Open Recommendations (139 total)

Medicaid Behavioral Health: CMS Guidance Needed to Better Align Demonstration Payment Rates with Costs and Prevent Duplication

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2 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services The Administrator of CMS should provide clear and consistent written guidance to states on how to avoid potential duplication between Medicaid CCBHC payments and other Medicaid payments. (Recommendation 2)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare and Medicaid Services The Administrator of CMS should issue clear and consistent written guidance that highlights the importance of rebasing CCBHC payment rates based on actual costs and provides more detailed information on when and how states should rebase their rates, such as suggested time frames. (Recommendation 1)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Federal Rulemaking: Selected Agencies Should Fully Describe Public Comment Data and Their Limitations

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1 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services The Administrator of CMS should fully describe available public comment data, including any limitations, to external users of the data. This should include coordination with GSA, as the manager of Regulations.gov, as appropriate. (Recommendation 3)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Medicaid Home- and Community-Based Services: Evaluating COVID-19 Response Could Help CMS Prepare for Future Emergencies

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2 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services The CMS Administrator should develop procedures to monitor temporary changes to Medicaid HCBS programs during public health emergencies. This should include procedures for collecting and analyzing data during emergencies on the effects of these changes. (Recommendation 1)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

As of September 2021, we are awaiting updates from the agency.
Centers for Medicare and Medicaid Services The CMS Administrator should evaluate the temporary changes to Medicaid HCBS programs after the COVID-19 emergency and develop corrective action plans to address any opportunities for improvement it identifies. (Recommendation 2)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

As of September 2021, we are awaiting updates from the agency.

Medicare: Additional Reporting on Key Staffing Information and Stronger Payment Incentives Needed for Skilled Nursing Facilities [Reissued with revisions on Aug. 10, 2021.]

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3 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services The Administrator of CMS should assess the feasibility of incorporating into the Five-Star System staffing ratings information on weekend decreases in RN and total nurse staffing levels, and minimum RN and total nurse staffing thresholds below which SNF residents are at increased risk of quality problems—such as those that were identified in the CMS staffing study. (Recommendation 3)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare and Medicaid Services The Administrator of CMS should report weekend decreases in RN and total nurse staffing levels on the Care Compare website. (Recommendation 1)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare and Medicaid Services The Administrator of CMS should report minimum RN and total nurse staffing thresholds below which SNF residents are at increased risk of quality problems—such as thresholds that are similar to those identified in the CMS staffing study—on the Care Compare website. (Recommendation 2)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Medicare Advantage: Beneficiary Disenrollments to Fee-for-Service in Last Year of Life Increase Medicare Spending

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1 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services The Administrator of CMS should review disenrollments by MA beneficiaries in the last year of life as part of the agency's broader efforts to review disenrollments by MA beneficiaries in poorer health. (Recommendation 1)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Medicaid: CMS Needs to Implement Risk-Based Oversight of Puerto Rico's Procurement Process

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1 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare and Medicaid Services The Administrator of CMS should take steps to implement ongoing, risk-based oversight of Medicaid procurement processes in Puerto Rico; such actions could include performing an assessment of competitive and noncompetitive procurement processes to identify risks and address them by promoting competition, as appropriate for the efficient operation of the Medicaid program. (Recommendation 1)
Open

Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.

CMS concurred with our recommendation and indicated a commitment to work with Puerto Rico to improve its procurement processes. In July 2021, CMS reported it would provide feedback on Puerto Rico's plans to reform procurement processes, respond to any requests from Puerto Rico for technical assistance, and begin a risk-based assessment of Puerto Rico's reformed procurement processes once they are implemented. When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.