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As of May 8, 2024, there are 5104 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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4921 - 4940 of 5104 Recommendations, including 412 Priority Recommendations

NASA: Actions Needed to Improve Transparency and Assess Long-Term Affordability of Human Exploration Programs

GAO-14-385
Cristina T. Chaplain
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1 Open Recommendations
1 Priority
Agency Recommendation Status
National Aeronautics and Space Administration
Priority Rec.
To provide the Congress with the necessary insight into program affordability, ensure its ability to effectively monitor total program costs and execution, and to facilitate investment decisions, the NASA's Administrator should direct the Human Exploration and Operations Mission Directorate to establish a separate cost and schedule baseline for work required to support the SLS Block I Exploration Mission-2 (EM-2) and report this information to the Congress through NASA's annual budget submission. If NASA decides to fly the SLS Block I beyond EM-2, establish separate life cycle cost and schedule baseline estimates for those efforts, to include funding for operations and sustainment, and report this information annually to Congress via the agency's budget submission.
Open

NASA partially agreed with this recommendation. Officials stated that NASA defined and documented life-cycle costs for SLS to a first demonstrated capability, consistent with cost estimating best practices and NASA project and program management policy. In February 2023, officials stated that following the successful launch of Artemis I, the agency is updating the schedule for Artemis II. In spring 2022, SLS and the ground systems programs provided the first 5-year operational cost estimate and NASA plans to update it in spring 2023. Additionally, NASA plans to create a cost estimate for

Uranium Contamination: Overall Scope, Time Frame, and Cost Information Is Needed for Contamination Cleanup on the Navajo Reservation

GAO-14-323
J. Alfredo Gómez
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3 Open Recommendations
Agency Recommendation Status
Congress To develop an estimate of the scope of work remaining to address uranium contamination on or near the Navajo reservation, Congress should consider requiring that the Environmental Protection Agency take the lead and work with the other federal agencies to develop an overall estimate of the remaining scope of the work, time frames, and costs.
Open

As of May 2023, we are not aware of any legislation being enacted to address this matter for congressional consideration.
Department of the Interior In light of the problems BIA has encountered in managing the cleanup at the Tuba City Dump site, the Secretary of the Interior should direct the Assistant Secretary for Indian Affairs to employ best practices in creating the schedule and cost estimates for the remedial action cleanup phase.
Open

As of February 2024, BIA had developed a dump site closure acquisition package. BIA officials stated that they followed GAO-identified best practices for cost and schedule estimating to create the cost and schedule estimates included in the acquisition package and that they would provide GAO with supporting documentation. GAO will assess BIA's actions once they are complete and we have reviewed any documentation provided.
Department of the Interior In light of the problems BIA has encountered in managing the cleanup at the Tuba City Dump site, the Secretary of the Interior should direct the Assistant Secretary for Indian Affairs to identify and examine any lessons learned from managing the remedial investigation and feasibility study contract and consider these lessons as part of the acquisition planning process for the remedial action contract.
Open

As of February 2024, BIA had developed a dump site closure acquisition package that incorporated lessons learned from managing the remedial investigation and feasibility study contract. BIA stated that it needed additional time to document that it had identified and incorporated these lessons learned. We will assess BIA's actions once they are complete and BIA has provided the relevant documentation.

Paid Tax Return Preparers: In a Limited Study, Preparers Made Significant Errors

GAO-14-467T
James (Jay) R. McTigue, Jr
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1 Open Recommendations
Agency Recommendation Status
Congress If Congress agrees that significant paid preparer errors exist, it should consider legislation granting IRS the authority to regulate paid tax preparers.
Open

Multiple bills have been introduced in the Congress that would authorize the Department of Treasury to regulate paid tax preparers and establish professional requirements, as GAO recommended in April 2014 and November 2022. However, as of March 2024, no action has been taken on any of these bills. GAO testified on October 1, 2015 on improper payments and the tax gap before Senate Finance and on December 10, 2015 on GAO recommendations before the Subcommittee on Regulatory Affairs and Federal Management, Committee on Homeland Security and Governmental Affairs, US Senate. Both hearings increased

2014 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits

GAO-14-343SP
Orice Williams Brown, A. Nikki Clowers
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1 Open Recommendations
Agency Recommendation Status
Congress Congress should consider passing legislation to require the Social Security Administration (SSA) to offset Disability Insurance (DI) benefits for any Unemployment Insurance (UI) benefits received in the same period.
Open

In April 2014, the Government Accountability Office (GAO) recommended that Congress consider implementing legislation that would mandate the Social Security Administration (SSA) to offset Disability Insurance (DI) benefits by any Unemployment Insurance (UI) benefits received during the same period. The Social Security Disability Insurance and Unemployment Benefits Double Dip Elimination Act was first introduced during the 114th Congress in 2015 as bills S.2005 and H.R.918, but the bills were not enacted then. These bills would have implemented the GAO recommendation at that time. During the

Drug Shortages: Public Health Threat Continues, Despite Efforts to Help Ensure Product Availability

GAO-14-194
Marcia Crosse
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1 Open Recommendations
Agency Recommendation Status
Food and Drug Administration To enhance its oversight of drug shortages, particularly as the agency fine-tunes the manner in which it gathers data on shortages and transitions from its database to a more robust system, the Commissioner of FDA should conduct periodic analyses using the existing drug shortages database (and, eventually, the new drug shortages information system) to routinely and systematically assess drug shortage information, and use this information proactively to identify risk factors for potential drug shortages early, thereby potentially helping FDA to recognize trends, clarify causes, and resolve problems before drugs go into short supply.
Open – Partially Addressed

In September 2018, FDA told us that it was using its drug shortage data system, the "Shortage Tracker," to summarize information reported by manufacturers as the reasons for existing shortages. The agency indicated that it was developing a model that would help identify early indicators that may predict future shortages. In June 2021, the agency reported that it encountered several challenges with directly predicting drug shortages while working on its initial modeling, including a lack of information on several critical elements of the drug supply chain. In a June 2023 written response, FDA

Federal Motor Carrier Safety: Modifying the Compliance, Safety, Accountability Program Would Improve the Ability to Identify High Risk Carriers

GAO-14-114
Susan Fleming
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1 Open Recommendations
Agency Recommendation Status
Department of Transportation To improve the CSA program, the Secretary of Transportation should direct the FMCSA Administrator to revise the SMS methodology to better account for limitations in drawing comparisons of safety performance information across carriers; in doing so, the Secretary of Transportation should direct the FMCSA Administrator to conduct a formal analysis that specifically identifies: (1) limitations in the data used to calculate SMS scores including variability in the carrier population and the quality and quantity of data available for carrier safety performance assessments, and (2) limitations in the resulting SMS scores including their precision, confidence, and reliability for the purposes for which they are used.
Open

FMCSA did not agree with this recommendation and has requested that we close the recommendation as not implemented. However, in response to a similar 2017 review by the National Academy of Sciences, FMCSA developed and tested a new methodology to compare safety performance across motor carriers. We believe the changes made could account for the data and other limitations we identified in our report. In February 2023, FMCSA published proposed changes to the SMS methodology for comment in the Federal Register. As of March 2024, FMCSA is still in the process of reviewing comments and has not made

Computer Matching Act: OMB and Selected Agencies Need to Ensure Consistent Implementation

GAO-14-44
Gregory C. Wilshusen
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3 Open Recommendations
Agency Recommendation Status
Department of Labor To improve the implementation of the act, the Secretary of Labor should develop and implement policies and procedures for cost-benefit analyses related to computer matching agreements to include key elements such as personnel and computer costs, as well as avoidance of future improper payments and recovery of improper payments and debts.
Open

Although department officials have stated that they are taking actions to address this recommendation, as of March 2024, we have not yet received information to validate agency actions. Subsequent to the agency sending documentation, we plan to verify whether implementation has occurred.
Department of Labor To improve the implementation of the act, the Secretary of Labor should ensure the DIB reviews cost-benefit analyses to make certain cost savings information for the computer matching program is included before approving CMAs.
Open

Although department officials have stated that they are taking actions to address this recommendation, as of March 2024, we have not yet received information to validate agency actions. Subsequent to the agency sending documentation, we plan to verify whether implementation has occurred.
Department of Labor To improve the implementation of the act, the Secretary of Labor should ensure the DIB performs annual reviews and submits annual reports on agency computer matching activities, as required by the act.
Open

Although department officials have stated that they are taking actions to address this recommendation, as of March 2024, we have not yet received information to validate agency actions. Subsequent to the agency sending documentation, we plan to verify whether implementation has occurred.

Clinical Data Registries: HHS Could Improve Medicare Quality and Efficiency through Key Requirements and Oversight

GAO-14-75
Linda Kohn
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4 Open Recommendations
Agency Recommendation Status
Department of Health and Human Services To help ensure that qualified CDRs promote improved quality and efficiency of physician care for Medicare beneficiaries, the Secretary of Health and Human Services should direct CMS to establish a requirement for qualified CDRs to demonstrate improvement on key measures of quality and efficiency for their target populations.
Open

As of August 2023, CMS had implemented requirements for qualified CDRs to provide performance feedback to participating clinicians at least 4 times a year. These requirements did not call on qualified CDRs to demonstrate improved performance on their measures of quality and efficiency, as GAO recommended. However, CMS officials expect that the Merit-based Incentive Payment System (MIPS) Value Pathways, once fully implemented, may help to address this recommendation. MIPS Value Pathways are a new quality measurement reporting option for clinicians starting in 2023. CMS officials believe that
Department of Health and Human Services To help ensure that qualified CDRs promote improved quality and efficiency of physician care for Medicare beneficiaries, the Secretary of Health and Human Services should direct CMS to establish a process for monitoring compliance with requirements for qualified CDRs that draws on relevant expert judgment. This process should assess CDR performance on each requirement in a way that takes into account the varying circumstances of CDRs and their available opportunities to promote quality and efficiency improvement for their target populations.
Open – Partially Addressed

As of August 2023, CMS's website documents its process for monitoring qualified CDRs. Based on the available information, this monitoring focuses on ensuring qualified CDR compliance with expectations such as having relevant measure development expertise, incorporating medical knowledge, and not submitting false or inaccurate data. However, this approach differs from our recommendation that CMS draw on expert judgment to take account of the different circumstances and opportunities for improving quality and efficiency across qualified CDRs. Incorporating expert judgment into CMS's oversight of
Department of Health and Human Services To help ensure that qualified CDRs promote improved quality and efficiency of physician care for Medicare beneficiaries, the Secretary of Health and Human Services should determine and implement actions to reduce barriers to the development of qualified CDRs, such as (1) developing guidance that clarifies Health Insurance Portability and Accountability Act requirements to promote participation in qualified CDRs; (2) working with private sector entities to make relevant multipayer cost data available to qualified CDRs; (3) testing one or more models of shared savings between Medicare and qualified CDRs that achieve reduced Medicare expenditures with improved quality of care, and (4) providing technical assistance to qualified CDRs.
Open – Partially Addressed

As of August 2023, CMS officials had provided examples of technical assistance provided to groups seeking to set up qualified CDRs, covering topics such as program requirements, how to construct different types of quality measures, and assistance with measure concepts and feedback on self-nomination to be a qualified CDR. This technical assistance is consistent with GAO's recommendation to reduce barriers in the development of qualified CDRs, but it was not clear if similar technical assistance had continued on an ongoing basis. As of August 2023, CMS's website included links to written
Department of Health and Human Services To help ensure that qualified CDRs promote improved quality and efficiency of physician care for Medicare beneficiaries, the Secretary of Health and Human Services should determine key data elements needed by qualified CDRs--such as those relevant for a required core set of measures--and direct Office of the National Coordinator for Health Information Technology and CMS to include these data elements, if feasible, in the requirements for certification of EHRs under the EHR incentive programs.
Open

As of August 2023, CMS had provided information on its ongoing efforts to promote the development of electronic clinical quality measures in general, along with its broader vision to report quality information through digital means. However, it had not provided information on steps taken to address the two key objectives of the recommendation that are specific to qualified CDRs: 1) identifying a set of clinical data elements that are needed for the particular quality measures used by qualified CDRs, and 2) incorporating these data elements into federal requirements for EHRs, where feasible

Reverse Auctions: Guidance Is Needed to Maximize Competition and Achieve Cost Savings

GAO-14-108
Michele Mackin
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Office of Management and Budget
Priority Rec.
To help mitigate confusion about the use of reverse auctions in federal acquisitions, the Director of the Office of Management and Budget should take steps to amend the FAR to address agencies' use of reverse auctions.
Open – Partially Addressed

In providing comments on this report, OMB generally concurred with this recommendation. In response, in December 2020, FAR Council members published a notice of proposed rulemaking to amend the FAR to provide guidance on reverse auctions. The notice required that comments on the proposed rule be submitted by early February 2021. As of December 2023, OMB had received proposed revisions to FAR guidance for its consideration.

Clean Water Act: Changes Needed If Key EPA Program Is to Help Fulfill the Nation's Water Quality Goals

GAO-14-80
J. Alfredo Gómez
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Environmental Protection Agency
Priority Rec.
To enhance the likelihood that TMDLs support the nation's waters' attainment of water quality standards and to strengthen water quality management, the Administrator of EPA should develop and issue new regulations requiring that TMDLs include additional elements--and consider requiring the elements that are now optional--specifically, elements reflecting key features identified by NRC as necessary for attaining water quality standards, such as comprehensive identification of impairment and plans to monitor water bodies to verify that water quality is improving.
Open

As of April 2024, EPA officials stated that they believe this action has been implemented. Since June 2020, they said the agency has taken several actions that change the focus of the total maximum daily loads (TMDL) program to focus efforts on implementing TMDLs. First, EPA developed a TMDL Vision document to focus on integrating and implementing different efforts to restore and protect the nation's aquatic resources. Second, EPA held regional meetings to discuss different TMDL topics such as monitoring, implementation, and reasonable assurance. Included in these discussions were good

National Mediation Board: Strengthening Planning and Controls Could Better Facilitate Rail and Air Labor Relations

GAO-14-5
Revae Moran
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1 Open Recommendations
Agency Recommendation Status
National Mediation Board In order to improve NMB's planning and make the most effective use of its limited resources, the Chairman of the National Mediation Board should develop and fully implement key components of an information security program in accordance with the Federal Information Security Management Act of 2002.
Open – Partially Addressed

NMB agreed with this recommendation. In April 2022, we reported in GAO-22-105266 that NMB had taken steps to further implement key information security practices but had not fully implemented this recommendation. Specifically, we found that NMB was following five of eight key information security practices laid out in the Federal Information Security Modernization Act of 2014 (FISMA), such as developing and documenting an information technology security policy. As of July 2023, NMB has conducted testing and evaluation of all its major information systems, as required by FISMA. NMB has also

Hurricane Sandy Relief: Improved Guidance on Designing Internal Control Plans Could Enhance Oversight of Disaster Funding

GAO-14-58
Beryl (Berri) H. Davis
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Office of Management and Budget
Priority Rec.
To proactively prepare for oversight of future disaster relief funding, the Director of OMB should develop standard guidance for federal agencies to use in designing internal control plans for disaster relief funding. Such guidance could leverage existing internal control review processes and should include, at a minimum, the following elements: (1) robust criteria for identifying and documenting incremental risks and mitigating controls related to the funding and (2) requirements for documenting the linkage between the incremental risks related to disaster funding and efforts to address known internal control risks.
Open

The Office of Management and Budget (OMB) stated that they generally agreed with our recommendation and requested additional information on the findings to inform future guidance. In July 2016, OMB issued the revised Circular A-123, Management's Responsibility for Enterprise Risk Management and Internal Control. The Circular requires agencies to implement enterprise risk management, which includes the development of a risk profile that analyzes the risks faced in achieving strategic objectives and identifies options for addressing them. In April 2017, OMB staff stated that they believe that

Minority AIDS Initiative: Consolidation of Fragmented HIV/AIDS Funding Could Reduce Administrative Challenges

GAO-14-84
Marcia Crosse
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1 Open Recommendations
Agency Recommendation Status
Department of Health and Human Services In order to reduce the administrative costs associated with a fragmented MAI grant structure that diminishes the effective use of HHS's limited HIV/AIDS funding, and to enhance services to minority populations, HHS should consolidate disparate MAI funding streams into core HIV/AIDS funding during its budget request and allocation process.
Open

HHS stated that it does not support the consolidation of Minority AIDS Initiative (MAI) funds into core funding. As of January 2024, HHS had not changed its position. We will update the status of this recommendation when we receive additional information.
Note: the list of open recommendations for the last report may continue on the next page.

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