only ESRD drugs. The Administrator should conduct this assessment before implementing this expanded bundled payment.

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

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: In order to ensure effective monitoring of treatment of mineral and bone disorder, the Administrator of CMS should continue collecting data for quality measures related to this condition from sources such as the Elab Project until CROWNWeb is fully implemented and concerns about its data reliability have been adequately addressed.

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

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Dicken, John E
    Phone: (202)512-7043

    1 open recommendations
    Recommendation: To help ensure the longer-term compliance of nursing homes that have successfully returned to substantial compliance under temporary management, the Administrator of CMS should develop guidance for states to enhance their oversight of such homes, such as implementing reactivation of temporary management if the home does not maintain substantial compliance over the 2 years following the conclusion of the sanction.

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

    Comments: September 2017: CMS provided documentation of training documents developed for State Agency Directors and Enforcement Specialists covering a variety of topics including when to use the temporary management sanction. Neither the new training nor relevant sections of the CFR or State Operations Manual appear to provide guidance on longer-term oversight of nursing homes that have returned to substantial compliance under temporary management. September 2016: GAO has not received additional information from CMS. July 2015: CMS indicated it will provide GAO with updated actions in early 2016. July 2014: CMS said the recommendation was in process and CMS was drafting an internal enforcement action plan to discuss enforcement remedies including temporary management. June 2013: CMS officials said they have been making an effort to work with the Regional Offices and states on the appropriate use of all sanctions in general, including the use of Temporary Management. June 2012: CMS officials said that the agency continues to investigate the various uses of CMP monies and the potential to use CMPs to recruit, train and supervise temporary managers is one of several options under consideration. May 2011: CMS agreed this was an important recommendation, but due to the Affordable Care Act implementation, the agency said they temporarily deferred planned work until 2012.
    Director: Goldstein, Mark L
    Phone: (202) 512-3000

    2 open recommendations
    Recommendation: To improve the effectiveness and accountability of FCC's efforts to oversee wireless phone service, the Chairman of the Federal Communications Commission should direct the commission to develop goals and related measures for FCC's informal complaint-handing efforts that clearly articulate intended outcomes and address important dimensions of performance.

    Agency: Federal Communications Commission
    Status: Open

    Comments: In its February 5, 2010 response, FCC stated that it would consider establishing meaningful and measurable outcome-based standards in the context of its efforts to reassess goals for the mediation of informal consumer complaints. FCC noted that it already has basic performance metrics for responding to consumer complaints in a timely manner and will examine ways to automate such responses and provide them by email, which may be more efficient than processing these complaints manually and mailing a paper response. In June 2011, FCC stated it had taken steps to improve its complaint-handling efforts by increasing staff training and beginning an effort to revise its complaint coding and intake process, which it expects to complete by the end of fiscal year 2011. FCC also stated it is considering other enhancements for fiscal year 2012. However, this response did not mention any direct action in response to the recommendation. In May 2012, FCC stated it had begun an effort to improve its informal complaint-handling, including revising its complaint intake and coding procedures with an emphasis on collecting information to enhance policymaking and compliance activities. The response did not specifically mention goals and measures, but said the effort was ongoing and expected to continue through the end of 2012. In August 2013, FCC stated it was considering a proposal for comprehensive reform to its consumer complaint process. The agency hoped to institute performance measures for the consumer complaint process as part of the reform. In June 2014, FCC staff said that the FCC Chairman had set a goal to reform the agency's complaint process by the end of 2014. In August 2016, FCC staff said that the agency is working to develop performance metrics for its complaint-handling efforts. We will continue to follow up with FCC about its efforts.
    Recommendation: To better ensure a systemwide focus in providing oversight of wireless phone service and improve FCC's partnership with state agencies that also oversee this service, the Chairman of the Federal Communications Commission should direct the commission to develop and issue guidance delineating federal and state authority to regulate wireless phone service, including pulling together prior rulings on this issue; addressing the related open proceedings on truth-in-billing and early termination fees; and, if needed, seeking appropriate statutory authority from Congress.

    Agency: Federal Communications Commission
    Status: Open

    Comments: In its February 5, 2010 response, FCC noted that the Notice of Inquiry on Consumer Information and Disclosure it released on August 9, 2009, provides an opportunity for the agency to review prior rulings and related open proceedings. The response also stated that FCC's Wireless Bureau and Consumer and Governmental Affairs Bureau are working together to review areas of the Communications Act where clarification is needed regarding state and federal roles for oversight of wireless phone service. In June 2011, FCC stated that it was continuing to hold regular meetings with associations representing state agency officials, but did not mention taking any action to directly address the recommendation. In May 2012, FCC stated that the topic of wireless regulation is discussed during intergovernmental webinars FCC hosts with state and local government offices, but did not indicate it had developed and issued guidance as called for in the recommendation. In August 2013, FCC stated that it has not issued any formal guidance on delineating federal and state wireless oversight authority. In June 2014, FCC stated that the commission was considering making changes to its truth-in-billing rules by the end of 2014 and that such a proceeding would include addressing how FCC partners with states in protecting wireless consumers. In July 2016, FCC said that it planned to address this issue in December 2017.