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As of May 16, 2024, there are 5137 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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301 - 320 of 412 Recommendations

Foreign Military Sales: Financial Oversight of the Use of Overhead Funds Needs Strengthening

GAO-18-553
Thomas Melito
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Department of Defense
Priority Rec.
The Secretary of Defense should ensure that the Director of DSCA takes steps to work with Defense Finance and Accounting Service (DFAS)--DSCA's financial service provider--and other DOD components, as appropriate, to improve the reliability of the data the DSCA obtains on all DOD components' use of FMS administrative funds, including actual execution data, at an appropriate level of detail, such as by object class. (Recommendation 1)
Open

In February and May 2019, DSCA informed us that it had taken some steps to implement this recommendation, including establishing an automatic interface with certain DOD components' accounting systems to provide DSCA with daily information and data on those components' actual spending of FMS administrative funds. DSCA noted that it is working toward establishing automatic interfaces for the other components that receive these funds. As of July 2023, officials informed us that they continue to work toward implementation of these recommendations. We continue to monitor DOD's ongoing actions to

Tax Fraud and Noncompliance: IRS Could Further Leverage the Return Review Program to Strengthen Tax Enforcement

GAO-18-544
James (Jay) R. McTigue, Jr
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2 Open Recommendations
2 Priority
Agency Recommendation Status
Internal Revenue Service
Priority Rec.
Based on the assessment in recommendation 2, the Commissioner of Internal Revenue should implement the most cost-effective method to digitize information provided by taxpayers who file returns on paper. (Recommendation 3)
Open – Partially Addressed

IRS agreed with GAO's July 2018 recommendation and has been implementing parts of its digitization strategy over the last few years. This includes filing electronic amended returns and an internet portal for businesses to e-file forms 1099. In August 2023, IRS announced an initiative to give taxpayers the option to go paperless if they choose to do so, and by Filing Season 2025, IRS expects to achieve paperless processing by digitizing all paper-filed returns when received, consistent with our recommendation. Digitization allows IRS to reduce processing time, use the Return Review Program
Internal Revenue Service
Priority Rec.
Based on the assessment in recommendation 4, the Commissioner of Internal Revenue should expand RRP to support identified activities. (Recommendation 5)
Open – Partially Addressed

IRS agreed with GAO's July 2018 recommendation and has taken steps to expand its use of RRP in recent years. For example, in October 2022, IRS started using RRP to check for fraud and other withholding errors on amended returns. These steps highlight RRP's potential to support fraud detection and other enforcement activities, but more can be done. IRS's April 2023 Inflation Reduction Act Strategic Operating Plan contains plans to enhance systemic checks on tax returns to identify issues at the point of filing and notify taxpayers.

Federal Employee Misconduct: Actions Needed to Ensure Agencies Have Tools to Effectively Address Misconduct

GAO-18-48
Robert N. Goldenkoff
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Office of Personnel Management
Priority Rec.
The Director of OPM, after consultation with the CHCO Council, should provide guidance to agencies to enhance the training received by managers/supervisors and human capital staff to ensure that they have the guidance and technical assistance they need to effectively address misconduct and maximize the productivity of their workforces. (Recommendation 3)
Open

OPM partially agreed with this recommendation. In March 2024, OPM reported that it had taken several steps toward implementing this recommendation. In December 2023, OPM issued guidance to agencies on effectively using probationary periods. According to OPM, it is also updating an online supervisory training course and written guidance for supervisors and human resources staff on handling employee misconduct. OPM plans to finalize this guidance in Fall 2024. To fully implement this recommendation, OPM needs to complete its update of guidance on training supervisors and human capital staff on

Drug Discount Program: Federal Oversight of Compliance at 340B Contract Pharmacies Needs Improvement

GAO-18-480
Debra A. Draper
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2 Open Recommendations
2 Priority
Agency Recommendation Status
Health Resources and Services Administration
Priority Rec.
The Administrator of HRSA should issue guidance to covered entities on the prevention of duplicate discounts under Medicaid managed care, working with CMS as HRSA deems necessary to coordinate with guidance provided to state Medicaid programs.(Recommendation 2)
Open

HHS concurred with this recommendation. After the report was issued, HHS indicated that it believes that guidance does not provide HRSA appropriate enforcement capability and that this recommendation can only be accomplished after policy is issued. In February 2024, HRSA noted that the agency may be able to issue guidance to covered entities on the prevention of duplicate discounts under Medicaid managed care pending the outcome of a proposed CMS rule related to the Medicaid Drug Rebate program.
Health Resources and Services Administration
Priority Rec.
The Administrator of HRSA should incorporate an assessment of covered entities' compliance with the prohibition on duplicate discounts, as it relates to Medicaid managed care claims, into its audit process after guidance has been issued and ensure that identified violations are rectified by the entities. (Recommendation 3)
Open

HHS concurred with this recommendation. After the report was issued, HHS indicated that it believes that guidance does not provide HRSA appropriate enforcement capability and that this recommendation can only be accomplished after policy is issued. In February 2024, HRSA noted that the agency may be able to issue guidance to covered entities on the prevention of duplicate discounts under Medicaid managed care pending the outcome of a proposed CMS rule related to the Medicaid Drug Rebate program. HRSA would then need to update its audit processes accordingly to implement this recommendation.

Veterans Choice Program: Improvements Needed to Address Access-Related Challenges as VA Plans Consolidation of its Community Care Programs

GAO-18-281
Sharon M. Silas, A. Nikki Clowers
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2 Open Recommendations
2 Priority
Agency Recommendation Status
Office of the Under Secretary for Health
Priority Rec.
The Under Secretary for Health should establish an achievable wait-time goal for the consolidated community care program that VA plans to implement that will permit VHA to monitor whether veterans are receiving VA community care within time frames that are comparable to the amount of time they would otherwise wait to receive care at VHA medical facilities. (Recommendation 1)
Open – Partially Addressed

VA agreed with our recommendation. Congress passed the Consolidated Appropriations Act, 2023, on December 29, 2022, which requires the Veterans Health Administration (VHA) ensure the Veterans Community Care Program (VCCP) third-party administrators furnish care within the eligibility standards of the Program. This requirement aligns with our recommendation to establish a performance metric for receipt of community care under the VCCP. In February 2024, VA officials stated that the current contracts with the VCCP third-party administrators have established network adequacy standards that are
Office of the Under Secretary for Health
Priority Rec.
The Under Secretary for Health should design an appointment scheduling process for the consolidated community care program that VA plans to implement that sets forth time frames within which (1) veterans' referrals must be processed, (2) veterans' appointments must be scheduled, and (3) veterans' appointments must occur, which are consistent with the wait-time goal VHA has established for the program. (Recommendation 2)
Open – Partially Addressed

VA agreed with our recommendation, and has so far, defined time frames for when a community care referral must be processed and scheduled, but has not yet defined a timeliness standard for when a veteran's appointment should occur. Congress passed the Consolidated Appropriations Act, 2023, on December 29, 2022, which requires the Veterans Health Administration (VHA) ensure the Veterans Community Care Program (VCCP) third-party administrators furnish care within the eligibility standards of the Program. This requirement aligns with one of our recommendations to establish a performance metric

Strategic Petroleum Reserve: DOE Needs to Strengthen Its Approach to Planning the Future of the Emergency Stockpile

GAO-18-477
Frank Rusco
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2 Open Recommendations
2 Priority
Agency Recommendation Status
Department of Energy
Priority Rec.
The Secretary of Energy should take actions to ensure that the agency periodically conducts and provides to Congress a strategic review of the SPR that, among other things, takes into account changes in crude oil and petroleum product market conditions and contains additional analysis, such as the costs and benefits of a wide range of different SPR sizes. (Recommendation 2)
Open

In May 2018, DOE agreed with the recommendation for periodic strategic reviews of the SPR and providing this information to Congress. In September 2018, DOE stated that a 5-year time interval between reviews was an appropriate timeframe and would allow current strategic plans to be implemented and assessed. At the time, DOE officials told us that the department would complete a SPR Long-Term Strategic Review by the end of fiscal year 2021--5 years from the last review in 2016. However, as of April 2024, DOE had not finalized its review. To fully address this recommendation, DOE needs to take
Department of Energy
Priority Rec.
The Secretary of Energy should conduct or complete studies on the costs and benefits of regional petroleum product reserves for all U.S. regions that have been identified as vulnerable to fuel supply disruptions, and the Secretary should report the results to Congress. (Recommendation 3)
Open

In May 2018, DOE disagreed with the recommendation to conduct or complete studies on the costs and benefits of regional petroleum product reserves. DOE stated that the agency's position is that government-owned and -operated regional petroleum product reserves are an inefficient and expensive solution to respond to regional fuel supply disruptions. In September 2018, December 2019, and December 2020, DOE noted that given the inefficient and expensive nature of storing refined petroleum products in above-ground tanks, it would be an inappropriate use of taxpayer funds to conduct any additional

Critical Infrastructure Protection: Additional Actions Are Essential for Assessing Cybersecurity Framework Adoption

GAO-18-211
Nick Marinos
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3 Open Recommendations
3 Priority
Agency Recommendation Status
Department of the Treasury
Priority Rec.
The Secretary of Treasury should take steps to consult with respective sector partner(s), such as the SCC, DHS and NIST, as appropriate, to develop methods for determining the level and type of framework adoption by entities across their respective sector. (Recommendation 9)
Open

Treasury neither agreed nor disagreed with this recommendation, stating that it does not have the authority to compel entities to share cybersecurity framework (framework) adoption data. Treasury stated that the voluntary nature of private sector participation in sector risk management agency activities affects its ability to implement certain recommendations, but it plans to collaborate with the sector to develop methods to determine the level and type of framework adoption. As of March 2024, Treasury had not identified a time frame for completing these efforts. Although working across the
Department of Agriculture
Priority Rec.
The Secretary of Agriculture, in cooperation with the Secretary of Health and Human Services, should take steps to consult with respective sector partner(s), such as the sector coordinating council (SCC), Department of Homeland Security (DHS) and NIST, as appropriate, to develop methods for determining the level and type of framework adoption by entities across their respective sector. (Recommendation 1)
Open – Partially Addressed

USDA neither agreed nor disagreed with the recommendation, but stated that it would attempt to develop a measurement mechanism as part of its annual data calls to the Food and Agriculture Sector. USDA has taken steps towards determining framework adoption across the sector. For example, USDA has distributed several requests for information to sector members that include questions regarding framework adoption and resulting improvements. In addition, USDA requested feedback from sector partners and made subsequent changes to its data calls responses. Despite these efforts, as of February 2024
Department of Health and Human Services
Priority Rec.
The Secretary of Health and Human Services, in cooperation with the Secretary of Agriculture, should take steps to consult with respective sector partner(s), such as the SCC, DHS and NIST, as appropriate, to develop methods for determining the level and type of framework adoption by entities across their respective sector. (Recommendation 6)
Open – Partially Addressed

HHS agreed with this recommendation. In April 2023, HHS, in collaboration with the Healthcare and Public Health Sector Coordinating Council, published an analysis that describes industry adoption of the National Institute of Standards and Technology cybersecurity framework based on results from a third-party survey sent to hospitals. HHS also evaluated the extent to which responding hospitals adopted the five core functions of the cybersecurity framework and its associated subcategories. In addition, HHS coordinated with the Department of Agriculture in taking initial steps to determine

Medicaid Assisted Living Services: Improved Federal Oversight of Beneficiary Health and Welfare is Needed

GAO-18-179
Katherine Iritani
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Centers for Medicare & Medicaid Services
Priority Rec.
The Administrator of CMS should establish standard Medicaid reporting requirements for all states to annually report key information on critical incidents, considering, at a minimum, the type of critical incidents involving Medicaid beneficiaries, and the type of residential facilities, including assisted living facilities, where critical incidents occurred. (Recommendation 2)
Open

HHS neither agreed nor disagreed with this recommendation. As of January 2023, CMS had provided states with technical assistance on critical incident reporting, including providing training and an optional incident reporting template. CMS published a proposed rule in May 2023 that included provisions to standardize critical incident oversight, including requirements to report data to CMS. As of February 2024, CMS was reviewing public comments on the proposed rule. To fully implement this recommendation, CMS should establish standard Medicaid reporting requirements for all states to report

Personnel Security Clearances: Additional Actions Needed to Ensure Quality, Address Timeliness, and Reduce Investigation Backlog

GAO-18-29
Brenda S. Farrell
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Office of the Director of National Intelligence
Priority Rec.
The Director of National Intelligence, in his capacity as Security Executive Agent, and in coordination with the other Security, Suitability, and Credentialing Performance Accountability Council Principals--the Deputy Director for Management of OMB in his capacity as Chair of the PAC, the Director of OPM, and the Under Secretary of Defense for Intelligence--should conduct an evidence-based review of the investigation and adjudication timeliness objectives for completing the fastest 90 percent of initial secret and initial top secret security clearances.(Recommendation 2)
Open – Partially Addressed

ODNI stated that it did not concur with many of the report's recommendations but did not state with which recommendations it did not concur. In November 2023, ODNI and OPM issued the Federal Personnel Vetting Performance Management Standards Implementation Guidance. This guidance includes updated timeliness objectives for initial secret and initial top secret security clearances including the investigation and adjudication phases. However, the guidance does not discuss how ODNI and OPM developed these measures and whether they conducted an evidence-based review to inform the development of the

Automated Vehicles: Comprehensive Plan Could Help DOT Address Challenges

GAO-18-132
David Wise
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Department of Transportation
Priority Rec.
The Secretary of Transportation should develop and implement a comprehensive plan to better manage departmental initiatives related to automated vehicles. This plan should include leading principles such as goals, priorities, steps to achieve results, milestones, and performance measures to track progress. (Recommendation 1)
Open

DOT has described broad principles and goals related to emerging technologies but has not developed and implemented a comprehensive plan for automated vehicles. For example, DOT's 2022-2026 strategic plan describes the department's goals related to emerging technologies in general. Some DOT activities-such as ongoing rulemaking on topics including occupant protection and crash avoidance in automated vehicles-include milestones, one element of comprehensive planning. However, as of April 2024, DOT does not have an overall plan for automated vehicles that articulates the elements of a

Veterans Affairs Contracting: Improvements in Buying Medical and Surgical Supplies Could Yield Cost Savings and Efficiency

GAO-18-34
Shelby S. Oakley
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Department of Veterans Affairs
Priority Rec.
The Director of the MSPV-NG program office should, with input from the Strategic Acquisition Center (SAC), develop, document, and communicate to stakeholders an overarching strategy for the program, including how the program office will prioritize categories of supplies for future phases of requirement development and contracting. (Recommendation 1)
Open – Partially Addressed

VA agreed with our recommendation. VA had planned to implement a new Medical Surgical Prime Vendor (MSPV) program, called MSPV 2.0, starting in 2020; it had also been piloting the Defense Logistics Agency's (DLA) MSPV program since 2019. Since 2017, VA has pursued four different versions of this program, but none have fully achieved VA's goals. As of February 2023, VA is again developing another iteration of this program, called MSPV Gen Z, and plans to issue a solicitation in the near future. According to VA acquisition officials, this new iteration is intended to address some of the issues

Child Well-Being: Key Considerations for Policymakers, Including the Need for a Federal Cross-Agency Priority Goal

GAO-18-41SP
Kathy Larin
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Office of Management and Budget
Priority Rec.
GAO recommends that the Director of OMB consider developing a goal that addresses a coordinated federal approach to child well-being among its next set of cross-agency priority (CAP) goals, including working with relevant agencies to ensure their strategic plans include goals and objectives related to the CAP goal. (Recommendation 1)
Open

OMB neither agreed nor disagreed with this recommendation. In November 2017, OMB staff noted that the agency was developing its next set of CAP goals, which are usually reserved for a limited set of priorities, and expects to announce these goals concurrent with the FY19 budget. As part of the process, agency staff said they consult relevant Congressional committees and other stakeholders. As of December 2022, OMB reported that it does not plan to take further action on this recommendation. We continue to believe this recommendation could provide an opportunity across the federal government to

Coast Guard: Actions Needed to Close Stations Identified as Overlapping and Unnecessarily Duplicative

GAO-18-9
Jenny Grover
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1 Open Recommendations
1 Priority
Agency Recommendation Status
United States Coast Guard
Priority Rec.
The Commandant of the Coast Guard should take action to close the stations identified according to its plan and target dates. (Recommendation 3)
Open – Partially Addressed

In 2017, GAO reported that the Coast Guard has not taken action to implement the results of its analyses which recommended station closures even though it has completed requirements to pursue some station closures. For example, a 2013 analysis of Coast Guard stations identified unnecessary duplication and recommended certain stations that could be permanently closed without negatively affecting the Coast Guard's ability to meet its 2-hour search and rescue response standard and other mission requirements. However, as of August 2017 the Coast Guard had not closed any stations, nor developed a

Veterans Health Administration: Better Data and Evaluation Could Help Improve Physician Staffing, Recruitment, and Retention Strategies

GAO-18-124
Debra A. Draper
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Veterans Health Administration
Priority Rec.
The Undersecretary for Health should develop and implement a process to accurately count all physicians providing care at each medical center, including physicians who are not employed by VHA. (Recommendation 1)
Open

As of February 2024, VHA continued to disagree with the recommendation and have not taken any action. Although VA responded to our report by stating that the ability to count physicians does not affect its ability to assess workload, we maintain that an accurate count of all physicians providing care at each medical center is necessary for accurate workforce planning. To implement the first recommendation, VHA needs to develop a system-wide process to collect information on all physicians providing care at VAMCs, including physicians that are not employed by VHA. This information should be
Note: the list of open recommendations for the last report may continue on the next page.

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