Recommendation: The Under Secretary of Defense for Acquisition and Sustainment should establish procedures requiring the military departments to collect and share findings from their peer reviews of MDAP contracting approaches—including choice of contract type—such as by updating the existing online compendium of best practices and lessons learned as they complete their reviews.

Agency: Department of Defense
Status: Open

Comments: DOD agreed with this recommendation, but as of August 2020 has not taken any action to implement it.

Recommendation: The Secretary of Defense should ensure that the Under Secretary of Defense for Acquisition and Sustainment develop and implement a plan to guide and coordinate efforts to implement the Wideband AOA recommendations to support timely, informed decisions on its next wideband satellite communications architecture. (Recommendation 1)

Agency: Department of Defense: Office of the Secretary of Defense
Status: Open

Comments: DOD concurred with our recommendation, but as of July 2020 is still working to implement its corrective action plan.

Recommendation: The Administrator of the General Services Administration (GSA), in coordination with the Director of the Office of Management and Budget, should ensure that the average cost per square foot performance measure for GSA-managed space is calculated using actual cost information. (Recommendation 1)

Agency: General Services Administration: Office of the Administrator
Status: Open

Comments: GSA concurred with this recommendation and has developed an action plan to implement it. In January 2020, GSA officials told us that GSA will change the method for calculating the average cost per square foot performance measure by now using the actual rent agencies paid to GSA in the calculation. GSA officials also stated that GSA will post this information annually to performance.gov. We will continue to monitor GSA's implementation of these efforts.

Recommendation: The Secretary of VA should direct the Under Secretary for Health and the Assistant Secretary for Information and Technology/Chief Information Officer to develop and implement a methodology for reliably identifying and reporting the total costs of VistA. The methodology should include steps to identify the definition of VistA and what is to be included in its sustainment activities, as well as ensure that comprehensive costs are corroborated by reliable data. (Recommendation 1)

Agency: Department of Veterans Affairs
Status: Open

Comments: The Department of Veterans Affairs (VA) generally agreed with our conclusions and concurred with our recommendation. In a January 2020 update, the department described steps it planned to take to address the recommendation including establishing a team of experts to formulate a comprehensive taxonomy for VistA and all of its components, identifying authoritative and reliable data sources to assign costs to those components, and developing a methodology for ongoing cost tracking and reporting. The department expects these steps to be implemented by September 30, 2020. We will continue to monitor the department's progress to address this recommendation.

Recommendation: The Under Secretary for Health should work with the Department of Veterans Affairs (VA's) Office of Construction and Facilities Management to ensure that VHA incorporates the 12 steps in the GAO Cost Estimating and Assessment Guide in VHA's updated construction projects' cost-estimating guidance. (Recommendation 1)

Agency: Department of Veterans Affairs: Veterans Health Administration
Status: Open

Comments: The Office of Capital Asset Management Engineering and Support (OCAMES) is working with the Office of Construction and Facility Management (OCFM) to make necessary updates to CFM's Cost Estimating and Assessment Guide. GAO has reviewed VA's revisions and found that while they incorporated information on two of the 12 steps in GAO's Cost Estimating and Assessment Guide, the guidance currently meets or substantially meets only 4 of the 12 steps. GAO met with OCFM and OCAMES staff in April 2020 to further discuss our guidance and how to apply it. The VA staff will consider how to further apply our guidance.

Recommendation: The Under Secretary for Health should obtain information on cost increases, schedule delays, and reasons for contract modifications in its updated Capital Asset Database through requiring medical center staff to provide the information or another appropriate method. (Recommendation 5)

Agency: Department of Veterans Affairs: Veterans Health Administration
Status: Open

Comments: OCAMES is finalizing updates and fixing issues related to improvements to the Capital Asset Database; these updates include additional information related to change orders. Due to unexpected challenges with data connections and issues; however, these improvements have not yet been completed. The change in completion date is caused by data connection issues and progress on the overall system was stalled. GAO will continue to monitor VA's progress in implementing this recommendation.

Recommendation: The Under Secretary for Health should develop a comprehensive plan that includes elements such as milestones and roles and responsibilities for updating VHA's Capital Asset Database. (Recommendation 6)

Agency: Department of Veterans Affairs: Veterans Health Administration
Status: Open

Comments: OCAMES is still finalizing updates and fixing issues related to improvements to the Capital Asset Database. Until the updates have been finalized, roles and responsibilities cannot be created. Upon completion of updates, roles and responsibilities will be developed.

Recommendation: The Director of NSF should revise the agency's policies for developing schedules for large facilities projects, and for reviewing those schedules, to better incorporate the best practices in GAO's schedule guide. (Recommendation 2)

Agency: National Science Foundation
Status: Open

Comments: NSF agreed with this recommendation and, as of November 2019, had updated its internal guidance to include a new section related to schedule reviews. The updated guidance states that the NSF Large Facilities Office will lead analysis of the schedule for each proposed major facilities project, which will include a technical evaluation by the sponsoring office. As further steps to implement this recommendation, NSF planned to develop (1) a new section of the Major Facilities Guide on schedule development, estimating, and analysis and (2) new internal guidance on including project schedules as part of external panels' oversight reviews. NSF anticipated completing these actions by mid-fiscal year 2020. We will continue to monitor and provide updates on NSF's actions to address this recommendation.

Recommendation: The FAA Administrator should fulfill the CSLCA mandate to include ensuring a balance of risk between the federal government and launch companies as part of FAA's MPL methodology evaluation by reexamining the current probability thresholds. (Recommendation 1)

Agency: Department of Transportation: Federal Aviation Administration
Status: Open

Comments: In March 2020 Department of Transportation (DOT) officials stated that FAA had not yet finished reexamining the current maximum probable loss (MPL) probability thresholds or completed a subsequent rulemaking to address the probability thresholds. The officials also stated that FAA's focus for the prior two years has been on streamlining the launch and reentry license regulations (SLR2) rulemaking in response to the President's Space Policy Directive 2, which contains the National Space Council's recommendations for commercial space regulatory reform. According to the officials, this effort will continue through 2020, and that after it is completed, FAA will evaluate whether to begin a new rulemaking to address MPL analyses.

Recommendation: The FAA Administrator should fulfill the CSLCA mandate to analyze the cost impact of implementing its revised MPL methodology by evaluating the impact on the direct costs of launch companies and the federal government. (Recommendation 2)

Agency: Department of Transportation: Federal Aviation Administration
Status: Open

Comments: In March 2020, Department of Transportation (DOT) officials stated that FAA had not yet finished reexamining the current maximum probable loss (MPL) probability thresholds or completed a subsequent rulemaking to address the probability thresholds. The officials also stated that FAA's focus for the prior two years has been on streamlining the launch and reentry license regulations (SLR2) rulemaking in response to the President's Space Policy Directive 2, which contains the National Space Council's recommendations for commercial space regulatory reform. According to the officials, this effort will continue through 2020, and that after it is completed, FAA will evaluate whether to begin a new rulemaking to address MPL analyses.

Recommendation: The FAA Administrator should fulfill the CSLCA mandate to evaluate its MPL methodology in consultation with the commercial space sector and insurance providers by consulting with those entities on the cost impact of its revised MPL methodology, including an updated cost-of-casualty amount, on the launch industry and the federal government. (Recommendation 3)

Agency: Department of Transportation: Federal Aviation Administration
Status: Open

Comments: In March 2020, Department of Transportation (DOT) officials stated that FAA had not yet finished reexamining the current maximum probable loss (MPL) probability thresholds or completed a subsequent rulemaking to address the probability thresholds. The officials also stated that FAA's focus for the prior two years has been on streamlining the launch and reentry license regulations (SLR2) rulemaking in response to the President's Space Policy Directive 2, which contains the National Space Council's recommendations for commercial space regulatory reform. According to the officials, this effort will continue through 2020, and that after it is completed, FAA will evaluate whether to begin a new rulemaking to address MPL analyses.

Recommendation: The FAA Administrator should establish an estimated completion date for developing and implementing a plan to establish guidance on the most appropriate MPL methodologies and tools to use for each launch. (Recommendation 4)

Agency: Department of Transportation: Federal Aviation Administration
Status: Open

Comments: In March 2020, Department of Transportation (DOT) officials stated that FAA had not yet finished reexamining the current maximum probable loss (MPL) probability thresholds or completed a subsequent rulemaking to address the probability thresholds. The officials also stated that FAA's focus for the prior two years has been on streamlining the launch and reentry license regulations (SLR2) rulemaking in response to the President's Space Policy Directive 2, which contains the National Space Council's recommendations for commercial space regulatory reform. According to the officials, this effort will continue through 2020, and that after it is completed, FAA will evaluate whether to begin a new rulemaking to address MPL analyses.

Recommendation: The Director of National Intelligence should develop a plan for monitoring continuous evaluation performance, to include assessing continuous evaluation at various phases of implementation. (Recommendation 3)

Agency: Office of the Director of National Intelligence
Status: Open

Comments: ODNI generally concurred with this recommendation. As of November 2019, ODNI has provided information that may allow us to close this recommendation. We are currently evaluating that information and will update this recommendation once that evaluation is complete.

Recommendation: The Director of National Intelligence should develop performance measures for continuous evaluation that agencies must track and determine a process and schedule for agencies to regularly report those measures to ODNI. At minimum, these performance measures should be clear, quantifiable, objective, and linked to measurable goals. (Recommendation 4)

Agency: Office of the Director of National Intelligence
Status: Open

Comments: ODNI generally concurred with this recommendation. As of November 2019, ODNI provided information that may allow us to close this recommendation. We are currently evaluating this information and once that evaluation is complete, we will update the status.

Recommendation: The Director of National Intelligence should, in coordination with the Deputy Director for Management of the Office of Management and Budget in the capacity as Chair of the Security, Suitability, and Credentialing Performance Accountability Council, conduct an evidence-based review of the timeliness goal of 195 days for completing the fastest 90 percent of periodic reinvestigations and the associated goals for the different phases of periodic reinvestigations, and adjust the goal if appropriate, taking into consideration available resources, the additional workload of continuous evaluation, and the risks associated with individuals retaining access to classified information without determining their continued eligibility. (Recommendation 5)

Agency: Office of the Director of National Intelligence
Status: Open

Comments: ODNI generally concurred with this recommendation. As of November 2019, ODNI stated that with the advent of Trusted Workforce 2.0, discussions are being held about timeliness goals and the periodic reinvestigation model writ large. Once we confirm what actions have been taken, we will update the status of this recommendation.

Recommendation: The Director of National Intelligence should, once ODNI has further defined the continuous evaluation program, to include issuing a Security Executive Agent Directive and developing an implementation plan, in coordination with the Deputy Director for Management of the Office of Management and Budget in the capacity as Chair of the Security, Suitability, and Credentialing Performance Accountability Council, assess the potential effects of continuous evaluation on agency resources and develop a plan, in consultation with implementing agencies, to address those effects, such as modifying the scope of periodic reinvestigations, changing the frequency of periodic reinvestigations, or replacing periodic reinvestigations for certain clearance holders. (Recommendation 6)

Agency: Office of the Director of National Intelligence
Status: Open

Comments: ODNI generally concurred with this recommendation. As of November 2019, ODNI provided information that may allow us to close this recommendation. We are currently evaluating that information and once that evaluation is complete, we will update the status of this recommendation.

Recommendation: The Secretary of Transportation should develop an evaluation plan for the Infrastructure for Rebuilding America (INFRA) program in advance of issuing the notice of funding opportunity and ensure the program's evaluation plan clearly defines how all review teams should apply criteria, assess applications, and assign ratings to ensure that all applications are consistently reviewed. (Recommendation 1)

Agency: Department of Transportation
Status: Open

Comments: In 2019, we found that DOT's evaluation plan for the INFRA 2017-2018 round of funding was not finalized prior to DOT's issuance of the notice of funding opportunity. In addition, we raised concerns with a lack of documentation outlining why members of the INFRA senior review team followed up with some applicants over others. DOT told us that, for the fiscal year 2020 INFRA awards, it plans to provide information in the Notice of Funding Opportunity and evaluation plan explaining under the circumstances under which additional information may be sought from applicants. DOT stated that it plans to complete these actions by March 2020. We will continue to monitor DOT's actions.

Recommendation: The Secretary of Transportation should ensure all program applicants be notified in writing of the outcomes of the application selection process. For unsuccessful applicants, the notification should include a brief explanation of the decision. (Recommendation 2)

Agency: Department of Transportation
Status: Open

Comments: DOT officials told us that they formally notified unsuccessful INFRA applicants of selection decisions via email and offered applicants the chance to schedule a debriefing with DOT officials. As of January 2020, we are assessing DOT's actions.

Recommendation: The Secretary of Transportation should require INFRA program teams document their decision-making rationale throughout all levels of review in the application selection process. (Recommendation 3)

Agency: Department of Transportation
Status: Open

Comments: In 2019, we again raised concerns with the lack of documentation outlining DOT's rationale for its INFRA award decisions, as well as a lack of documentation regarding why members of the senior review team followed-up with some applicants over others. DOT stated that it would work to address these issues by updating its internal guidance. We will continue to monitor DOT's actions.

Recommendation: The Under Secretary of Defense for Acquisition, Technology, and Logistics, in coordination with the F-35 Program Executive Officer, should re-examine the metrics that it will use to hold the contractor accountable under the fixed-price, performance-based contracts to ensure that such metrics are objectively measurable, are fully reflective of processes over which the contractor has control, and drive desired behaviors by all stakeholders. (Recommendation 2)

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD concurred with this recommendation. As of December 2019, documentation provided by DOD stated that it had established a joint working group to assess the feasibility of and examine options for DOD's planned 5-year performance-based logistics contract. A DOD official said that this group is also working to identify appropriate metrics to hold the contractor accountable under a potential long-term performance-based contract. DOD has not provided us with a timeline of when the working group's assessment will be complete. We will continue to monitor DOD's efforts to re-examine metrics to ensure that they are objectively measureable, fully reflective of processes over which the contractor has control, and drive desired behaviors by all stakeholders.

Recommendation: The Under Secretary of Defense for Acquisition, Technology, and Logistics, in coordination with the F-35 Program Executive Officer, should, prior to entering into multi-year, fixed-price, performance-based contracts, ensure that DOD has sufficient knowledge of the actual costs of sustainment and technical characteristics of the aircraft after baseline development is complete and the system reaches maturity. (Recommendation 3)

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD concurred with this recommendation. As of December 2019, documentation provided by DOD stated that it had established a joint working group to assess the feasibility of and examine options for DOD's planned 5-year performance-based logistics (PBL) contract. As a product of this assessment, DOD expects that the department will be able to outline what level of knowledge is required of the actual costs of sustainment and technical characteristics of the aircraft in order to enter into a PBL sustainment construct. DOD has not provided us with a timeline of when the working group's assessment will be complete. We will continue to monitor DOD's efforts in this area.

Recommendation: The appropriate entities within the Executive Office of the President, including the Council on Environmental Quality, Office and Management and Budget, and Office of Science and Technology Policy, should use information on the potential economic effects of climate change to help identify significant climate risks facing the federal government and craft appropriate federal responses. Such responses could include establishing a strategy to identify, prioritize, and guide federal investments to enhance resilience against future disasters. (Recommendation 1)

Agency: Executive Office of the President
Status: Open

Comments: As of July 14, 2020, the Executive Office of the President has yet to take action on this recommendation.

Recommendation: The Secretary of the Army should direct the Chief of Engineers and the Commanding General of the U.S. Army Corps of Engineers to systematically review data on municipal and industrial water storage agreements stored within the OMBIL system and correct errors, as appropriate, to ensure that the data are accurate and complete.

Agency: Department of Defense: Department of the Army
Status: Open

Comments: As of September 2020, based on information provided by the Corps, the agency has reviewed approximately half of the data and hopes to review the rest of the data by the end of June 2021.

Recommendation: The Secretary of the Army should direct the Chief of Engineers and the Commanding General of the U.S. Army Corps of Engineers to collect and analyze data on the length of time it takes to complete the reallocation process.

Agency: Department of Defense: Department of the Army
Status: Open

Comments: As of September 2020, the Corps is studying how data are captured in the OMBIL system to ensure the agency has a sustainable approach that can be used to collect and analyze data into the future. The Corps hopes to complete its actions on this recommendation by the end of December 2021.

Recommendation: Early in the next decennial cycle, the Secretary of Commerce should direct the Under Secretary of the Economics and Statistics Administration and the Director of the U.S. Census Bureau to plan and execute more flexible, and perhaps smaller, address canvassing test and evaluation activity needed to support key design decisions having significant effect on the cost and quality of the census.

Agency: Department of Commerce
Status: Open

Comments: As of September 2020, the Bureau had not yet begun its 2030 testing and evaluation planning. When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: As DOD continues to improve the completeness and transparency of subsequent joint reports' methodologies in order to assist Congress in understanding the basis of the NC3 estimates by documenting the methodological assumptions and limitations affecting the report's estimates for sustaining and modernizing the NC3 system, as we previously recommended, for future joint reports, the DOD CIO should include explanations of how DOD (1) selects program elements for inclusion in its NC3 estimate, (2) determines its weighted analysis ratios, and (3) differentiates its methodology for calculating operation and maintenance estimates from its methodologies for calculating estimates for the other NC3 line items.

Agency: Department of Defense: Office of the Chief Information Officer
Status: Open

Comments: DOD concurred with our recommendation. As of the issuance of the Fiscal Year (FY) 2019 Joint Report, DOD has taken some steps to address this recommendation. For example, DOD provided more information on the methodologies used to develop NC3 budget estimates. However, the methodology reported for NC3 estimates is still not transparent and DOD must still provide additional information beyond what the methodology in the joint report to clarify differences with the FYDP. However, according to DOD officials, actions will be taken to incorporate a more robust methodology that takes into account these issues in the FY2020 Joint Report. We will re-evaluate DOD's implementation of this recommendation as we review future joint reports.

Recommendation: In order to assist Congress in comparing year-to-year cost estimates between joint reports, for future joint reports, the Secretary of the Air Force should provide information about any programmatic changes (i.e., programs being moved from one line item to another) in its estimates and include an explanation of the reasons for those changes and how those changes may affect year-to-year comparisons of the budget estimates.

Agency: Department of Defense: Department of the Air Force
Status: Open

Comments: DOD concurred with our recommendation. In the Fiscal Year 2019 Joint Report issued in November 2018, the Air Force identified some instances of programmatic changes in its estimates. However, not all programmatic changes were identified in the report. We will continue to monitor DOD's response to this recommendation as we review future annual joint budget estimate reports.

Recommendation: The Administrator of CMS should evaluate the possible costs and savings of using disposable devices that could potentially substitute for DME, including options for benefit categories and payment methodologies that could be used to cover these substitutes, and, if appropriate, seek legislative authority to cover these devices.

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

Comments: In March 2019, HHS included in its fiscal year 2020 budget a legislative proposal to extend Medicare coverage to disposable devices that could potentially substitute for DME in treating and managing diabetes. As of March 2020, CMS has not provided documentation of the evaluation of possible costs and savings that we recommended and that we believe underpins the legislative proposal. We will review this documentation once provided.

Recommendation: The Under Secretary of Defense for Acquisition, Technology and Logistics should identify the specific types of information that would best meet the department's needs and, based on that determination, collect and analyze relevant data after contract performance is sufficiently complete to determine the extent to which contracts with incentives achieved their desired outcomes.

Agency: Department of Defense: Office of the Secretary of Defense: Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics
Status: Open

Comments: DOD concurred with our recommendation and has taken steps to address it. For example, in April 2018, the department developed a template for the military departments to use to identify specific types of information to collect. Since then, each of the military departments has initiated or planned to initiate efforts to collect and analyze information about outcomes of incentive contracts. In addition, in July 2020 DOD provided examples of selected DOD, Army, and Navy incentive contracts documented in the template previously noted. The department did not provide additional information about the Air Force's efforts, or about how DOD is analyzing the information to determine whether incentives can achieve desired outcomes. GAO has ongoing work to review DOD's use of fixed-price type contracts--including fixed-price incentive contracts--for major DOD systems, which may provide additional insights related to this recommendation.

Recommendation: To better understand the available opportunities for collecting inmate health care utilization data, BOP should conduct a cost-effectiveness analysis of potential solutions, and take steps toward implementation of the most effective solution.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In 2018, BOP contracted with a management consulting firm to improve organizational alignment and strengthen data analytics capabilities. This firm is also examining data analytics solutions and by late March 2020 is expected to make recommendations to BOP to support a request for purchase (RFP) for the most cost-effective one. BOP anticipates the RFP will then follow within the subsequent three months. This contracting work is a positive step that should help BOP identify the most cost-effective solution to collect health care utilization data. BOP is still in the early stages of implementing this action, therefore it is too soon to assess whether its efforts will fully address GAO's recommendation. However, once these actions are completed, BOP could be better positioned to find a solution for collecting the needed data.

Recommendation: To better understand the available opportunities for controlling health care costs, BOP should implement its guidance to conduct "spend analyses" of BOP's health care spending, using data sources already available

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In 2018, BOP contracted with a management consulting firm to identify opportunities to improve organizational alignment and strengthen data analytics capabilities. As part of this effort, BOP also contracted with a health care finance expert, who began working with BOP Health Services Division in June 2019. The expert has met with subject matter experts across disciplines to identify reliable sources for medical cost data, including medical activities data, staffing data, and medical cost data to support conducting spend analyses. BOP expects this effort to be completed by late spring 2020. This contracting work is a positive step toward implementing BOP's spend analysis guidance; however, since BOP has not yet completed this effort, it is too soon to assess whether BOP's efforts will fully address GAO's recommendation. Once BOP has completed this effort, it could be better positioned to identify opportunities for controlling health care costs.

Recommendation: To determine the actual or likely effectiveness of its ongoing or planned health care cost control initiatives, BOP should evaluate the extent to which its initiatives achieve their cost control aim.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In 2018, BOP contracted with a management consulting firm to identify opportunities to improve organizational alignment and strengthen data analytics capabilities. As part of this effort, BOP also contracted with a health care finance expert, who began working with BOP Health Services Division in June 2019. BOP is working with this expert to validate existing financial data sources and apply a standardized cost accounting model to evaluate the cost effectiveness of key health care cost control initiatives. According to BOP, the model is being developed in phases with the initial phase expected to be completed by late March 2020. The second phase of the model is scheduled to launch in October 2020. This is a positive step that will better position BOP to evaluate its health care cost control initiations. Since BOP has not yet completed this effort, it is therefore too soon to assess whether its efforts will fully address GAO's recommendation. However, once BOP has completed this effort, it could help BOP evaluate the effectiveness of its health care cost control initiatives.

Recommendation: To enhance its strategic planning for and implementation of health care cost control efforts, BOP should incorporate elements of a sound planning approach and (1) establish a means of measuring progress toward and effectiveness of its activities for its current strategic objectives and goals related to controlling health care costs; and (2) identify the resources and investments necessary for implementation of its planned health care cost control initiatives.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: BOP agreed with GAO's June 2017 recommendation and has begun to take steps to address it. In October 2018, BOP initiated a contract with an external group of public administration experts to examine BOP's organizational structure and its lines of authority. The group completed its study and issued a report in October 2019, which included recommendations for BOP. According to BOP, the Health Services Division is in the process of creating a Strategic Plan Advisory Group, which will implement recommendations in the October 2019 report, and will establish a 2020-2025 Strategic Plan. The Strategic Plan Advisory Group will also evaluate metrics, including those related to financial performance that will, according to BOP, enable it to identify the resources and investments to help control health care costs. This action is a positive step that could help BOP enhance its strategic planning for and implementation of health care cost control efforts. However, BOP is in the early stages of implementing this recommendation; thus it is too soon to assess if BOP will find the most effective method for enhancing its strategic planning.

Recommendation: To improve the reliability and utility of its Federal Medical Center mission analyses, BOP should document the analyses and findings that underlie its recommendations.

Agency: Department of Justice: Bureau of Prisons
Status: Open

Comments: In June 2017, BOP agreed with GAO's recommendation. However, BOP decided to end the Federal Medical Center mission analyses process. Instead, in September 2018 BOP established a Medical Referral Center (MRC) Executive Advisory Board, made up of BOP's Health Services Division leadership and wardens from all seven MRCs. According to BOP, the Board plans to develop and implement dashboard metrics by the end of calendar year 2020 to monitor essential functions at the centers, which it hopes will improve management of the inmate health care system. In the meantime, BOP reports that the Board has already developed and implemented the MRC pipeline patient dashboard, which permits the MRC wardens to monitor incoming patients in advance of arrival and to maximize the best patient care and housing until treatment is complete. In addition, the Board has developed and implemented the Memory Disorder Unit at one if its MRCs. This resulted in BOP making more efficient use its inpatient beds, as inmates that were housed in community hospitals could return to a BOP inpatient setting. While these steps might not fulfill the recommendation as worded, they have already resulted in some improvements to the utility of the MRCs, and therefore the intent of the recommendation. We will continue to monitor progress on this effort to ensure BOP develops and implements the metrics as planned.

Recommendation: To minimize unnecessary overlap and duplication and more efficiently use DOD's U.S. distribution centers, the Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology, and Logistics (or the subsequent Under Secretary for Acquisition and Sustainment), in conjunction with the Director of DLA, and the Secretaries of the Army, the Air Force, and the Navy, to assess and direct the implementation of actions, as appropriate, that can be taken using existing authorities to close, realign, or dispose of existing infrastructure.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with the recommendation. DOD began reviewing its secondary item inventory warehousing in July 2017 to consolidate underused distribution centers. In February 2018, DOD officials stated that the department will conduct three site studies by fiscal year 2019 to assess the viability and any potential savings from consolidation at these locations. In April 2019, DOD officials stated that the site studies had been completed and they anticipate a final report in late May 2019.

Recommendation: The Secretary of Commerce should direct the NOAA Administrator to develop a strategy for expanding NOAA's use of the private sector in its hydrographic survey program, as required by law.

Agency: Department of Commerce
Status: Open

Comments: In September 2018, NOAA reported that it had awarded a contract to assess hydrographic surveying needs and had drafted a Memorandum of Agreement to improve coordination with the U.S. Geological Survey on data acquisition and management. NOAA also reported that it planned to identify surveying tasks that could be accomplished using the private sector, and would take steps to improve the funding transfer process so that it could take advantage of Federal Emergency Management Agency and National Transportation Safety Board funds available for certain types of private sector survey activities. NOAA officials stated these tasks would be completed and a final strategy on working with the private sector issued by December 30, 2020.

Recommendation: To improve insight into cost changes for individual ships in the Ford Class, the program office should prepare cost summary and funding summary sections for each individual ship in the class as part of the SAR for the overall Ford-Class program.

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: In its comments on our draft report DOD disagreed with our recommendation, stating that it currently provides progress reports to Congress on costs for CVN 78 and CVN 79. In July 2020, Navy officials stated that the department continues to disagree with this recommendation. We continue to maintain that Selected Acquisition Reports represent the primary statutorily required means for DOD to report on program status. Grouping average unit costs for all Ford-class ships obscures individual ship cost growth and does not provide Congress with an adequate level of insight to monitor this over $55 billion program. Our recommendation would ensure that Congress receives insight into the costs of each existing and planned Ford-class ship. To fully implement this recommendation, the report should include cost information on individual ships.

Recommendation: To ensure accountability for BIE school facility funds, the Secretary of the Interior should direct the Assistant Secretary--Indian Affairs to develop a comprehensive long-term capital asset plan to inform its allocation of school facility funds. Such a plan should include a prioritized list of school repair and maintenance projects with the greatest need for funding.

Agency: Department of the Interior
Status: Open

Comments: Interior agreed with this recommendation. In August 2017, Indian Affairs reported that its Office of Facilities, Property, and Safety Management was undergoing a reorganization to establish a work group focused on asset management and will continue to work with the Office of Management and Budget to develop a capital asset management plan. In October 2018, Indian Affairs provided a prioritized list of deferred maintenance projects for 2018 and documentation of its processes for prioritizing school deferred maintenance requirements and allocating one type of construction funding. They also provided a memorandum on facilities management communication and organizational roles and responsibilities and sample agendas and minutes from meetings regarding construction. Indian affairs did not provide a long term capital asset plan. We will continue to monitor Indian Affairs' efforts to implement this recommendation and await documentation on the actions it is taking to develop a capital asset plan. We will continue to monitor Indian Affairs' efforts to implement this recommendation and await documentation on the actions it is taking to develop a capital asset plan.

Recommendation: To ensure accountability for BIE school facility funds, the Secretary of the Interior should direct the Assistant Secretary--Indian Affairs to improve oversight and technical assistance to tribal organizations to enhance tribal capacity to manage major construction projects.

Agency: Department of the Interior
Status: Open

Comments: Interior agreed with this recommendation. In August 2017, Indian Affairs reported that its Division of Facilities Management and Construction will develop a project tracking and monitoring process for all projects above a certain monetary threshold. Additionally, Indian Affairs reported that this office will work with BIA and BIE officials to identify common challenges that tribes face in managing projects and provide appropriate technical assistance. In September 2018, Indian Affairs provided documentation of templates it had created for regional Indian Affairs officials to use in communicating with tribes and agendas for training presentations. Neither of these documents show any direct technical assistance to tribes or address oversight. We will continue to monitor Indian Affairs' efforts to implement this recommendation and await documentation on the actions it is taking to improve oversight and technical assistance to tribal organizations.

Recommendation: To ensure that IGCEs contain key information consistent with good cost estimating practices, the Secretaries of Education, Health and Human Services, Housing and Urban Development, and Labor should revise or clarify guidance to require that IGCEs document data sources, methodology, and assumptions, and take steps to help ensure that guidance is followed by, for example, providing training or issuing reminders to officials to include this information when developing IGCEs.

Agency: Department of Health and Human Services
Status: Open

Comments: HHS agreed with the recommendation and stated that it will revise guidance on independent government cost estimates. As of September 2020, despite numerous requests, we still have not received any information on steps HHS has taken to address this recommendation.

Recommendation: To ensure that IGCEs are optimized as a tool in the procurement planning process, the Secretaries of Defense, Education, Health and Human Services, Homeland Security, Housing and Urban Development, and Labor should take steps to ensure that, when appropriate, contracting staff document differences between IGCE and final contract award value in the contract file.

Agency: Department of Health and Human Services
Status: Open

Comments: HHS agreed with the recommendation and stated that it will revise guidance on independent government cost estimates. As of September 2020, despite numerous requests, we still have not received any information on steps HHS has taken to address this recommendation.

Recommendation: To improve the Department of Defense's ability to maintain its capability in the Asia-Pacific region, the Secretary of Defense should direct the appropriate entities to resolve selected identified capability deficiencies associated with the relocation in the movement of Marine Corps units by, for example, reconsidering when units should move to Guam to minimize leaving facilities vacant.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation and stated that the Marine Corps' plans for the movement of units from Okinawa to Guam has considered many factors, including, among others, the capabilities required to support Pacific Command and the logistical requirements associated with the movement of forces. In March 2020, DOD stated that the Marine Corps and Pacific Command have done extensive planning and analysis to determine how best to posture, move, and support distributed III Marine Expeditionary Force Marines. However, as of May 2020, DOD has not provided documentation of this analysis. When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Recommendation: To improve the Department of Defense's ability to maintain its capability in the Asia-Pacific region, the Secretary of Defense should direct the appropriate entities to resolve selected identified capability deficiencies associated with the relocation in training needs in Iwakuni, Hawaii, and CNMI by, for example, identifying other suitable training areas.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation and stated that it has already conducted an extensive analysis of training needs. As of May 2020, DOD has not provided documentation of actions the agency has taken in response to this recommendation. We continue to believe the recommendation is valid and will monitor DOD's efforts to address it.

Recommendation: To improve the Department of Defense's ability to maintain its capability in the Asia-Pacific region, the Secretary of Defense should direct the appropriate entities to resolve selected identified capability deficiencies associated with the relocation in reduction in runway length at the Futenma Replacement Facility by, for example, selecting other runways that would support mission requirements.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. As of March 2020, DOD had not identified any additional runways and stated that this is a Government of Japan responsibility. As of May 2020, DOD has not provided documentation of actions the agency has taken in response to this recommendation. We continue to believe the recommendation is valid and will monitor DOD's efforts to address it.

Recommendation: To improve the Department of Defense's ability to maintain its capability in the Asia-Pacific region, the Secretary of Defense should direct the appropriate entities to resolve selected identified capability deficiencies associated with the relocation in challenges in Australia regarding seasonal changes and biosecurity requirements that affect equipment downtime by, for example, deciding on a location for the wet season and identifying a solution for biosecurity requirements.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. As of March 2020, DOD stated that no new decisions have been made regarding the Australia rotation. As of May 2020, DOD has not provided documentation of actions the agency has taken in response to this recommendation. We continue to believe the recommendation is valid and will monitor DOD's efforts to address it.

Recommendation: To provide DOD with reliable information on potential sources of delays for the design and construction of infrastructure in Guam, the Secretary of Defense should direct the appropriate entities to update the Marine Corps' integrated master schedule for Guam so that it meets the comprehensive, well-constructed, and credible characteristics for a reliable schedule. For example, the update to the schedule should include resources for nonconstruction activities.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. In March 2020, DOD stated that the updated integrated master schedule for Guam conforms to the GAO Schedule Assessment Guide and accounts for the best practices of a reliable schedule. However, as of May 2020, we have not received an updated integrated master schedule that meets the criteria for a reliable schedule.

Recommendation: To provide DOD and Congress with more-reliable information to inform funding decisions associated with the relocation of Marines to Guam, the Secretary of Defense should direct the appropriate entities to revise the cost estimates for Guam to address all best practices established by GAO's cost estimating guide. Specifically, the revisions to the cost estimates should include: a unifying Work Breakdown Structure, risk and sensitivity analyses, and an independent cost estimate.

Agency: Department of Defense
Status: Open

Comments: DOD nonconcurred with this recommendation. In March 2020, DOD stated that the department does not accept the assertion that GAO's best practices for cost estimates are universally applicable to a wide range of activities that includes military construction, acquisition, or basing. As of May 2020, DOD has not provided documentation of actions the agency has taken in response to this recommendation. We continue to believe the recommendation is valid and will monitor DOD's efforts to address it.

Recommendation: To provide DOD and Congress with more-reliable information to inform funding decisions associated with the relocation of Marines to Hawaii and the establishment of a rotational presence in Australia, the Secretary of Defense should direct the appropriate entities to revise the DOD cost estimates for Hawaii to address all best practices for the comprehensive characteristic established by the GAO cost estimating guide, specifically to capture entire life-cycle costs and develop a Work Breakdown Structure.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. As of March 2020, DOD stated that it continues to update its cost estimates for the Hawaii program in line with GAO's cost estimating guide but did not agree that detailed cost estimates are required at this early planning stage to make decisions in the 2026 timeframe and beyond. As of May 2020, DOD has not provided documentation of actions the agency has taken in response to this recommendation. We continue to believe the recommendation is valid and will monitor DOD's efforts to address it.

Recommendation: To provide DOD and Congress with more-reliable information to inform funding decisions associated with the relocation of Marines to Hawaii and the establishment of a rotational presence in Australia, the Secretary of Defense should revise the DOD cost estimates for Australia to address all best practices for the comprehensive characteristic established by the GAO cost estimating guide, specifically to capture entire life-cycle costs and develop a Work Breakdown Structure.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. As of March 2020, DOD stated that it continues to update its cost estimates for the Australia program in line with GAO's cost estimating guide. However, DOD stated that since Australia will build or provide much of the infrastructure enhancements in support of the Marine Corps, cost estimates will not incorporate the construction costs. As of May 2020, DOD has not provided documentation of actions the agency has taken in response to this recommendation. We continue to believe the recommendation is valid and will monitor DOD's efforts to address it.

Recommendation: To improve consistency in CMS oversight of federal spending under section 1115 demonstrations, the Secretary of Health and Human Services should require the Administrator of CMS to develop and document standard operating procedures for monitoring spending under demonstrations that (1) require setting reporting requirements for states that provide CMS the data elements needed for CMS to assess compliance with demonstration spending limits; (2) require consistent enforcement of states' compliance with financial reporting requirements; and (3) require consistent tracking of the amount of unspent funds under demonstration spending limits.

Agency: Department of Health and Human Services
Status: Open

Comments: The Department of Health and Human Services (HHS) has taken steps to improve the consistency of oversight of federal spending under section 1115 demonstrations. In November 2018, HHS officials reported that they have developed draft guidance, including a standard reporting tool for states, to better ensure consistent reporting of the elements needed to assess compliance with demonstration spending limits and was in the process of testing the tool with two states. In addition, the agency is developing standard operating procedures for agency staff to require consistent tracking of unspent funds under the spending limit. As of November 2019, HHS has not provided any updates. GAO will continue to monitor HHS's actions and once procedures are in place, GAO will assess whether they address our recommendation.

Recommendation: To increase the likelihood that its IT investments develop reliable cost estimates, the Secretary of HUD should finalize, and ensure the implementation of, guidance that incorporates the best practices called for in the GAO Cost Estimating and Assessment Guide.

Agency: Department of Housing and Urban Development
Status: Open

Comments: In April 2017, HUD reported that the department concurred with the recommendation and noted that the Office of the Chief Information Officer (OCIO) intended to establish cost estimation guidance for IT projects within its IT Management Framework Guide, incorporating appropriate best practices from the GAO Cost Estimating and Assessment Guide. In March 2019, HUD reported that, with contractor assistance, the department had begun to develop a standard methodology for investment lifecycle cost estimation; however, the methodology had not been fully institutionalized across all investments, and a policy for cost estimation had not been developed. Lacking an updated IT Management Framework and cost estimation policy, OCIO took additional interim action in the most recent budget cycle to reduce cost estimation risk by having the Chief Technology Officer standardize the cost estimates for IT investments. HUD continues to take action intended to address this recommendation; however, OCIO has not yet finalized a cost estimation methodology or the associated policy for IT investments or established a timeframe for implementing cost estimation practices departmentwide.

Recommendation: To improve efforts to promote EHR use and electronic exchange of health information in post-acute care settings, the Secretary of Health and Human Services should direct CMS and ONC to comprehensively plan for how to achieve the department's goal related to the use of EHRs and electronic information exchange in post-acute care settings. This planning may include, for example, identifying specific actions related to post-acute care settings and identifying and considering external factors.

Agency: Department of Health and Human Services
Status: Open

Comments: HHS concurred with this recommendation. As of February 2020, HHS provided information describing actions it has taken to help increase the use of EHRs and electronic information exchange in post-acute care settings. These actions are important, but do not address the comprehensive planning that GAO recommended. To fully implement this recommendation, HHS should provide information to show comprehensive planning for how HHS's specific actions are expected to lead to achieving the goal of increasing the use of EHRs and electronic information exchange in post-acute settings.

Recommendation: To better enable DOD to provide congressional decision makers with complete and reliable information on the total anticipated costs for the JIAC consolidation efforts, the Office of the Assistant Secretary of Defense for Energy, Installations, and Environment's Basing Office--in coordination with the Office of the Assistant Secretary of the Air Force Installations, Environment and Energy-- should update future construction cost estimates for consolidating the JIAC at RAF Croughton using best practices for cost estimating as identified in the GAO Cost Estimating and Assessment Guide. Specifically, cost estimates for the JIAC consolidation should fully incorporate all four characteristics of a high-quality, reliable estimate.

Agency: Department of Defense: Office of the Secretary of Defense: Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics: Office of the Assistant Secretary of Defense for Energy, Installations, and Environment
Status: Open

Comments: In commenting on this report, DOD did not concur with our recommendation. DOD agreed that many components in the GAO Cost Estimating and Assessment Guide are broadly applicable in the decision process leading up to a military construction budget request. However, DOD further stated that once military construction funds are authorized and appropriated by Congress, the department transitions to a project management mode, and it would be a waste of resources to continue to generate cost estimates once they have transitioned to managing project execution using actual cost data. However, as we note in the report, DOD guidance for estimating construction costs, DOD's Unified Facilities Criteria 3-740-05, states that in the MILCON program, construction cost estimates are prepared throughout the planning, design, and construction phases of a construction project to account for the refinement of the project?s design and requirements. The final estimate should document the department?s assessment of the program's most probable cost and ensure that enough funds are available to execute it. As of October 2016, the military construction funds had not been authorized by Congress for the third phase of the JIAC construction project. According to DOD officials, construction is not scheduled to begin until fall of 2017, and the contract has not yet been awarded. Further, the GAO Cost Estimating and Assessment Guide states that regardless of whether changes to the program result from a major contract modification or an overtarget budget, the cost estimate should be regularly updated to reflect all changes. This is also a requirement outlined in OMB's Capital Programming Guide. The purpose of updating the cost estimate is to check its accuracy, defend the estimate over time, and archive cost and technical data for use in future estimates. After the internal agency and congressional budgets are prepared and submitted, it is imperative that cost estimators continue to monitor the program to determine whether the preliminary information and assumptions remain relevant and accurate. Keeping the estimate updated gives decision makers accurate information for assessing alternative decisions. Cost estimates must also be updated whenever requirements change, and the results should be reconciled and recorded against the old estimate baseline. Therefore, we continue to believe that DOD's implementation of our recommendation to update future JIAC cost estimates using the best practices identified in the GAO Cost Estimating and Assessment Guide would assist in ensuring that decision makers have complete and reliable information about costs associated with the JIAC consolidation and as the third phase of the JIAC project is authorized. Implementing our recommendation would also ensure that DOD develops a reliable historical record for the cost of the JIAC that can be used to estimate other similar projects in the future. As of June 2017, the agency had not taken any action to implement this recommendation. As of July 2018, a senior DOD official said that DOD is developing a new analysis of alternatives (AOA) for JIAC consolidation and will use, as appropriate, our AOA best practices. Those best practices include several focused on cost estimation. We have requested information on the extent to which the AOA team will use best practices for cost estimating to update the JIAC consolidation cost estimate. When we confirm what actions DOD has taken, we will provide updated information. As of September 2019, a senior DOD official said that DOD's prior non-concur with our recommendation is still valid for the reasons mentioned above.

Recommendation: To determine whether CSA interventions influence motor carrier safety performance, the Secretary of Transportation should direct the FMCSA Administrator to identify and implement, as appropriate, methods to evaluate the effectiveness of individual intervention types or common intervention patterns to obtain more complete, appropriate, and accurate information on the effectiveness of interventions in improving motor carrier safety performance. In identifying and implementing appropriate methods, FMCSA should incorporate accepted practices for designing program effectiveness evaluations, including practices that would enable FMCSA to more confidently attribute changes in carriers' safety behavior to CSA interventions.

Agency: Department of Transportation
Status: Open

Comments: FMCSA has reviewed the methodology for its effectiveness model and identified many of the same limitations GAO discussed in its report. FMCSA also identified several approaches to address these limitations, including modifying its model to measure individual intervention types. However, as of July 2020, FMCSA had not implemented any of its proposed approaches.

Recommendation: To enable FMCSA management to monitor the agency's progress in achieving its effectiveness and efficiency outcomes for CSA interventions and balance priorities, the Secretary of Transportation should direct the FMCSA Administrator to establish and use performance measures to regularly monitor progress toward both FMCSA's effectiveness outcome and its efficiency outcome.

Agency: Department of Transportation
Status: Open

Comments: The Federal Motor Carrier Safety Administration (FMCSA) plans to establish an inventory of effectiveness and efficiency measures and monitor performance on an ongoing basis. FMCSA is working to modify its model to measure the effectiveness of individual intervention types. However, as of July 2020, it had not implemented any of its proposed modifications.

Recommendation: As DOT, in response to the FAST Act, conducts additional evaluation and analysis of ECP brakes and updates the regulatory impact analysis, the Secretary of Transportation should direct FRA and PHMSA to create a plan to collect data from railroads' ongoing and future operational experiences using ECP brakes. The plan should include details on how the agency will work with railroads to collect this data, ensure that such data are reliable, and analyze these data to conduct a retrospective analysis of the ECP brakes requirement that could help inform any potential future actions regarding ECP brakes.

Agency: Department of Transportation
Status: Open

Comments: In December 2017, DOT announced that it would rescind the electronically-controlled pneumatic (ECP) brake rule because its updated Regulatory Impact Analysis estimated that the rule's costs would exceed its benefits. Subsequently, in September 2018, DOT rescinded the ECP brake rule. As a result, DOT confirmed with us in August 2019 that it does not intend to create a plan to collect data from railroads' use of ECP brakes.

Recommendation: As DOT, in response to the FAST Act, conducts additional evaluation and analysis of ECP brakes and updates the regulatory impact analysis, if, based on its updated analysis, DOT promulgates a new rule on the applicable ECP brake system requirements, the Secretary of Transportation should direct FRA and PHMSA to require that freight railroads, once they equip with ECP brakes in response to the requirement, collect and provide data to FRA on their ongoing operational experience with ECP brakes.

Agency: Department of Transportation
Status: Open

Comments: In December 2017, DOT announced that it would rescind the electronically-controlled pneumatic (ECP) brake rule because its updated Regulatory Impact Analysis estimated that the rule's costs would exceed its benefits. DOT subsequently rescinded the ECP brake rule in September 2018. As a result, this recommendation is currently no longer relevant and DOT confirmed with us in August 2019 that it does not plan to implement this regulation.

Recommendation: To fully assess the size and composition of the medical force, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to conduct a new analysis of the required number of active-duty and civilian medical personnel that mitigates known limitations.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. As of August 2020, DOD has not addressed this recommendation. In response to a provision in Senate Report 115-125, we assessed DOD's interim and final draft responses to a requirement in the National Defense Authorization Act (NDAA) for Fiscal Year 2017 to assess the required number of wartime medical and dental personnel. In our ensuing February 2019 report, we found that DOD had not determined the required size and composition of its operational medical and dental personnel who support the wartime mission or submitted a complete report to Congress. Specifically, leaders from the Office of the Secretary of Defense (OSD) disagreed with the military departments' initial estimates of required personnel that were developed to report to Congress. OSD officials cited concerns that the departments had not applied assumptions for operating jointly in a deployed environment and for leveraging efficiencies among personnel and units. We found that the military departments applied different planning assumptions in estimating required personnel, such as the definition of "operational" requirements. Further, although not required by the NDAA for Fiscal Year 2017, DOD's assessment did not include civilian medical personnel. Until DOD completes such an analysis, it cannot be assured that its medical force is appropriately sized.

Recommendation: To strengthen ongoing efforts to analyze the costs of medical force readiness and establish clinical currency standards, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to take steps to identify and mitigate limitations regarding the standard for maintaining providers' clinical skills, including improving the accuracy of information concerning providers' workload and conducting an analytically rigorous calculation of active-duty providers' time devoted to military-specific responsibilities.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. As of August 2020, DOD has taken steps to address this recommendation, but has not completed all necessary actions. In February 2019, we reported that DOD had begun work on a metric to assess the clinical readiness of providers, but noted that the department's methodology was limited. In particular, the methodology did not provide complete, accurate, and consistent data or fully demonstrate results. Further, although DOD provided documentation in February 2020 outlining the medical specialties to which its clinical readiness metric would apply, it has not fully budgeted for the cost of implementing the metric. DOD's July 2018 report in response to Section 703 of the National Defense Authorization Act for Fiscal Year 2017 notes steps taken to assess the accuracy of information concerning providers' workload, but does not address the time active-duty providers devote to military-specific responsibilities. Until DOD addresses these issues, its efforts to analyze the costs of medical force readiness and establish clinical currency standards will remain limited.

Recommendation: To help achieve DOD's goals for transferring health care into its own facilities and increasing the productivity of active-duty medical providers, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to develop a strategy for achieving these goals that reflects the leading practices of effective federal strategic planning.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. As of September 2020, DOD has not yet addressed this recommendation.

Recommendation: To strengthen ongoing efforts within DOD to address the Study's recommendations to use the provider model outputs to inform execution of health care delivery and to refine the model for future use, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to modify DOD's model to reflect the military service of the physicians and military treatment facilities included in the model.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. As of September 2020 DOD has not implemented this recommendation. In its July 2018 report in response to Section 703 of the National Defense Authorization Act for Fiscal Year 2017, DOD stated in response to this recommendation that facilities in several large Military Health System (MHS) markets are staffed in a multi-service manner. While this is an important point, it remains true that, as the report notes, DOD's model "assumed uniformed providers were interchangeable," and that such an approach does not reflect the single-service nature of most medical treatment facilities within the MHS. Until DOD's model reflects this, the results of its approach will continue to be limited.

Recommendation: To strengthen any future assessments of additional changes to DOD's network of military treatment facilities, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to describe steps taken to assess the reliability of data supporting the assessment, including, at a minimum, the sources of data, data limitations, and efforts to test data reliability.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. As of September 2020, DOD has taken steps to address this recommendation, but has not completed all necessary actions. In its July 2018 report in response to Section 703 of the National Defense Authorization Act for Fiscal Year 2017, DOD included the sources of its data and some data limitations, but not efforts to test data reliability. Until DOD fully incorporates assessments of data reliability into its analysis of future changes to the Military Health System, such as its implementation plan Section 703, it will continue to lack assurance that its approach is fully supported by reliable information.

Recommendation: To strengthen any future assessments of additional changes to DOD's network of military treatment facilities, the Secretary of Defense should direct the Assistant Secretary of Defense (Health Affairs) to include in any accompanying cost estimates an appropriate level of detail, all significant costs, and an assessment of the reliability of the data supporting the cost estimate.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. As of September 2020, DOD has not addressed this recommendation. As we reported in May 2020, DOD's plan to restructure MTFs in response to Section 703 of the National Defense Authorization Act for Fiscal Year 2017, DOD concluded that civilian health care was more cost-effective than care in its MTFs without considering other assumptions that could affect its conclusions. For example, DOD applied assumptions about the cost of military personnel salaries, MTF workloads, and reimbursement rates for TRICARE that likely underestimated the cost-effectiveness of MTFs. Until DOD's approach to assessing changes to its network of MTFs is accompanied by cost estimates with an appropriate level of detail, all significant costs, and an assessment of the reliability of the data supporting the cost estimate, its approach will remain limited.

Recommendation: To improve DOD's management and oversight of contingency construction in the CENTCOM area of responsibility and in other geographic combatant commands where applicable, and to improve DOD's awareness of how much O&M funding the department uses for construction projects to support contingency operations, the Secretary of Defense should direct the Secretaries of the military departments, in coordination with the Under Secretary of Defense (Comptroller), to track the universe and cost of ongoing and future contingency construction projects that are funded from O&M appropriations under section 2805 of Title 10, U.S. Code (unspecified minor military construction authority).

Agency: Department of Defense
Status: Open

Comments: DOD non concurred with this recommendation and, as of August 2020, has not altered its position or taken action to address the recommendation. According to DOD officials, the department does not have the data systems that can track and report projects executed using O&M appropriations and that doing so is not cost effective and would not improve decision making. However, we continue to believe DOD could adapt an existing system or mechanism for recording and capturing these data in an automated form. For example, as we noted in our report, we believe through appropriate modifications, the cost of contingency construction projects could be readily available in the Army's existing accounting and finance system. Further, we continue to believe that knowing the universe and cost of all O&M-funded construction projects supporting contingency operations is important for decision making.

Recommendation: To improve DOD's management and oversight of contingency construction in the CENTCOM area of responsibility and in other geographic combatant commands where applicable, and to improve DOD's ability to quickly fund contingency construction projects that are not ideally suited to the current standard Military Construction and Operation and Maintenance processes and time frames and reduce reliance on funding approaches that pose risks regarding the appropriate use of funding, negative operational impacts, and unnecessary duplication, DOD should evaluate and improve the use of existing processes and authorities to the extent possible; determine whether additional authorities are needed to support urgent construction needs; and revise existing departmental processes or seek additional authorities, as appropriate.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. In response to a GAO follow-up request in August 2020, DOD stated that it continues to review current processes and authorities annually and submits legislative proposals and changes policies when appropriate. For example, DOD is working to revise authorities and designations for construction agents in Joint Operational Areas executing contingency construction to improve flexibility and responsiveness. According to the department, this change will be effective once DOD Directive 4270.5, Military Construction is completed in the second quarter of fiscal year 2012. As DOD's process is continuous, there will be no end date for completion of all actions associated with this recommendation, according to a DOD official.

Recommendation: To improve DOD's management and oversight of contingency construction in the CENTCOM area of responsibility and in other geographic combatant commands where applicable, and to help ensure that DOD limits demands on available resources to those necessary to meet contingency construction project requirements and communicates those requirements effectively, the Secretary of Defense should, in coordination with the Secretary of the Army, direct the Army Corps of Engineers to develop a control activity for documenting level-of-construction determinations before the Army Corps of Engineers designs the projects and estimates their costs.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation stating that the appropriate level of construction is a function of required service life and mission requirements, both of which are determined by the facility user rather than the construction agent. The Department agreed that these parameters must be defined and documented during the facility planning process by the Component responsible for developing facility requirements, and then communicated to the appropriate construction agent (i.e. the Army Corps of Engineers, Naval Facilities Engineering Command, or the Air Force Civil Engineer Center). In response to a GAO follow-up request in August 2020, a DOD official stated that the department is revising DOD guidance to clarify that level-of-construction determinations are to be documented by construction agents once received from facility user. The revision will be included in an update of DOD Directive 4270.5, Military Construction, which is to be completed in the second quarter of fiscal year 2012. Once completed, this should address the intent and close out GAO's recommendation as implemented.

Recommendation: To improve DOD's management and oversight of contingency construction in the CENTCOM area of responsibility and in other geographic combatant commands where applicable, and to ensure that DOD avoids constructing facilities that may be unneeded to support U.S. forces and to comprehensively document the results of its reviews of ongoing construction projects when changes in mission requirements occur, the Secretary of Defense should, in coordination with the Chairman of the Joint Chiefs of Staff, direct the Secretaries of the military departments and the Commander of CENTCOM to develop implementing guidance for the review and verification of ongoing contingency construction projects when mission changes occur.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. In response to a GAO follow-up request in August 2020, a DOD official stated that the Department believes all combatant commanders involved in contingency operations should conduct periodic reviews of new or ongoing construction projects to ensure they still meet operational needs. As a result, the Secretary of Defense plans to, in coordination with the Chairman of the Joint Chiefs of Staff, direct the Secretaries of the military departments and the Combatant Commanders to develop guidance for the review and verification of ongoing contingency construction projects when mission changes occur. According to the DOD official, the Secretary of Defense plans to provide this direction in the pending update of DOD Directive 4270.5, Military Construction for application in Joint Operational Areas and contingency operations. The expected completion of this action is during the second quarter of fiscal year 2012, at which point the intent of GAO's recommendation will have been addressed.

Recommendation: To improve DOD's management and oversight of contingency construction in the CENTCOM area of responsibility and in other geographic combatant commands where applicable, and to improve the awareness of the combatant and service component commands' responsibilities to record and share lessons learned and to ensure that important contingency-construction-related lessons are recorded, the Secretary of Defense should, in coordination with the Chairman of the Joint Chiefs of Staff, direct the Commander of CENTCOM to revise Central Command Regulation 415-1 or issue other guidance as appropriate to specifically detail the role of the combatant command and service component commands in recording contingency construction lessons learned from the CENTCOM area of responsibility in the Joint Lessons Learned Information System.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. In August 2020, DOD stated that CENTCOM Regulation 525-4 chapter 10-3 establishes comprehensive reporting requirements for the Joint Lessons Learned program that encompass the contingency construction function. Further, while this information does not need to be repeated in CENTCOM regulation 415-1, DOD stated that the application of 525-4 to contingency construction would be reinforced by referencing it in 415-1. Accordingly, in February 2020, the Deputy Assistant Secretary of Defense-Facilities Management DOD issued a memo directing the Commander, USCENTCOM, to revise CENTCOM Regulation 415-1 accordingly. We will continue to monitor to evaluate whether the Commander, USCENTCOM completes this tasking and whether the resulting guidance addresses our recommendation.

Recommendation: In light of potential concerns regarding the appropriate use of funding raised by several of the examples identified in this report, the Secretary of Defense should direct the Secretaries of the Army and the Air Force to review these and, as appropriate, other construction projects in the contingency environment presenting similar circumstances to ensure that funds were properly used.

Agency: Department of Defense
Status: Open

Comments: DOD did not concur with this recommendation. At the time of our report, the department stated that the recommendation is redundant of current practice and referenced department processes to conduct periodic reviews to ensure compliance, among other processes, guidance, and training. In response to a GAO follow-up request in August 2020, DOD's position on the recommendation has not changed, However, as we noted in our report, our recommendation is not that DOD create new processes but instead that DOD use the periodic review processes it referenced to evaluate the examples in our report and ensure that funds were appropriately used. The examples in our report present instances where the department had developed multiple construction projects, each below the O&M maximum for unspecified minor military construction, to meet what may have been an overarching construction requirement. We noted a similar instance where the department had used its review process and found that an Antidefiency Act violation had occurred. In light of the concerns raised by the examples in our report, we continue to believe that DOD should use its existing processes to review the facts and circumstances presented by these examples and determine whether funds were appropriately used.

Recommendation: To improve the accessibility and reliability of SNF expenditure data, the Acting Administrator of CMS should take steps to improve the accessibility of SNF expenditure data, making it easier for public stakeholders to locate and use the data.

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

Comments: In September 2016, GAO recommended that CMS improve the accessibility and reliability of SNF expenditure data, thereby making it easier for public stakeholders to locate and use the data. The agency concurred with this recommendation in 2016 and stated that it would review the feasibility of increasing the accessibility of this data. However, in August 2017, HHS told GAO that it now believes that the cost of implementing this recommendation would outweigh its benefits. HHS confirmed in July 2019 that its position on this recommendation has not changed. GAO continues to hold that data on SNFs' relative expenditures should be readily accessible to the public to ensure transparency in SNF expenditures.

Recommendation: To improve the accessibility and reliability of SNF expenditure data, the Acting Administrator of CMS should take steps to ensure the accuracy and completeness of SNF expenditure data.

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

Comments: In September 2016, GAO recommended that CMS take steps to ensure the accuracy and completeness of SNF expenditure data. However, the agency did not concur with this recommendation. HHS reported in 2016 that the amount of time and resources to verify the accuracy and completeness of SNF expenditure data could be substantial, without assurance of benefit to the agency and the public. However, during the course of our work, GAO found that CMS uses this expenditure data to update overall SNF payment rates, in addition to more general purposes. GAO continues to believe that CMS should take steps to ensure reliable expenditure data are accurate and complete. As of July 2019, the agency continues to non-concur with this recommendation.

Recommendation: In the event that operational test results for PDB-8 and PDB-8.1 reveal performance shortfalls that require additional development of the near and mid-term upgrades tested, the Secretary of Defense should direct the Secretary of the Army to establish mechanisms for overseeing those upgrades commensurate with other major defense acquisition programs, to include an initial report--similar to a Selected Acquisition Report--as soon as practical following operational testing for both PDB-8 and PDB-8.1, on the near and mid-term upgrades evaluated during these tests, including: (1) cost, schedule, and performance estimates for any additional development that is needed; and (2) an estimate of the amount of development costs it has incurred since 2013 for near- and mid-term Patriot upgrades operationally tested along with PDB-8 and PDB-8.1.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. In 2017, operational testing for PDB-8 was completed and results show some performance shortfalls although DOD asserts that there is no additional development required. DOD plans to reassess the need for any additional action after operational testing for PDB-8.1 is completed as planned in the first quarter of fiscal year 2022.

Recommendation: In the event that operational test results for PDB-8 and PDB-8.1 reveal performance shortfalls that require additional development of the near and mid-term upgrades tested, the Secretary of Defense should direct the Secretary of the Army to establish mechanisms for overseeing those upgrades commensurate with other major defense acquisition programs, to include annual updates to Congress comparing the latest cost and schedule estimates against the initial estimates and providing explanations for any major deviations until development is complete.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. In 2017, operational testing for PDB-8 was completed and results show some performance shortfalls although DOD asserts that there is no additional development required. DOD plans to reassess the need for any additional action after operational testing for PDB-8.1 is completed as planned in the first quarter of fiscal year 2022.

Recommendation: To ensure that NNSA will provide clear information to stakeholders about the program needs that the revised CMRR project will satisfy, the Secretary should direct the Under Secretary for Nuclear Security, in his capacity as the NNSA Administrator, to update the program requirements document for the revised CMRR project to clarify whether the project will provide plutonium analysis equipment to meet the needs of DOE and NNSA programs other than those in the Office of Defense Programs.

Agency: Department of Energy
Status: Open

Comments: As of August 2020, LANL has drafted a revised PRD but NNSA's review is not yet complete. This recommendation will remain open until we can evaluate the PRD.

Recommendation: To provide the Congress and NASA a reliable estimate of program cost and schedule that are useful to support management and stakeholder decisions, the NASA Administrator should direct the Orion program to perform an updated JCL analysis including updating cost and schedule estimates in adherence with cost and schedule estimating best practices.

Agency: National Aeronautics and Space Administration
Status: Open
Priority recommendation

Comments: NASA partially agreed with this recommendation, stating that the agency reviewed, in detail, the Orion integrated cost/schedule and risk analysis methodology and determined the rigor to be a sufficient basis for the agency commitments. In November 2019, Orion program officials told us that in response to a recent policy change, the program office will update its joint confidence level analysis when the program has its Key Decision Point D review. This review occurs before the program enters the system assembly integration and test, and launch phase and is not scheduled to occur until December 2020. To fully implement this recommendation, NASA will need to provide evidence that it updated its joint confidence level analysis when the Orion program holds its Key Decision Point D review.

Recommendation: To determine the suitability of Medicare's Part B drug payment rate methodology for drugs with coupon programs, Congress should consider (1) granting CMS the authority to collect data from drug manufacturers on coupon discounts for Part B drugs paid based on ASP, and (2) requiring the agency to periodically collect these data and report on the implications that coupon programs may have for this methodology.

Agency: Congress
Status: Open

Comments: As of August 2020, Congress had not passed legislation to address this Matter for Congressional Consideration. We will update the status of this Matter if such action occurs.

Recommendation: To help the department achieve the benefits anticipated from JIE, the Secretary should direct the DOD CIO and other entities, as appropriate, to develop a reliable JIE cost estimate and baseline, consistent with the best practices described in this report.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation; however, it has not yet implemented it. In its written response to our draft report, DOD stated that its partial concurrence was due to the language we used to introduce the recommendations. Specifically, we stated that the Secretary of Defense should direct the appropriate entities to implement the recommendations. In its comments, DOD stated that the DOD Chief Information Officer (CIO) was responsible for implementing JIE, and referred to a May 2013 memo from the Deputy Secretary of Defense directing DOD components to participate in and implement JIE under the direction of the DOD CIO. In response to DOD's comments, we revised the language used to introduce our recommendations. Specifically, we revised the language to call for the Secretary to direct the DOD CIO and other entities, as appropriate, to take the recommended actions. Since we made our recommendation, the department approved a cost baseline for one of the components of JIE, the Joint Regional Security Stacks (JRSS), and developed a cost estimate for another component, the Enterprise Collaboration and Productivity Services (ECAPS) program. The ECAPS cost estimate was substantially consistent with the practices described in the report. However, the JRSS cost estimate was not developed consistent with the best practices described in the report. Specifically, the department did not demonstrate that the cost estimate was well documented, comprehensive, accurate, and credible. In May 2019, officials in the Office of the DOD CIO stated that it would provide documentation to address the gaps in the JRSS cost estimate; however, as of July 2019, DOD had not provided the documentation. The officials also stated that planning for JIE components other than JRSS and ECAPS had not begun; therefore, there were no other JIE component cost estimates. We will continue to monitor the department's efforts to implement this recommendation.

Recommendation: To help the department achieve the benefits anticipated from JIE, the Secretary should direct the DOD CIO and other entities, as appropriate, to develop a JIE schedule management plan and reliable schedule, consistent with practices described in this report.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation; however, it has not yet implemented it. In its written response to our draft report, DOD stated that its partial concurrence was due to the language we used to introduce the recommendations. Specifically, we stated that the Secretary of Defense should direct the appropriate entities to implement the recommendations. In its comments DOD stated that the DOD Chief Information Officer (CIO) is responsible for implementing JIE, and referred to a May 2013 memo from the Deputy Secretary of Defense directing DOD components to participate in and implement JIE under the direction of the DOD CIO. In response to DOD's comments we revised the language used to introduce our recommendations. Specifically, we revised the language to call for the Secretary to direct the DOD CIO and other entities, as appropriate, to take the recommended actions. In March 2017, the JIE Executive Committee approved a schedule baseline for the Non-secure Internet Protocol Router network part of the Joint Regional Security Stacks (JRSS) component; however, the schedule was not consistent with the practices described in our report. In addition, In May 2019, officials in the Office of the DOD CIO stated that another JIE initiative, the Enterprise Collaboration and Productivity Services program, had an approved baseline schedule. However, as of July 2019, DOD had not provided the schedule.

Recommendation: To help the department achieve the benefits anticipated from JIE, the Secretary should direct the DOD CIO and other entities, as appropriate, to develop a JRSS schedule management plan and reliable JRSS schedule and schedule baseline, consistent with practices described in this report.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation; however, it has not implemented it. In its written response to our draft report, DOD stated that its partial concurrence was due to the language we used to introduce the recommendations. Specifically, we stated that the Secretary of Defense should direct the appropriate entities to implement the recommendations. In its comments DOD stated that the DOD Chief Information Officer (CIO) is responsible for implementing JIE, and referred to a May 2013 memo from the Deputy Secretary of Defense directing DOD components to participate in and implement JIE under the direction of the DOD CIO. In response to DOD's comments we revised the language used to introduce our recommendations. Specifically, we revised the language to call for the Secretary to direct the DOD CIO and other entities, as appropriate, to take the recommended actions. In March 2017, the JIE Executive Committee approved a schedule baseline for the Non-secure Internet Protocol Router network component of JRSS; however, the schedule was not consistent with the practices described in our report. In May 2019, officials in the Office of the DOD CIO said that the JRSS schedule had not been re-baselined and the department had not developed a schedule management plan. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department achieve the benefits anticipated from JIE, the Secretary should direct the DOD CIO and other entities, as appropriate, to complete an assessment to determine the number of staff and the specific skills and abilities needed to effectively achieve JIE, consistent with the workforce planning practices described in this report.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and has taken steps to implement it; however, more needs to be done. In its written response to our draft report, DOD stated that its partial concurrence was due to the language we used to introduce the recommendations. Specifically, we stated that the Secretary of Defense should direct the appropriate entities to implement the recommendations. In its comments, DOD stated that the DOD Chief Information Officer (CIO) is responsible for implementing the Joint Information Environment (JIE), and referred to a May 2013 memo from the Deputy Secretary of Defense directing DOD components to participate in and implement JIE under the direction of the DOD CIO. In response to DOD's comments, we revised the language used to introduce our recommendations. Specifically, we revised the language to call for the Secretary to direct the DOD CIO and other entities, as appropriate, to take the recommended actions. Since we made our recommendation, the department has developed an inventory of cybersecurity knowledge and skills of existing staff. Specifically, we reported in our June 2018 report Cybersecurity Workforce: Agencies Need to Improve Baseline Assessments and Procedures for Coding Positions (GAO-18-466) that the department had developed an assessment that included the percentage of cybersecurity personnel holding certifications and the level of preparedness of personnel without existing credentials to take certification exams. In August 2018, the office of the DOD CIO stated that the department planned to identify work roles of critical need and establish gap assessment and mitigation strategies by April 2019. However, as of July 2019, the department had not provided an update on the status of its efforts to address the recommendation.

Recommendation: To help the department achieve the benefits anticipated from JIE, the Secretary should direct the DOD CIO and other entities, as appropriate, to develop a strategy for conducting JIE security assessments that describes the resources needed to execute the strategy, responsible organizations, and a schedule to complete the assessments.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation; however, as of August 2018, it has not provided evidence that it has addressed it. In its written response to our draft report, DOD stated that its partial concurrence was due to the language we used to introduce the recommendations. Specifically, we stated that the Secretary of Defense should direct the appropriate entities to implement the recommendations. In its comments, DOD stated that the DOD Chief Information Officer (CIO) is responsible for implementing the Joint Information Environment (JIE), and referred to a May 2013 memo from the Deputy Secretary of Defense directing DOD components to participate in and implement JIE under the direction of the DOD CIO. In response to DOD's comments, we revised the language used to introduce our recommendations. Specifically, we revised the language to call for the Secretary to direct the DOD CIO and other entities, as appropriate, to take the recommended actions. In May 2019, the office of the DOD CIO stated that it had developed a schedule to complete JIE security assessments. However, as of July 2019, the office had not provided the schedule or demonstrated that it has a strategy for conducting JIE security assessments that includes the rest of the elements of our recommendation.

Recommendation: To help the department achieve the benefits anticipated from JIE, the Secretary should direct the DOD CIO and other entities, as appropriate, to develop a reliable Joint Regional Security Stacks (JRSS) cost estimate and baseline, consistent with practices described in this report.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation; however it has not fully implemented it. In its written response to our draft report, DOD stated that its partial concurrence was due to the language we used to introduce the recommendations. Specifically, we stated that the Secretary of Defense should direct the appropriate entities to implement the recommendations. In its comments, DOD stated that the DOD Chief Information Officer (CIO) is responsible for implementing JIE, and referred to a May 2013 memo from the Deputy Secretary of Defense directing DOD components to participate in and implement JIE under the direction of the DOD CIO. In response to DOD's comments, we revised the language used to introduce our recommendations. Specifically, we revised the language to call for the Secretary to direct the DOD CIO and other entities, as appropriate, to take the recommended actions. Since we made our recommendation, in April 2017, the JRSS program office documented the methodology, ground rules and assumptions, among other things, used to develop the cost estimate we reviewed in our report, and the JIE Executive Committee established the estimate as its JRSS cost baseline. However, the cost estimate documentation was not sufficient to address our recommendation. Specifically, it did not demonstrate that the cost estimate was well documented, comprehensive, accurate and credible. In May 2019, officials in the Office of the DOD CIO stated that it would provide documentation to address the gaps. However, as of July 2019, DOD had not provided the documentation.

Recommendation: To ensure efficient use of federal resources, the Administrator of CMS should account for Medicaid payments a hospital has received that offset uncompensated care costs when determining hospital uncompensated care costs for the purposes of making Medicare UC payments to individual hospitals.

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

Comments: No executive action taken as of March 2020. CMS initially agreed with GAO's June 2016 recommendation. However, in October 2018, and again in December 2019 , CMS indicated that it was reconsidering whether to offset Medicare Uncompensated Care (UC) payments by Medicaid's uncompensated care payments. CMS stated that because Medicare UC payments are distributed based on hospitals' relative (not actual) uncompensated care costs, it would not be appropriate to account for Medicaid payments that reduce hospital uncompensated care. However, in some states Medicaid payments reduce or even eliminate hospital uncompensated care costs, which can result in an inequitable distribution of payments. Because the total amount of Medicare UC payments is capped, not accounting for Medicaid payments will result in hospitals that have little or no uncompensated care costs receiving a higher proportion of Medicare UC payments than warranted, resulting in in less funding for hospitals that actually have uncompensated care costs. Implementing GAO's recommendation would ensure that Medicare UC payments are based on accurate levels of uncompensated care costs and result in CMS better targeting billions of dollars in Medicare UC payments to hospitals that do have with the most uncompensated care costs, while avoiding making payments to hospitals with little or no uncompensated care costs.

Recommendation: To ensure Bureau and congressional confidence that the Bureau's budgeted contingencies are at appropriate levels, the Secretary of Commerce and Under Secretary for Economic Affairs should direct the Census Bureau to improve control over how risk and uncertainty are accounted for and communicated with the Bureau's decennial cost estimation process, such as by implementing and institutionalizing processes or methods for doing so with clear guidance.

Agency: Department of Commerce
Status: Open
Priority recommendation

Comments: Commerce agreed with this recommendation. Specifically, we reported that the Bureau should ensure that its budget for contingencies for the 2020 Census reflect an accurate accounting of risk and uncertainty. In doing this, the Bureau should improve controls over risk and uncertainty in the cost estimate process, and institutionalize these controls by providing clear methods for their use. In July 2018, we completed a review of documentation to support the updated October 2017 cost estimate and found that the Bureau performed uncertainty and sensitivity analysis on the estimate and appropriately added funding into the cost estimate to reflect inherent uncertainty and to account for specific risks. In order to fully implement this recommendation, the Bureau will need to link specific risks to funds set aside in the $1.2 billion general risk contingency fund. Therefore, as of January 2020, this recommendation remains valid and should be addressed: that the Bureau properly account for risk in the 2020 Census cost estimate.

Recommendation: To ensure that risks associated with ALIS are addressed expediently and holistically, the Secretary of Defense should direct the F-35 Program Executive Officer to improve the reliability of its cost estimates, conduct uncertainty and sensitivity analyses consistent with cost-estimating best practices identified in GAO's Cost Estimating and Assessment Guide.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. According to DOD officials, as of July 2018, this recommendation conflicts with established Office of the Under Secretary of Defense/Cost Estimation and Program Evaluation guidance for cost estimation and uncertainty analysis. Absent a change in policy at that level, the Joint Program Office will continue to follow Office of the Under Secretary of Defense/Cost Estimation and Program Evaluation policy on this issue. We continue to believe that in order for any risks associated with ALIS to be addressed expediently and holistically, uncertainty and sensitivity analysis must be used on the F-35s cost estimates to improve its overall reliability. Thus, this recommendation will remain open.

Recommendation: To ensure that risks associated with ALIS are addressed expediently and holistically, the Secretary of Defense should direct the F-35 Program Executive Officer to improve the reliability of its cost estimates, ensure that future estimates of ALIS costs use historical data as available and reflect significant program changes consistent with cost-estimating best practices identified in GAO's Cost Estimating and Assessment Guide.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. According to DOD officials, since April 2016, the F-35 program has continued to update the ALIS estimate with the latest available cost data, based on recent contracts. Until more reliable actual costs become available, the program utilizes negotiated contract costs, incorporates program initiatives, and ensures the estimate reflects the latest technical baseline and requirements. Until actual costs associated with ALIS historical data are incorporated in the F-35 cost estimate, we believe that the estimate will not be as reliable as it could be. For this reason, this recommendation will remain open.

Recommendation: To improve the use of warranties and guarantees in Navy shipbuilding, the Secretary of the Defense should direct the Secretary of the Navy, for future ship construction contracts, to determine whether or not a warranty as provided in the FAR, provides value and document the costs, benefits, and other factors used to make this decision. To inform this determination, the Navy should begin differentiating the government's and shipbuilder's responsibility for defects and track the costs to correct all defects after ship delivery.

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD partially concurred with this recommendation in February 2016 by committing to study policy changes with regard to warranties, but disagreed that additional cost data were needed to inform these decisions, and questioned whether warranties are suitable for ship acquisitions. In February 2017, a Navy-funded study found that the Navy had no policy to collect data, and that the little data available were not useful for determining when warranties are suitable. In response to the study, the Navy agreed that, by December 2017, it would make some policy and contractual changes to collect data, but it continued to maintain that warranties are likely not suitable for ship contracts. In January 2018, the Navy issued guidance to help contracting officers determine when and how to use a warranty or guarantee, but the Navy has collected only one warranty cost proposal from one shipbuilder for a contract for a single ship and, going forward, Navy officials stated that they do not have plans to systematically collect such data. In August 2019, we recommended in GAO-19-512 that the Navy collect warranty pricing on its new class of frigates, as the Navy initially did not include warranty pricing as part of its request for proposals for the ship class. However, as of August 2020, the Navy has not made meaningful efforts to gain pricing data for warranties and has stated that the department does not plan to take any further action. To fully implement this recommendation, the Navy needs to collect additional data in order to determine cases in which warranties could contribute to improvements in the cost and quality of Navy ships.

Recommendation: As part of its lease reform efforts and to increase possible cost savings, the GSA Administrator should seek to reduce leasing costs for federal agencies by allowing tenant agencies the option of choosing non-cancelable occupancy agreements with lower administrative costs, particularly for leases with firm terms of 5 years or less.

Agency: General Services Administration
Status: Open

Comments: In November 2018, GSA officials said that they were unlikely to implement this recommendation because it would shift costs from the tenants to GSA but not reduce overall costs. GAO continues to believe that reducing unnecessary costs to tenant agencies would reduce overall leasing costs by encouraging GSA to be more efficient.

Recommendation: To determine the extent to which Medicare payments are aligned with costs for specific types of dialysis treatment and training, the Administrator of CMS should take steps to improve the reliability of the cost report data for treatment and training associated with specific types of dialysis.

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

Comments: As of February 2020, CMS has not implemented this recommendation. HHS agreed with this recommendation and stated in February 2020 that CMS was exploring ways to clarify the cost report instructions in an effort to improve the accuracy of the information submitted. We will update the status of this recommendation when we receive additional information.

Recommendation: To ensure that patients with chronic kidney disease receive objective and timely education related to this condition, the Administrator of CMS should examine the Kidney Disease Education benefit and, if appropriate, seek legislation to revise the categories of providers and patients eligible for the benefit.

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

Comments: As of February 2020, CMS has not implemented this recommendation. HHS did not agree with this recommendation and stated in June 2016 that CMS continuously works to pay appropriately for ESRD services and must prioritize its activities to improve care for dialysis patients. While we acknowledge the need for CMS to prioritize its activities to improve dialysis care, it is important for CMS to help ensure that Medicare patients with chronic kidney disease understand their condition, how to manage it, and the implications of the various treatment options available, particularly given the central role of patient choice in dialysis care. The limited use of the Kidney Disease Education benefit that we noted in our report suggests that it may be difficult for Medicare patients to receive this education and underscores the need for CMS to examine and potentially revise the benefit. We will update the status of this recommendation when we receive additional information.

Recommendation: To improve the availability of information needed for effective and efficient management of the PCS program, including program costs and time-on-station requirements, the Secretary of Defense should direct the Under Secretary of Defense (Comptroller), in coordination with the military services, to improve the completeness and consistency of PCS data in service budget materials. This action should include revising existing guidance on the reporting of non-temporary storage costs, and clarifying existing guidance on the presentation of other PCS data.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. DOD formed a working group to address issues concerning the PCS program, including the Office of the Deputy Assistant Secretary of Defense (Military Personnel Policy) within the Office of the Assistant Secretary of Defense (Manpower and Reserve Affairs), and the Director, Military Personnel and Construction within the Office of the Deputy Comptroller (Program/Budget). As of September 2018 the working group has met multiple times, with its initial focus primarily on adjudication of major legislation associated with housing flexibility during PCS. In addition, the working group reported to Congress in June 2017 on military family stability and PCS, and sponsored a family stability review by RAND. However, as of September 2018 DOD stated that the Office of the Undersecretary of Defense (Comptroller) was continuing to coordinate with the military services to synchronize and clarify budgetary reporting requirements. As such, we believe that this recommendation remains open.

Recommendation: To improve the availability of information needed for effective and efficient management of the PCS program, including program costs and time-on-station requirements, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in coordination with the military services, to complete periodic evaluations of whether the PCS program is efficiently supporting DOD's requirements for assigning military personnel to new locations while reimbursing servicemembers for allowable expenses incurred during PCS moves. These periodic evaluations should identify changes in PCS per-move costs over time, factors driving such changes, and steps that could be taken to manage and control cost growth.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with this recommendation. DOD formed a working group to address issues concerning the PCS program, including the Office of the Deputy Assistant Secretary of Defense (Military Personnel Policy) within the Office of the Assistant Secretary of Defense (Manpower and Reserve Affairs), and the Director, Military Personnel and Construction within the Office of the Deputy Comptroller (Program/Budget). As of September 2018 the working group has met multiple times, with its initial focus primarily on adjudication of major legislation associated with housing flexibility during PCS. In addition, the working group reported to Congress in June 2017 on military family stability and PCS, and sponsored a family stability review by RAND. The working group has also reviewed PCS initiatives completed by the military services, and the timeliness of PCS orders. As of September 2018, a combatant commander review of overseas tour lengths and an initiative led by the Office of the Undersecretary of Defense (Comptroller) to review PCS data and costs are ongoing. DOD expects these initiatives, as well as additional efforts to collect and analyze PCS data, will continue into fiscal year 2019. While the initiatives DOD mentioned in its response demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: To improve the availability of information needed for effective and efficient management of the PCS program, including program costs and time-on-station requirements, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in coordination with the military services, to improve the completeness and consistency of data on exceptions used for PCS moves that occur prior to established time-on-station lengths. This action should include clarifying existing guidance with regard to how the services collect, maintain, and report data on exceptions for use in evaluating performance in meeting time-on-station requirements and addressing challenges related to the services' abilities to collect, maintain, and report exceptions data.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. DOD formed a working group to address issues concerning the PCS program, including the Office of the Deputy Assistant Secretary of Defense (Military Personnel Policy) within the Office of the Assistant Secretary of Defense (Manpower and Reserve Affairs), and the Director, Military Personnel and Construction within the Office of the Deputy Comptroller (Program/Budget). As of September 2018 the working group has met multiple times, with its initial focus primarily on adjudication of major legislation associated with housing flexibility during PCS. In addition, the working group reported to Congress in June 2017 on military family stability and PCS, and sponsored a family stability review by RAND. The working group has also reviewed PCS initiatives completed by the military services, and the timeliness of PCS orders. As of September 2018, a combatant commander review of overseas tour lengths and an initiative led by the Office of the Undersecretary of Defense (Comptroller) to review PCS data and costs are ongoing. DOD expects these initiatives, as well as additional efforts to collect and analyze PCS data, will continue into fiscal year 2019. While the initiatives DOD mentioned in its response demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: To improve the availability of information needed for effective and efficient management of the PCS program, including program costs and time-on-station requirements, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in coordination with the military services, to improve the completeness and consistency of data on waivers used for PCS moves that occur prior to established time-on-station lengths. This action should include establishing guidance for the military services to collect, maintain, and report data on waivers for use in evaluating performance in meeting time-on-station requirements and addressing challenges related to the services' abilities to collect, maintain, and report waiver data.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. DOD formed a working group to address issues concerning the PCS program, including the Office of the Deputy Assistant Secretary of Defense (Military Personnel Policy) within the Office of the Assistant Secretary of Defense (Manpower and Reserve Affairs), and the Director, Military Personnel and Construction within the Office of the Deputy Comptroller (Program/Budget). As of September 2018 the working group has met multiple times, with its initial focus primarily on adjudication of major legislation associated with housing flexibility during PCS. In addition, the working group reported to Congress in June 2017 on military family stability and PCS, and sponsored a family stability review by RAND. The working group has also reviewed PCS initiatives completed by the military services, and the timeliness of PCS orders. As of September 2018, a combatant commander review of overseas tour lengths and an initiative led by the Office of the Undersecretary of Defense (Comptroller) to review PCS data and costs are ongoing. DOD expects these initiatives, as well as additional efforts to collect and analyze PCS data, will continue into fiscal year 2019. While the initiatives DOD mentioned in its response demonstrate progress toward fully implementing our recommendation, we believe that this recommendation should remain open until more progress is made.

Recommendation: While recognizing that cargo preference serves policy goals established by Congress with respect to the U.S. merchant marine, including maintenance of a fleet capable of serving as a naval and military auxiliary in time of war or national emergency, Congress should consider clarifying cargo preference legislation regarding the definition of "geographic area" to ensure that agencies can fully utilize the flexibility Congress granted to them when it lowered the CPFA requirement.

Agency: Congress
Status: Open

Comments: GAO did not receive comments on the Matter for Congressional Consideration. As of July 2020, GAO found no evidence of legislation having been introduced to clarify the definition of "geographic area" with regard to cargo preference laws.

Recommendation: To balance combatant commanders' demands for forward presence with the Navy's needs to sustain a ready force over the long term and identify and mitigate risks consistent with Federal Standards for Internal Control, the Secretary of Defense should direct the Secretary of the Navy to, to fully implement its optimized fleet response plan, develop and implement a sustainable operational schedule for all ships homeported overseas.

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD concurred with this recommendation. In August 2015, the Navy reported that it had approved and implemented revised optimized fleet response plan schedules for all ships homeported overseas-six different operational schedules for various naval forces homeported in different overseas locations. We closed the recommendation as implemented in 2015. In 2017, the Navy suffered four significant mishaps at sea resulting in serious damage to its ships and the loss of 17 sailors. Three of the four ships involved were homeported in Japan. The resulting Navy investigations revealed that due to heavy operational demands, the Navy had not fully implemented the revised operational schedules it developed in 2015 for ships based in Japan. In light of this information, GAO re-opened this recommendation. As of February 2020, the Navy had developed a change to the operational schedule for ships homeported in Japan, but has not yet codified this change in Navy guidance. The Navy also established Commander, Naval Surface Group, Western Pacific (CNSGWP) to oversee surface ship maintenance, training, and certification for ships based in Japan. Due to continuing heavy operational demands, GAO will continue to monitor the Navy's adherence to the revised schedules before it closes this recommendation as implemented.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Commerce should ensure a reliable department-wide inventory of mobile service contracts is developed and maintained.

Agency: Department of Commerce
Status: Open

Comments: As of January 2020, the Department of Commerce had not implemented this recommendation. In July 2018, the department provided an inventory that shows, by service provider and department component, the number of devices per rate plan and monthly rate; however, the inventory did not include the number of voice minutes, gigabytes of data, and text messages allowed per line per month. Furthermore, the department had not demonstrated that it had accounted for all of its mobile service contracts. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Commerce should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: Department of Commerce
Status: Open

Comments: As of January 2020, the department had not addressed the recommendation. In July 2018, the department described steps it was taking to identify lines that were inactive for a period of three or more continuous months (zero usage). However, as of January 2020, the department had not demonstrated that it has established documented procedures that address the elements of our recommendation. We will continue to monitor the department's progress.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Defense should ensure an inventory of mobile devices and services is established department-wide (i.e., all components' devices and associated services are accounted for).

Agency: Department of Defense
Status: Open

Comments: The Department of Defense partially concurred with our recommendation; however, as of January 2020, the department had not implemented it. In response to our report, the department stated that it agreed that such an inventory has merits, but that maintaining one comes at considerable expense and effort. The department also stated, in 2016, that while it does not maintain a single, centralized device level inventory, the military departments track and manage their own devices and services . As we stated in our report, the inventory need not be generated centrally at the headquarters level; the department can compile a comprehensive inventory using its components' complete inventories. As of January 2020, the department had not demonstrated that all its components had inventories of unique devices and associated services. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Defense should ensure a reliable department-wide inventory of mobile service contracts is developed and maintained.

Agency: Department of Defense
Status: Open

Comments: The Department of Defense stated that it partially concurred with our recommendation; and has taken steps to address it. However, as of January 2020, the department had not demonstrated that it had implemented the recommendation. In response to our report, the department stated that it agreed that developing an inventory of mobile device contracts has merits, especially in a time of restricted government spending. The department also described several efforts it had undertaken to enhance mobile device management. However, as we stated in our report, any approach to managing mobile device contracts will be hampered by the lack of complete information on the contracts that are already in place. In August 2018, the department developed an inventory of mobile service contracts. However, the department had not demonstrated that the inventory included all its components' mobile service contracts. In August 2019, the department described steps it was taking to ensure that it has a complete inventory of mobile service contracts. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Health and Human Services should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: Department of Health and Human Services
Status: Open

Comments: As of December 2019, the Department of Health and Human Services had not implemented this recommendation. We will continue to monitor the department's implementation of this recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Homeland Security should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: Department of Homeland Security
Status: Open

Comments: In October 2019, the Department of Homeland Security developed an asset and inventory management plan for managing devices under its enterprise blanket purchase agreement. The plan includes procedures for assessing devices for zero usage; however, it does not include procedures for assessing over and under usage. The department also has not demonstrated that it has established procedures for devices not covered by its enterprise blanket purchase agreement.We will continue to monitor the department's efforts.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of the Interior should ensure an inventory of mobile devices and services is established department-wide (i.e., all components' devices and associated services are accounted for).

Agency: Department of the Interior
Status: Open

Comments: The Department of the Interior has not demonstrated that it has fully implemented this recommendation. As of January 2020, the department demonstrated that only one of its components, the Bureau of Reclamation, had an inventory of mobile devices and associated services. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of the Interior should ensure a reliable department-wide inventory of mobile service contracts is developed and maintained.

Agency: Department of the Interior
Status: Open

Comments: As of January 2020, the Department of the Interior had not demonstrated that it had fully addressed this recommendation. In August 2019, the department developed an inventory of mobile service contracts. However, the department did not demonstrate that it had accounted for all of its mobile service contracts. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Attorney General should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: Department of Justice
Status: Open

Comments: As of January 2020, the Department of Justice has made progress implementing this recommendation; however, more remains to be done. Specifically, in response to our findings, in April 2015, the department's Chief Information Officer issued a memo that required components to establish procedures for regular reviews of invoices for wireless services to identify unused and underused devices or services, as well as any over-usage charges to service plans. One of the components we reviewed, the Federal Bureau of Investigation, established procedures in July 2016 to monitor mobile device usage. In addition, the Justice Management Division (JMD) established procedures in May 2019 that apply to JMD as well some but not all other components. The other component we reviewed in our report, the Drug Enforcement Agency, had not established procedures that address our recommendation. We will continue to monitor the department's progress.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of State should ensure an inventory of mobile devices and services is established department-wide (i.e., all components' devices and associated services are accounted for).

Agency: Department of State
Status: Open

Comments: As of January 2020, the Department of State had not demonstrated that it has implemented this recommendation. The department has inventories of mobile device; however, the inventories do not include the services associated with each device. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of State should ensure a reliable department-wide inventory of mobile service contracts is maintained.

Agency: Department of State
Status: Open

Comments: As of January 2020, the Department of State had not implemented this recommendation. In June 2019, the department said it has a Telecom Expense Management System which can be used to document an inventory of domestic service contracts; however, the department did not provide the inventory. Furthermore, the department did not demonstrate that it has an inventory of international service contracts. We will continue to monitor the department's efforts to implement the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of Transportation should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: Department of Transportation
Status: Open

Comments: As of January 2020, the Department of Transportation had not addressed the recommendation. In December 2019, an official from the department's Audit Relations and Program Improvement office stated that all the department's telecommunication devices are managed through two programs and that these programs have mechanisms in place to ensure that telecommunications are managed in an effective and efficient manner. However, as of January 2020, the department had not provided evidence to demonstrate that it had implemented the recommendation. We will continue to monitor the department's efforts.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of the Treasury should ensure an inventory of mobile devices and services is established department-wide (i.e., all components' devices and associated services are accounted for).

Agency: Department of the Treasury
Status: Open

Comments: As of January 2020, the Department of the Treasury had not implemented the recommendation. In August 2019, the department stated that it had established enterprise-wide procurement vehicles for mobile devices. However, as of January 2020, the department had not demonstrated that it has an inventory of mobile devices and associated service information. We will continue to monitor the department's progress in implementing this recommendation.

Recommendation: To help the agency effectively manage spending on mobile devices and services, the Administrator of the National Aeronautics and Space Administration should ensure a complete inventory of mobile devices and associated services is established.

Agency: National Aeronautics and Space Administration
Status: Open

Comments: As of January 2020, the National Aeronautics and Space Administration (NASA) had not implemented the recommendation. We reported in May 2015, that NASA had an inventory of mobile devices and associated service information which included most, but not all, of the devices used by the agency. In November 2019, NASA's Office of the Chief Information Officer (OCIO) stated that the agency was in the process of enrolling devices in a new mobile device management tool, and that when the approximately 15 percent of devices that are not currently on NASA's new End-User Services Technology contract are brought on the contract, NASA will have a monthly deliverable depicting the services of all mobile devices. We will continue to monitor NASA's implementation of this recommendation.

Recommendation: To help the agency effectively manage spending on mobile devices and services, the Administrator of the National Aeronautics and Space Administration should ensure a reliable inventory of mobile service contracts is developed and maintained.

Agency: National Aeronautics and Space Administration
Status: Open

Comments: As of January 2020, the National Aeronautics and Space Administration (NASA) had not demonstrated that it has implemented the recommendation. NASA's Office of the Chief Information Officer (OCIO) stated that NASA had established, on September 1, 2019, the NASA End-User Services and Technology contract to procure mobile services, but as of November 2019, had not yet included 15 percent of its devices on the new contract. We will continue to monitor NASA's efforts to develop and maintain a mobile services contract inventory as described in our report.

Recommendation: To help the agency effectively manage spending on mobile devices and services, the Administrator of the National Aeronautics and Space Administration should ensure procedures to monitor and control spending are established agency-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: National Aeronautics and Space Administration
Status: Open

Comments: As of January 2020, the National Aeronautics and Space Administration (NASA) had not demonstrated that it had implemented the recommendation. In November 2019, NASA's Office of the Chief Information Officer (OCIO) stated that as part of enterprise mobility service contract deliverables, NASA requires monthly reports to monitor and optimize usage (zero, under, and over). NASA's OCIO also stated that the agency established role-based privileges to monitor and report on this activity agency-wide. However, the agency has not demonstrated that it has established procedures to assess device usage in accordance with our recommendation. We will continue to monitor NASA's implementation of the recommendation.

Recommendation: To help the department effectively manage spending on mobile devices and services, the Secretary of the Treasury should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.

Agency: Department of the Treasury
Status: Open

Comments: As of January 2020, the Department of the Treasury had not demonstrated that it has implemented the recommendation. In August 2019, an official from the department's Office of the Chief Information Officer stated that the department was collecting and analyzing information on voice and data utilization. However, as of January 2020, the department had not demonstrated that it had established procedures in accordance with our recommendation. We will continue to monitor the department's progress in implementing this recommendation.

Recommendation: To improve performance management of the Telecommunications Relay Service, following the establishment of TRS's performance goals, the Chairman of the Federal Communications Commission should conduct a robust risk assessment that can help FCC design a comprehensive internal-control system.

Agency: Federal Communications Commission
Status: Open

Comments: FCC indicated that a draft document was under review to implement this recommendation and would be approved before the end of FY-19. However, in September 2019, when we asked FCC for an update, we did not receive one. We will continue to communicate with FCC about the status of this recommendation.

Recommendation: If Congress wishes to evaluate the effectiveness of the ITC and the PTC as incentives for the development of renewable utility-scale electricity generation projects as it considers proposals to extend the ITC or reauthorize the PTC, it should consider directing the Commissioner of Internal Revenue to provide Congress with project-level data currently collected from taxpayers who claim the ITC in lieu of the PTC--such as the number of projects for which they are claiming the credit, the technology of the projects taking the credit, and the total generating capacity added--and make such data available for analysis. Additionally, take steps to collect and report the same data from all taxpayers claiming the ITC.

Agency: Congress
Status: Open

Comments: Congress has not taken action on this matter as of June 11, 2020.

Recommendation: If Congress wishes to evaluate the effectiveness of the ITC and the PTC as incentives for the development of renewable utility-scale electricity generation projects as it considers proposals to extend the ITC or reauthorize the PTC, it should consider directing the Commissioner of Internal Revenue to take steps to collect project-level data from taxpayers claiming the PTC--such as the number of projects for which they are claiming the credit, the technology of the projects taking the credit, and the total generating capacity--and make these data available for analysis.

Agency: Congress
Status: Open

Comments: Congress has not taken action on this matter as of June 11, 2020.

Recommendation: To improve CMS's oversight of Medicaid payments, the Administrator of CMS should take steps to ensure that states report accurate provider-specific payment data that include accurate unique national provider identifiers (NPI).

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

Comments: In November 2019, CMS issued a proposed rule that the agency said would promote state accountability, improve federal oversight, and strengthen the fiscal integrity of the Medicaid program. Among other things, the proposed rule would require states to report supplemental payments made to individual providers; furthermore, it would require states to include the National Provider Identifier (NPI) number-a unique 10-digit identification number assigned to health care providers. GAO will continue to monitor the status of the proposed rule and will review a final rule, if one is issued, to determine the extent it addresses the recommendation.

Recommendation: To improve CMS's oversight of Medicaid payments, the Administrator of CMS should develop a policy establishing criteria for when such payments at the provider level are economical and efficient.

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

Comments: In November 2019, CMS issued a proposed rule that the agency said would require states to demonstrate to CMS that supplemental payments to individual providers are economical and efficient and also require states to end and then seek CMS approval to renew supplemental payments every three years. GAO will monitor the status of the proposed rule and will review a final rule, if one is issued, to determine the extent to which it addresses the recommendation.

Recommendation: To improve CMS's oversight of Medicaid payments, the Administrator of CMS should, once criteria are developed, develop a process for identifying and reviewing payments to individual providers in order to determine whether they are economical and efficient.

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

Comments: In November 2019, CMS issued a proposed rule that the agency said would require states to demonstrate to CMS that supplemental payments to individual providers are economical and efficient and also require states to end and then seek CMS approval to renew supplemental payments every three years. GAO will monitor the status of the proposed rule and will review a final rule, if one is issued, to determine the extent to which it addresses the recommendation.

Recommendation: To improve DOD's ability to collect and maintain reliable data on its acquisitions, the Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology, and Logistics, in consultation with DOD components, to establish guidelines on what constitutes a "current" ACAT II or III program for reporting purposes; the types of programs, if any, that do not require ACAT designations; and whether the rules for identifying current MDAPs would be appropriate for ACAT II and III programs.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and stated that it planned to review existing policy to see if revisions were needed. Since that time, DOD has taken some steps to implement this recommendation, but has not established department-wide guidelines as we recommended. Starting in September 2018, DOD began providing the military departments with a capability to identify ACAT II and III programs using the Defense Acquisition Visibility Environment (DAVE) system. The DAVE system is now considered to be a trusted source for ACAT II and III program data. DOD, in consultation with the military departments, established standard data elements for collection across ACAT II and III programs for inclusion in DAVE, but the military departments determine individually what constitutes a "current" program and the types of programs that do not require ACAT designations. As of August 2019, the Army and Navy have established guidance regarding what constitutes an active ACAT II or III program for reporting purposes. We have requested an update on DOD's recent actions to address this recommendation, but have not received information as of September 2020. We will continue to monitor DOD's progress in implementing this recommendation.

Recommendation: To improve DOD's ability to collect and maintain reliable data on its acquisitions, the Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology, and Logistics, in consultation with DOD components, to determine what metrics should be used and what data should be collected on ACAT II and III programs to measure cost and schedule performance; and whether the use of DAMIR and the MDAP selected acquisition report format may be appropriate for collecting data on ACAT II and III programs.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and stated that it planned to review existing policy to see if revisions were needed. DOD has taken steps to implement this recommendation, but has yet to determine at the department level what metrics should be collected on ACAT II and III cost and schedule performance as we recommended. DOD determined that the use of the Defense Acquisition Visibility Environment (DAVE) system, which is closely related to DAMIR, was appropriate to collect information on ACAT II and III programs and has made that system available to the military departments. Specifically, DOD provided the military departments with the capability to identify ACAT II and III programs in DAVE/DAMIR in September 2018 and made the DAVE/DAMIR Acquisition Program Baseline (APB) workflow tool for cost and schedule data collection available for components' use in April 2019. However, according to officials from the Office of the Under Secretary of Defense for Acquisition and Sustainment, the military departments are responsible for individually determining what cost and schedule metrics to collect and monitor for ACAT II and III programs. According to December 2018 Army guidance, the Army will require all ACAT II and III programs use DOD's APB tool by the end of fiscal year 2019 to capture baseline cost, schedule, and performance parameters for ACAT II and III programs. According to Navy officials, the Navy is developing an APB tool in its for a future update of its acquisition information system that will collect APB cost and schedule information for ACAT II and III programs. We have requested an update on DOD's recent actions to address this recommendation, but have not received information as of September 2020. We will continue to monitor DOD's progress in implementing this recommendation.

Recommendation: To improve DOD's ability to collect and maintain reliable data on its acquisitions, the Secretary of Defense should direct the Secretaries of the Air Force, Army, and Navy and the Commander of SOCOM to assess the reliability of data collected on ACAT II and III programs and work with PEOs to develop a strategy to improve procedures for the entry and maintenance of data.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and stated that it would direct DOD components to evaluate data on ACAT II and III programs and report back on the reliability of the data and plans to improve it. In September 2015, the Assistant Secretary of Defense directed the military departments and DOD components to assess the reliability of ACAT II and III data, but in July 2018, the Office of the Under Secretary of Defense for Acquisition & Sustainment confirmed that based on the results of the assessments reported by the components, it does not plan to take any additional action to implement this recommendation. Since that time, as of September 2018, DOD began providing standard data elements and definitions of those elements that it collects for ACAT II and III program identification in order to improve the consistency of data. However, officials from the Office of the Under Secretary of Defense for Acquisition and Sustainment stated that it is still up to the military departments to ensure the accuracy of data entered. We have requested an update on DOD's recent actions to address this recommendation, but have not received information as of September 2020. We will continue to monitor DOD's progress in implementing this recommendation.

Recommendation: To improve DOD's ability to collect and maintain reliable data on its acquisitions, the Secretary of Defense should direct the Secretaries of the Air Force, Army, and Navy and the Commander of SOCOM to develop implementation plans to coordinate and execute component initiatives to improve data on ACAT II and III programs.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and stated that it would direct DOD components to evaluate data on ACAT II and III programs and report back plans to improve it. In September 2015, the Office of the Assistant Secretary of Defense for Acquisition requested that DOD components provide an update on their plans to improve the availability and quality of ACAT II and III data. In July 2018, the Office of the Under Secretary of Defense for Acquisition & Sustainment confirmed that based on an assessment of the information reported by the components, it does not plan to take any additional action to implement this recommendation. Officials from the Office of the Under Secretary of Defense for Acquisition & Sustainment reiterated in August 2019 that while DOD now provides a department-wide system to be used for collecting basic program data for ACAT II and III programs, it remains the responsibility of the military departments to enter complete and accurate data. We have requested an update on DOD's recent actions to address this recommendation, but have not received information as of September 2020. We will continue to monitor DOD's progress in implementing this recommendation.

Recommendation: To help ensure compliance with relevant provisions of DOD acquisition policy with the purpose of improving DOD's ability to provide oversight for ACAT II and III programs, including those programs that may become MDAPs, the Secretary of Defense should direct the Secretary of the Air Force and Commander of SOCOM to establish a mechanism to ensure compliance with APB requirements in DOD policy.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and stated that the Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics would issue guidance to DOD components related to APB requirements for ACAT II and III programs. DOD has taken some steps related to this recommendation. In September 2015, the Office of the Assistant Secretary of Defense for Acquisition requested that DOD components review their mechanisms for establishing and enforcing the APB requirements for all ACAT II and III programs. In July 2018, the Office of the Under Secretary of Defense for Acquisition & Sustainment confirmed that, based on the results of these reviews, it does not plans to take any action to implement this recommendation. However, in 2019, DOD made its DAVE/DAMIR APB workflow tool available for military department use, and the Air Force elected to use the tool to create and track APBs for ACAT II and III programs. We have requested an update on DOD's recent actions to address this recommendation, but have not received information as of September 2020. We will continue to monitor DOD's progress in implementing this recommendation.

Recommendation: To help ensure compliance with relevant provisions of DOD acquisition policy with the purpose of improving DOD's ability to provide oversight for ACAT II and III programs, including those programs that may become MDAPs, the Secretary of Defense should direct the Secretaries of the Air Force, Army, and Navy to improve component procedures for notifying the Defense Acquisition Executive of programs with a cost estimate within 10 percent of ACAT I cost thresholds.

Agency: Department of Defense
Status: Open

Comments: DOD partially concurred with our recommendation and stated that the Office of the Under Secretary of Defense for Acquisition, Technology, and Logistics would issue guidance to DOD components related to notification requirements for programs approaching ACAT I cost thresholds. The Army and Navy have reiterated existing guidance and the Air Force is evaluating additional actions it might take to improve its notification procedures. The Office of the Under Secretary of Defense for Acquisition & Sustainment confirmed in July 2018 that it does not plan to take additional actions to implement this recommendation, and as of August 2019, that office has not directed DOD components to improve their processes as we recommended .We have requested an update on DOD's recent actions to address this recommendation, but have not received information as of September 2020. We will continue to monitor DOD's progress in implementing this recommendation.

Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Acquisition, Technology, and Logistics to require MAIS programs to establish their first acquisition program baseline within 2 years of beginning work on the programs.

Agency: Department of Defense
Status: Open

Comments: As of January 2020, DOD had made limited progress addressing our recommendation for business system programs; however, it had not addressed the recommendation for non-business system programs. Specifically, the department updated its instruction on business systems requirements and acquisition to include, among other things, guidance on establishing baselines against which to measure progress for developing needed business capability. However, the instruction did not explicitly require that a program baseline be established within 2 years. Specifically, according to the instruction, baselines may be established at the program level or at the release level (i.e., for a manageable subset of functionality in support of the business capability), within 2 years after programs have validated a business capability is needed and received approval to conduct solution analysis. If at the program level, the baseline is to be set prior to the development of the first release or deployment. If at the release level, the baseline is to be set prior to the development of each release or deployment. In January 2020, the department also issued interim policy for software-intensive systems. However, while the interim policy requires program managers to develop an acquisition strategy that includes delivering software within one year from the date funds are first obligated to acquire or develop new software capability, the interim policy does not require software-intensive system programs to establish a program baseline within 2 years.

Recommendation: To improve the reliability and reporting of investment performance information and management of selected major investments, the Commissioner of the IRS should direct the Chief Technology Officer to modify reporting of the Affordable Care Act Administration testing status to senior management to include a comprehensive report on all impacted systems--including an explanation for why impacted systems were not tested at a particular level--and ensure this reporting is aligned with the manner in which testing is being performed.

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

Comments: IRS disagreed with this recommendation at the time we made it stating that it followed a rigorous risk-based process for planning the tests of ACA-impacted systems, including the types and levels of testing, and that it had comprehensive reporting for the filing season 2015 release, which included ACA impacted systems. However, as noted in our report, our review of ACA Testing Review Checkpoint reports and filing season reports, which officials stated were used to provide comprehensive reports to senior managers, did not identify the status of testing for all systems impacted by ACA Releases 5.0 and 6.0. In September 2017, IRS finished developing ACA and the investment transitioned to the operations and maintenance phase. We followed up with IRS to determine the extent to which it might be implementing the recommendation in light of this transition. In response, in June and December 2019 , IRS provided some documentation, including systems acceptance test plans and end-of-test results reports for ACA releases completed since September 2017. We reviewed the documentation provided and determined that it did not provide a status of testing for all systems impacted as we recommended. As of September 2020, we were following up with IRS to determine if the agency has other documentation provided to senior managers that addresses our recommendation.

Recommendation: To help the Department of Health and Human Services better control spending and encourage efficient delivery of care, Congress should consider requiring Medicare to pay PCHs as it pays PPS teaching hospitals, or provide the Secretary with the authority to otherwise modify how Medicare pays PCHs. To generate cost savings from any reduction in outpatient payments to PCHs, Congress should also provide that all forgone outpatient payment adjustment amounts be returned to the Supplementary Medical Insurance Trust Fund.

Agency: Congress
Status: Open

Comments: As of March 2020, no legislative action had been identified that changes how PCHs are paid for inpatient services, as GAO suggested in February 2015. The 21st Century Cures Act-Pub. L. No. 114-255, ?16002, 130 Stat. 1033, 1325 (2016), enacted in December 2016-slightly reduces the additional payments to PCHs for outpatient services furnished on or after January 1, 2018, and returns savings to the Supplementary Medical Insurance Trust Fund. However, the law does not substantively change how PCHs are paid for outpatient services, which differs from how Medicare pays PPS teaching hospitals. Until Medicare pays these cancer hospitals in a way that encourages greater efficiency, Medicare remains at risk for overspending.

Recommendation: To better inform Congress in the future about crop insurance program costs, reduce present costs, and ensure greater actuarial soundness, the Administrator of the U.S. Department of Agriculture's Risk Management Agency should monitor and report on crop insurance costs in areas that have higher crop production risks.

Agency: Department of Agriculture: Risk Management Agency
Status: Open

Comments: As of May 2020, the Department of Agriculture has not taken action to implement this recommendation.

Recommendation: To better inform Congress in the future about crop insurance program costs, reduce present costs, and ensure greater actuarial soundness, the Administrator of the U.S. Department of Agriculture's Risk Management Agency should, as appropriate, increase its adjustments of premium rates in areas with higher crop production risks by as much as the full 20 percent annually that is allowed by law.

Agency: Department of Agriculture: Risk Management Agency
Status: Open

Comments: As of May 2020, the Department of Agriculture has not taken action to implement this recommendation.

Recommendation: To improve the reliability of its cost estimates, as NRC revises its cost estimating procedures, the NRC Chairman should ensure that the agency aligns the procedures with relevant cost estimating best practices identified in the GAO Cost Estimating and Assessment Guide and ensure that future cost estimates are prepared in accordance with relevant cost estimating best practices.

Agency: Nuclear Regulatory Commission
Status: Open
Priority recommendation

Comments: In August 2019, NRC staff reported that the Commission had directed them to revise the guidance and resubmit it to the Commission by January 2020. In February 2020, the NRC staff submitted the revised guidance to the Commission. NRC staff said that following Commission review and approval, they will publish the guidance. We will review the cost-benefit guidance when it is released and determine if it responds to this recommendation.

Recommendation: To improve the management of DHS FOIA requests, the Secretary of DHS should direct the Chief FOIA Officer to improve reporting of FOIA costs by including salaries, employee benefits, non-personnel direct costs, indirect costs, and costs for other offices.

Agency: Department of Homeland Security
Status: Open

Comments: As of August 2020, we have followed up with the department to request documentation but have not yet received evidence of DHS's planned actions to address this recommendation.

Recommendation: To improve the management of DHS FOIA requests, the Secretary of DHS should direct the Chief FOIA Officer to direct USCIS and Coast Guard to fully implement the recommended FOIA processing system capabilities and the section 508 requirement.

Agency: Department of Homeland Security
Status: Open

Comments: As of August 2020, we have followed up with the department to request documentation but have not yet received evidence of DHS's planned actions to address this recommendation.

Recommendation: To improve the management of DHS FOIA requests, the Secretary of DHS should direct the Chief FOIA Officer to determine the viability of re-establishing the service-level agreement between the U.S. Citizenship and Immigration Services (USCIS) and U.S. Immigration and Customs Enforcement to eliminate duplication in the processing of immigration files. If the benefits of doing so would exceed the costs, re-establish the agreement.

Agency: Department of Homeland Security
Status: Open

Comments: As of August 2020, we have followed up with the department to request documentation but have not yet received evidence of DHS's planned actions to address this recommendation.

Recommendation: To improve consumers' access to relevant and understandable information on the cost and quality of health care services, the Secretary of HHS should direct the Administrator of CMS to include in the CMS Compare websites, to the extent feasible, estimated out-of-pocket costs for Medicare beneficiaries for common treatments that can be planned in advance.

Agency: Department of Health and Human Services
Status: Open

Comments: As of September 2019, HHS officials have not informed us of any actions taken to implement this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: To improve consumers' access to relevant and understandable information on the cost and quality of health care services, the Secretary of HHS should direct the Administrator of CMS to organize cost and quality information in the CMS Compare websites to facilitate consumer identification of the highest-performing providers, such as by listing providers in order based on their performance.

Agency: Department of Health and Human Services
Status: Open

Comments: As of September 2019, HHS officials have not informed us of any actions taken to implement this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: To improve consumers' access to relevant and understandable information on the cost and quality of health care services, the Secretary of HHS should direct the Administrator of CMS to include in the CMS Compare websites the capability for consumers to customize the information presented, to better focus on information relevant to them.

Agency: Department of Health and Human Services
Status: Open

Comments: As of September 2019, HHS officials have not informed us of any actions taken to implement this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: To improve consumers' access to relevant and understandable information on the cost and quality of health care services, the Secretary of HHS should direct the Administrator of CMS to develop specific procedures and performance metrics to ensure that CMS's efforts to promote the development and use of its own and others' transparency tools adequately address the needs of consumers.

Agency: Department of Health and Human Services
Status: Open

Comments: As of September 2019, HHS officials have not informed us of any actions taken to implement this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: To help ensure that agencies report comparable and reliable data to Enterprise Human Resources Integration (EHRI), the Director of OPM, in coordination with agencies and payroll service providers, should develop guidance for agencies on which activities to enter, or not enter, as paid administrative leave in agency time and attendance systems.

Agency: Office of Personnel Management
Status: Open

Comments: To address agency use of paid administrative leave that may exceed reasonable amounts as well as discrepancies in recording and reporting paid administrative leave, in December 2016, Congress passed the "Administrative Leave Act of 2016." The act mandates new categories of paid leave, including "investigative leave," "notice leave," and "weather and safety leave" and sets limitations on the duration of paid administrative leave as well as the new categories of investigative and notice leave. The Act also requires OPM to establish regulations on (1) when to grant administrative leave and the other new categories of paid leave, and (2) the proper recording and reporting of these types of paid leave. In July 2017, OPM proposed new rules to regulate paid administrative leave, but has not finalized all these rules. In April 2018, OPM issued final regulations for "weather and safety leave" and announced that it would issue separate final regulations for "administrative leave," "investigative leave," and "notice leave" at a later date. In July 2019, OPM officials told us that they have not finalized the remaining regulations due to legal and practical concerns related to employees serving overseas. For example, the proposed rules could conflict with overseas personnel observing local holidays for security, diplomatic, and practical reasons. OPM also announced that it is reconvening its interagency working group for dismissal and closure procedures to update its "DC Dismissal and Closure Procedures" guidance to reflect the new "weather and safety leave" procedures. In addition, in response to our recommendation, in May 2015, OPM issued a fact sheet on administrative leave, which discusses the appropriate use of an agency's administrative leave authority, including a definition of administrative leave as well as applicable government-wide, individual agency, and emergency policies on the use of administrative leave. However, this fact sheet will need to be revised to reflect the newly issued regulations for "weather and safety leave" in addition to the regulations for the other categories of paid leave when they are in effect. Once all regulations are finalized, the proposed rules, along with updated fact sheet guidance, should help agencies and federal employees appropriately use, record, and report administrative leave. We will be contacting OPM to receive an update on the status of this recommendation once all the regulations are finalized and the fact sheet guidance is revised.

Recommendation: To help ensure that agencies report comparable and reliable data to EHRI, the Director of OPM, in coordination with agencies and payroll service providers, should provide updated and specific guidance to payroll service providers on which activities to report, or not report, to the paid administrative leave data element in EHRI.

Agency: Office of Personnel Management
Status: Open

Comments: To address agency use of paid administrative leave that may exceed reasonable amounts as well as discrepancies in recording and reporting paid administrative leave, in December 2016, Congress passed the "Administrative Leave Act of 2016." The act mandates new categories of paid leave, including "investigative leave," "notice leave," and "weather and safety leave" and sets limitations on the duration of paid administrative leave as well as the new categories of investigative and notice leave. The Act also requires OPM to establish regulations on (1) when to grant administrative leave and the other new categories of paid leave, and (2) the proper recording and reporting of these types of paid leave. In July 2017, OPM proposed new rules to regulate paid administrative leave, but has not finalized all these rules. In April 2018, OPM issued final regulations for "weather and safety leave" and announced that it would issue separate final regulations for "administrative leave," "investigative leave," and "notice leave" at a later date. To accompany the final regulations for "weather and safety leave," OPM issued two new data standards for agencies to report Paid Holiday Time Off and Weather and Safety Leave Hours Used that became effective in May 2018. Also, in November 2018, OPM released an update to its "DC Dismissal and Closure Procedures" guidance to reflect the new "weather and safety leave" procedures. Once all regulations are finalized, the proposed rules, along with updated guidance to payroll providers for reporting paid administrative leave and the new leave categories, should help agencies report comparable and reliable data to EHRI. We will be contacting OPM to receive an update on the status of this recommendation once the regulations are finalized and the guidance is revised.

Recommendation: To help DOD address key risks to F-35 affordability and operational readiness, and to improve the reliability of its O&S cost estimates for the life cycle of the program, the Secretary of Defense should direct the F-35 Program Executive Officer, to enable DOD to better identify, address, and mitigate performance issues with the Autonomic Logistics Information System (ALIS) that could have an effect on affordability, as well as readiness, to establish a performance-measurement process for ALIS that includes, but is not limited to, performance metrics and targets that (1) are based on intended behavior of the system in actual operations and (2) tie system performance to user requirements.

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD concurred with our recommendation. According to DOD officials, as of July 2018, plans are emerging between the services and the Joint Program Office on a path forward for ALIS, focusing on both the current iteration of ALIS and the future state. Going forward, the services and the Joint Program Office are developing plans for the necessary re-architecture of ALIS. Once these current improvements and future requirements are finalized, appropriate performance metrics, tying system performance in operations environments to user requirements, will be incorporated. As of January 2020, DOD officials stated that there was no update to this status. Although DOD has a way ahead as it relates to developing performance metrics for ALIS, DOD has yet to develop any metrics that are based on intended behavior of the system and tie system performance to user requirements. Until DOD takes this action, our recommendation will remain open.

Recommendation: To help DOD address key risks to F-35 affordability and operational readiness, and to improve the reliability of its O&S cost estimates for the life cycle of the program, the Secretary of Defense should direct the F-35 Program Executive Officer, to develop a high level of confidence that the aircraft will achieve its R+M goals, to develop a software reliability and maintainability (R+M) assessment process, with metrics, by which the program can monitor and determine the effect that software issues may have on overall F-35 R+M issues.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with our recommendation. According to DOD officials, as of July 2018, the department and the Joint Program Office, as part of their focus on agile software development, are working to incorporate software reliability and maintainability metrics into future software development and sustainment contracts. Some of the proposed metrics under consideration include: change failure rate; number of errors in developmental/user/operational testing; time to fix on critical errors; and mean time to restore. As of September 2019, DOD officials stated that there was no update to this status. Although attention is being paid to software Reliability & Maintainability, until DOD develops a process focused on software and its effects on overall Reliability & Maintainability issues, this recommendation will remain open.

Recommendation: To help DOD address key risks to F-35 affordability and operational readiness, and to improve the reliability of its O&S cost estimates for the life cycle of the program, the Secretary of Defense should direct the F-35 Program Executive Officer, to promote competition, address affordability, and inform its overarching sustainment strategy, to develop a long-term Intellectual Property (IP) Strategy to include, but not be limited to, the identification of (1) current levels of technical data rights ownership by the federal government and (2) all critical technical data needs and their associated costs.

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD concurred with our recommendation. According to DOD officials, as of January 2020, in the updated F-35 Life Cycle Sustainment Plan (LCSP) issued in January 2019, "Secure Use of Appropriate Technical Data" was one of the identified elements of success necessary to improve F-35 readiness and reduce sustainment costs. As part of the ongoing Plans of Action & Milestones (POAM) implementation process for the LCSP success elements, the F-35 Joint Program Office is working with the OEMs to determine the data rights the government already has, and to determine the specific technical data the government needs, and what it needs that data to accomplish. Significant progress has been made on both fronts with the prime contractor. We acknowledge that progress surrounding technical data rights is being made; however, until an Intellectual Property strategy is developed and released, this recommendation will remain open.

Recommendation: In order to improve transparency and allow for more informed decision making by congressional leaders and DHS and GSA decision-makers, before requesting additional funding for the DHS headquarters consolidation project, the Secretary of Homeland Security and the Administrator of the General Services Administration should work jointly to conduct the following assessments and use the results to inform updated DHS headquarters consolidation plans: (1) a comprehensive needs assessment and gap analysis of current and needed capabilities that take into consideration changing conditions, and (2) an alternatives analysis that identifies the costs and benefits of leasing and construction alternatives for the remainder of the project and prioritizes options to account for funding instability.

Agency: Department of Homeland Security
Status: Open
Priority recommendation

Comments: The Department of Homeland Security Headquarters Consolidation Accountability Act of 2015 (Pub. L. No. 114-150) was enacted on April 29, 2016. Among other things, the act requires DHS, in coordination with GSA, to submit information to Congress about DHS headquarters consolidation efforts not later than 120 days of enactment. As of April 2020, DHS and GSA had not submitted the information to Congress required by Pub. L. No. 114-150. Required information includes a comprehensive assessment of property and facilities utilized by DHS in the National Capital Region, and an analysis that identifies the costs and benefits of leasing and construction alternatives for the remainder of the consolidation project. DHS reported that DHS and GSA prepared a comprehensive response to P.L. No. 114-150, but that the consolidation plan and response needed to be revised based on changing budget circumstances, among other things. In April 2020, DHS estimated that the final consolidation plan will be completed and approved in 2020. GAO will review the latest information on DHS headquarters consolidation efforts when it is provided to Congress, and will assess the materials in the context of this recommendation at that time. Continued DHS and GSA attention to following leading capital planning practices is critical given the project's multi-billion dollar cost and impact on future departmental operations.

Recommendation: In order to improve transparency and allow for more informed decision making by congressional leaders and DHS and GSA decision-makers, before requesting additional funding for the DHS headquarters consolidation project, the Secretary of Homeland Security and the Administrator of the General Services Administration should work jointly to conduct the following assessments and use the results to inform updated DHS headquarters consolidation plans: (1) a comprehensive needs assessment and gap analysis of current and needed capabilities that take into consideration changing conditions, and (2) an alternatives analysis that identifies the costs and benefits of leasing and construction alternatives for the remainder of the project and prioritizes options to account for funding instability.

Agency: General Services Administration
Status: Open
Priority recommendation

Comments: The Department of Homeland Security Headquarters Consolidation Accountability Act of 2015 (Pub. L. No. 114-150), enacted on April 29, 2016, mirrors GAO recommendations in this area. Among other things, the act requires DHS, in coordination with GSA, to submit information to Congress about DHS's headquarters consolidation efforts not later than 120 days of enactment. As of April 2020, DHS and GSA had not submitted the information to Congress required by Pub. L. No. 114-150. Required information includes a comprehensive assessment of property and facilities utilized by DHS in the National Capital Region, and an analysis that identifies the costs and benefits of leasing and construction alternatives for the remainder of the consolidation project. DHS reported that DHS and GSA prepared a comprehensive response to P.L. No. 114-150, but that the consolidation plan and response needed to be revised based on changing budget circumstances, among other things. In April 2020, DHS estimated that the final consolidation plan will be completed and approved in 2020. We will review the latest information on DHS's headquarters consolidation efforts when it is provided to Congress, and will assess the materials in the context of these recommendations at that time. Continued DHS and GSA attention to following leading practices for capital planning and cost and schedule estimation is critical given the project's multi-billion dollar cost and impact on future departmental operations.

Recommendation: In order to improve transparency and allow for more informed decision making by congressional leaders and DHS and GSA decision-makers, before requesting additional funding for the DHS headquarters consolidation project, after revising the DHS headquarters consolidation plans, the Secretary of Homeland Security and the Administrator of the General Services Administration should work jointly to develop revised cost and schedule estimates for the remaining portions of the consolidation project that conform to GSA guidance and leading practices for cost and schedule estimation, including an independent evaluation of the estimates.

Agency: Department of Homeland Security
Status: Open
Priority recommendation

Comments: The Department of Homeland Security Headquarters Consolidation Accountability Act of 2015 (Pub. L. No. 114-150) was enacted on April 29, 2016. Among other things, the act requires DHS, in coordination with GSA, to submit information to Congress about DHS headquarters consolidation efforts not later than 120 days of enactment. As of April 2020, DHS and GSA had not submitted the information to Congress required by Pub. L. No. 114-150. Required information includes updated cost and schedule estimates for the consolidation project that are consistent with GAO's recommendations in GAO-14-648. Furthermore, the act requires the Comptroller General to evaluate the cost and schedule estimates not later than 90 days after their submittal to Congress. DHS reported that DHS and GSA prepared a comprehensive response to P.L. No. 114-150, but that the consolidation plan and response needed to be revised based on changing budget circumstances, among other things. In April 2020, DHS estimated that the final consolidation plan will be completed and approved in 2020. GAO will review the latest DHS headquarters consolidation cost and schedule estimates when they are provided to Congress, and will assess the materials in the context of this recommendation at that time. Continued DHS and GSA attention to following leading cost and schedule estimation practices is critical given the project's multi-billion dollar cost and impact on future departmental operations.

Recommendation: In order to improve transparency and allow for more informed decision making by congressional leaders and DHS and GSA decision-makers, before requesting additional funding for the DHS headquarters consolidation project, after revising the DHS headquarters consolidation plans, the Secretary of Homeland Security and the Administrator of the General Services Administration should work jointly to develop revised cost and schedule estimates for the remaining portions of the consolidation project that conform to GSA guidance and leading practices for cost and schedule estimation, including an independent evaluation of the estimates.

Agency: General Services Administration
Status: Open
Priority recommendation

Comments: The Department of Homeland Security Headquarters Consolidation Accountability Act of 2015 (Pub. L. No. 114-150) was enacted on April 29, 2016. Among other things, the act requires DHS, in coordination with GSA, to submit information to Congress about DHS headquarters consolidation efforts not later than 120 days of enactment. As of April 2020, DHS and GSA had not submitted the information to Congress required by Pub. L. No. 114-150. Required information includes updated cost and schedule estimates for the consolidation project that are consistent with GAO's recommendations in GAO-14-648. Furthermore, the act requires the Comptroller General to evaluate the cost and schedule estimates not later than 90 days after their submittal to Congress. DHS reported that DHS and GSA prepared a comprehensive response to P.L. No. 114-150, but that the consolidation plan and response needed to be revised based on changing budget circumstances, among other things. In April 2020, DHS estimated that the final consolidation plan will be completed and approved in 2020. GAO will review the latest DHS headquarters consolidation cost and schedule estimates when they are provided to Congress, and will assess the materials in the context of this recommendation at that time. Continued DHS and GSA attention to following leading cost and schedule estimation practices is critical given the project's multi-billion dollar cost and impact on future departmental operations.

Recommendation: Congress should consider making future funding for the St. Elizabeths project contingent upon DHS and GSA developing a revised headquarters consolidation plan, for the remainder of the project, that conforms with leading practices and that (1) recognizes changes in workplace standards, (2) identifies which components are to be colocated at St. Elizabeths and in leased and owned space throughout the National Capital Region, and (3) develops and provides reliable cost and schedule estimates.

Agency: Congress
Status: Open

Comments: The Department of Homeland Security Headquarters Consolidation Accountability Act of 2015 (Pub. L. No. 114-150) was enacted on April 29, 2016. Among other things, the act requires DHS, in coordination with GSA, to submit information to Congress about DHS headquarters consolidation efforts not later than 120 days of enactment. As of March 2019, DHS and GSA had not submitted the information to Congress required by Pub. L. No. 114-150. Required information includes: a comprehensive assessment of property and facilities utilized by DHS in the National Capital Region; an analysis that identifies the costs and benefits of leasing and construction alternatives for the remainder of the consolidation project; and updated cost and schedule estimates for the project that are consistent with GAO's recommendations in GAO-14-648. Furthermore, the act requires the Comptroller General to evaluate the cost and schedule estimates not later than 90 days after their submittal to Congress. DHS reported that DHS and GSA prepared a comprehensive response to P.L. No. 114-150, but that the consolidation plan and response needed to be revised based on changing budget circumstances, among other things. In April 2020, DHS estimated that the final consolidation plan will be completed and approved in 2020. A comprehensive report to Congress on DHS headquarters consolidation, along with reliable project cost and schedule estimates, could inform Congress's funding decisions.

Recommendation: To ensure that the Corps meets the statutory requirements related to deauthorization of projects, the Secretary of Defense should direct the Secretary of the Army to direct the Chief of Engineers and Commanding General of the U.S. Army Corps of Engineers to determine what projects are eligible for deauthorization, transmit the list to Congress, and publish projects that are deauthorized in the Federal Register once the new database includes all authorized projects.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation. The Corps developed a list of projects for deauthorization in accordance with the Water Resources Development Act (WRDA) of 1986, Section 1001, and provided the list to OMB for clearance on January 26, 2018. Additionally, on December 9, 2019, the Corps reported that it provided a list of projects eligible for deauthorization in FY 2020 to the Assistant Secretary of the Army for Civil Works for review. Upon approval, the list will be sent to OMB for clearance. After receiving OMB clearance, according to the Corps, the list will be provided to Congress and the public in accordance with WRDA. As of July 2020, we are continuing to monitor the Corps' progress in implementing the recommendation.

Recommendation: To ensure that the Corps meets the statutory requirements related to deauthorization of incomplete water resources studies, the Secretary of Defense should direct the Secretary of the Army to direct the Chief of Engineers and Commanding General of the U.S. Army Corps of Engineers to determine what studies are eligible for deauthorization and transmit the list to Congress.

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation and as of December 2016, a task order has been awarded for a contractor to prepare a comprehensive inventory of studies authorized by statute. The Corps reported that once the comprehensive inventory of studies is complete, the Corps will develop policies and procedures for the study deauthorization process and those policies and procedures will be used to carry out the process of deauthorizing studies. In March 2020, the Corps reported that it was working to develop a scheduled for providing us with a list of studies eligible for deathorization. As of July 2020, we are continuing to monitor the Corps' progress in implementing the recommendation.

Recommendation: To reduce the cost of the crop insurance program and achieve budgetary savings for deficit reduction or other purposes, Congress should consider reducing the level of federal premium subsidies for revenue crop insurance policies. In doing so, Congress should consider whether to make the full amount of this reduction in an initial year, or to phase in the full amount of this reduction over several years. In addition, Congress should consider directing the Secretary of Agriculture to monitor and report on the impact, if any, of the reduction on farmer participation in the crop insurance program.

Agency: Congress
Status: Open

Comments: As of March 2020, Congress has not taken action to implement this matter.

Recommendation: To help ensure that DOD has the necessary information to determine the extent to which cost savings result from any future consolidation of training within METC or the Education and Training Directorate, the Assistant Secretary of Defense for Health Affairs should direct the Director of the DHA to develop baseline cost information as part of its metrics to assess achievement of cost savings.

Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
Status: Open

Comments: DOD concurred with this recommendation. As of November 2019, DOD is engaged in actions to help address this recommendation. Specifically, METC is developing a strategic plan concerning its objectives and goals and is assessing further consolidation efforts, such as in its medical and dental labs programs. However, DOD has not yet addressed our concerns regarding the DHA's Education and Training Directorate. In its most recent report on DHA shared services, the Education and Training Directorate listed the same 2 product lines noted in our report. Therefore, DOD savings that continue to be attributed to this Directorate are not specifically the result of any consolidation of training within METC or the directorate overall as we had recommended. Until this is done, we suggest this recommendation remain open.

Recommendation: To help realize the reform effort's goal of achieving cost savings, the Assistant Secretary of Defense for Health Affairs should direct the Director of the DHA to conduct a fully developed business case analysis for the Education and Training Directorate's reform effort. In this analysis the Director should (1) identify the cost-related problem that it seeks to address by establishing the Education and Training Directorate, (2) explain how the processes it has identified will address the costrelated problem, and (3) conduct and document an analysis of benefits, costs, and risks.

Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
Status: Open

Comments: DOD concurred with this recommendation. As of November 2019, DOD has not taken steps to address this recommendation. In its most recent report on DHA shared services, the Education and Training Directorate listed the same 2 product lines noted in our report, which as we reported in 2014, overlap with the DHA's Contracting and Procurement and Information Technology shared services. For example, while cost savings for Modeling and Simulation are allocated to the Medical Education and Training Directorate, implementation costs are to be incurred by the Contracting and Procurement shared service. This recommendation will remain open until DOD either identifies common functions to consolidate within Medical Education and Training to achieve cost savings or develops a justification for the transfer of these functions from the military services to the DHA that is not premised on cost savings.

Recommendation: To provide the Congress with the necessary insight into program planning and affordability, and to decrease the risk of cost and schedule overruns, NASA's Administrator should direct the Human Exploration and Operations Mission Directorate to take the following action: To allow for a continued assessment of progress and affordability, NASA should structure each future increment of SLS capability with a total cost exceeding the $250 million threshold for designation as a major project as a separate development effort within the SLS program. In doing so, NASA should require each increment to complete both the technical and programmatic reviews required of other major development projects, per the agency's acquisition and system engineering policies.

Agency: National Aeronautics and Space Administration
Status: Open
Priority recommendation

Comments: NASA agreed with this recommendation. In January 2020, NASA stated that it planned to establish an agency baseline commitment for capability upgrades (e.g., Block 1B upgrades, such as Mobile Launcher-2 and Exploration Upper Stage) above the $250 million threshold. A joint confidence level analysis will be performed at key decision points and will include the cost and schedule range estimates for each of these upgrades. To fully implement this recommendation, however, NASA needs to provide evidence that each capability upgrade is designated a major project and is required to complete the technical and programmatic reviews required of other major development projects.

Recommendation: To provide the Congress with the necessary insight into program planning and affordability, and to decrease the risk of cost and schedule overruns, NASA's Administrator should direct the Human Exploration and Operations Mission Directorate to take the following action: Provide decision makers with an informed basis for making investment decisions regarding the SLS program, NASA should identify a range of possible missions for each future SLS variant that includes cost and schedule estimates and plans for how those possible missions would fit within NASA's funding profile.

Agency: National Aeronautics and Space Administration
Status: Open
Priority recommendation

Comments: NASA agreed with this recommendation. In January 2020, NASA stated that new leadership at the Human Exploration and Operations Mission Directorate is conducting an internal independent assessment to assess the current schedule and technical approach for achieving a lunar landing by 2024, including the utilization of SLS for Artemis missions. With the insights gained from this assessment, NASA will move forward with planning and executing these missions through the annual budgeting process. To fully address this recommendation, NASA will need to identify cost and schedule estimates for possible SLS missions beyond its first exploration mission, now known as Artemis I, and how its planned missions would fit within NASA's funding profile.

Recommendation: To help minimize Treasury borrowing costs over time by better understanding and managing the risks posed by Treasury floating rate notes and by enhancing demand for Treasury securities, the Secretary of the Treasury should track and report an additional measure of the length of the portfolio that captures the interest rate reset frequency of securities in the portfolio.

Agency: Department of the Treasury
Status: Open

Comments: Treasury agreed with our recommendation but has not yet introduced this additional metric. In July 2019 we reached out to Treasury to obtain information on the status of this recommendation. As of October 2019, no new metric has been publicly introduced.

Recommendation: To reduce uncertainty about the expected cost and schedule of the U.S. ITER Project and its potential impact on the U.S. fusion program, once the ITER Organization completes its reassessment of the international project schedule, the Secretary of Energy should direct the Associate Director of the Office of Fusion Energy Sciences to use that schedule, if reliable, to propose a final, stable funding plan for the U.S. ITER Project, approve a performance baseline with finalized cost and schedule estimates, and communicate this information to Congress.

Agency: Department of Energy
Status: Open
Priority recommendation

Comments: DOE approved a performance baseline for the first plasma portion of the U.S. ITER Project in January 2017 and communicated that performance baseline to Congress. However, as of June 2020, DOE has not set a performance baseline for the post-first plasma portion of the project. DOE officials told us the Administration was reviewing U.S. participation in ITER. They said that if, at the end of the review, the Administration decided to continue U.S. participation in ITER, then DOE would set a performance baseline for the post-first plasma portion of the U.S. ITER Project.

Recommendation: To reduce uncertainty about the expected cost and schedule of the U.S. ITER Project and its potential impact on the U.S. fusion program, the Secretary of Energy should direct the Associate Director of the Office of Fusion Energy Sciences to direct the U.S. ITER Project Office to revise and update the project's cost estimate to meet all characteristics of high-quality, reliable cost estimates. Specifically, the U.S. ITER Project Office should revise the project's cost estimate to ensure it is credible by including a comprehensive sensitivity analysis that includes all significant cost elements and conducting an independent cost estimate.

Agency: Department of Energy
Status: Open

Comments: DOE revised and updated the cost estimate for the first plasma portion of the U.S. ITER Project in November 2016. Officials reported that, as part of that update, the U.S. ITER Project Office completed a comprehensive sensitivity analysis and that the Office of Science's Office of Project Assessment had conducted a review of the revised cost estimate. However, as of June 2020, DOE had yet to revise and update the cost estimate for the post-first plasma portion of the U.S. ITER Project. DOE officials told us they planned to do so when they set a performance baseline for that portion of the project, which they expected to do if, at the end of an ongoing review, the Administration decided to continue U.S. participation in ITER.

Recommendation: 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.

Agency: National Aeronautics and Space Administration
Status: Open
Priority recommendation

Comments: NASA partially agreed with this recommendation, stating that it 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 and that it would report costs associated with the second exploration mission via its annual budget submission. In January 2020, NASA stated that it is evaluating changes to NASA Procedural Requirements 7120.5E, "NASA Space Flight Program and Project Management Requirements," to better enable the necessary insight into program affordability and efficient monitoring of total program costs and execution for multi-year, multi-cadence type programs. Further, NASA stated that it is investigating plans to redefine performance expectations for multi-decade programs' formal commitments while maintaining visibility to the entire plan. To address this recommendation, NASA needs to establish separate cost and schedule baselines for work required to support SLS for EM-2, which is now known as Artemis II.

Recommendation: 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, because NASA intends to use the increased capabilities of the SLS, Orion, and Ground Systems Development and Operations efforts well into the future and has chosen to estimate costs associated with achieving the capabilities, the NASA's Administrator should direct the Human Exploration and Operations Mission Directorate to establish separate cost and schedule baselines for each additional capability that encompass all life cycle costs, to include operations and sustainment. When NASA cannot fully specify costs due to lack of well-defined missions or flight manifests, forecast a cost estimate range -- including life cycle costs -- having minimum and maximum boundaries. These baselines or ranges should be reported to Congress annually via the agency's budget submission.

Agency: National Aeronautics and Space Administration
Status: Open
Priority recommendation

Comments: NASA partially agreed with this recommendation, stating that it had established separate programs for SLS, Orion, and the ground systems and adopted a block upgrade approach for SLS. In January 2020, NASA stated that it plans to establish an agency baseline commitment for capability upgrades (e.g., Block 1B upgrades, such as Mobile Launcher-2 and Exploration Upper Stage) above the $250 million threshold. A joint confidence level analysis will be performed at key decision points and will include the cost and schedule range estimates for each of these upgrades. To address this recommendation, NASA needs to provide evidence that it established separate cost and schedule baselines for each additional SLS, Orion, and Ground Systems Development and Operations capability blocks that encompass all life-cycle costs, including operations and sustainment.

Recommendation: 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.

Agency: Congress
Status: Open

Comments: As of September 2020, we are not aware of any legislation being enacted to address this matter for congressional consideration.

Recommendation: 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.

Agency: Department of the Interior
Status: Open

Comments: As of September 2020, BIA and EPA had selected a cleanup option for Tuba City Dump, but BIA had not created schedule or cost estimates for the cleanup action. BIA stated it anticipated completing the cleanup design, which will include cost and schedule estimates, by September 2022. GAO will assess BIA's actions once they are complete.

Recommendation: 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.

Agency: Department of the Interior
Status: Open

Comments: As of September 2020, BIA and EPA had selected a cleanup option for Tuba City Dump, but BIA had not initiated the acquisition planning process for the future cleanup contract. BIA stated it anticipated completing the cleanup design work, including the acquisition package, by September 2022. GAO will assess BIA's actions once they are complete.

Recommendation: 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.

Agency: Executive Office of the President: Office of Management and Budget
Status: Open
Priority recommendation

Comments: In providing comments on this report, OMB generally concurred with this recommendation. The FAR Council members issued a timetable in Spring 2020 for the proposed regulatory changes to address the use of reverse auctions in response to GAO's recommendations and 2015 guidance released by the Office of Federal Procurement Policy (OFPP). The notice of proposed rulemaking was planned for August 2020. As of August 10, 2020, the notice of proposed rulemaking had not been published. OMB officials did not provide a revised date when they planned to publish the notice.

Recommendation: To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's methodology for estimating and comparing the full cost of its various workforces, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation to further develop guidance for cost elements that users have identified as challenging to calculate, such as general and administrative, overhead, advertising and recruiting, and training.

Agency: Department of Defense
Status: Open

Comments: According to DOD's April 2017 report on Comparing the Cost of Civilians and Contractors, DOD's Cost Assessment and Program Evaluation (CAPE) office is updating fiscal year 2017 estimates in its Full Cost of Manpower (FCoM) system to reflect separate officer and enlisted training costs. If more specific cost estimates are required, users of FCoM are directed to cost estimating tools operated by the military departments.

Recommendation: To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's methodology for estimating and comparing the full cost of its various workforces, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation to develop business rules for estimating the full cost of National Guard and Reserve personnel.

Agency: Department of Defense
Status: Open

Comments: According to DOD's April 2017 report in Comparing the Cost of Civilians and Contractors, a cost estimating function for Reserve Component personnel far exceeds the combination of variables for developing active component and DOD civilian cost estimates. Due to the scope of the Full Cost of Manpower (FCoM) contract, OSD(CAPE) has not adopted this recommendation in terms of a web-based application. However, OSD(CAPE) intends to address general business rules for Reserve Component cost estimates in the next DoDI revision.

Recommendation: To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's methodology for estimating and comparing the full cost of its various workforces, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation, in coordination with the department's Office of the Actuary and appropriate federal actuarial offices, to reevaluate the inclusion and quantification of pension, retiree health care costs, and other relevant costs of an actuarial nature and make revisions as appropriate.

Agency: Department of Defense
Status: Open

Comments: According to DOD's April 2017 report on Comparing the Cost of Civilians and Contractors, OSD(CAPE) has reviewed the inclusion of payments that the government makes to retirement and health benefits. All identified costs that are attributable to current retirees and past service of active civilian and military personnel, such as unfunded liabilities, are being revised in the cost estimating guidelines. OSD(CAPE) intends to incorporate these changes in the next DoDI revision and coordinate a review with the Office of the DoD Actuaty.

Recommendation: To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's ability to estimate contractor support costs, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation, consistent with established practices for developing credible cost estimates, to research the data sources it is currently using and reassess its contractor support data sources for use when determining contractor support costs.

Agency: Department of Defense
Status: Open

Comments: According to DOD's April 2017 report on Comparing the Cost of Civilian and Contractors, the department's efforts to improve data sources are ongoing.

Recommendation: To help address the uncertainty NIH faces, related to the potential impact of increasing indirect costs on its funding of future research, the Director of NIH should assess the impact of growth in indirect costs on its research mission, including, as necessary, planning for how to deal with potential future increases in indirect costs that could limit the amount of funding available for total research, including the direct costs of research projects.

Agency: Department of Health and Human Services: Public Health Service: National Institutes of Health
Status: Open

Comments: As of July 7, 2015, NIH provided some information indicating that it had taken action to address our recommendation by tracking the size of indirect costs as a proportion of NIH's overall budget as part of the agency's annual budget planning process and risk assessment program. However, we determined that the actions did not fully address the recommendation because they focus on the agency's overall budget and do not assess the potential ongoing impact of indirect costs for universities on its mission. As of September 2018, NIH officials have not informed us of any additional actions taken to implement this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: To improve DOD's corrosion-prevention and control program, and to enhance DOD in its oversight of the status and potential benefits of its equipment-related corrosion projects, the Under Secretary of Defense for Acquisition, Technology and Logistics should require the Director, Corrosion Policy and Oversight Office, to revise the DOD Corrosion Prevention and Mitigation Strategic Plan or other guidance to require that the military departments include in all follow-on reports the details of measures of achievement other than ROI, such as the features, results, and potential benefits of the project.

Agency: Department of Defense: Office of the Under Secretary of Defense for Acquisition, Technology and Logistics
Status: Open

Comments: DOD did not concur with this recommendation. As of March 2016, DOD had not implemented this recommendation and stated that the DoD Corrosion Prevention and Mitigation Strategic Plan currently provide sufficient guidance in this regard. As of March 2019, DOD has decided to take action to implement this recommendation. According to DOD Corrosion Office officials, they plan to list measures of achievement for the military departments to follow on the departments' corrosion project in a new DOD manual on corrosion. The Office's goal is to create this new manual by the end of calendar year 2020. We will monitor the extent to which DOD implements this recommendation.

Recommendation: To help improve its ability to oversee M&O contractor costs, including indirect costs, for its laboratories and make more effective use of DOE and contractor resources, the Secretary of Energy should take--or, as appropriate, direct the Administrator of NNSA to incorporate more specific benchmarking requirements into future laboratory contracts--similar to the benchmarking requirements used by DOE to assess and manage pension and post-retirement benefit costs--including which costs should be benchmarked, how frequently benchmarking should occur, and what process should be used to ensure corrective actions are taken, as needed.

Agency: Department of Energy
Status: Open

Comments: In April 2017, the Director of NNSA Office of Policy issued guidance to NNSA Laboratory Field Office Managers to update contracts to include a new clause requiring laboratory contractors to submit a strategic plan every year in accordance with guidance. Part of the annual plan requires contractors to discuss the costs of doing business and cost-increase factors at the sites, including overhead dollars. The annual strategic plan is due to the NNSA Office of Policy by August 15 each year. The annual strategic plans included information on indirect costs and cost drivers, but did not include benchmarking. We again requested information on the benchmarking requirements, if any, in July 2020.

Recommendation: To reduce the incentive for facilities to restrict their service provision to avoid reaching the LVPA treatment threshold, the Administrator of CMS should consider revisions such as changing the LVPA to a tiered adjustment.

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

Comments: As of February 2020, CMS had not implemented this recommendation. CMS stated in February 2020 that the agency had extensive discussions with the Medicare Payment Advisory Commission regarding the Commission's suggestions for modifying the LVPA. CMS also stated that the agency was analyzing the design of the LVPA as part of its evaluation of the ESRD Prospective Payment System. This recommendation remains open because CMS has not provided documentation of steps such as those described above that the agency has taken to consider revisions to the LVPA. We will update the status of this recommendation upon receipt of additional information from CMS.

Recommendation: To ensure that up-to-date data are available on the road damages imposed by all vehicles types compared with the revenues each contributes to the Highway Trust Fund, the Secretary of Transportation should direct the FHWA Administrator to revise and publish the agency's Highway Cost Allocation Study and update it periodically as warranted.

Agency: Department of Transportation
Status: Open

Comments: As of April 2020, FHWA stated it does not plan to revise and publish the agency's Highway Cost Allocation Study because of the cost of doing so and the uncertainty about whether and how it would be used. GAO continues to believe that up to date information on the cost of road damage imposed by all vehicle types compared with the revenues contributed by those vehicles to the Highway Trust Fund is needed to help determine whether user fees are sufficient to cover damage costs. Moreover, Congress and the administration need to agree on a long-term sustainable plan for balancing spending from and revenues to the Highway Trust Fund and, for this reason, funding surface transportation is on GAO's High Risk List. GAO will continue to monitor any efforts by DOT and FHWA to respond to our recommendation.

Recommendation: In light of the agency's declining revenue associated with its basic statutory function and the charging for information that is often freely available elsewhere, Congress should consider examining the appropriateness and viability of the fee-based model under which NTIS currently operates for disseminating technical information to determine whether the use of this model should be continued.

Agency: Congress
Status: Open

Comments: Congress had taken a number of actions that affect the NTIS fee-based model for disseminating technical information. Specifically, for the past 5 fiscal years and in the current Consolidated Appropriations Act, 2020, NTIS is prohibited from charging customers for reports generated by legislative branch offices unless the agency tells the customer how an electronic copy of the report can be accessed or downloaded for free online. The act further states that, if a customer still requires such a report from NTIS, the agency should not charge more than what is needed to recover the cost of processing, reproducing, and delivering the document requested. It remains to be seen whether these requirements will be continued under the yet to be introduced House and Senate bills making appropriations for the Department of Commerce (Commerce) for fiscal year 2021. Congress again has the opportunity to consider legislation that would ensure the assessment of the appropriateness or viability of NTIS functions.

Recommendation: To improve NASA management and oversight of its spaceflight projects, and to improve the reliability of project EVM data, the NASA Administrator should direct the appropriate offices to modify the NASA Procedural Requirements (NPR) 7120.5 to require projects to implement a formal surveillance program that: (1) Ensures anomalies in contractor-delivered and in-house monthly earned value management reports are identified and explained, and report periodically to the center and mission directorate's leadership on relevant trends in the number of unexplained anomalies. (2) Ensures consistent use of work breakdown structures (WBS) for both the EVM report and the schedule. (3) Ensures that lower level EVM data reconcile to project level EVM data using the same WBS structure. (4) Improves underlying schedules so that they are properly sequenced using predecessor and successor dependencies and are free of constraints to the extent practicable so that the EVM baseline is reliable.

Agency: National Aeronautics and Space Administration
Status: Open
Priority recommendation

Comments: NASA partially agreed with this recommendation, stating that the reliability and utility of the EVM data needed to be improved but that it did not plan to implement a formal surveillance plan due to resource constraints. Since initially commenting on the report, however, in December 2018, NASA included an initiative in its Corrective Action Plan-a plan put in place in response to recent programmatic performance and NASA's designation on GAO's High-Risk List-to enhance EVM implementation. In June 2019, NASA issued EVM guidance that covered several items, including enhancing in-house and contracted earned value management surveillance and requiring EVM reporting at Baseline Performance Review. NASA officials reported that its near-term plans are well-defined to address the reliability of project EVM data, but they have expressed concerns about funding challenges and cultural resistance. To fully implement this recommendation, NASA will need to take action and provide documentary support for several of its identified planned next steps to enhance EVM surveillance. Without implementing proper surveillance, NASA may be utilizing unreliable EVM data in its analyses to inform its cost and schedule decision making.

Recommendation: To help ensure that EM more effectively manages all its projects, the Secretary of Energy should direct the Senior Advisor for Environmental Management and the Director of the Office of Management, as appropriate, to provide the Office of Acquisition and Project Management with information on EM's project classification decisions to ensure that all capital asset projects have been appropriately classified and are managed in accordance with DOE Order 413.3B.

Agency: Department of Energy
Status: Open

Comments: DOE agreed with our recommendation. EM is working with DOE's Office of Project Management to draft a Cleanup Project Management Policy (expected to be completed in fall 2020) to address the Decommissioning and Deactivation phase of cleanup. This policy will become an appendix in DOE's Order 413.3B. EM officials further stated that EM plans to develop an additional Cleanup Program Management Policy that would classify the remaining types of activities not covered by the Cleanup Project Management Policy, including what EM currently classifies as operations activities. EM plans to implement this policy by the end of fiscal year 2020.

Recommendation: To ensure that federal funding efficiently and effectively responds to the countercyclical nature of the Medicaid program, Congress may wish to consider enacting an FMAP formula that is targeted for variable state Medicaid needs and provides automatic, timely, and temporary increased FMAP assistance in response to national economic downturns.

Agency: Congress
Status: Open

Comments: As of September 2020, no legislation had been enacted. GAO has testified on at least one bill that had been introduced in the Congress that would implement this Matter for Congressional Consideration. On February 10, 2016, GAO testified on considerations related to the Medicaid funding formula. See Medicaid: Changes to Funding Formula Could Improve Allocation of Funds to States GAO-16-377T January 26, 2016. We also cited this report in our discussion on Medicaid funding during economic downturns in Medicaid: Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding (GAO-16-726). We cited this Matter in Opportunities to Improve the Federal Recovery and Response Efforts (GAO-20-625) and in COVID-19: Brief Update on Initial Federal Response to the Pandemic (GAO-20-708).

Recommendation: Congressmay wish to consider amending the Internal Revenue Code to authorize IRS to assess penalties on preparers for failure to comply with section 6011(e)(3).

Agency: Congress
Status: Open

Comments: A bill was introduced on June 28, 2011, which would have amended electronic filing requirements for paid preparers. This included language amending section 6695 of the Internal Revenue Code to include a penalty of $50 for failure to electronically file returns under section 6011 (e)(3). However, this bill was never enacted. As of January 2020, there are no bills pending that would provide IRS with authority to penalize paid preparers for failure to electronically file returns as GAO recommended

Recommendation: As HHS implements its current and forthcoming efforts to make transparent price information available to consumers, HHS should determine the feasibility of making estimates of complete costs of health care services available to consumers through any of these efforts.

Agency: Department of Health and Human Services
Status: Open

Comments: In May 2013, CMS released average inpatient hospital charge information for more than 3,000 hospitals that receive Medicare Inpatient Prospective Payment System payments for the 100 most frequently billed discharges using DRGs from FY2011 and corresponding average Medicare payments. Shortly thereafter CMS also released outpatient charges. In April 2014, CMS also released data on payments to physicians under Medicare part B. This represents an effort to provide price transparency, although these are not complete cost estimates according to our definition in this report. As of September 2015, we are awaiting an update from HHS on the status of this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: As HHS implements its current and forthcoming efforts to make transparent price information available to consumers, HHS should determine, as appropriate, the next steps for making estimates of complete costs of health care services available to consumers.

Agency: Department of Health and Human Services
Status: Open

Comments: As of September 2015, we are awaiting an update from HHS on the status of this recommendation. We will update the status of this recommendation when we receive additional information.

Recommendation: To promote an efficient use of resources and to better plan for the design of a new performance management system, the Secretary of Defense should direct the Deputy Assistant Secretary of Defense for Civilian Personnel Policy to, in conjunction with the DOD Comptroller, help ensure that information identifying and supporting the costs of the NSPS termination and new performance management system is documented, reliable, traceable to a source document, and readily available for examination.

Agency: Department of Defense
Status: Open

Comments: GAO staff met with DOD officials in October 2019 to discuss the status of the department's new performance management system and any efforts to address this recommendation. DOD officials agreed to provide documentation related to these efforts, but, as of November 2019, this documentation. has not been received. Further updates will be made once that documentation is received and reviewed.

Recommendation: To help ensure that Medicare beneficiaries have access to high-quality dialysis care, the Administrator of CMS should assess the extent to which the bundled payment for dialysis care will be sufficient to cover an efficient dialysis organization's costs to provide such care when the bundled payment expands to cover oral-only ESRD drugs. The Administrator should conduct this assessment before implementing this expanded bundled payment.

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

Comments: CMS, as required by the Protecting Access to Medicare Act of 2014 (PAMA), delayed until 2024 when the bundled payment for dialysis care is expanded to cover oral-only ESRD drugs. Because PAMA requires CMS to use the most recent year of data available to implement this payment change, CMS has been unable to implement our recommendation. We will update the status of this recommendation upon receipt of additional information from CMS.

Recommendation: To help improve the effectiveness of the Bureau's outreach and enumeration efforts, especially for HTC populations, should they be used again in the 2020 Census, and improve the Bureau's marketing/outreach efforts, the Secretary of Commerce should require the Under Secretary for Economic Affairs as well as the Director of the U.S. Census Bureau to develop mechanisms to increase coordination and communication between the partnership and local census office staff. Possible actions include offering more opportunities for joint training, establishing protocols for coordination, and more effectively leveraging the partnership contact database to better align partnership outreach activities with local needs.

Agency: Department of Commerce
Status: Open
Priority recommendation

Comments: The Department generally agreed with this recommendation. In 2011, the Bureau reported on the agency's assessment of the partnership program. In September 2014, the Bureau's Path to the 2020 Census, identified the Partnership Program as one of the best methods for communicating the importance of response and states its intent to map out details about the Partnership Program in early 2016. As of March 2018, Bureau officials said they were developing coordination mechanisms between partnership and Area Census Office staff for the 2020 Census. For example, the Bureau updated a form it had used during the 2010 Census to track partnership outreach activities to help facilitate information sharing within the Bureau and said it plans to make additional updates. In March 2019, the Bureau informed us that it is assigning at least one partnership specialist to each census office manager to help address this recommendation. As we reported in May 2020, the Bureau had not put in place expectations for how Partnership staff should support area census office staff. We also reported that pluralities of area census office managers we surveyed in March 2020 were dissatsified with the level of clarity of roles and responsibilities of Partnership staff, as well as the level of communication and coordination between Partnership and office staff. To fully implement this recommendation, the Bureau will need to take such steps as documenting for partnership specialists and their area census office manager how they are expected to work together and other significant mechanisms that would increase effectiveness of coordination and communication between partnership and local field office staff.

Recommendation: To help improve the effectiveness of the Bureau's outreach and enumeration efforts, especially for HTC populations, should they be used again in the 2020 Census, and to improve some of the Bureau's key efforts to enumerate HTC populations, the Secretary of Commerce should require the Under Secretary for Economic Affairs as well as the Director of the U.S. Census Bureau to determine the factors that led to the staffing issues observed during SBE and take corrective actions to ensure more efficient SBE staffing levels in 2020.

Agency: Department of Commerce
Status: Open

Comments: The Department generally agreed with this recommendation. In September 2012, the Bureau issued its assessment of the Service Based Enumeration Program. The assessment reported on the number of individuals counted and the complexities of this special enumeration activity. The assessment did not address the Bureau's approach to staffing this special enumeration activity. In its 2020 Census Operational Plan, issued in October 2017, the Bureau provided a high level overview of reengineered field operations plans but did not provide details on special enumeration efforts. In April 2018, the Bureau provided us with its planned staffing ratios for its Service-Based Enumeration activity for the 2020 Census in comparison to those used in the 2010 Census, as well as results of its 2016 Census Test of SBE activity. As of August 2020 we have ongoing work that will be examining implementation of peak field operations and providing updates to this recommendation. In order to fully implement this recommendation, the Bureau needs to demonstrate that its planning for how it will determine staffing levels for SBE takes into account the factors that led to inefficient staffing allocation previously.

Recommendation: To help improve the effectiveness of the Bureau's outreach and enumeration efforts, especially for HTC populations, should they be used again in the 2020 Census, and to improve some of the Bureau's key efforts to enumerate HTC populations, the Secretary of Commerce should require the Under Secretary for Economic Affairs as well as the Director of the U.S. Census Bureau to evaluate the extent to which each special enumeration activity improved the count of traditionally hard-to-enumerate groups and use the results to help inform decision making on spending for these programs in 2020.

Agency: Department of Commerce
Status: Open
Priority recommendation

Comments: The Department generally agreed with this recommendation. In 2012, the Bureau reported on assessments of many 2010 special enumeration activities such as the Service-Based Enumeration and the Be Counted/Questionnaire Assistance Center Programs. These assessments revealed the number of persons counted and spending for the special enumeration activities. Separately, the Bureau issued results of the 2010 Census Coverage Measurement Program that described the level of coverage of various hard-to-enumerate populations generally without attributing coverage to specific enumeration activities. Since 2015, the Bureau has issued annual updates of its 2020 Census Operational Plans, which have not provided details of plans for various special enumeration activities. In April 2017 Bureau officials provided us with evaluation results of its 2010 communication efforts and other documents related to ongoing efforts to reduce errors in the census. As of August 2020, we are in communication with Bureau officials about steps they are taking to implement this recommendation. To fully implement this recommendation, the Bureau needs to demonstrate how it is relying on data about how various special enumeration activities of historically hard-to-enumerate groups contributed to census coverage in 2010 to inform its design for the 2020 Census.

Recommendation: To ensure that the Department of Defense is taking full advantage of the cost savings that can be achieved by implementing CPC projects, the Secretary of Defense should direct the Under Secretary of Defense (Acquisition, Technology and Logistics) to update applicable guidance, such as DOD Instruction 5000.67, Prevention and Mitigation of Corrosion on DOD Military Equipment and Infrastructure or the DOD Corrosion Prevention and Mitigation Strategic Plan to further define the responsibilities of the military departments' Corrosion Executives, to include more specific oversight and review of the project proposals before and during the project selection process.

Agency: Department of Defense
Status: Open

Comments: DOD has not updated DOD Instruction 5000.67 - Prevention and Mitigation of Corrosion on DOD Military Equipment and Infrastructure, the DOD Corrosion Prevention and Mitigation Strategic Plan, or other applicable guidance since the publication of our report. DOD did not concur with this recommendation at the time of our report but as of March 2019, has since decided to take action to implement it. Corrosion Office officials agree that Corrosion Executives' responsibilities in the Corrosion Prevention Project selection process have to be further defined. They plan to clearly document the selection procedures and participation of the Corrosion Executive in an update to DOD Instruction 5000.67 (Prevention and Mitigation of Corrosion on DOD Military Equipment and Infrastructure) and in the new DOD manual on corrosion. The Corrosion Office's goal is to complete this instruction update and create the new manual by the end of calendar year 2020. We will monitor the extent to which DOD implements this recommendation.

Recommendation: To allow Congress to better oversee management of the nuclear security enterprise and to improve NNSA's management information with respect to the base capabilities necessary to ensure nuclear weapons are safe, secure, and reliable, the Administrator of NNSA should, once the Stockpile Services work breakdown structure reflects a product or capability basis, use this work breakdown structure to develop product/capability cost estimates that adequately justify the congressional budget request for Stockpile Services.

Agency: Department of Energy: National Nuclear Security Administration
Status: Open

Comments: NNSA has significantly improved its work breakdown structure for Stockpile Services. The work breakdown structure now reflects a product or capability basis to a much greater extent than it did previously. NNSA restructured its budget starting with its fiscal year 2021 budget justification materials. GAO, through ongoing work, is continuing to monitor NNSA's development of cost estimates for Stockpile Services products and capabilities that inform future years' budget requests and justifications.

Recommendation: To address USPS's financial viability in the short term, Congress may wish to consider providing financial relief to USPS, including modifying its retiree health benefit cost structure in a fiscally responsible manner. Congress may also wish to consider any and all options available to reduce USPS costs, including revising the statutory framework for collective bargaining to ensure that binding arbitration takes its financial condition into account. At the same time, to facilitate making progress in difficult areas, Congress may wish to consider establishing (1) a panel of independent experts, similar to a BRAC-like commission, to coordinate with USPS and stakeholders to develop a package of proposed legislative and operational changes needed to reduce costs and address challenges to USPS's business model and (2) procedures for the review and approval of these proposals by the President and Congress. These proposals could focus on adapting delivery and retail services to declining mail volumes; making postal operations, networks, and workforce more cost-efficient; and generating new revenue.

Agency: Congress
Status: Open

Comments: As of March 2020, Congress has taken no action on this matter.

Recommendation: Should the program be extended beyond 2009, to ensure that the maximum amount of capital ends up in low-income community businesses, Congress may wish to consider offering grants to CDEs that would provide the funds to low-income community businesses. If it does so, Congress may wish to require Treasury to gather appropriate data to assess whether and to what extent the grant program increases the amount of federal subsidy provided to low-income community businesses compared to the NMTC; whether the grant program otherwise affects the success of efforts to assist low-income communities; and how costs for administering the program incurred by the CDFI Fund, CDEs, and investors would change. One option may be for Congress to set aside a portion of funds to be used as grants and a portion to be used as tax credit allocation authority under the current structure of the program in a future allocation round to facilitate comparison of the two program structures.

Agency: Congress
Status: Open

Comments: No legislative action has been identified as of March 2020. Section 141 of division Q of the Further Consolidated Appropriations Act, 2020, extended NMTC through 2020 (Public Law 116-94). However, this act did not offer grants in lieu of credits, as GAO suggested in January 2010. The Joint Committee on Taxation estimates the cost of this extension to be approximately $1.5 billion. Offering grants in lieu of NMTCs could result in a greater portion of the federal subsidy reaching low-income community businesses.

Recommendation: In order to significantly reduce the uncertainty that some taxpayers have about their ability to earn credits for their research activities, the Secretary of the Treasury should issue regulations clarifying the definition of gross receipts for purposes of computing the research credit for controlled groups of corporations.

Agency: Department of the Treasury
Status: Open

Comments: Treasury issued proposed regulations clarifying the definition of gross receipts on December 13, 2013 and solicited public comments. During the course of 2014, tax practitioners and business executives submitted comments criticizing the regulations and asking for them to be withdrawn. As of March 2020, Treasury has yet to issue final regulations that would include responses to these criticisms. The regulations would not become effective until the tax year beginning after the date on which the regulations are published in final form.

Recommendation: In order to significantly reduce the uncertainty that some taxpayers have about their ability to earn credits for their research activities, the Secretary of the Treasury should provide additional guidance to more clearly identify what types of activities are considered to be qualified support activities.

Agency: Department of the Treasury
Status: Open

Comments: As of March 2020, Treasury has not issued regulations to clarify what types of activities are considered to be qualified support activities.

Recommendation: In order to significantly reduce the uncertainty that some taxpayers have about their ability to earn credits for their research activities, the Secretary of the Treasury should provide additional guidance to more clearly identify when commercial production of a qualified product is deemed to begin.

Agency: Department of the Treasury
Status: Open

Comments: As of March 2020, Treasury has not issued regulations to more clearly identify when commercial production of a qualified product is deemed to begin.

Recommendation: In order to reduce economic inefficiencies and excessive revenue costs resulting from inaccuracies in the base of the research tax credit, Congress should consider eliminating the regular credit option for computing the research credit.

Agency: Congress
Status: Open

Comments: While legislation has been introduced to expand the research tax credit, as of December 2019, Congress had not enacted legislation to eliminate the regular computation option for the research tax credit or to add a minimum base to the ASC option, as GAO suggested in November 2009. The credit is designed to encourage business innovation by providing a subsidy for new research. Continued use of the regular computation credit option, which arbitrarily distributes subsidies across taxpayers, can distort investment decisions so that research spending and economic activity are not allocated to sectors that offer the highest returns to society. These misallocations may reduce economic efficiency and, thereby, diminish any economic benefits of the credit.

Recommendation: In order to reduce economic inefficiencies and excessive revenue costs resulting from inaccuracies in the base of the research tax credit, Congress should consider adding a minimum base to the ASC that equals 50 percent of the taxpayer's current-year qualified research expenses.

Agency: Congress
Status: Open

Comments: While legislation has been introduced to expand the research tax credit, as of December 2019, Congress had not enacted legislation to eliminate the regular computation option for the research tax credit or to add a minimum base to the ASC option, as GAO suggested in November 2009. The credit is designed to encourage business innovation by providing a subsidy for new research. Continued use of the regular computation credit option, which arbitrarily distributes subsidies across taxpayers, can distort investment decisions so that research spending and economic activity are not allocated to sectors that offer the highest returns to society. These misallocations may reduce economic efficiency and, thereby, diminish any economic benefits of the credit. Adding a minimum base for the ASC would reduce the revenue cost of the credit without affecting the average incentive it provides for research.

Recommendation: If Congress nevertheless wishes to continue offering the regular research credit to taxpayers, it may wish to consider reducing inaccuracies in the credit's base and to reduce taxpayers' uncertainty and compliance costs and IRS's administrative costs by updating the historical base period that regular credit claimants use to compute their fixed base percentages.

Agency: Congress
Status: Open

Comments: While legislation has been introduced to expand the research tax credit, as of March 2020, no action has been taken by Congress to update the historical base period that regular credit claimants use to compute their fixed base percentages.

Recommendation: If Congress nevertheless wishes to continue offering the regular research credit to taxpayers, it may wish to consider reducing inaccuracies in the credit's base and to reduce taxpayers' uncertainty and compliance costs and IRS's administrative costs by eliminating base period recordkeeping requirements for taxpayers that elect to use a fixed base percentage of 16 percent in their computation of the credit.

Agency: Congress
Status: Open

Comments: While legislation has been introduced to expand the research tax credit, as of March 2020, no action has been taken to eliminate base period recordkeeping requirements for taxpayers that elect to use a fixed base percentage of 16 percent in their computation of the credit.

Recommendation: If Congress nevertheless wishes to continue offering the regular research credit to taxpayers, it may wish to consider reducing inaccuracies in the credit's base and to reduce taxpayers' uncertainty and compliance costs and IRS's administrative costs by clarifying for Treasury its intent regarding the definition of gross receipts for purposes of computing the research credit for controlled groups of corporations. In particular it may want to consider clarifying that the regulations generally excluding transfers between members of controlled groups apply to both gross receipts and QREs and specifically clarifying how it intended sales by domestic members to foreign members to be treated. Such clarification would help to resolve open controversies relating to past claims, even if the regular credit were discontinued for future years.

Agency: Congress
Status: Open

Comments: While legislation has been introduced to expand the research tax credit, as of March 2020, no action has been taken by Congress to clarify for Treasury its intent regarding the definition of gross receipts for purposes of computing the research credit for controlled groups of corporations. In particular, it may want to consider clarifying that the regulations generally excluding transfers between members of controlled groups apply to both gross receipts and QREs and specifically clarifying how it intended sales by domestic members to foreign members to be treated. Such clarification would help to resolve open controversies relating to past claims, even if the regular credit were discontinued for future years.

Recommendation: To strengthen NNSA's oversight practices and current and future facility modernization efforts, and to improve the transparency and usefulness of cost analyses prepared for future NNSA nuclear facilities modernization projects, the Secretary of Energy should direct the Administrator of NNSA to ensure that life cycle cost analyses include a thorough and balanced evaluation of short- and long-term construction and financing alternatives. Such analyses should consider the full useful life of the facility rather than the 20-year requirement for GSA leases or any predetermined length of time that might produce results that favor one option over another.

Agency: Department of Energy
Status: Open

Comments: NNSA provided evidence that it requires life cycle cost analyses for projects greater than $20 million. However, this is not fully responsive to GAO's recommendation. For example, the recommendation stated that each life cycle cost analysis performed includes short- and long-term construction and financing alternatives and that these analyses should consider the full life of the facility rather than the 20-year requirements for GSA leases or any predetermined length of time. NNSA's actions do not address this aspect of the life cycle cost analysis. Our work found that facility's life cycle cost analysis only covered 20 years and it failed to reflect cost savings over a longer useful life (possibly over 50 years) that could have been realized if the facility were purchased instead of leased. Nothing in the Order addresses how the life cycle cost period to be analyzed should be established (e.g., 20 years or 50 plus years). Although we requested additional information from NNSA on this recommendation in fiscal year 2019, the agency has not responded. As a result, as of June 2020, the recommendation remains open.

Recommendation: To strengthen NNSA's oversight practices and current and future facility modernization efforts, and because of the importance of mitigating the risks of outsourcing nuclear weapons components and other information that if exported, might allow potential adversaries to develop or advance their nuclear capabilities, the Secretary of Energy should direct the Administrator of NNSA to take immediate action to assess the effectiveness of NNSA's oversight of KCP's current export control and nonproliferation practices and, if appropriate, initiate corrective actions to strengthen that oversight.

Agency: Department of Energy
Status: Open

Comments: As of August 2020, there has been no change in the status of this recommendation. While NNSA/contractor actions are commendable and appear to be beneficial, such as adding performance-based incentives, training 950 employees, and including new contract clauses in its supplier purchase orders, these actions do not fully satisfy the recommendation. GAO's recommendation was specifically directed at the effectiveness of NNSA's oversight of the KCP contractor's export control and nonproliferation practices and to initiate corrective actions to strengthen that NNSA oversight. While the Kansas City Site Office's addition of a performance based incentive seems to be a good improvement, NNSA has not demonstrated its own oversight effectiveness. Our review of NNSA's response provided in March 2014 was not persuasive. In addition, GAO-16-710 found that as of May 2016, the Secretary of Energy had not used the enhanced procurement authority to ensure supply chain integrity, and the Department of Energy (DOE) had not developed processes for using the authority, as it had not fully assessed the circumstances under which the authority might be useful. Although NNSA provided additional information on this recommendation in August 2019, these actions relied primarily on contractor self assessments and not on independent federal oversight. As a result, this recommendation will continue to remain open.

Recommendation: To improve the management of the stockpile life extension program, the Administrator of NNSA should direct the Deputy Administrator for Defense Programs to develop a realistic schedule for the W76 warhead and future life extension programs that allows NNSA to (1) address technical challenges while meeting all military requirements and (2) build in time for unexpected technical challenges that may delay the program.

Agency: Department of Energy: National Nuclear Security Administration
Status: Open

Comments: In past and ongoing work, GAO has identified areas where NNSA's modernization plans may not align with planned funding requests over the Future Years Nuclear Security Plan (FYNSP) and post-FYNSP periods. Based on the FY 2014 Stockpile Stewardship and Management Plan (SSMP), (GAO-14-45) NNSA plans to work on five life extension programs (LEP) or major alterations through 2038. The FY 2014 SSMP states that the LEP workload represents a resource and production throughput challenge that requires improvements in LEP planning and execution. GAO's analysis indicates there is limited contingency time built into the LEP schedules, all of which are technically ambitious. Any delays in schedules could lead to an increase in program costs or a reduction in the number built for any of the LEPs, both of which have occurred in prior and ongoing LEPs. While NNSA has acknowledged issues and identified some steps to improve the LEP process, this recommendation will remain open and unimplemented until NNSA demonstrates successful LEP and refurbishment execution. We reconfirmed this finding in GAO-17-341 where we found the following: In some cases, NNSA's FY 2017 nuclear security budget materials do not align with the agency's modernization plans, both within the 5-year FYNSP for fiscal years 2017 through 2021 and beyond, raising concerns about the affordability of NNSA's planned portfolio of modernization programs. As of June 2020, this situation has not been fully addressed as evidenced by cost increases and likely delays in the B61-12 and W88 ALTV programs; an aggressive schedule in the W80-4 program, and a large scope in the W87-1 warhead replacement. In addition, new programs contained in the 2018 Nuclear Posture Review and the announcement of a new development effort, the W93, may further stress NNSA's program.

Recommendation: To improve the management of the stockpile life extension program, the Administrator of NNSA should direct the Deputy Administrator for Defense Programs to ensure that the program managers responsible for overseeing the construction of new facilities directly related to future life extension programs coordinate with the program managers of such future programs to avoid the types of delays and problems faced with the construction and operation of the Fogbank manufacturing facility for the W76 program.

Agency: Department of Energy: National Nuclear Security Administration
Status: Open

Comments: A number of Stockpile Stewardship and Management Plans (SSMP) state that the life extension program (LEP) workload represents a resource and production throughput challenge that requires improvements in LEP planning and execution. The officials elaborated that the main area that will be strained is pit production. NNSA's plutonium strategy needs to be resourced fully and implemented successfully by 2030 to support the W87 warhead replacement. Additionally, the officials said that the UPF project and an arrange of associated programmatic efforts need to be operational by 2025 or there will be challenges in completing all of the planned LEPs. In addition, NNSA needs to re-establish depleted uranium operations, construct a new lithium facility and establish a domestic uranium enrichment function for tritium production by the late 2020s to meet stockpile needs. As such, this recommendation remains open and, given the aggressive warhead and bomb modernization efforts proceeding in parallel with infrastructure modernization efforts, will likely remain open for some time.

Recommendation: To improve the management of the stockpile life extension program, the Administrator of NNSA should direct the Deputy Administrator for Defense Programs to ensure that program managers for the construction of new facilities for future life extensions base their schedule for the construction and start-up of a facility on the life extension program managers' needs identified in their risk mitigation strategies.

Agency: Department of Energy: National Nuclear Security Administration
Status: Open

Comments: NNSA has generally improved its management of construction projects, to include requirements setting, Analysis of Alternatives, and independent cost estimates, among other items. However, it is too soon to tell if these positive developments will help--or hinder--LEPs that are underway or are being conducted. Key uranium activities, to include construction and operating funds will not be complete until 2025; key tritium and lithium programs and facilities will not complete until the 2030s; key plutonium activities are underway as well, but will not be complete until the late 2020s. As of June 2020, there are no significant changes related to this recommendation, and it will continue to remain open.

Recommendation: Given the potential for improving compliance now and in the future, Congress may wish to provide IRS with the authority to use math error checks to identify and correct returns with ineligible (1) IRA "catch-up" contributions, and (2) contributions to traditional IRAs from taxpayers over age 70-1/2.

Agency: Congress
Status: Open

Comments: As of March 2020, Congress has expanded IRS's math error authority in certain circumstances, but not as broadly as GAO suggested in February 2010. Section 208 of division Q of the Consolidated Appropriations Act, 2016 (Public Law 114-113 enacted in December 2015) gave IRS the authority to use math error authority if (1) a taxpayer claimed the Earned Income Tax Credit, Child Tax Credit, or the American Opportunity Tax Credit (AOTC) during the period in which a taxpayer is not permitted to claim such credit as a consequence of either having made a prior fraudulent or reckless claim; or (2) a taxpayer omitted information required to be reported because the taxpayer made prior improper claims of the Child Tax Credit or the AOTC. While expanding math error authority is consistent with what GAO suggested in February 2010, GAO maintains that a broader authorization of math error authority with appropriate controls would enable IRS to correct obvious noncompliance, would be less intrusive and burdensome to taxpayers than audits, and would potentially help taxpayers who underclaim tax benefits to which they are entitled. If Congress decides to extend broader math error authority to IRS, controls may be needed to ensure that this authority is used properly such as requiring IRS to report on its use of math error authority. The Administration also requested that Congress expand IRS's math error authority as part of the Service's Congressional Budget Justification and Annual Performance Report and Plan for fiscal year 2019. Specifically, the Administration requested authority to correct a taxpayer's return in the following circumstances: 1) the information provided by the taxpayer does not match the information contained in government databases; 2) the taxpayer has exceeded the lifetime limit for claiming a deduction or credit; or 3) the taxpayer has failed to include with his or her return certain documentation that is required by statute. As of April 2019, the Congress had not provided IRS with such authority.

Recommendation: In order to improve freight mobility by more clearly defining the federal role in the freight transportation network and to begin to align federal investments with economically significant national benefits, the Secretary of Transportation should develop with Congress and public and private sector stakeholders a comprehensive national strategy for freight transportation. This national strategy should include defining the federal role and national interests in freight transportation, including economically-based and objective criteria to identify areas of national significance for freight transportation and to determine whether federal funds are required in those areas.

Agency: Department of Transportation
Status: Open

Comments: To fully implement this recommendation, DOT should complete and issue a National Freight Strategic Plan. As part of the development of the National Freight Strategic Plan, DOT should include defining the federal role in freight transportation, including economically-based and objective criteria to identify areas of national significance for freight transportation and to determine whether federal funds are required in those areas. As of February 2020, DOT had not issued the National Freight Strategic Plan and DOT officials said they were planning to issue the strategy by the end of 2020.

Recommendation: In order to improve freight mobility by more clearly defining the federal role in the freight transportation network and to begin to align federal investments with economically significant national benefits, the Secretary of Transportation should develop with Congress and public and private sector stakeholders a comprehensive national strategy for freight transportation. This national strategy should include establishing the roles of regional, state, and local governments, as well as the private sector.

Agency: Department of Transportation
Status: Open

Comments: To fully implement this recommendation, DOT should complete and issue a National Freight Strategic Plan. As part of the development of the National Freight Strategic Plan, DOT should include establishing the roles of regional, state, and local governments, as well as the private sector. As of February 2020, DOT had not issued the National Freight Strategic Plan and DOT officials said they were planning to issue the strategy by the end of 2020.

Recommendation: In order to improve freight mobility by more clearly defining the federal role in the freight transportation network and to begin to align federal investments with economically significant national benefits, the Secretary of Transportation should develop with Congress and public and private sector stakeholders a comprehensive national strategy for freight transportation. This national strategy should include using new or existing federal funding sources and mechanisms to support a targeted, cost-effective, and sustainable federal role in freight transportation.

Agency: Department of Transportation
Status: Open

Comments: To fully implement this recommendation, DOT should complete and issue a National Freight Strategic Plan. As part of the development of the National Freight Strategic Plan, DOT should include using new or existing federal funding sources and mechanisms to support a targeted, cost-effective, and sustainable federal role in freight transportation. As of February 2020, DOT had not issued the National Freight Strategic Plan and DOT officials said they were planning to issue the strategy by the end of 2020.