GAO’s recommendations database contains report recommendations that still need to be addressed.
GAO’s priority recommendations are those that we believe warrant priority attention.
We sent letters to the heads of key departments and agencies, urging them to continue focusing on these issues.
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Our recommendations help congressional and agency leaders prepare for appropriations and oversight activities, as well as help improve government operations.
Moreover, when implemented, some of our priority recommendations can save large amounts of money, help Congress make decisions on major issues, and substantially improve or transform major government programs or agencies, among other benefits.
As of June 17, 2020, there are 4969 open recommendations, of which 518 are priority recommendations. Recommendations remain open until they are designated as Closed-implemented or Closed-not implemented.
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Recommendation: To help ensure that quality care is provided to AI/AN people, as part of the implementation of its quality framework, the Secretary of HHS should direct the Director of IHS to ensure that agency-wide standards for the quality of care provided in its federally operated facilities are developed, that facility performance in meeting these standards is systematically monitored over time, and that enhancements are made to its adverse event reporting system.
Agency: Department of Health and Human Services Status: Open Priority recommendation
Comments: HHS concurred with this recommendation and cited steps that have been taken to improve the quality of care in IHS's federally-operated facilities, including establishing an IHS Office of Quality, and developing a dashboard of standards for quality of care. In addition, IHS awarded a contract to a software development firm in December 2018 to design a new adverse event reporting and tracking system for the agency. In March 2020, IHS officials told us the agency had completed a 3 site pilot test, and that one site had gone live with the adverse events reporting system. However, the COVID-19 pandemic response has diverted IHS resources that would be required for successful implementation of the software and adoption of new workflows for managing adverse events. Therefore, IHS is temporarily halting further roll-out of the system until such time as the COVID-19 national emergency has resolved or a determination is made by IHS leadership that IHS can reasonably be expected to manage a new software release despite on-going disaster response. As such, IHS stated that the recommendation should remain open. We agreed and said we will assess HHS's actions once completed.
Recommendation: To improve compliance with waiver policies, SSA should develop a timetable for implementing updates to its Debt Management System to: (a) Align system controls with SSA policy, so that waivers over $1,000 cannot be administratively waived. (b) Ensure that evidence supporting waiver decisions is sufficiently maintained to allow for subsequent monitoring and oversight.
Agency: Social Security Administration Status: Open Priority recommendation
Comments: As of December 2019, SSA expects to release (1) an update to its Debt Management System in fiscal year 2021 to ensure that evidence is collected to support waiver decisions, and (2) another update by fiscal year 2022 that will include controls to prevent users from administratively waiving overpayments that are above $1,000. While SSA has set timeframes for these updates to the Debt Management System, it has yet to provide documentation confirming that both parts of GAO's recommendation will be addressed within these timeframes. We will close this recommendation once SSA provides documentation of its plans and timetable for updating its Debt Management System.
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.