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 December 31, 1969, there are open recommendations, of which are priority recommendations. Recommendations remain open until they are designated as Closed-implemented or Closed-not implemented.
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Recommendation: The Assistant Secretary for Special Education and Rehabilitative Services should review information provided by states related to changes in federal special education rights when a parent places a student with a disability in a private school and work with states to correct inaccurate information.
Agency: Department of Education: Office of Special Education and Rehabilitative Services Status: Open Priority recommendation
Comments: Education generally agreed with this recommendation. However, the agency believes it is necessary to review the full documents containing information provided by states, so that it can determine the context in which the information was presented. We will coordinate with Education as appropriate to facilitate such a review. In 2019, the agency began working with relevant states to improve the information provided, and stated that it would review states' revised information to parents about federal rights of children with disabilities who are placed by parents in private schools. We will consider closing this recommendation when Education completes its work with relevant states to correct any inaccurate information.
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 calling for an updated plan for the Veterans Benefits Management System. However, as of July 2019, the department had not developed a plan that included a schedule for when the Veterans Benefits Administration intends to complete development and implementation of the system, as well as the estimated cost of doing so. More specifically, the department reported that the target completion date and costs for VBMS completion were unknown as the requirements for future development were still being defined.We will continue to monitor VA's actions in response to this recommendation.
Recommendation: To help ensure appropriate payments to MA plans, the Administrator of CMS should take steps to improve the accuracy of the adjustment made for differences in diagnostic coding practices between MA and Medicare FFS. Such steps could include, for example, accounting for additional beneficiary characteristics, including the most current data available, identifying and accounting for all years of coding differences that could affect the payment year for which an adjustment is made, and incorporating the trend of the impact of coding differences on risk scores.
Agency: Department of Health and Human Services: Centers for Medicare and Medicaid Services Status: Open Priority recommendation
Comments: CMS indicated in October 2019 that it disagrees with our recommendation. CMS stated that, given the complexity of measuring coding changes attributable to plan behavior and the difficulty of measuring countervailing factors, there is not a single correct factor within the viable range of adjustment factors. In addition, the agency noted that there is policy discretion with respect to the appropriate adjustment factor for the payment year. In the Medicare Advantage Call Letter of April 2019, CMS stated that it will apply the statutory minimum adjustment of 5.90 percent for calendar year 2020. As of October 2019, CMS had not provided any documentation of its analysis and the basis for its determination. Although the application of the 5.90 percent adjustment and other recent changes CMS has made to its methodology for calculating the diagnostic coding adjustment (i.e., the exclusion of diagnosis codes that were differentially reported in Medicare fee-for-service and Medicare Advantage) likely brings CMS's adjustment closer to what GAO's analysis projects to be an accurate adjustment, a modified methodology that incorporates more recent data, accounts for all relevant years of coding differences, and incorporates the effect of coding difference trends would better ensure an accurate adjustment in future years. Until CMS shows the sufficiency of the diagnostic coding adjustment or implements an adjustment based on analysis using an updated methodology, payments to Medicare Advantage plans may not accurately account for differences in diagnostic coding between these plans and traditional Medicare providers.