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As of May 8, 2024, there are 5108 open recommendations that still need to be addressed. 412 of these are priority recommendations, those that we believe warrant priority attention. Learn more about our priority designation on our Recommendations page.

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5001 - 5020 of 5108 Recommendations, including 412 Priority Recommendations

Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions

GAO-12-966
James Cosgrove
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2 Open Recommendations
Agency Recommendation Status
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred advanced imaging services and help CMS address the increases in these services, the Administrator of CMS should determine and implement a payment reduction for self-referred advanced imaging services to recognize efficiencies when the same provider refers and performs a service.
Open

HHS disagreed with our recommendation and, as of February 2024, had no plans to take further action. CMS did not believe that a payment reduction would address overutilization that occurs as a result of self-referral and that the agency's multiple procedure payment reduction policy for advanced imaging already captures efficiencies inherent in providing multiple advanced imaging services by the same physician. Further, CMS does not think a payment reduction for self-referred services would be effective. We maintain that CMS should determine and implement a payment reduction to recognize
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred advanced imaging services and help CMS address the increases in these services, the Administrator of CMS should determine and implement an approach to ensure the appropriateness of advanced imaging services referred by self-referring providers.
Open

HHS initially stated that it would consider our recommendation, but as of February 2024, the agency disagreed and had no plans to take further action. However, we maintain that our recommendation is valid, in part because we found that providers who began to self-refer advanced imaging services substantially increased their referral of such services relative to other providers in 2010. To the extent that these additional referrals are unnecessary, they pose an unacceptable risk for beneficiaries, particularly in the case of computerized tomography (CT) services, which involve the use of

Federal Training Investments: Office of Personnel Management and Agencies Can Do More to Ensure Cost-Effective Decisions

GAO-12-878
Yvonne Jones
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2 Open Recommendations
Agency Recommendation Status
Office of Personnel Management To improve federal training investment decision-making processes, the Director of OPM should include in existing or new OPM guidance or technical assistance additional information in the following areas: (1) Steps agencies should take and factors they should consider when prioritizing federal training investments agency-wide, including developing a process to rank training using criteria, such as expected demand for the investment from internal sources, availability of resources to support the effort, potential for increased revenue, and risk of unfavorable consequences if investments are not made. (2) Steps agencies should take and factors they should consider for comparing the merits of different delivery mechanisms and determining the mix of mechanisms to use, in order to ensure efficient and cost-effective delivery of federal training. Such guidance could include requesting that agencies consistently utilize Standard Form-182 to document and report training costs associated with the different delivery mechanisms employed.
Open

According to OPM it has developed training prioritization criteria for agencies that also includes examples of how agencies could rank their training investments. In addition, OPM formed a working group to gain a better understanding of how agencies document, track, and report training information. The group consisted of members from USDA, EEOC, FMC, HUD, PTO, DOD, Energy, USAID, FTC, Treasury, and State. The working group recommended and OPM made changes to the SF 182 designed to help improve federal training investment decision-making. According to OPM, these changes include updating its
Office of Personnel Management To improve federal training investment decision-making processes, the Director of OPM should, in line with statutory and regulatory provisions on maintenance and reporting of training information, work with the CHCO Council to improve the reliability of agency training investment information by: (1) ensuring that agencies are familiar with and follow guidance outlined in OPM's Guide for the Collection and Management of Training Information regarding which training events should be documented as training and reported to OPM; (2) developing policies to strengthen the utilization of Standard Form- 182 to document and report training costs; (3) encouraging agencies through guidance and technical assistance, to develop policies that require consistent reporting of training data to their learning management systems; and (4) encouraging each agency to assess its existing training information system(s) and identify whether it is providing complete and reliable data and, if not, to develop approaches to improve the system(s), in order to do so.
Open

In response, OPM provided a refresher to the Chief Learning Officers Council on OPM's guidance on Reporting of Training Data. This included reviewing OPM's and agencies' responsibilities for the collection and reporting of data and reviewing the process of how agency data is transmitted to EHRI. Further, OPM says it highlighted the Guide to Human Resources Reporting as the source for the required format for reporting training data to EHRI and provided the Guide for Collection and Management of Training Information. Both guides are also located on OPM's website. OPM's training data report

Slot-Controlled Airports: FAA's Rules Could Be Improved to Enhance Competition and Use of Available Capacity

GAO-12-902
Susan Fleming
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2 Open Recommendations
Agency Recommendation Status
Department of Transportation To help maximize the use of available capacity at slot-controlled airports, enhance competition through greater airline access to slots, and enhance transparency of slot information, the Secretary of Transportation should direct the FAA Administrator to apply slot rules to individual slots, as opposed to pools of slots within a slot period.
Open

Previously, in January 2015, the FAA issued a Notice of Proposed Rulemaking (NPRM) for the New York City area airports. The proposal included changes to how the FAA would determine compliance with minimum slot usage rules similar to GAO's recommendation and the WSG. Under that concept, a slot would only be considered for a flight or series of flights in a single slot and not potentially applied or averaged to more than one slot. The NPRM was withdrawn by DOT and FAA in April 2016 to allow further evaluation of recent changes in demand, competition, operations, and other factors in the New York
Department of Transportation With respect to possible future regulatory action, the DOT Secretary should consider requiring airlines to schedule a certain percentage, or all, of their slot allocations, similar to practices maintained elsewhere in the world.
Open

The Department concurs that any future rulemaking should consider changes to the minimum slot usage rules to improve slot utilization at the slot controlled airports and provide greater harmonization with industry standards applied at airports outside the U.S. The FAA and the Department of Transportation stated that they will evaluate the circumstances at the New York City area airports and DCA and, if necessary, will consider steps to improve slot utilization, including future rulemaking. Previously, DOT said it continues to evaluate options, including potential future rulemaking activities

Federal Disaster Assistance: Improved Criteria Needed to Assess a Jurisdiction's Capability to Respond and Recover on Its Own

GAO-12-838
William O. Jenkins, Jr.
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Federal Emergency Management Agency
Priority Rec.
To increase the efficiency and effectiveness of the process for disaster declarations, the FEMA Administrator should develop and implement a methodology that provides a more comprehensive assessment of a jurisdiction's capability to respond to and recover from a disaster without federal assistance. This should include one or more measures of a jurisdiction's fiscal capacity, such as TTR, and consideration of the jurisdiction's response and recovery capabilities. If FEMA continues to use the PA per capita indicator to assist in identifying a jurisdiction's capabilities to respond to and recover from a disaster, it should adjust the indicator to accurately reflect the annual changes in the U.S. economy since 1986, when the current indicator was first adopted for use. In addition, implementing the adjustment by raising the indicator in steps over several years would give jurisdictions more time to plan for and adjust to the change.
Open – Partially Addressed

FEMA has taken actions to update its methodology to provide a more comprehensive assessment of a jurisdiction's capability to respond to and recover from a disaster without federal assistance . In particular, FEMA has taken steps to update the factors considered when evaluating a request for a major disaster declaration for Public Assistance, specifically the estimated cost of assistance (i.e. the per capita indicator), via the federal rulemaking process three times--in 2016, 2017, and 2020. However, as of February 2024, the agency has not issued a final rule updating the estimated cost of

Management Report: Improvements Are Needed to Strengthen the American Battle Monuments Commission's Internal Controls and Accounting Procedures

GAO-12-830R
Cheryl E. Clark, Nabajyoti Barkakati
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1 Open Recommendations
Agency Recommendation Status
American Battle Monuments Commission The Commission should direct the appropriate officials to establish a mechanism to monitor implementation of existing Commission policy to perform biennial physical inventory counts of all items of equipment with an obligated balance of $500 or more.
Open

During our audit of the American Battle Monuments Commission's (ABMC) fiscal year 2011 financial statements, we found that ABMC had not performed independent physical inventory of equipment it owned at the various cemeteries across the world. We found that although ABMC had a policy to perform biennial physical inventory counts of all equipment over $500, this policy was not adhered to during fiscal year 2011. As a result, we recommended that ABMC establish a mechanism to monitor the implementation of existing ABMC policy to perform biennial physical inventory counts of all items of equipment

Indian Health Service: Action Needed to Ensure Equitable Allocation of Resources for the Contract Health Service Program

GAO-12-446
Kathleen M. King
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1 Open Recommendations
Agency Recommendation Status
Congress In order to ensure an equitable allocation of CHS program funds, the Congress should consider requiring IHS to develop and use a new method to allocate all CHS program funds to account for variations across areas that would replace the existing base funding, annual adjustment, and program increase methodologies, notwithstanding any restrictions currently in federal law.
Open

As of March 2024, Congress has not acted on this recommendation. We will update the status of this recommendation if Congress takes action.

National Security: DOD Should Reevaluate Requirements for the Selective Service System

GAO-12-623
Brenda S. Farrell
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1 Open Recommendations
Agency Recommendation Status
Department of Defense To help ensure that DOD and Congress have visibility over the necessity of the Selective Service System to meeting DOD's needs, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to establish a process of periodically reevaluating DOD's requirements for the Selective Service System in light of changing threats, operating environments, and strategic guidance.
Open

DOD concurred with this recommendation and said that it would establish a process to review the mission and requirements for the Selective Service System. In August 2023, GAO staff met with OSD and Selective Service System staff to discuss the intent of this recommendations. OSD staff told us that they consider their requirements for the Selective Service System through their war planning and war gaming processes and have determined that current war plans do not have a requirement to use the draft. Selective Service System personnel told us that they are confident they can execute the current

Appraised Values on Tax Returns: Burdens on Taxpayers Could Be Reduced and Selected Practices Improved

GAO-12-608
James R. White
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1 Open Recommendations
Agency Recommendation Status
Congress To reduce the compliance burden on taxpayers making noncash contributions, Congress should consider raising the threshold at which taxpayers are required to have qualified appraisals for a particular contribution. Raising the threshold and giving IRS the authority to adjust this value for inflation in the future would maintain the consistent treatment of taxpayers over time.
Open

No legislative action taken as of March 2024. The current appraisal threshold for certain contributions over $5,000 has existed since 1984. The absence of an inflation adjustment since then means that many contributors who pay for appraisals would not have needed to do so when the current threshold was first introduced. We continue to monitor for new legislation. .

DOD Business Systems Modernization: Governance Mechanisms for Implementing Management Controls Need to Be Improved

GAO-12-685
Valerie C. Melvin
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1 Open Recommendations
Agency Recommendation Status
Department of Defense To ensure that DOD continues to implement the full range of institutional management controls needed to address its business systems modernization high-risk area, the Secretary of Defense should ensure that the Deputy Secretary of Defense, as the department's Chief Management Officer, establish a policy that clarifies the roles, responsibilities, and relationships among the Chief Management Officer, Deputy Chief Management Officer, DOD and military department Chief Information Officers, Principal Staff Assistants, military department Chief Management Officers, and the heads of the military departments and defense agencies, associated with the development of a federated business enterprise architecture (BEA). Among other things, the policy should address the development and implementation of an overarching taxonomy and associated ontologies to help ensure that each of the respective portions of the architecture will be properly linked and aligned. In addition, the policy should address alignment and coordination of business process areas, military department and defense agency activities associated with developing and implementing each of the various components of the BEA, and relationships among these entities.
Open

As of September 2023, the Department of Defense (DOD) has not addressed this recommendation. Specifically, in September 2023, DOD stated that it no longer plans to establish a working group to codify the way forward for its business enterprise architecture (BEA) modernization. Instead, the department stated that it plans to use a formal coordination process to develop a DOD BEA framework and guidebook to describe its BEA modernization approach. DOD also stated that its framework and guidebook will describe DOD component roles and responsibilities for developing, maintaining, and using the BEA

VA Administrative Investigations: Improvements Needed in Collecting and Sharing Information

GAO-12-483
Debra A. Draper
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2 Open Recommendations
Agency Recommendation Status
Department of Veterans Affairs To systematically gauge the extent to which deficiencies identified by individual AIBs may be occurring throughout VHA; and to maximize opportunities for sharing information across VHA to improve its overall operations, the Secretary of Veterans Affairs should direct the Under Secretary for Health to establish a process to collect and analyze aggregate data from AIB investigations, including the number of investigations conducted, the types of matters investigated, whether the matters were substantiated, and systemic deficiencies identified.
Open

VA concurred with this recommendation and noted that it would explore any new processes for collecting and analyzing aggregate data from AIB investigations. In September 2015, VA reported that VHA had established a workgroup to review this recommendation and also had created a database to collect and analyze aggregate data from AIB investigations into senior executive service (SES) employees. Based on the results of an informal survey as well as its analysis of AIB data for SES employees, VA stated that central office oversight of the AIB process is not needed and that several systems already
Department of Veterans Affairs To systematically gauge the extent to which deficiencies identified by individual AIBs may be occurring throughout VHA; and to maximize opportunities for sharing information across VHA to improve its overall operations, the Secretary of Veterans Affairs should direct the Under Secretary for Health to establish a process for sharing information about systemic changes, including policies and procedures implemented in response to the results of AIB investigations, which may have broader applicability throughout VHA.
Open

VA concurred with this recommendation and noted that it would explore any new processes for collecting and analyzing aggregate data from AIB investigations. In September 2015, VA reported that it had established a working group to review this recommendation. In addition, VA also had created a database to collect and analyze aggregate data from AIB investigations into senior executive service (SES) employees to identify trends and address deficiencies. Based on an informal survey of its working group and its analysis of AIB data for SES employees, VA stated that VISNs currently provide adequate

Highway Infrastructure: Federal-State Partnership Produces Benefits and Poses Oversight Risks

GAO-12-474
Phillip R. Herr
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1 Open Recommendations
Agency Recommendation Status
Congress As we have previously recommended, Congress should consider reexamining and refocusing surface transportation programs, including establishing well-defined goals with direct links to identified federal interests and roles. Based on this review, there may be areas where national interests are less evident and where Congress may wish to consider narrowing FHWA's responsibilities.
Open

In November 2021, the Infrastructure Investment and Jobs Act (Pub. L. No. 117-58) was enacted to reauthorize surface transportation programs, among other actions. In doing so, Congress generally increased the number of programs FHWA administers, which include four new formula grant programs and a number of new grant discretionary programs. As of March 2024, Congress has not taken any additional action in this area. GAO will continue to monitor congressional action in this area.

Tobacco Taxes: Large Disparities in Rates for Smoking Products Trigger Significant Market Shifts to Avoid Higher Taxes

GAO-12-475
David Gootnick
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1 Open Recommendations
Agency Recommendation Status
Congress Disparities in tax rates on smoking tobacco products have negative revenue implications because they create incentives for manufacturers and consumers to substitute higher-taxed products with lower-taxed products. In light of that fact, as Congress continues its oversight of CHIPRA and Tobacco Control Act implementation, it may wish to consider modifying tobacco tax rates to eliminate significant tax differentials between similar products. Specifically, Congress may wish to consider equalizing tax rates on roll-your-own and pipe tobacco and, in consultation with Treasury, also consider options for reducing tax avoidance due to tax differentials between small and large cigars.
Open

As of March 2024, Congress has not passed legislation to eliminate tax differentials between roll-your-own and pipe tobacco or between small and large cigars. GAO's April 2012 report noted that prior federal and state legislation has aimed to discourage tobacco use and raise revenues by increasing taxes on tobacco products. Modifying tax rates to eliminate the tax differentials between similar tobacco products could address potential future revenue losses stemming from the substitution of higher-taxed products with lower-taxed products.

Crop Insurance: Savings Would Result from Program Changes and Greater Use of Data Mining

GAO-12-256
Lisa R. Shames
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1 Open Recommendations
Agency Recommendation Status
Congress To reduce the cost of the crop insurance program, Congress may wish to consider limiting the subsidy for premiums that an individual farmer can receive each year or reducing the subsidy for all farmers participating in the program, or both limiting and reducing these subsidies.
Open

As of February 2024, Congress has not taken action to implement this matter.

Medicare Secondary Payer: Additional Steps Are Needed to Improve Program Effectiveness for Non-Group Health Plans

GAO-12-333
Kathleen M. King
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1 Open Recommendations
Agency Recommendation Status
Centers for Medicare & Medicaid Services To improve the effectiveness of the MSP program and process for NGHPs, and to improve the agency's communication regarding the MSP process for situations involving NGHPs, the Acting Administrator of CMS should develop guidance regarding liability and no-fault set-aside arrangements.
Open

Since April 2012, the month the recommendation was made, CMS officials have reported at various times that the agency was planning to issue either regulatory or sub-regulatory guidance on this topic. In March 2019, officials said that the agency now planned to issue regulatory guidance. In August 2021, CMS officials said that they drafted a Notice of Proposed Rulemaking to address future medical obligations, through a set-aside arrangement for beneficiaries who receive liability insurance as well as workers' compensation settlements. Officials said that this was to be published in the spring

2012 Annual Report: Opportunities to Reduce Duplication, Overlap and Fragmentation, Achieve Savings, and Enhance Revenue

GAO-12-342SP
Janet St. Laurent, Zina Merritt
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2 Open Recommendations
Agency Recommendation Status
Federal Emergency Management Agency The Federal Emergency Management Agency (FEMA) should complete a national preparedness assessment of capability gaps at each level based on tiered, capability-specific performance objectives to enable prioritization of grant funding, and FEMA could identify the potential costs for establishing and maintaining those capabilities at each level and determine what capabilities federal agencies should provide.
Open – Partially Addressed

FEMA concurred with the recommendation and has taken steps to implement it. First in 2022, FEMA developed the National Stakeholder Preparedness Review (National SPR) is a first-of-its-kind federal self-assessment of capabilities. The National SPR goals are to gauge the Nation's readiness for catastrophic disasters, to identify national-level emergency management capability gaps and planning assumptions for all hazards and specific scenarios, and to inform preparedness efforts. Next, FEMA drafted the Concurrence of the Target Gap Overviews (previously called the capability assessment sheets)
Social Security Administration In response to prior recommendations, the Social Security Administration (SSA) has taken steps to explore the possibilities of sharing information with states and the workers' compensation insurance industry to identify persons who might be receiving workers' compensation benefits. While some information sharing has taken place, GAO continues to believe that additional opportunities exist to share information. While obtaining information from states is difficult, these efforts may help identify workers' compensation beneficiaries so that benefits can be appropriately and accurately offset.
Open – Partially Addressed

As GAO indicated in February 2012, additional opportunities exist for data sharing with states and the workers' compensation insurance industry to identify persons who might be receiving workers' compensation. While SSA has taken some steps to explore information sharing with states, the data SSA has on workers' compensation benefits are limited, and the agency is also now working to obtain federal workers' compensation data. In January 2013, SSA stated that its SSA Access to State Records Online (SASRO) agreements with states outline conditions under which it is permitted access to query
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