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Priority Open Recommendations: Department of Health and Human Services

GAO-20-552PR Published: Apr 23, 2020. Publicly Released: Apr 30, 2020.
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Fast Facts

We make more than 1,000 recommendations annually to help improve government. We alert department heads to the recommendations that can save the most money, address issues on our High Risk List, or significantly improve their operations.

This report outlines our 55 priority open recommendations for HHS as of April 2020.

For example, HHS should work with its interagency biodefense team to document key steps for making and enforcing decisions related to biological threats, e.g., COVID-19.

HHS has closed 13 priority recommendations since March 2019, and can refocus its efforts on more of these when the COVID-19 response is no longer a top priority.

HHS priority recommendation graphic

HHS priority recommendation graphic

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What GAO Found

In March 2019, GAO identified 54 priority recommendations for the Department of Health and Human Services (HHS). Since then, HHS has implemented 13 of those recommendations by, among other things, taking actions to track Medicare beneficiaries at high risk of harm from opioids and issuing guidance to help reduce financial risk to the Medicaid program. In addition to the 13 priority recommendations HHS implemented, four recommendations are no longer open priority recommendations, primarily because they became a lower priority due to recent policy changes or agency actions.

In April 2020, GAO identified 18 additional priority recommendations for HHS—including some recommendations related to the Coronavirus Disease 2019 pandemic—bringing the total number to 55. These recommendations involve the following areas:

  • the Medicare program’s payment policy and design;
  • oversight, accountability, and transparency of Medicaid spending;
  • security of health information technology and cybersecurity;
  • oversight of medical products and food imported into the United States;
  • quality of health care services provided by the Indian Health Service;
  • national efforts to prevent, respond to, and recover from drug misuse;
  • oversight of public health related programs and issues;
  • integrity of health insurance marketplace subsidies and enrollment; and
  • oversight of fraud risk in the Head Start program.

GAO recognizes that HHS and its component agencies are focused on the nation’s efforts to respond to and recover from the Coronavirus Disease 2019 (COVID-19) pandemic. The emergence of the COVID-19 pandemic underscores the need for sustained attention on improving HHS’s operations, and such improvements can be accomplished in part through HHS’s continued attention to addressing GAO’s priority recommendations.

Why GAO Did This Study

Priority open recommendations are the GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional and/or executive branch decision making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations.

For more information, contact Angela N. Clowers at (202) 512-7114 or

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