Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau identifies metrics on the extent to which governments participating in LUCA overlap in their coverage of residents, as well as the characteristics of participants such as type of government and geographic area, and reports on such metrics. (Recommendation 1)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that its 2020 LUCA Assessment would identify the impacts, if any, of governments providing overlapping coverage in their submissions to the Bureau. In order to fully implement this recommendation, the Bureau will need to identify metrics on submissions from governments that describe both the participating governments and extent of their overlap in coverage.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau takes steps to conduct in-office reviews of a greater share of addresses submitted by governments before the addresses are added to the Bureau's address list for potential field work. (Recommendation 2)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would continue to identify improvements to address list-sharing programs so that more addresses submitted by governments are reviewed using in-office methods. In order to fully implement this recommendation, the Bureau will need to take steps that result in a greater share of addresses submitted by governments being reviewed in-office.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau, as part of the Bureau's assessment of LUCA for 2020, consults with OMB to report on the factors that led to enumeration outcomes of addresses reinstated to the Bureau's master address list by the LUCA appeals process. (Recommendation 3)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would research appeals-reinstated addresses to determine the factors that led to the initial rejection of those addresses, any reasons for their reinstatement upon appeal, and the enumeration outcomes of those addresses. In order to fully implement this recommendation, the Bureau will need to complete and report on this work.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau identifies and tracks specific costs for related address list development efforts. (Recommendation 4)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would use existing systems to identify and report the costs of individual address list update-related activities. The Bureau also indicated that it would develop the means for capturing the cost of machine-based methods of updating the address list. In order to fully implement this recommendation, the Bureau will need to identify and track costs with sufficient detail to compare the relative cost-effectiveness of alternative efforts it considers and uses to build its address list.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau improves the use of LUCA results to inform procedures of other decennial operations, such as sharing information on address update quality to inform NRFU planning or administrative records modeling. (Recommendation 5)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would investigate how best to improve the flow of address data from governments into other census activities, such as research on administrative records or address canvassing. In order to fully implement this recommendation, the Bureau will need to establish and demonstrate the use of pathways for data on address collected from governments and their quality to inform the planning of other census activities that rely on address data.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau realigns the schedule of LUCA-related programs to provide participants with more time to review addresses. (Recommendation 6)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would look for opportunities to allow participants more time to review the address list for their areas, subject to the timing and design of LUCA 2030. In order to fully implement this recommendation, the Bureau will need to ensure that governments invited to review addresses are provided sufficient time to review them.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau uses the Bureau's data on hard-to-count areas to inform geographic activities such as: targeting LUCA outreach to tribal, state, and local governments; planning additional rounds of in-office address canvassing; and providing feedback to tribal, state, and local governments on gaps in their respective address data. (Recommendation 7)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would give participants access to the Bureau's data on hard-to-count areas so that participants could prioritize their address list review efforts. In order to fully implement this recommendation, the Bureau will need to demonstrate how it is using its data on hard-to-count areas to improve targeting of outreach to governments, planning other address-improvement activity, and providing feedback to governments.

Recommendation: The Secretary of Commerce should ensure that the Director of the Census Bureau, as part of the Bureau's strategic planning process for geographic programs, reexamines LUCA in conjunction with stakeholders, other federal agencies as appropriate, and Congress to address the issues we have identified, including but not limited to:

• Identifying and assessing alternatives and describing corresponding effects on the decennial census.
• Reporting out on the assessment of alternatives, including justifications.
• Developing legislative proposals, as appropriate, for any changes needed to LUCA and address data in order to implement preferred alternatives. (Recommendation 8)

Agency: Department of Commerce
Status: Open

Comments: Commerce agreed with this recommendation. In its April 2020 action plan, the Bureau indicated that it would reach out to stakeholders in the Summer of 2022 to discuss reexamining LUCA and other address frame initiatives. In order to fully implement this recommendation, the Bureau will need to carryout a reexamination with stakeholders on the issues identified in our report as well as identify and report on alternatives as well as legislative proposals as may be appropriate.

Recommendation: The Commissioner of Internal Revenue should direct the Chief of Appeals, in coordination with the IRS Human Capital Office, to conduct a skills gap analysis specific to Appeals mission needs and develop a strategy for mitigating any identified gaps. (Recommendation 1)

Agency: Department of the Treasury: Internal Revenue Service
Status: Open

Comments: IRS agreed with this recommendation. As of April 2020, the Office of Appeals stated that it is working with the IRS Human Capital Office to design a questionnaire for all Appeals managers to identify the technical and organizational skills necessary to meet organizational short and long-term needs for the Appeals Officer position. This information will be used to conduct a skills gap analysis on the current Appeals workforce and to enhance the selection/hiring process to ensure future hires possess necessary skills. IRS plans to complete these actions by October 2020, and Appeals stated that time frame for this corrective action may be affected by budgetary and resource constraints. GAO will continue to monitor IRS's implementation of this recommendation.

Recommendation: The Commissioner of Internal Revenue should evaluate the existing monitoring for collection due process appeal requests and address deficiencies in collection staff meeting the requirement for timely transfer to the Office of Appeals. (Recommendation 2)

Agency: Department of the Treasury: Internal Revenue Service
Status: Open

Comments: IRS agreed with this recommendation. In July 2019, IRS evaluated the existing monitoring for collection due process appeal requests to identify any impediments to collection staff timely transferring these requests to the Office of Appeals and provided the studies and related recommendations to GAO. The affected IRS collection units have developed action plans to address deficiencies in case transfer time. These plans include modifying inventory software to alert both staff and managers on the number of days collection due process requests have been under review. IRS also plans to update relevant IRM documentation in early 2020 to ensure that receipt dates of collection due process appeal requests are recorded for all cases and that there is appropriate notation of reasons why certain cases exceed established timeframes for transfer to the Office of Appeals. To fully implement this recommendation, IRS will need to provide GAO copies of the updated IRM as well as evidence of other corrective actions outlined in its evaluations of its monitoring procedures for collection due process appeal requests. GAO will continue to monitor the implementation of this recommendation.

Recommendation: The Commissioner of Internal Revenue should establish timeframes and monitoring procedures for timely transfer of taxpayer appeals requests by examination compliance units to the Office of Appeals. (Recommendation 3)

Agency: Department of the Treasury: Internal Revenue Service
Status: Open
Priority recommendation

Comments: IRS agreed with this recommendation. All four IRS business operating divisions have a corrective action plan and established and documented time frames for timely appeal transfer as of February 2020. While three business operating divisions have reporting procedures planned for monitoring timely appeal transfer, one division has not provided a plan for monitoring its timeliness in transferring cases to the Office of Appeals. To fully implement this recommendation, IRS needs to assess whether the planned monitoring actions will result in timely transfer of examination appeals. As of February 2020, data tracking the time from taxpayer request for appeal to when it is received by the Office of Appeals indicated that the actual transfer times are longer than the established time frames. Delays in transferring such requests can result in increased interest costs for taxpayers because interest continues to accumulate on the tax liability during the appeal process. Further, taxpayers unsure of their appeal status may call or write to IRS, tying up other IRS staff to respond to inquiries about appeals delayed in transfer. GAO will continue to monitor IRS's implementation of this recommendation.

Recommendation: The Commissioner of Internal Revenue should direct the Chief of Appeals to regularly report and share with each compliance unit the data on the time elapsed between when a taxpayer requests an appeal to when it is received in the Office of Appeals. (Recommendation 4)

Agency: Department of the Treasury: Internal Revenue Service
Status: Open

Comments: IRS agreed with this recommendation. In February 2019, IRS stated that the Chief of Appeals will share with each compliance unit data on the time elapsed between when a taxpayer requests an appeal to when it is received in the Office of Appeals. Appeals will also conduct an assessment with IRS compliance units of the time elapsed between when a taxpayer requests an appeal to when it is received in the Office of Appeals and implement improvements based on that assessment. As of February 2020, Appeals demonstrated that it provided to compliance units initial example data that tracks the time from taxpayer request for appeal to when it is received by the Office of Appeals. As of April 2020, it continues to refine the format of these reports. Appeals said it plans to do an assessment of the data with compliance units and will provide an example of this analysis when it is complete. IRS plans to complete these actions by October 2020, and GAO will continue to monitor IRS's implementation of this recommendation.

Recommendation: The Commissioner of Internal Revenue should provide more transparency to taxpayers on historical average total appeal resolution times. This could include publishing average total resolution times by workstream on an Office of Appeals web page as well as including total expected times in the Appeals welcome letter. (Recommendation 5)

Agency: Department of the Treasury: Internal Revenue Service
Status: Open

Comments: IRS agreed with this recommendation. In February 2019, IRS stated that the Chief of Appeals will review appeal resolution times and participate in IRS-wide efforts to improve transparency of resolution timeframes. As of June 2019, the Office of Appeals explained that IRS was beginning to simplify its website, including the Appeals website, with a focus on making it more customer friendly. IRS plans to complete these actions by June 2020, and GAO will continue to monitor IRS's implementation of this recommendation.

Recommendation: The Secretary of the Treasury, consistent with its responsibilities under GPRAMA and Executive Orders for customer service, should ensure that the Commissioner of Internal Revenue takes action to make Appeals customer service standards and performance results more transparent to the public. This could include publishing customer service standards and related performance measure results on the Office of Appeals web page on IRS.gov. (Recommendation 6)

Agency: Department of the Treasury
Status: Open

Comments: Treasury agreed with this recommendation and plans to monitor IRS implementation. In February 2019, IRS stated that it will publish customer service standards and related performance measure results on the Office of Appeals web page on IRS.gov. As of April 2020, the Office of Appeals stated it plans to use information from its redesigned customer satisfaction survey to address this recommendation and is determining how to include the performance information on its website. IRS plans to complete these actions by June 2020, and GAO will continue to monitor IRS's implementation of this recommendation.

Recommendation: The Secretary of the Treasury, consistent with its responsibilities under GPRAMA and Executive Orders for customer service, should ensure that the Commissioner of Internal Revenue takes action to develop a mechanism to solicit and consider public input and customer feedback on a regular basis on current and proposed IRS appeal policies and procedures. This could include leveraging existing IRS advisory bodies or establishing an Office of Appeals advisory body representing the taxpaying public, the tax practitioner community, and businesses to solicit customer perspectives. (Recommendation 7)

Agency: Department of the Treasury
Status: Open

Comments: Treasury agreed with this recommendation and will monitor IRS implementation. In February 2019, IRS stated that it will leverage existing IRS advisory bodies to solicit customer perspectives. In January 2020, the Office of Appeals reported that it had begun to meet with the IRS Advisory Committee (IRSAC) to solicit customer perspectives, with its first interactions beginning in November 2019. The Office of Appeals stated that, in addition to this action, its leadership continues to meet with other external bodies to capture public input and customer feedback on an ad hoc basis. As of April 2020, the Office of Appeals stated it plans to participate in IRSAC's public meetings. Since the Office of Appeals has only begun leveraging IRSAC to solicit customer perspectives in November 2019 in a working session, GAO will continue to monitor the implementation of this recommendation to ensure sustained interaction with IRSAC through working sessions, as well as public meetings.

Recommendation: The Deputy Commissioner for Hearings Operations should evaluate the costs versus the benefits of changing system limitations that hinder users' ability to correctly and efficiently identify and transfer batches of cases. (Recommendation 2)

Agency: Social Security Administration
Status: Open

Comments: SSA agreed and in May 2019 stated that it is in the early stages of developing and rolling out a new case processing system to replace its Case Processing and Management System called the Hearings and Appeals Case Processing System (HACPS). HACPS will provide end-to-end disability claims processing infrastructure to support the full life-cycle of a disability claim and give users greater flexibility in correctly and accurately transferring cases to and from hearing sites process. It will include hearings and appeals case processing functionality. In early 2020, SSA reported that there were six releases of HACPS from November 2018 through September 2019 and they expect full implementation by early FY 2021.

Recommendation: The Secretary of Veterans Affairs should clearly articulate in VA's appeals plan how VA will monitor and assess the new appeals process compared to the legacy process, including specifying a balanced set of goals and measures--such as timeliness goals for all VBA appeals options and Board dockets, and measures of accuracy, veteran satisfaction, and cost--and related baseline data. (Recommendation 2)

Agency: Department of Veterans Affairs
Status: Open
Priority recommendation

Comments: VA concurred with this recommendation and, as of March 2020, addressed some but not all aspects of it. Regarding monitoring, VA has made progress in monitoring and addressing workload changes in its new and legacy appeals processes. For example, VA has developed sensitivity models and other analyses to monitor and forecast future VBA and Board workloads, production, and staffing requirements to help VA manage the new and legacy appeals processes. Further, the Board is aiming to complete non-remanded legacy appeals by December 2022 by first addressing hearing-requested appeals. However, VBA and the Board have yet to specify a complete set of balanced goals for monitoring the new and legacy appeals processes (e.g., timely and accurate processing of appeals while ensuring veteran satisfaction). For example, the Board will not establish timeliness goals for all new Board options until after collecting additional data during implementation of the new appeals process, thus delaying VA's vision for what successful implementation should look like and hindering awareness of resources required to achieve that vision. Regarding comparing the performance of the new and legacy appeals processes, VA officials have previously reported that they intend to use timeliness and productivity metrics from section 5 of the Appeals Modernization Act. Further, VBA and Board officials have articulated steps they are taking to collect, through surveys, comparable information on veterans' satisfaction with the new and legacy appeals processes. However, VA has not fully articulated detailed steps and timeframes for assessing the relative performance of the new and legacy appeals processes. For example, VA has not indicated how it will assess whether or the extent to which the new process, which also allows for multiple appeal opportunities, will achieve final resolution of veterans' appeals sooner, on average, than the legacy process, as we recommended in GAO-17-234. We will consider closing this recommendation when VA provides documentation indicating how it will assess the new appeals process against the legacy process vis a vis balanced measures.

Recommendation: The Secretary of Veterans Affairs should augment the master schedule for VA's appeals plan to reflect all activities--such as modifications to information technology (IT) systems--as well as assigned responsibilities, interdependencies, start and end dates for key activities for each workgroup, and resources, to establish accountability and reduce overall risk of implementation failures. (Recommendation 3)

Agency: Department of Veterans Affairs
Status: Open

Comments: VA concurred with this recommendation. Since our report was issued, VA took significant action on its project plan and in February 2019, implemented the Veterans Appeals Improvement and Modernization Act of 2017. VA provided increasingly more details in updates to its plan about sub-activities related to processing legacy appeals, monitoring implementation, drafting Board policies, training, and testing of the new process. For example, VA added activities related to the Rapid Appeals Modernization Program (RAMP) test of the VBA-only options as well as the test of the new Board options. In spring and summer 2018, according to VA officials, VA set a baseline schedule for implementing appeals reform in response to the potential February 2019 implementation date established in the Act. In October 2018, VA provided us with lower-level schedules and other related information that allowed us to conduct a more detailed assessment of VA's IMS against applicable best practices criteria. However, as of December 2018, VA's schedule did not fully align with best practices. For example, VA's schedule did not contain a work breakdown structure that defines the work, activities, and resources necessary to accomplish implementation-details that would inform resources and time needed for the project. (For details on this assessment, see GAO-19-272T.) While VA fully implemented appeals reform in February 2019, incorporating such lessons learned into future project planning could help VA improve its project scheduling capabilities. Specifically, in February 2020 VA reported that Caseflow-VA's replacement system intended to support appeals reform-had "minimal functionality," with many functionalities yet to be implemented. We will consider closing this recommendation when VA has produced a more complete plan for-and that establishes accountability and reduces risk of failure related to-developing, implementing, and integrating remaining key functionality envisioned under Caseflow. We will also continue tracking whether the Board addresses long-term Caseflow planning under recommendation 2 in GAO-17-234.

Recommendation: The Secretary of Veterans Affairs should ensure that the appeals plan more fully addresses risk associated with appeals reform--for example, by assessing risks against a balanced set of goals and measures, articulating success criteria and an assessment plan for RAMP, and testing or conducting sensitivity analyses of all appeals options--prior to fully implementing the new appeals process. (Recommendation 4)

Agency: Department of Veterans Affairs
Status: Open
Priority recommendation

Comments: The Department of Veterans Affairs (VA) concurred with our recommendation to more fully address risks associated with implementing a new appeals process. As of March 2020, VA has taken many steps to address our recommendation, although key steps are remaining for VA to better assess risks associated with implementing appeals reform and managing appeals workloads in the legacy process. Specifically, since May 2018, VBA and Board officials reported developing and using new sensitivity analyses that would allow the agency to project potential budget needs and staffing requirements. Further, VBA is using these analyses to more accurately predict resolution of legacy appeals given certain assumptions. Furthermore, in addition to testing two appeal options available within VBA through its Rapid Appeals Modernization Program (RAMP), VA conducted small-scale testing of the three new Board appeals options through the Board's Early Applicability of Appeals Modernization (BEAAM) pilot, testing that was missing from VA's original November 2017 plan. VA also reported using lessons learned from testing all appeals options to update the implementation process. However, as designed, RAMP and BEAAM lacked well-defined, measurable criteria for assessing lessons learned from its testing, and the agency did not fully test all aspects of the appeals options before moving to full implementation in February 2019. Even though VA has fully implemented the new disability appeals process without addressing these aspects of our recommendation, many of the other principles of sound planning practices that informed our recommendation remain relevant, even after implementation, to ensure the new process meets veterans' needs. Specifically, VA has not developed mitigation strategies for all identified risks, such as veterans appealing to the Board at higher rates than expected or choosing more resource-intensive Board options, such as those involving new evidence or a hearing. As of January 2020, the more resource-intensive hearing option accounted for over 50 percent of new appeals inventory. At the same time, the Board reported it plans to prioritize resources on reducing the legacy appeals inventory and on the least resource intensive appeal option for which it established a timeliness goal. Although the Board has increased productivity, addressing legacy hearings will take several years as veterans may continue choosing the new hearing option at high rates and the Board prioritizes other workloads. This circumstance could subject veterans to longer wait times and increasing backlogs under the hearing option. As of March 2020, VA also has not established a complete and balanced set of goals and measures for the new appeals options, which are a necessary pre-condition to effectively assessing risk. Lacking a complete set of goals and measures, VA may not have comprehensively identified key risks.

Recommendation: The Assistant Administrator for Recovery should develop a detailed workforce plan that documents steps for hiring, training, and retaining key appeals staff. The plan should also address staff transitions resulting from deployments to disasters. (Recommendation 3)

Agency: Department of Homeland Security: Directorate of Emergency Preparedness and Response: Federal Emergency Management Agency
Status: Open

Comments: DHS concurred with this recommendation and said it would take steps to implement it. According to FEMA, to prepare for the potential production of a detailed regional workforce plan, PAAB (Public Assistance Appeals Branch) has been collecting information from the Regions regarding the percentage of time (on a monthly basis) that each Regional appeals analyst has worked on appeals. In August 2018, PAAB shared with the Regions its preliminary analysis of this information and asked the Regions to provide feedback regarding the methods used to analyze this information. PAAB said that they intend to assess first-level appeals' regional inventory and timeliness issues, as well as the work needed to prepare and finalize a detailed regional workforce plan. According to FEMA, PAAB is also analyzing second-level appeal inventory and timeliness, and will continue to monitor second-level appeal timeliness. In April 2020, we met with FEMA to discuss additional information and documentation they sent us involving their analysis of appeal inventories and whether this analysis is part of a larger effort to develop a detailed workforce plan as called for in the recommendation. As a result of this meeting, we received further documentation from FEMA in July 2020, and are in the process of evaluating this to determine whether FEMA has fully addressed this recommendation.

Recommendation: The Assistant Administrator for Recovery should work with Regional Administrators in all 10 regional offices, to establish and use goals and measures for processing first-level PA appeals to monitor performance and report on progress. (Recommendation 4)

Agency: Department of Homeland Security: Directorate of Emergency Preparedness and Response: Federal Emergency Management Agency
Status: Open

Comments: DHS concurred with this recommendation and said it would take steps to implement it. According to FEMA, in July 2018, the Public Assistance Division and PAAB transmitted a survey to the Regions containing questions about how each Region establishes goals for processing first-level appeals and how each Region measures and monitors performance with respect to those goals. Thereafter, the Regions provided survey responses to PAAB. According to FEMA, PAAB has begun analyzing the survey responses for the purpose of enabling FEMA's Associate Administrator for the Office of Response and Recovery and FEMA's Chief of Staff to work with all FEMA Regional Administrators to establish and use goals and measures for processing first-level PA appeals to monitor performance and report on progress. In April 2020, we met with FEMA to discuss additional information and documentation they sent us involving these efforts and their development of performance metrics that reflect best practices for the timely processing, tracking, and reporting of first appeals. As a result of this meeting, we received further documentation from FEMA in July 2020, and are in the process of evaluating this to determine whether FEMA has fully addressed this recommendation.

Recommendation: The Commissioner of SSA should develop a set of public performance measures, to include accuracy and consistency, as well as timeliness, of administrative law judges' (ALJ) disability decisions. SSA could consider whether existing quality review or monitoring efforts could provide suitable data for such measures. (Recommendation 1)

Agency: Social Security Administration
Status: Open

Comments: SSA agreed with this recommendation and stated that it would address it as part of a comprehensive assessment and refinement of its oversight roles and processes. As of February 2020, SSA officials reported that the agency developed a new review of hearing decisions to assess decisional quality on a national level. Officials said they implemented the review throughout fiscal year 2019 and will draft a report on the findings in fiscal year 2020. As they review results from this review, SSA officials said that they will assess whether existing quality review measures will provide suitable data for performance measures related to timeliness, consistency, and accuracy. Officials said they do not have a timeline for implementing this recommendation.

Recommendation: The Commissioner of SSA should systematically evaluate the efficiency and effectiveness of its quality assurance reviews and take steps to reduce or better manage any unnecessary overlap among them to ensure strategic use of resources. Such steps could include enhancing collaboration where reviews overlap or only conducting the reviews that are most efficient and effective in achieving agency goals for improving accuracy and consistency of ALJ disability decisions. (Recommendation 2)

Agency: Social Security Administration
Status: Open

Comments: SSA agreed with this recommendation and stated that it would address this recommendation as part of a comprehensive assessment and refinement of its oversight roles and processes. In March 2018, SSA noted that the Offices of Quality Review and Appellate Operations are now consolidated under the Office of Analytics, Review, and Oversight (OARO). According to SSA, OARO was created with the purposes of enhancing collaboration, eliminating unnecessary overlap, and enhancing the efficiency of reviews. As of February 2020, SSA officials said that they developed a new review of favorable and unfavorable hearing decisions to provide statistically valid results on the quality of decisions on appealed disability claims at the national level. Officials said they will use the results of this one-time review to help assess the utility of their other quality reviews. Successful completion of these efforts should help to ensure effective use of resources in overseeing the quality of decisions on appealed disability claims.

Recommendation: To improve CMS's oversight of states' MLTSS programs, the Administrator of CMS should take steps to identify and obtain key information needed to oversee states' efforts to monitor beneficiary access to quality services, including, at a minimum, obtaining information specific to network adequacy, critical incidents, and appeals and grievances.

Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services
Status: Open

Comments: The Department of Health and Human Services (HHS) agreed with this recommendation. In December 2017, HHS communicated its intent to review regulations and enhance its capacity to measure, monitor, and improve care and quality across a number of domains, including MLTSS. As of February 2020, HHS stated that it is developing guidance related to reporting on key information needed to oversee beneficiary access to care. GAO will continue to monitor the department's actions and any steps taken to address this recommendation.

Recommendation: In order to improve employee misconduct policies and procedures, the Secretary of Homeland Security should direct the FEMA Administrator to document policies and procedures to address potential Surge Capacity Force misconduct.

Agency: Department of Homeland Security
Status: Open

Comments: We found that the Federal Emergency Management Agency (FEMA) had developed and documented misconduct policies and procedures for most employees, but not its entire workforce. Specifically, FEMA had not documented misconduct policies and procedures for Surge Capacity Force members, who may augment FEMA's workforce in the event of a catastrophic disaster. As a result, we recommended that FEMA document policies and procedures to address potential Surge Capacity Force misconduct. In September 2017, FEMA officials reported taking action to address this recommendation. Specifically, FEMA distributed a memorandum to Federal Coordinating Officers and Federal Disaster Recovery Coordinators providing guidance on how and to whom to report allegations of misconduct by Surge Capacity Force members, coordination efforts regarding investigations, and how to address the member's duty status during the course of an investigation. FEMA stated that it will further address this recommendation by updating the FEMA Human Capital Plan for the Surge Capacity Force. As of August 2020, FEMA was finalizing a comprehensive Human Capital Guide based on lessons learned during the 2017 disaster season, which will address the Surge Capacity Force. This recommendation will remain open until the Human Capital Guide is completed.

Recommendation: In order to improve employee misconduct policies and procedures, the Secretary of Homeland Security should direct the FEMA Administrator to document Reservist disciplinary options and appeals policies and procedures that are currently in practice at the agency.

Agency: Department of Homeland Security
Status: Open

Comments: We found that the Federal Emergency Management Agency's (FEMA) policies and procedures for Reservist employees did not outline disciplinary options to address misconduct or address the appeals process available for Reservists. As a result, we recommended that FEMA document Reservist disciplinary options and appeals policies and procedures that are currently in practice at the agency. In September 2017, FEMA reported that the Office of Response and Recovery was drafting an addendum to the FEMA Reservist program manual. As of August 2020, FEMA was finalizing a FEMA Reservist Performance Management Directive which will provide agency-wide guidance for Reservist management and discipline. FEMA expects the directive to be completed by November 2020. This recommendation will remain open until the directive is complete.

Recommendation: In order to better identify and address trends in employee misconduct, the Secretary of Homeland Security should direct the FEMA Administrator to, once the quality of the data is improved, conduct routine reporting on employee misconduct trends.

Agency: Department of Homeland Security
Status: Open

Comments: We found that the Federal Emergency Management Agency (FEMA) did not regularly conduct trend analysis on misconduct cases, and that the quality of the data restricted the agency's ability to identify and address trends. As a result, we recommended that, once steps were taken to improve the quality of the data, FEMA should conduct routine reporting on employee misconduct trends. As of July 2020, FEMA's Office of Professional Responsibility (OPR) changed plans on which information system to use for reporting purposes due to cyber security concerns. According to FEMA officials, OPR will be using a DHS enterprise system and the system will be able to generate regular reporting. FEMA anticipates reporting functionality by October 2020. We will continue to monitor FEMA's efforts to address the recommendation.

Recommendation: To further align efforts to address appeals workload and improve timeliness of decisions, and reduce the risk that efforts will not go as planned, the Secretary of Veterans Affairs should direct the Under Secretary for Benefits; the Chairman, Board of Veterans' Appeals; and the Chief Information Officer, as appropriate, to develop a schedule for IT updates that explicitly addresses when and how any process reform will be integrated into new systems and when Caseflow will be ready to support a potential streamlined appeals process at its onset.

Agency: Department of Veterans Affairs
Status: Open

Comments: VA concurred in principle with this recommendation. Moreover, since our March 2017 report, Congress passed the Veterans Appeals Improvement and Modernization Act of 2017, which required VA to develop a comprehensive appeals plan that included, among other things, descriptions of modifications to, cost estimates of and timelines for information technology that the agency needs to carry out appeals reform. However, more than a year after implementation of appeals reform, VA's February 2020 updated plan and FY 2021 budget request indicate that Caseflow has "minimal functionality", with many functionalities yet to be implemented. Further, VA's February 2020 updated plan and its FY 2021 budget request do not include specific steps or goals related to achieving overall functionality, integrated testing, or IT training for staff on new functionality still to be implemented in 2020 or beyond. While the VA's use of the agile process for IT development can help mitigate risks and avoid cost overruns and delays, VA's plans do not signal when Caseflow will support all of the Board's workflow needs for processing appeals under the new process. Such longer-term planning also could help ensure that all potential changes are anticipated in the plans of various VA components. For example, VA's February 2020 updated plan states that VHA cannot use Caseflow to efficiently and effectively manage its appeals workload. Longer-term planning could also ensure more transparency around additional resources needed to fully implement Caseflow versus other appeals-related technologies enterprise wide. We will consider closing this recommendation when VA has produced a longer-term plan for developing, implementing and integrating Caseflow functionality in support of a streamlined appeals process, including clear definitions of initial/minimal operating capability and full operational capability.

Recommendation: To better understand whether appeals process reform, in conjunction with other efforts, has improved timeliness, the Secretary of Veterans Affairs should direct the Under Secretary for Benefits; the Chairman, Board of Veterans' Appeals; and the Chief Information Officer, as appropriate to develop a strategy for assessing process reform--relative to the current process--that ensures transparency in reporting to Congress and the public on the extent to which VA is improving veterans' experiences with its disability appeals process.

Agency: Department of Veterans Affairs
Status: Open

Comments: VA concurred in principle with this recommendation. Moreover, since our March 2017 report, Congress passed the Veterans Appeals Improvement and Modernization Act of 2017, which required VA to produce a comprehensive appeals plan that required VA, among other things, to periodically publish a range of metrics, including timeliness, related to the processing of appeals under the new and legacy system. As of February 2019, VA implemented appeals reform; however VA has not indicated how it will assess whether or the extent to which the new process, which also allows for multiple appeal opportunities, will achieve final resolution of veterans' appeals sooner, on average, than the legacy process. We will consider closing this recommendation when the Board establishes timeliness goals for all new appeals options and VA has produced a plan for analyzing whether the new process is an improvement. Closure of this recommendation is related to recommendation 2 in GAO-18-352.

Recommendation: To provide greater transparency in the reporting of FOIA litigation costs, Congress could consider requiring Justice to provide a cost estimate for collecting and reporting information on costs incurred when defending lawsuits in which the plaintiffs prevailed.

Agency: Congress
Status: Open

Comments: As of February 2020, Congress has not yet considered if it plans to amend FOIA regarding the reporting of costs for defending lawsuits in which the plaintiffs prevailed.

Recommendation: Congress could consider amending the act to require Justice to reflect in its Litigation and Compliance reports, changes in the award of attorneys' fees and costs resulting from the appeals process and settlement agreements between agencies and plaintiffs, if deemed to be cost-effective.

Agency: Congress
Status: Open

Comments: As of February 2020, Congress has not yet considered if it plans to amend FOIA to require Justice to make changes to its Litigation and Compliance reports.

Recommendation: To reduce the number of Medicare appeals and to strengthen oversight of the Medicare FFS appeals process, the Secretary of Health and Human Services should direct CMS, Office of Medicare Hearings and Appeals (OMHA), or Departmental Appeals Board (DAB) to modify the various Medicare appeals data systems to collect information on the reasons for appeal decisions at Level 3.

Agency: Department of Health and Human Services
Status: Open

Comments: According to HHS as of August 2016, OMHA and DAB were considering the cost and technical feasibility of collecting this information within their appeals data systems. As of August 2018, OMHA has begun to take action on this recommendation. Specifically, in the July 2017 interim release of the Electronic Case Adjudication and Processing Environment (ECAPE) system, OMHA added a "Reason for Disposition" data field. However, the "Reason for Disposition" data field is currently limited in the number of reasons that can be selected, and ECAPE has not yet been rolled out to all OMHA offices. In May 2019, HHS reported that OMHA had modified the "Reason for Disposition" data field to capture more categories, and that DAB had modified its case management system to capture the reasons for appeal decisions at Level 3 and was working to develop system interoperability with ECAPE. In August 2019, OMHA officials noted that ECAPE had been implemented in 6 of OMHA's 10 field offices and was on track to implement ECAPE in all 10 field offices and its satellite office by the end of 2019. We will update the status of this recommendation when we receive additional information regarding DAB's efforts to implement this recommendation.

Recommendation: To reduce the number of Medicare appeals and to strengthen oversight of the Medicare FFS appeals process, the Secretary of Health and Human Services should direct CMS, OMHA, or DAB to modify the various Medicare appeals data systems to capture the amount, or an estimate, of Medicare allowed charges at stake in appeals in Medicare Appeals System (MAS) and Medicare Operations Division Automated Case Tracking System (MODACTS).

Agency: Department of Health and Human Services
Status: Open

Comments: According to HHS as of August 2016, this information was not captured in any CMS system, including MAS. HHS reported that if MAS is modified to capture the amount of Medicare allowed charges at stake, OMHA will consider modifying its Electronic Case Adjudication and Processing Environment (ECAPE) to include this information as well, and DAB can capture it in a new case management system currently being developed by the agency. As of August 2019, HHS officials stated that developing a methodology to estimate the amount that CMS would have paid providers is complex and would not be appropriate for use in determining whether the appeal meets the amount in controversy requirements for a Level 3 appeal. The basis for our recommendation was also so that HHS could better monitor important appeal trends. Additionally, without this information, HHS does not know the actual amount of Medicare reimbursement at issue in the appeals process. We will update the status of this recommendation when we receive additional information regarding HHS's efforts to implement it.

Recommendation: To reduce the number of Medicare appeals and to strengthen oversight of the Medicare FFS appeals process, the Secretary of Health and Human Services should direct CMS, OMHA, or DAB to modify the various Medicare appeals data systems to collect consistent data across systems, including appeal categories and appeal decisions across MAS and MODACTS.

Agency: Department of Health and Human Services
Status: Open

Comments: According to HHS as of August 2016, HHS reported taking several initial steps to standardize data across Medicare appeals systems. As of August 2018, HHS was continuing to take steps to implement GAO's recommendation to standardize data collection on appeals across its multiple data systems. Specifically, HHS stated that, in November 2016, CMS and OMHA modified the MAS system to standardize appeal categories between Levels 1 through 3, which will help to facilitate more accurate trending analyses across appeal levels. Further, as of April 2017, all Part A Medicare Administrative Contractors (MAC), who are responsible for Part A Level 1 appeals, were successfully processing appeals in MAS, according to HHS. In August 2019, OMHA officials noted that the ECAPE system, which will interact with MAS for reporting purposes, had been implemented in 6 of OMHA's 10 field offices and would be implemented in all 10 field offices and its satellite office by the end of 2019. However, Part B and DME MACs, which are responsible for Part B and DME Level 1 appeals, have not been fully transitioned to MAS. Therefore, appeals categories are still inconsistent for these claims. According to HHS, CMS has not received funding to transition the remaining Level 1 appeals contractors to MAS. Additionally, HHS reported that DAB continues to explore ways to develop interoperability between MODACTS and OMHA's ECAPE system. Therefore, we will continue to monitor progress on the implementation of this recommendation.