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    Results:

    Subject Term: Audits

    18 publications with a total of 53 open recommendations including 9 priority recommendations
    Director: Timothy J. DiNapoli
    Phone: (202) 512-4841

    7 open recommendations
    Recommendation: To enhance management attention to closing out contracts, the Secretary of Defense should develop a means for department-wide oversight into components' progress in meeting their goals on closing contracts and the status of contracts eligible for closeout. (Recommendation 1)

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To enhance management attention to closing out contracts, the Secretary of Health and Human Services should develop a means for department-wide oversight into components' progress in meeting their goals on closing contracts and the status of contracts eligible for closeout. (Recommendation 2)

    Agency: Department of Health and Human Services
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To enhance management attention to closing out contracts, the Secretary of Homeland Security should develop a means, either at the agency or the component level, to track where the contracts are in the closeout process, and establish goals and performance measures for closing contracts. (Recommendation 3)

    Agency: Department of Homeland Security
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To enhance management attention to closing out contracts, the Attorney General should direct the Senior Procurement Executive to ensure the development of a means to track data on the number and type of contracts eligible for closeout and where the contracts are in the closeout process, as well as a means to assess--at the agency or component level--progress by establishing goals and performance measures for closing contracts. (Recommendation 4)

    Agency: Department of Justice
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To enhance management attention to closing out contracts, the Secretary of State should develop a means at the agency level to track data on the entirety of the number and type of contracts eligible for closeout, where the contracts are in the closeout process, and establish goals and performance measures for closing contracts. (Recommendation 5)

    Agency: Department of State
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To manage its incurred cost inventory, the Director, DCAA should assess and implement options for reducing the length of time to begin incurred cost audit work and establish related performance measures. (Recommendation 6)

    Agency: Department of Defense: Defense Contract Audit Agency
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To manage its incurred cost inventory, the Director, DCAA should comprehensively assess the use and effect of multi-year audits on both DCAA and contractors and establish related performance measures. (Recommendation 7)

    Agency: Department of Defense: Defense Contract Audit Agency
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Carolyn L. Yocom
    Phone: (202) 512-7114

    3 open recommendations
    Recommendation: To build upon CMS's collaborative audit efforts and help enhance future collaboration, CMS should identify opportunities to address barriers that limit states' participation in collaborative audits. Such opportunities could include improving communication with states before, during, and after audits are completed; and ensuring that audits align with states' program integrity needs, including the need for oversight of services provided in managed care delivery systems.

    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: To better support states' efforts to reduce improper payments and communicate effective program integrity practices across the states, CMS should collaborate with states to develop a systematic approach to collect promising state program integrity practices.

    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: To better support states' efforts to reduce improper payments and communicate effective program integrity practices across the states, CMS should collaborate with states to create and implement a communication strategy for sharing promising program integrity practices with states in an efficient and timely manner.

    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: Kimberly M. Gianopoulos
    Phone: (202) 512-8612

    1 open recommendations
    including 1 priority recommendation
    Recommendation: To improve the effectiveness of the SEC's conflict minerals disclosure rule, the Secretary of Commerce should submit to the appropriate congressional committees a plan outlining steps that Commerce will take, with associated time frames, to (1) assess the accuracy of the independent private sector audits (IPSA) and other due diligence processes described under section 13(p) of the Securities Exchange Act of 1934; (2) develop recommendations for the process used to carry out such audits, including ways to improve the accuracy of the audits and establish standards of best practices for such audits; and (3) acquire the necessary knowledge, skills, and abilities to carry out these responsibilities.

    Agency: Department of Commerce
    Status: Open
    Priority recommendation

    Comments: Commerce agreed with this recommendation. In response to this recommendation, Commerce indicated in an October 25, 2016 letter to GAO that it has developed a three-step approach which parallels the three distinct elements of the recommendation. To fully implement this recommendation, Commerce needs to submit the said three-step plan, including associated timeframes for their completion, to the appropriate congressional committees. Section 1502 of the Dodd-Frank Act defines "appropriate committees" to mean the Committee on Appropriations, the Committee on Foreign Affairs, the Committee on Ways and Means, and the Committee on Financial Services of the House of Representatives; and the Committee on Appropriations, the Committee on Foreign Relations, the Committee on Finance, and the Committee on Banking, Housing, and Urban Affairs of the Senate.
    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: James Cosgrove
    Phone: (202) 512-7114

    5 open recommendations
    including 1 priority recommendation
    Recommendation: As CMS continues to implement and refine the contract-level RADV audit process to improve the efficiency and effectiveness of reducing and recovering improper payments and to improve the accuracy of CMS's calculation of coding intensity, the Administrator should modify that calculation by taking actions such as the following: (1) including only the three most recent pair-years of risk score data for all contracts; (2) standardizing the changes in disease risk scores to account for the expected increase in risk scores for all MA contracts; (3) developing a method of accounting for diagnostic errors not coded by providers, such as requiring that diagnoses added by MA organizations be flagged as supplemental diagnoses in the agency's Encounter Data System to separately calculate coding intensity scores related only to diagnoses that were added through MA organizations' supplemental record review (that is, were not coded by providers); and (4) including MA beneficiaries enrolled in contracts that were renewed from a different contract under the same MA organization during the pair-year period.

    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: As CMS continues to implement and refine the contract-level RADV audit process to improve the efficiency and effectiveness of reducing and recovering improper payments. The Administrator should modify CMS's selection of contracts for contract-level RADV audits to focus on those contracts most likely to have high rates of improper payments by taking actions such as the following: (1) selecting more contracts with the highest coding intensity scores; (2) excluding contracts with low coding intensity scores; (3) selecting contracts with high rates of unsupported diagnoses in prior contract-level RADV audits; (4) if a contract with a high rate of unsupported diagnoses is no longer in operation, selecting a contract under the same MA organization that includes the service area of the prior contract; and (5) selecting some contracts with high enrollment that also have either high rates of unsupported diagnoses in prior contract-level RADV audits or high coding intensity scores.

    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: As CMS continues to implement and refine the contract-level RADV audit process to improve the efficiency and effectiveness of reducing and recovering improper payments. The Administrator should enhance the timeliness of CMS's contract-level RADV process by taking actions such as the following: (1) closely aligning the time frames in CMS's contract-level RADV audits with those of the national RADV audits the agency uses to estimate the MA improper payment rate; (2) reducing the time between notifying MA organizations of contract audit selection and notifying them about the beneficiaries and diagnoses that will be audited; (3) improving the reliability and performance of the agency's process for transferring medical records from MA organizations, including assessing the feasibility of updating Electronic Submission of Medical Documentation for use in transferring medical records in contract-level RADV audits; and (4) requiring that CMS contract-level RADV auditors complete their medical record reviews within a specific number of days comparable to other medical record review time frames in the Medicare program.

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

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: As CMS continues to implement and refine the contract-level RADV audit process to improve the efficiency and effectiveness of reducing and recovering improper payments. The Administrator should improve the timeliness of CMS's contract-level RADV appeal process by requiring that reconsideration decisions be rendered within a specified number of days comparable to other medical record review and first-level appeal time frames in the Medicare program.

    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: As CMS continues to implement and refine the contract-level RADV audit process to improve the efficiency and effectiveness of reducing and recovering improper payments. The Administrator should ensure that CMS develops specific plans and a timetable for incorporating a RAC in the MA program as mandated by the Patient Protection and Affordable Care Act.

    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: King, Kathleen M
    Phone: (202) 512-7114

    3 open recommendations
    including 3 priority recommendations
    Recommendation: As CMS prepares to solicit the next RAC contract(s), to improve the agency's RAC program operations and contractor oversight, the Administrator of CMS should ensure that work statements included in solicitations for contract proposals and the executed contract(s) set clear expectations about the work CMS intends the RAC to perform and that time frames are established that reflect the time needed to reach milestones.

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

    Comments: HHS agreed with our recommendation. As of March 2017, HHS stated that the agency was evaluating its strategy for the Medicare Part D RAC. Once HHS has completed its evaluation, we will update the status of these recommendations. As of May 2017, GAO considers this recommendation open.
    Recommendation: As CMS prepares to solicit the next RAC contract(s), to improve the agency's RAC program operations and contractor oversight, the Administrator of CMS should conduct annual evaluations of the RAC's performance against measurable performance standards to provide a clear basis on which CMS and the RAC can assess RAC performance in identifying improper payments.

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

    Comments: HHS agreed with our recommendations. As of March 2017, HHS stated that the agency was evaluating its strategy for the Medicare Part D RAC. Once HHS has completed its evaluation, we will update the status of these recommendations. As of May 2017, GAO considers this recommendation open.
    Recommendation: As CMS prepares to solicit the next RAC contract(s), to improve the agency's RAC program operations and contractor oversight, the Administrator of CMS should review the agency's process for identifying, reviewing, and approving new audit issues to identify process improvements that will help ensure the efficient development of appropriate audit issues (i.e., reduce audit issue denials and increase audit issue approvals) and thereby maximize the collection of improper payments.

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

    Comments: HHS agreed with our recommendations. As of March 2017, HHS stated that the agency was evaluating its strategy for the Medicare Part D RAC. Once HHS has completed its evaluation, we will update the status of these recommendations. As of May 2017, GAO considers this recommendation open.
    Director: Mctigue Jr, James R
    Phone: (202) 512-7968

    3 open recommendations
    including 2 priority recommendations
    Recommendation: Congress should consider altering the TEFRA audit procedures to require partnerships to designate a qualified Tax Matters Partner (TMP) and, if that TMP is an entity, to also identify a representative who is an individual and for partnerships to keep the designation up to date.

    Agency: Congress
    Status: Open

    Comments: In October 2015, H.R. 1314 was amended to include the Bipartisan Budget Act of 2015, which included provisions that would repeal the TEFRA audit procedures and put in place new audit procedures for partnerships with more than 100 partners. This legislation was signed into law in November 2015. According to the legislation, the new audit procedures would require partnerships to designate a qualified representative for the partnership audit. However, the legislation did not require audited partnerships to identify a representative who is an individual nor do they require that audited partnerships keep the designation up to date as suggested in GAO's report. The legislation does give IRS the authority to develop regulations about how the partnership representative should be designated by the partnership and such regulations may address the items in GAO's report. Currently regulations are under development at IRS. The legislation specifies that the new partnership audit procedures apply to partnership returns filed for tax years beginning after December 31, 2017.
    Recommendation: The Commissioner of Internal Revenue should track the results of large partnerships audits: (a) define a large partnership based on asset size and number of partners; (b) revise the activity codes to align with the large partnership definition; and (c) separately account for field audits and campus audits.

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

    Comments: No executive action taken. IRS said that it plans to address parts of GAO's September 2014 recommendation about tracking the audit results on large partnerships but has not yet done so. In November 2014, IRS said that it plans to define large partnerships using asset size and the number of partners and to find an alternative method to account for field and campus large partnership cases using existing capabilities, but that revising IRS's activity codes to enable it to track large partnership audits would be dependent on future funding. In March 2017, IRS told GAO that it would need until September 2017 to address this recommendation as IRS continues to monitor efforts to implement the Bipartisan Budget Act (BBA). Section 1101 of the Bipartisan Budget Act of 2015 (Public law 114-74), which was enacted in November 2015, includes provisions that repeal TEFRA audit procedures and put in place audit procedures that would require partnerships with more than 100 partners to pay audit adjustments at the partnership level, among other changes. IRS explained that these changes significantly alter the procedural and administrative components of partnerships. IRS said it would need this additional time to analyze options and determine the most appropriate steps for effectively tracking the results of large partnership audits. Without changes to tracking partnership audit results, IRS cannot conduct analysis to identify ways to better plan and use IRS resources in auditing large partnerships as well as analyze whether large partnerships present a high noncompliance risk.
    Recommendation: The Commissioner of Internal Revenue should analyze the audit results by these activity codes and types of audits to identify opportunities to better plan and use IRS resources in auditing large partnerships.

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

    Comments: As of October 2016, the Internal Revenue Service (IRS) said that based on completion of GAO's recommendations on tracking results and after sufficient large partnership audit results have been obtained, it still plans to conduct a study to analyze these results and recommend any ways in which resource use can be improved. IRS still expects to complete this analysis by September 2018.
    Director: Wise, David J
    Phone: (202) 512-2834

    1 open recommendations
    Recommendation: To provide increased transparency about the funding amounts agencies are spending to maintain their assets and manage their backlogs, the Director of OMB should require the OMB Deputy Director for Management, as chair of the FRPC, in collaboration and consultation with FRPC member agencies, to collect information through FRPP or other mechanisms on agencies' costs for annual recurring maintenance and repair performed--information that is currently incorporated within agencies' annual operating costs--and report summary level information in the FRPC's fiscal year report. This recommendation is not intended to limit FRPC from continuing to collect and report on agencies' overall annual operating costs, which can include annual maintenance costs plus other operating expenses such as the cost of utilities.

    Agency: Executive Office of the President: Office of Management and Budget
    Status: Open

    Comments: As of December 2015, OMB had worked with the FRPC to develop a method to collect annual recurring maintenance and repair data in the FRPP. This effort includes (1) developing separate definitions for "operations" and "maintenance" costs, which are currently reported in the FRPP as a combined cost number, and (2) defining a methodology that agencies can use to consistently collect and report annual deferred maintenance and repair expenditures. OMB expects these actions to be completed by the fiscal year 2018 FRPP reporting cycle. As of March 28, 2017, OMB had not provided GAO with any additional updates regarding the status of this recommendation.
    Director: Khan, Asif A
    Phone: (202) 512-9869

    5 open recommendations
    Recommendation: To strengthen the design of controls over active duty Army military payroll, and to assure the effectiveness of the UCFR process as a compensating control for confirming the accuracy of its military pay, the Secretary of Defense should direct the Secretary of the Army to revise AR 37-104-4, Military Pay and Allowances Policy, to establish a requirement for periodic monitoring of the effectiveness of unit commander UCFR reviews.

    Agency: Department of Defense
    Status: Open

    Comments: In June 2013, DOD and Army officials told us that the Army and Defense Finance and Accounting Service (DFAS) performed an analysis of the effectiveness of the Unit Commander Finance Report (UCFR) in preventing payroll errors. The officials shared a February 21, 2013, Army memo on the results of the analysis, which indicated that while the UCFR was an effective tool as a snapshot of a Soldier's pay, it was not comprehensive enough to provide the level of detail needed to manage many pay entitlements. Additionally, analytical results showed that in most cases, having units certify and return UCFRs to the Finance Office did not result in corrective action in the month the condition requiring action first appeared on the report. The officials told us the Army intends to rely on existing primary controls over pay transactions and the implementation of the Integrated Personnel and Pay System-Army (IPPS-A), which was targeted for implementation in 2017, to address the issues we reported rather than revising AR-37-104-4 to require certification of the UCFR and its return to the Finance Office. The Army concluded that if used properly, the UCFR could provide a secondary control for units to identify a limited number of pay discrepancies. The Army's Finance Command Director subsequently told us that because the analysis showed that the UCFR was not being used as an effective tool by unit commanders, the Army would continue to pursue methods to improve pay transaction timeliness through training and command awareness efforts, to include use of the UCFR, pending implementation of IPPS-A. For example, the Army expanded the list of entitlements that, similar to UCFRs, are sent to commands for review and increased the frequency of the command reviews. The Army also implemented a process for monitoring high-risk special pays that have an anniversary date, such as Foreign Language Proficiency Bonus, Basic Allowance for Housing, and Basic Allowance for Subsistence, and confirming that the certifications have not expired. However, DOD's May 2017 FIAR Plan Status Report showed that the Army's IPPS-A is not expected to be fully implemented until April 2020. We will continue to assess DOD's efforts to address this recommendation.
    Recommendation: To strengthen the design of controls over active duty Army military payroll, and to assure the effectiveness of the UCFR process as a compensating control for confirming the accuracy of its military pay, the Secretary of Defense should direct the Secretary of the Army to revise AR 37-104-4, Military Pay and Allowances Policy, to require unit commanders to review and submit documentation showing completion of all monthly UCFR reviews.

    Agency: Department of Defense
    Status: Open

    Comments: In June 2013, DOD and Army officials told us that the Army and Defense Finance and Accounting Service (DFAS) performed an analysis of the effectiveness of the Unit Commander Finance Report (UCFR) in preventing late transactions for updating pay. The results of an Army analysis showed that units certifying and returning UCFRs to the Finance Office did not increase timely corrective actions being taken to a soldier's pay. In a memo dated Feb. 21, 2013, the Army stated, "Creating a mandatory process of requiring Commanders to certify and return the UCFR (even when there are no errors) imposes additional administrative requirements and associated costs on the unit, the Finance Office and DFAS." The memo further stated that, based on the sample taken, most units are already certifying UCFRs and returning them to Finance -- with little impact on Soldiers' pay." Army officials told us that based on the Feb. 21, 2013, memo and subsequent follow up, the Army intended to rely on existing primary controls over pay transactions and the implementation of the Integrated Personnel and Pay System-Army (IPPS-A) targeted for August 2017 to address the issues we reported, rather than revise AR-37-104-4 to require certification of the UCFR and its return to the Finance Office. Army officials told us they would continue to pursue methods to improve pay transaction timeliness through training and command awareness efforts, to include use of the UCFR. The Army stated that the development and fielding of IPPS-A offers opportunities for reducing errors and manual inputs, while providing improved transaction timeliness and pay accuracy. However, DOD's May 2017 FIAR Plan Status Report showed that the Army's IPPS-A is not expected to be fully implemented until April 2020. We will continue to assess DOD's efforts to address this recommendation.
    Recommendation: To strengthen the design of controls over active duty Army military payroll, and to assure the effectiveness of the UCFR process as a compensating control for confirming the accuracy of its military pay, the Secretary of Defense should direct the Secretary of the Army to revise AR 37-104-4, Military Pay and Allowances Policy, to specify the time frame for submitting UCFRs, such as no later than the 10th of the month.

    Agency: Department of Defense
    Status: Open

    Comments: In a Feb. 21, 2013 memo, the Army stated that its regulations require units to take immediate action when an error is discovered during a review of an Unit Commander Finance Report (UCFR). According to the Army, specifying a timeframe for the review and submission of UCFRs, such as 10 days, would also require the development of additional controls and monitoring procedures and create exceptions/waivers for those units deployed or on training exercises. As a result, the Army intended to rely on existing primary controls over pay transactions and the targeted implementation of the Integrated Personnel and Pay System-Army (IPPS-A) in August 2017 to address the issues, rather than revise AR-37-104-4. With the slippage in implementation of IPPS-A integrated military personnel and pay functionality to April 2020, the Army needs to reconsider our recommendation along with reasonable timeline accommodations for deployed units. We will continue to assess the Army's efforts to address this recommendation.
    Recommendation: To strengthen the design of controls over active duty Army military payroll, and to provide a means for monitoring the overall accuracy of the Army's military payroll, the Secretary of Defense should direct the DOD Comptroller to require DFAS-IN to develop criteria and establish a comprehensive metric to capture and measure all types of pay errors affecting accuracy.

    Agency: Department of Defense
    Status: Open

    Comments: In June 2013, the Defense Finance and Accounting Service (DFAS)-Indianapolis Director told us that DFAS conducted a gap analysis for two installations (Ft. Carson and Ft. Gordon). This analysis compared data on the effective date of pay impacting transactions (e.g., Basic Allowance for Housing, Foreign Language Proficiency Pay, etc.); the date transactions were entered into the pay system; the elapsed time in days from the effective date through each step of the process to the date pay was input to the military pay system. The Army's analysis concluded that most errors that occurred were due to units' late submissions of source documents. The Army's position is that the key metric for military pay accuracy is the timeliness of processing of pay impacting transactions. The Army intended to rely on the targeted August 2017 implementation of the Integrated Personnel and Pay System-Army (IPPS-A) to address pay transaction timeliness and address any other identified issues rather than require DFAS-Indianapolis to develop additional criteria and metrics within the current systems environment to measure all types of conditions affecting accuracy. However, DOD's May 2017 FIAR Plan Status Report showed that the Army's IPPS-A is not expected to be fully implemented until April 2020. We will continue to assess DOD's efforts to address this recommendation.
    Recommendation: To strengthen the design of controls over active duty Army military payroll, and to provide a means for monitoring the overall accuracy of the Army's military payroll, the Secretary of Defense should direct the Department of Defense (DOD) Comptroller to require DFAS-IN to establish an interim mechanism at DFAS-IN for identifying and analyzing the extent and causes of all types of military payroll errors processed by Defense Military Pay Offices (DMPOs), Army Finance Offices, Defense Joint Military Pay System-Active Component (DJMS-AC), and Case Management System (CMS) to address any systemic control weaknesses.

    Agency: Department of Defense
    Status: Open

    Comments: In June 2013, DOD and Army officials stated that DFAS, as part of its pre-assertion audit readiness efforts for the Military Pay Statement on Standards for Attestation Engagements (SSAE) No. 16, Reporting on Controls at a Service Organization examination, has identified and validated many controls over the completeness, accuracy and validity of military pay. This included identifying gaps in internal controls and developing and implementing corrective action plans to mitigate any gaps. The Army subsequently engaged another independent public accounting firm to assess its audit readiness for the Statement of Budgetary Resources, including audit readiness for its military pay. In addition, the Army underwent an audit of its fiscal year 2015 General Fund Schedule of Budgetary Activity. Both audit engagements identified military pay issues requiring corrective action. Most recently, the audit of the Army's fiscal year 2016 Budgetary Schedule resulted in a disclaimer of opinion, in part, due to the Army's inability to produce a complete and accurate population of accession, separation, promotion/reduction, special pay, and leave populations for Active Duty, Reserve, and Guard soldiers. In January 2016, the Army auditor reported that "without the ability to produce complete populations, the risk exists that a soldier is improperly accessed, separated, promoted/reduced, awarded special pay, and/or had his or her leave account adjusted incorrectly. Further, the Army's ability to identify and correct any errors is significantly reduced, potentially misstating payroll obligations and outlays reported on the schedule." Army officials stated that it intends to rely on its current transaction timeliness metrics, pre-payment statistical sampling, Improper Payment Elimination and Reporting Act (IPERA) reporting, and eventually implementation of the Integrated Personnel and Pay System - Army (IPPS-A) to address the issues regarding completeness, accuracy, and validity of military pay. However, DOD's May 2017 FIAR Plan Status Report showed that the Army's IPPS-A is not expected to be fully implemented until April 2020. Therefore, we believe that the Army needs to revisit our recommendation and establish an interim mechanism for identifying and analyzing the extent and causes of military payroll errors and take appropriate action to address any systemic control weaknesses. We will continue to assess the Army's efforts to address this recommendation.
    Director: Mctigue Jr, James R
    Phone: (202) 512-7968

    3 open recommendations
    including 1 priority recommendation
    Recommendation: To better ensure that IRS's limited enforcement resources are allocated in a manner that maximizes the revenue yield of the income tax, subject to other important objectives of tax administration, such as minimizing compliance costs and ensuring equitable treatment across different groups of taxpayers, the Commissioner of Internal Revenue should review disparities in the ratios of direct revenue yield to costs across different enforcement programs and across different groups of cases within programs and determine whether this evidence provides a basis for adjusting IRS's allocation of enforcement resources each year. As part of this review, IRS should develop estimates of the marginal direct revenue and marginal direct cost within each enforcement program and each taxpayer group.

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

    Comments: IRS agrees in principle to using ratios of direct revenue yield-to-cost to adjust its enforcement resource allocation, as GAO recommended in December 2012; however, IRS officials plan to wait until it has developed such ratios at the marginal level (e.g., for the last cases worked within specific categories of exams) before they make such adjustments. GAO maintains that IRS has a basis to adjust its allocation of enforcement resources each year and could improve resource allocation immediately (while it is still working to develop the marginal ratios) by using average yield-to-cost ratios for each category. IRS has developed a methodology for estimating marginal ratios for limited subsets of cases within their correspondence examination program. IRS officials are working to apply this methodology to other cases within that program; however, they expect this effort will be complex and time consuming and officials did not have a timeline for full implementation as of March 2017. If IRS does not take into account some measure of revenue yield per dollar of cost when making allocation decisions, it will miss an opportunity to collect significant amounts of additional revenue.
    Recommendation: To better ensure that IRS's limited enforcement resources are allocated in a manner that maximizes the revenue yield of the income tax, subject to other important objectives of tax administration, such as minimizing compliance costs and ensuring equitable treatment across different groups of taxpayers, the Commissioner of Internal Revenue should review disparities in the ratios of direct revenue yield to costs across different enforcement programs and across different groups of cases within programs and determine whether this evidence provides a basis for adjusting IRS's allocation of enforcement resources each year. As part of this review, IRS should compile data on the amount of time that specific grades of examiners and downstream employees spend on specific categories of exams that can be identified in ERIS.

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

    Comments: IRS has developed a methodology to estimate for each closed correspondence audit the total cost to IRS to identify, assess, and collect whatever direct revenue is collected from that audit. These estimated take into account the actual time applied in Examination and Appeals, as well as the job series and grades of the Exam and Appeals employees who handled each return. Collections cost do not vary significantly across the population of correspondence audits, so an average cost factor is used for that portion of the costs. IRS anticipates that expanding this estimation effort to other enforcement programs, such as field examination will require a much larger effort. As of December 2015, officials did not yet have a timeline for full implementation. If IRS does not take into account some measure of revenue yield per dollar of cost when making allocation decisions, it will miss an opportunity to collect significant amounts of additional revenue.
    Recommendation: To better ensure that IRS's limited enforcement resources are allocated in a manner that maximizes the revenue yield of the income tax, subject to other important objectives of tax administration, such as minimizing compliance costs and ensuring equitable treatment across different groups of taxpayers, the Commissioner of Internal Revenue should review disparities in the ratios of direct revenue yield to costs across different enforcement programs and across different groups of cases within programs and determine whether this evidence provides a basis for adjusting IRS's allocation of enforcement resources each year.As part of this review, IRS should explore the potential of estimating the marginal influence of enforcement activity on voluntary compliance, potentially taking advantage of new NRP data.

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

    Comments: IRS has not yet found a way to use NRP data or other data sources to estimate the indirect effects of audits. While they continue to explore alternative ways to estimate these effects, they expect to continue to account for these effects subjectively as they develop their enforcement resource allocation plans. As of December 2015, officials did not yet have a timeline for full implementation. If IRS does not take into account some measure of revenue yield per dollar of cost when making allocation decisions, it will miss an opportunity to collect significant amounts of additional revenue.
    Director: Wise, David J
    Phone: (202)512-5731

    1 open recommendations
    Recommendation: To improve NTD data collection for ADA paratransit,the Secretary of Transportation should direct the FTA Administrator to provide guidance to transit agencies on how to accurately complete existing ADA paratransit fields.

    Agency: Department of Transportation: Federal Transit Administration
    Status: Open

    Comments: The Federal Register final notice on April 7, 2015, shows that FTA is eliminating the collection of certain ADA paratransit data (trips and expenses) from the NTD. This clarification instructs respondents on how to exclude data for demand-responsive services that are not ADA paratransit. We are reviewing the documentation and will make a decision regarding closing this recommendation as implemented at the conclusion of our review.
    Director: Goldstein, Mark L
    Phone: (202) 512-2834

    2 open recommendations
    Recommendation: Given the challenges that FPS faces in assessing risks to federal facilities and managing its contract guard workforce, the Secretary of Homeland Security should develop and implement a new comprehensive and reliable system for contract guard oversight.

    Agency: Department of Homeland Security
    Status: Open

    Comments: According to FPS officials, as of September 2017, FPS is currently reviewing proposals and preparing to make a decision for the final contract award for a Post Tracking System (PTS). According to FPS, this PTS will allow FPS to comprehensively and reliability mange its contract guards. Once the contract is awarded in late 2017 FPS will begin to implement the PTS system. GAO is keeping this recommendation open pending successful implementation of this system.
    Recommendation: Given the challenges that FPS faces in assessing risks to federal facilities and managing its contract guard workforce, the Secretary of Homeland Security should verify independently that FPS's contract guards are current on all training and certification requirements.

    Agency: Department of Homeland Security
    Status: Open

    Comments: According to FPS officials, as of September 2017, FPS plans to address this recommendation through the implementation of FPS?s Training Academy and Management System (TAMS). FPS reported that this system should allow it to verify independently that FPS's contract guards are current on all training and certification requirements. FPS is currently taking various steps to finalize the system and anticipates full implementation of TAMS by August 2018. GAO is leaving this recommendation open pending successful implementation of TAMS.
    Director: Farrell, Brenda S
    Phone: (202) 512-3604

    1 open recommendations
    Recommendation: To improve transparency of costs and the efficiency of suitability andpersonnel security clearance background investigation processes thatcould lead to cost savings, the Deputy Director for Management, Office of Management and Budget, in the capacity as Chair of the Performance Accountability Council, should expand and specify reform-related guidance to help ensure that reform stakeholders identify opportunities for cost savings, such as preventing duplication in the development of electronic case-management and adjudication technologies in the suitability determination and personnel security clearance processes.

    Agency: Executive Office of the President: Office of Management and Budget: Performance Accountability Council
    Status: Open

    Comments: In July 2013, OMB provided GAO with an update to this recommendation. Although OMB has not yet issued guidance to help ensure that reform stakeholders identify opportunities for cost savings, OMB noted that it continues to work with Executive Agents on activities that reduce duplication in electronic case management and adjudication technologies for the suitability determination and personnel security clearance processes and provided four examples of those activities. (1)In March 2012, OMB's Office of E-Government and Information Technology began meeting with OPM regarding opportunities to enhance the functionality of non-DoD adjudicative entities that are serviced by OPM's Central Verification System, a subsystem of OPM's Personnel Investigation Processing System. (2) In March 2012, OPM provided programming language to the National Security Agency for the Electronic Questionnaire for Investigations Processing (EQIP), which the PAC previously identified as the Executive Branch solution for all investigation requests/applications. Since, NSA has begun development of a single classified automated EQIP solution for the Intelligence Community (IC). (3) In May 2012, DoD directed the consolidation of the seven non-IC DOD Central Adjudication Facilities under a single centralized authority. This more efficiently allocates adjudicative resources in a single case management system. (4) In anticipation of the IC's move to a cloud computing environment, ODNI's Special Security Directorate has begun discussion with IC components on how best to support further standardization and prevent duplication as they develop and modify IT systems to implement investigative and adjudicative training standards, respond to reporting requirements, and implement revised adjudicative guidelines. (5) The PAC, the Security Executive Agent, and DOD continue to promote the adoption of the DOD eAdjudication system (CATS) solution within other agencies across Government. The CATS e-Processing Suite (e-Delivery, e-Screening, and e-Adjudication processes) eliminates manual processes and realizes adjudicative efficiencies through the use of technology. DoD recently reported that During FY2012, e-Delivery saved the DoD approximately 590,000 hours (over 280 man-years) in employee processing and handling time, equating to a one-year salary cost avoidance of nearly $33 million. In addition, during FY2012, e-Adjudication saved the DoD approximately 57,000 hours (over 28 man years) in employee adjudication time, equating to a one-year salary cost avoidance of nearly $3.2 million. Shortly after the report was issued, OPM provided GAO with a letter dated May 25, 2012, that included its plans to address the recommendations that GAO made in GAO-12-197, to improve the transparency of the costs and efficiency of the suitability and security clearance background investigation process. Although this recommendation was geared toward the Deputy Director for Management at OMB, OPM pledged to support OMB in the implementation of this recommendation by 1) providing cost analysis data to support cost efficient Executive Branch implementation of new Federal Investigative Standards, 2) supporting standardization and consolidation of investigative systems and processes to the extent it benefits the goals of cost efficiency and reciprocity, and 3) providing recommendations for the standardization of technology supporting suitability adjudicative processes to the extent this benefits the goals of cost efficiency and reciprocity. OPM noted that, in March 2012, it provided OMB reform leadership with both cost analysis data to support the implementation of the new Federal Investigative Standards and recommendations for the standardization of technology for the consideration of OMB's e-Government experts.
    Director: Brown, Orice Williams
    Phone: (202)512-5837

    4 open recommendations
    Recommendation: While creating control systems at the same time that the emergency programs were being designed and implemented posed unique challenges, the recent crisis provided invaluable experience that the Federal Reserve System can apply in the future should the use of these authorities again become warranted. Going forward, to further strengthen policies for selecting vendors, ensuring the transparency and consistency of decision making involving the implementation of any future emergency programs, and managing risks related to these programs, the Chairman of the Federal Reserve Board should direct Federal Reserve Board and Reserve Bank staff to strengthen procedures in place to guide Reserve Banks' efforts to manage emergency program access for higher-risk borrowers by providing more specific guidance on how Reserve Bank staff should exercise discretion and document decisions to restrict or deny program access for depository institutions and primary dealers that would otherwise be eligible for emergency assistance.

    Agency: Federal Reserve System: Board of Governors
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: While creating control systems at the same time that the emergency programs were being designed and implemented posed unique challenges, the recent crisis provided invaluable experience that the Federal Reserve System can apply in the future should the use of these authorities again become warranted. Going forward, to further strengthen policies for selecting vendors, ensuring the transparency and consistency of decision making involving the implementation of any future emergency programs, and managing risks related to these programs, the Chairman of the Federal Reserve Board should direct Federal Reserve Board and Reserve Bank staff to document a plan for estimating and tracking losses that could occur under more adverse economic conditions within and across all emergency lending activities and for using this information to inform policy decisions, such as decisions to limit risk exposures through program design or restrictions applied to eligible borrowing institutions.

    Agency: Federal Reserve System: Board of Governors
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: While creating control systems at the same time that the emergency programs were being designed and implemented posed unique challenges, the recent crisis provided invaluable experience that the Federal Reserve System can apply in the future should the use of these authorities again become warranted. Going forward, to further strengthen policies for selecting vendors, ensuring the transparency and consistency of decision making involving the implementation of any future emergency programs, and managing risks related to these programs, the Chairman of the Federal Reserve Board should direct Federal Reserve Board and Reserve Bank staff, in drafting regulations to establish the policies and procedures governing emergency lending under section 13(3) of the Federal Reserve Act, to set forth the Federal Reserve Board's process for documenting, to the extent not otherwise required by law, its justification for each use of this authority.

    Agency: Federal Reserve System: Board of Governors
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: While creating control systems at the same time that the emergency programs were being designed and implemented posed unique challenges, the recent crisis provided invaluable experience that the Federal Reserve System can apply in the future should the use of these authorities again become warranted. Going forward, to further strengthen policies for selecting vendors, ensuring the transparency and consistency of decision making involving the implementation of any future emergency programs, and managing risks related to these programs, the Chairman of the Federal Reserve Board should direct Federal Reserve Board and Reserve Bank staff to document the Federal Reserve Board's guidance to Reserve Banks on types of emergency program decisions and risk events that require approval by or consultation with the Board of Governors, the Federal Open Market Committee, or other designated groups or officials at the Federal Reserve Board.

    Agency: Federal Reserve System: Board of Governors
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Trimble, David C
    Phone: (202)512-9338

    3 open recommendations
    including 1 priority recommendation
    Recommendation: To improve EPA's ability to oversee the states' implementation of the Safe Drinking Water Act and provide Congress and the public with more complete and accurate information on compliance, the Administrator of EPA should resume data verification audits to routinely evaluate the quality of selected drinking water data on health-based and monitoring violations that the states provide to EPA. These audits should also evaluate the quality of data on the enforcement actions that states and other primacy agencies have taken to correct violations.

    Agency: Environmental Protection Agency
    Status: Open
    Priority recommendation

    Comments: In October 2016, EPA reported that it had not resumed its data verification audits, but is continuing on-site file reviews, completing 5 in 2015, and planning to complete 8 in 2016. Further, EPA continues to focus on developing its SDWIS Prime, which will support electronic verification of data. It plans to have the system operational in March 2018. In the last year, EPA conducted two training events with the regional file review teams which the agency indicated helped (1) identify challenges in completing file reviews and potential solutions, and (2) share best practices to enhance the implementation of the protocol. EPA told us that as the regions build more capacity and experience in conducting these file reviews, EPA expects to gradually increase the number of file reviews completed in a year. According to OECA, who collaborates with the water office for file reviews in some regions, there were no systemic discrepancies between enforcement file contents and data reported to EPA in its test of the protocol for evaluating the quality of enforcement data in 3 states.
    Recommendation: To improve EPA's ability to oversee the states' implementation of the Safe Drinking Water Act and provide Congress and the public with more complete and accurate information on compliance, the Administrator of EPA should work with the states to establish a goal, or goals, for the completeness and accuracy of data on monitoring violations. In setting these goals, EPA may want to consider whether certain types of monitoring violations merit specific targets. For example, the agency may decide that a goal for the states to completely and accurately report when required monitoring was not done should differ from a goal for reporting when monitoring was done but not reported on time.

    Agency: Environmental Protection Agency
    Status: Open

    Comments: According to EPA, it has not worked with states to establish a national goal for the quality of monitoring violations. EPA stated that without the ability to conduct on-site data verifications using a statistically-based sample size, it is unable to derive a goal that would capture both completeness of state reporting to EPA and whether the states correctly assigned a violation for missed monitoring. EPA said that it intends to work with states to evaluate the establishment of a monitoring data quality goal once the new SDWIS NextGen data system has been developed and electronic data verification functions are incorporated into the system. In April 2015, EPA indicated that the agency intends to separate monitoring violations from reporting violations in the new SDWIS Primacy Agency data system. According to EPA, this will enable the primacy agencies and EPA to better understand the nature of system violations and with the violations delineated in this manner, will allow EPA to consider developing goals for monitoring and reporting violations. In September 2015, EPA reported to GAO that it anticipated that states will begin using SDWIS Prime in September 2017 and that it will consider GAO's recommendation once SDWIS Prime is fully operational and it is able to better establish such a goal.
    Recommendation: To improve EPA's ability to oversee the states' implementation of the Safe Drinking Water Act and provide Congress and the public with more complete and accurate information on compliance, the Administrator of EPA should consider whether EPA's performance measures for community water systems could be constructed to more clearly communicate the aggregate public health risk posed by these systems' noncompliance with SDWA and progress in having those systems return to compliance in a timely manner.

    Agency: Environmental Protection Agency
    Status: Open

    Comments: According to EPA, the agency has not made any adjustments to the performance measures for community water systems. EPA told us that, as part of its periodic review of the 5-year Strategic Plan, it will consult with the states, the Office of Management and Budget, GAO and the National Drinking Water Advisory Committee (NDWAC) on how it could construct a new measure to communicate better the aggregate public health risk posed by noncompliance as GAO suggests. EPA also said that it will continue to use a variety of tools and resources to convey to the public information on drinking water quality and potential health risks associated with exposure to contaminants. In April 2015, EPA wrote: OGWDW did not make any changes in Fiscal Year 2014 to the program's current community water system-based measure which communicates the results of efforts to return systems to compliance and maintain compliance. The "person month" measure provides insight into the duration of health based violations. For FY 15, we have developed a "person month" measure for tribal community water systems. Further efforts to evaluate the current measures and consideration of GAO suggestions will continue to be part of the Agency's periodic review of the five-year strategic plan. In September 2015, EPA told GAO that it was evaluating the effectiveness of the "person month" measure and is continuing to enhance and revise the measures taking GAO suggestions into consideration.
    Director: St James, Lorelei
    Phone: (214)777-5719

    1 open recommendations
    Recommendation: To improve the management and oversight of the Low-Income Program, the Chairman of the FCC should conduct a robust risk assessment of the Low-Income Program.

    Agency: Federal Communications Commission
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: White, James R
    Phone: (202)512-5594

    1 open recommendations
    Recommendation: Congress may wish to consider providing IRS with math error authority (MEA) to use prior years' tax return information to automatically verify taxpayers' compliance with the limit on the number of years the Hope credit can be claimed.

    Agency: Congress
    Status: Open

    Comments: As of August 3, 2017, Congress has not provided IRS with math error authority (MEA) to use prior years' tax return information to automatically verify taxpayers' compliance with the limit on the number of years the Hope Scholarship Credit, now known as the American Opportunity Tax Credit (AOTC) can be claimed. The AOTC can be claimed by taxpayers for qualified tuition and related expenses for 4 years of postsecondary education. Under the Protecting Americans From Tax Hikes Act of 2015, IRS was granted MEA to disallow a claim for the AOTC if the taxpayer is not permitted to claim the credit due to prior fraudulent or reckless claims, or if the taxpayer omitted information relating to prior improper claims of the credit. IRS does not have authority to automatically deny an AOTC even if the taxpayer claims the credit for more than the 4 allowable years. GAO has in the past provided technical assistance to the House Solutions Caucus in drafting legislative language for a bill on extending MEA to use prior years' returns for verifying compliance with limits on the credit. In addition, the Administration has for many years included a revenue proposal in Treasury's Green Book to provide IRS with "correctable error authority" where the (1) information provided by the taxpayer does not match the information contained in government databases, (2) taxpayer has exceeded the lifetime limit for claiming the credit or deduction, or (3) taxpayer failed to include proper documentation with his or her return. If this revenue proposal was enacted, IRS would have the authority to deny claims for the AOTC if the taxpayer has already received the credit for 4 years.
    Director: Dicken, John E
    Phone: (202)512-7043

    2 open recommendations
    Recommendation: To address state agency practices and external pressure that may compromise survey accuracy, the Administrator of CMS should reestablish expectations through guidance to state survey agencies that noncitation practices--official or unofficial--are inappropriate, and systematically monitor trends in states' citations.

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

    Comments: September 2017: HHS reported CMS is working to address this recommendation. We will update the status of this recommendation when we receive further information. September 2016: CMS has not yet provided additional information. GAO will update the recommendation, as appropriate, when information is received. July 2015: CMS indicated it will provide GAO with updated actions in early 2016. May 2014: Though the best method to address external pressures on State Agencies was not identified, CMS is continuing to address the consistency, effectiveness, and integrity of the survey process through the following activities: reviewing citation patterns for the nursing home surveys; systematically identifying and testing opportunities to make the survey process more efficient and effective; and holding monthly CO and RO calls to address consistencies in the survey and enforcement process. CMS Regional Offices also routinely hold conference calls (e.g., monthly) with the State Survey Agencies in their region to address survey, enforcement and certification issues and conduct the federal validation survey of the state's findings. CMS is looking to review specific regulatory deficiencies for trends and areas where additional guidance is needed. Anticipated completion date of October 31, 2014. June 2013: Though the best method to address external pressures on State Agencies was not identified. CMS is continuing to address the consistency, effectiveness, and integrity of the survey process through the following activities: reviewing citation patterns for the nursing home surveys; systematically identifying and testing opportunities to make the survey process more efficient and effective; and holding monthly CO and RO calls to address consistencies in the survey and enforcement process. CMS Regional Offices also routinely hold conference calls (e.g., monthly) with the State Survey Agencies in their region to address survey, enforcement and certification issues and conduct the federal validation survey of the state's findings. September 2010: CMS held a State/Federal meeting in April 2010. The discussion with the State/Federal meeting did not shed light on best method to address possible external pressures on State Agencies. Some expressed that poor documentation/inadequate investigation may cause deficiencies to be dropped and not necessarily external pressure. They will continue to work on developing next steps.
    Recommendation: To address state agency practices and external pressure that may compromise survey accuracy, the Administrator of CMS should establish expectations through guidance to state survey agencies to communicate and collaborate with their CMS regional offices when they experience significant pressure from legislators or the nursing home industry that may affect the survey process or surveyors' perceptions.

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

    Comments: September 2017: HHS reported CMS is working to address this recommendation. We will update the status of this recommendation when we receive further information. September 2016: CMS has not yet provided additional information. GAO will update the recommendation, as appropriate, when information is received. July 2015: CMS indicated it will provide GAO with updated actions in early 2016. May 2014: CMS has undertaken a broader review of both the QIS and traditional survey processes, and the extent to which the methodology and guidance result in an effective and efficient survey process. In August 2012, CMS convened a broad group of surveyors to address these issues and make recommendations which have resulted in continuing work to develop and test alternative guidance and processes. CMS is looking to review specific regulatory deficiencies for trends and areas where additional guidance is needed. Anticipated Completion date of December 31, 2014. June 2013: Though the best method to address external pressures on State Agencies was not identified. CMS is continuing to address the consistency, effectiveness, and integrity of the survey process through the following activities: reviewing citation patterns for the nursing home surveys; systematically identifying and testing opportunities to make the survey process more efficient and effective; and holding monthly CO and RO calls to address consistencies in the survey and enforcement process. CMS Regional Offices also routinely hold conference calls (e.g., monthly) with the State Survey Agencies in their region to address survey, enforcement and certification issues and conduct the federal validation survey of the state's findings. September 2010: CMS held a State/Federal meeting in April 2010. The discussion with the State/Federal meeting did not shed light on best method to address possible external pressures on State Agencies. CMS will continue to work on developing next steps.