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Priority Open Recommendations: Department of Health and Human Services

GAO-21-527PR Published: May 19, 2021. Publicly Released: May 26, 2021.
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Fast Facts

Each year, we make more than 1,000 recommendations to help improve the federal government. We alert department heads to where they can save the most money, address issues on our High-Risk List, or significantly improve government operations.

This report outlines our 61 priority open recommendations for the Department of Health and Human Services (HHS) as of May 2021. For example, HHS should develop a strategy to capture more complete data on confirmed COVID-19 cases and deaths in nursing homes since January 1, 2020.

Since our previous letter in April 2020, HHS implemented 8 of our priority recommendations.

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What GAO Found

In April 2020, GAO identified 55 priority recommendations for the Department of Health and Human Services (HHS). Since then, HHS has implemented eight of those recommendations by, among other things, taking actions to improve the quality of care in the Indian Health Service's federally-operated facilities and improve the accuracy and completeness of Medicaid data to expedite their use for program oversight. In addition to the eight priority recommendations HHS implemented, four recommendations are no longer open priority recommendations, primarily because they became a lower priority as a result of recent regulatory or programmatic changes.

In May 2021, GAO identified 18 additional priority recommendations for HHS—including some recommendations related to the Coronavirus Disease 2019 (COVID-19) pandemic—bringing the total number of priority recommendations to 61. These recommendations involve the following areas:

  • COVID-19 response and other public health emergency preparedness;
  • Public health and human services program oversight;
  • Food and Drug Administration oversight;
  • National efforts to prevent, respond to, and recover from drug misuse;
  • Improper payments in Medicaid and Medicare;
  • Medicaid program;
  • Medicare program;
  • Health information technology and cybersecurity; and
  • Health insurance premium tax credit payment integrity.

The ongoing COVID-19 pandemic underscores the need for sustained attention on improving HHS's operations. Implementing our priority recommendations could help improve the efficiency and effectiveness of key federal health care programs and funding, including those relevant to the nation's ongoing response to COVID-19.

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 A. Nicole Clowers at (202) 512-7114 or

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Compliance oversightCybersecurityDrug safetySubstance abuseFood safetyHealth careHealth insuranceHigh-risk issuesImproper paymentsInformation sharingManaged health careMedicaidMedicaid paymentsMedicaid programMedicareNursing homespandemicsPublic healthPublic health emergenciesRisk assessmentInsurance premiums