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.
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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: As CMS continues to implement and refine the contract-level RADV audit process to improve the efficiency and effectiveness of reducing and recovering improper payments. The Administrator should enhance the timeliness of CMS's contract-level RADV process by taking actions such as the following: (1) closely aligning the time frames in CMS's contract-level RADV audits with those of the national RADV audits the agency uses to estimate the MA improper payment rate; (2) reducing the time between notifying MA organizations of contract audit selection and notifying them about the beneficiaries and diagnoses that will be audited; (3) improving the reliability and performance of the agency's process for transferring medical records from MA organizations, including assessing the feasibility of updating Electronic Submission of Medical Documentation for use in transferring medical records in contract-level RADV audits; and (4) requiring that CMS contract-level RADV auditors complete their medical record reviews within a specific number of days comparable to other medical record review time frames in the Medicare program.
Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services Status: Open Priority recommendation
Comments: HHS concurred with this recommendation in its fiscal year 2021 budget justification. HHS reaffirmed its commitment to identifying and correcting improper payments in the MA program. It has begun taking steps to improve the timeliness of the contract-level RADV audit process, such as aligning the time frames in CMS's contract-level RADV audits with those of the national RADV audits. Once completed, CMS needs to provide evidence that the actions taken by the agency have enhanced the timeliness of CMS's contract-level RADV process.
Recommendation: To improve VA's efforts to effectively complete the development and implementation of VBMS, the Secretary of Veterans Affairs should direct the Under Secretary for Benefits and the Chief Information Officer to develop an updated plan for VBMS that includes (1) a schedule for when VBA intends to complete development and implementation of the system, including capabilities that fully support disability claims, pension claims, and appeals processing and (2) the estimated cost to complete development and implementation of the system.
Agency: Department of Veterans Affairs Status: Open Priority recommendation
Comments: The Department of Veterans Affairs (VA) concurred with our recommendation and as of January 2020, is continuing to develop requirements for VBMS in order to develop functionality to replace legacy information systems. In addition, the department subsequently provided us with expected completion dates for implementation of claims and appeals processing, but has not provided a schedule for the implementation of pension claims processing. To fully implement this recommendation, the department needs to provide the expected completion date for pension claims processing and an estimate of the cost to complete remaining development and implementation of VBMS.
Recommendation: To better ensure that FBI whistleblowers have access to recourse under DOJ's regulations should the individuals experience retaliation, and to minimize the possibility of discouraging future potential whistleblowers, the Attorney General should clarify in all current relevant DOJ guidance and communications, including FBI guidance and communications, to whom FBI employees may make protected disclosures and, further, explicitly state that employees will not have access to recourse if they experience retaliation for reporting alleged wrongdoing to someone not designated in DOJ's regulations.
Agency: Department of Justice Status: Open Priority recommendation
Comments: In response to our report, in December 2016, Congress passed and the President signed the FBI Whistleblower Protection Enhancement Act of 2016, Pub. L. No. 114-302, which, among other things, provides a means for FBI employees to obtain corrective action for retaliation for disclosures of wrongdoing made to supervisors and others in the employees' chain of command. Following this, the FBI worked closely with the Department of Justice's Office of Inspector General (DOJ-OIG) to develop a training that clearly identifies to whom FBI employees may make protected disclosures. In addition, the FBI issued an aligned policy directive and two fact sheets detailing whistleblower rights. In October 2018, a DOJ official reported to us that the department was in the process of updating its regulations and, in February 2020, DOJ officials confirmed that the updated regulation was in the departmental clearance process but they could not provide an estimate for when it would be finalized. As a result, as of February 2020, DOJ's regulations have not been updated and are inconsistent with the current statute and FBI's guidance and training; as such, the problem of unclear or conflicting guidance to FBI employees still needs to be addressed. To address this recommendation, DOJ would need to update its regulations and ensure that all relevant guidance is clear and consistent across the department.
Recommendation: To better ensure that DOJ is fulfilling its commitment to improving efficiency in handling these complaints, DOJ Office of Professional Responsibility (DOJ-OPR), Office of the Inspector General, OARM, and ODAG should jointly assess the impact of ongoing and planned efforts to reduce the duration of FBI whistleblower retaliation complaints throughout the entire investigation, adjudication, and appeal process to ensure that these changes are in fact shortening total complaint length, without sacrificing quality.
Agency: Department of Justice Status: Open Priority recommendation
Comments: DOJ agreed with this recommendation but, as of June 2020, has not fully addressed it. In January 2020, DOJ officials stated that while they have taken steps intended to expedite case handling and have annually compiled statistics on the numbers of open cases, they had not compiled information on case duration or undertaken an assessment of the impact of their efforts on case duration. In June 2020, DOJ officials provided documentation of a plan for ODAG, OARM, DOJ-OIG, and DOJ-OPR officials to semi-annually review case processing times and consider the impact of their efforts to expedite cases. DOJ's June 2020 plan, if fully implemented, would address the intent of this recommendation.