Recommendation: FERC should provide standard language and procedures to its staff on how to record information collected during inspections, including how and where to record information about safety deficiencies, in order to facilitate analysis of safety deficiencies across FERC's portfolio of regulated dams. (Recommendation 1)

Agency: Federal Energy Regulatory Commission
Status: Open

Comments: In February 2020, GAO confirmed that FERC had developed new standard operating procedures related for tracking deficiencies and follow-up items arising from dam safety inspections and other dam safety reviews. In addition, FERC told GAO that they plan to update their tracking system beginning in fiscal year 2021, which will facilitate the complete recording and subsequent analysis of safety deficiencies from inspections across FERC's portfolio of regulated dams. GAO will continue to monitor FERC's efforts to implement this recommendation.

Recommendation: FERC should use information from its inspections to assess safety risks across its portfolio of regulated dams to identify and prioritize safety risks at a national level. (Recommendation 2)

Agency: Federal Energy Regulatory Commission
Status: Open

Comments: In January 2019, FERC told GAO that it had begun developing a screening-level risk-assessment program to assess safety risks across the inventory of regulated dams and to help guide safety decisions. In February 2020, GAO confirmed that FERC had completed this screening-level risk assessment, and conducted some preliminary analysis of the results. In addition, FERC told GAO that the results of the screening level risk analyses will be used to revise the potential timing, frequency, and technical disciplines represented on dam safety inspections; to confirm or revise the urgency of existing and potential new follow up dam safety actions; and to identify previously unrecognized dam safety concerns and issues; to identify new dam safety priorities. GAO will continue to monitor FERC's efforts to implement this program.

Recommendation: The Chief Financial Officer of NRC should formally communicate to all licensees that supplemental billing information--including biweekly reports and monthly status reports on contractor charges--is available and how to request it. Formal communication that would reach all licensees could include adding information to their quarterly invoices. (Recommendation 1)

Agency: Nuclear Regulatory Commission
Status: Open

Comments: According to officials, NRC plans to provide licensees with access to biweekly reports in the summer 2020, with an enhancement to the eBilling system expected in May 2020 and communicating to licensees about the availability of the information in July 2020. Additionally, NRC developed a form for licensees to request additional information on contractor charges on their bill and notified licensees that they may request additional information on contractor charges by submitting this form to NRC.

Recommendation: In developing the project plan for electronic billing, the Chief Financial Officer of NRC should include steps to assess the results of implementing electronic billing, which includes comparing the actual performance to intended outcomes. (Recommendation 5)

Agency: Nuclear Regulatory Commission
Status: Open

Comments: According to NRC, about 10 percent of licensees are currently participating in eBilling. We requested information on how NRC plans to assess the results of eBilling. We will update the status of this recommendation when we receive additional information.

Recommendation: The Under Secretary for Health should specify in VHA policy that reviews of providers' clinical care after concerns have been raised should be documented, including retrospective and comprehensive reviews. (Recommendation 1)

Agency: Department of Veterans Affairs
Status: Open

Comments: VA agreed with the recommendation and indicated plans to revise policy to codify requirements to document reviews. As of April 2020, VA estimates completing these and other revisions to the policy in August 2020.

Recommendation: The Under Secretary for Health should specify in VHA policy a timeliness requirement for initiating reviews of providers' clinical care after a concern has been raised. (Recommendation 2)

Agency: Department of Veterans Affairs
Status: Open

Comments: VA agreed with the recommendation and indicated plans to revise policy to incorporate timeline expectations for initiating reviews after clinical care concerns have been raised. As of April 2020, VA estimates completing these and other revisions to the policy in August 2020.

Recommendation: To improve the management of DOD's credentialing program and better determine whether the program is achieving its desired results, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to develop and implement program performance measures that include key attributes, such as a baseline and goals, that can be used to assess performance.

Agency: Department of Defense
Status: Open

Comments: DOD did not concur with our recommendation to develop and implement performance measures for its credentialing program. In its response to the recommendation, DOD stated that servicemembers are not required to earn credentials and more than half of the credentials earned by servicemembers are voluntary. Therefore, establishing criteria that might create an incentive to force servicemembers into earning voluntary credentials would be counterproductive. DOD also stated that a basic reporting system is in place that captures credential attainment and associated costs that provides basic information to gauge the program's performance. As of April 2020, the department still does not plan to develop performance measures for the program.

Recommendation: Because some quantities of radioactive materials are potentially dangerous to human health if not properly handled, NRC should take action to better track and secure these materials and verify the legitimacy of the licenses for those who seek to possess them. Specifically, the NRC should take the steps needed to include category 3 sources in the National Source Tracking System and add agreement state category 3 licenses to the Web-based Licensing System as quickly as reasonably possible.

Agency: Nuclear Regulatory Commission
Status: Open
Priority recommendation

Comments: In October 2016, NRC issued a Staff Requirements Memorandum (SRM) "Proposed Staff Re-Evaluation of Category 3 Source Accountability," (SRM-COMJMB-16-0001) and directed NRC staff to take specific actions to evaluate whether it is necessary to revise NRC regulations or processes governing source protection and accountability for category 3 sources. Among other things, this re-evaluation was expected to consider GAO's recommendations. In August 2017, NRC staff completed its analysis and provided recommendations to the NRC Commissioners. (Most of this analysis is available on NRC's website.) In its analysis, the NRC staff recommended not including category 3 sources in the National Source Tracking System. They also recommended not adding agreement state category 3 licenses to the Web-based Licensing System. As of January 2020, the NRC Commissioners have yet to take action on the staff analysis.

Recommendation: Because some quantities of radioactive materials are potentially dangerous to human health if not properly handled, NRC should take action to better track and secure these materials and verify the legitimacy of the licenses for those who seek to possess them. Specifically, the NRC should at least until such time that category 3 licenses can be verified using the License Verification System, require that transferors of category 3 quantities of radioactive materials confirm the validity of a would-be purchaser's radioactive materials license with the appropriate regulatory authority before transferring any category 3 quantities of licensed materials.

Agency: Nuclear Regulatory Commission
Status: Open
Priority recommendation

Comments: In October 2016, NRC issued a Staff Requirements Memorandum (SRM) "Proposed Staff Re-Evaluation of Category 3 Source Accountability," (SRM-COMJMB-16-0001) and directed NRC staff to take specific actions to evaluate whether it is necessary to revise NRC regulations or processes governing source protection and accountability for category 3 sources. Among other things, this re-evaluation was expected to consider GAO's recommendations. In August 2017, NRC staff completed its analysis and provided recommendations to the NRC Commissioners. (Most of this analysis is available on NRC's website.) In its analysis, the NRC staff recommended not requiring transferors of category 3 quantities of radiological material to confirm the validity of licenses prior to transferring any category 3 quantities of these materials. As of January 2020, the NRC Commissioners have yet to take action on the staff analysis.

Recommendation: Because some quantities of radioactive materials are potentially dangerous to human health if not properly handled, NRC should take action to better track and secure these materials and verify the legitimacy of the licenses for those who seek to possess them. Specifically, the NRC should, as part of the ongoing efforts of NRC working groups meeting to develop enhancements to the prelicensing requirements for category 3 licenses, consider requiring that an on-site security review be conducted for all unknown applicants of category 3 licenses to verify that each applicant is prepared to implement the required security measures before taking possession of licensed radioactive materials.

Agency: Nuclear Regulatory Commission
Status: Open

Comments: In October 2016, NRC issued a Staff Requirements Memorandum (SRM) "Proposed Staff Re-Evaluation of Category 3 Source Accountability," (SRM-COMJMB-16-0001) and directed NRC staff to take specific actions to evaluate whether it is necessary to revise NRC regulations or processes governing source protection and accountability for category 3 sources. Among other things, this re-evaluation will consider GAO's recommendations. In August 2017, NRC staff completed its analysis and provided recommendations to the NRC Commissioners. (Most of this analysis is available on NRC's website.) In its analysis, the NRC staff recommended requiring all safety and security equipment to be in place before granting a license to a previously unknown entity. This requirement would apply to all unknown entities applying for a radioactive material license regardless of the quantity of licensed material requested. If NRC took this action, it would fully address this recommendation. As of January 2020, the NRC Commissioners have yet to take action on the staff analysis.

Recommendation: To help ensure that practitioners who may be ineligible do not possess a controlled substance registration and that practitioners who pose an increased risk of illicit diversion are identified, the Acting Administrator of DEA should take additional actions to strengthen verification controls. Specifically, the Acting Administrator of DEA should develop policies and procedures to validate SSNs and apply the policies and procedures to all new and existing SSNs in the CSA2; such an approach could involve collaborating with SSA to assess the feasibility of checking registrants' SSNs against the Enumeration Verification System.

Agency: Department of Justice: Drug Enforcement Administration
Status: Open

Comments: In April 2018, DEA told us that it assessed the feasibility of directly collaborating with SSA to check registrants' SSNs against any SSA systems, including the Enumeration Verification System (EVS), and is unable to implement a data verification process to validate SSNs against EVS without legislative authority. Specifically, DEA said that access to SSA's systems would require passage of new legislation to authorize DEA to fully participate in a data exchange agreement with SSA, which DEA said was also confirmed by Senate staff. In June 2020, DEA provided documentation of SSA's response to DEA's request to access EVS which stated that SSA was unable to enter into a data exchange under the conditions DEA initially proposed. However, it also stated that SSA would explore granting DEA access if DEA requested number-holder's consent. Therefore, we continue to believe there is a possible path forward in using SSA's service. Additionally, DEA told us that it would use information from the Federation of State Medical Boards (FSMB) to validate SSNs. However, as of August 2020, DEA has not provided any documentation to support how or if this has been implemented. Further, as noted in our report, FSMB is limited to information for medical doctors, osteopathic doctors and some physician assistants, which make up only a portion of DEA's registrants. As we noted in our report, validating SSNs will help establish registrants' identities which will better ensure DEA has the information necessary to implement its existing controls and to identify other registrations held by each individual, including past adverse actions taken against previous registrations. As such, we continue to believe that DEA should take steps to validate the information it receives. We will continue to monitor the agency's progress in this area.

Recommendation: To help ensure that practitioners who may be ineligible do not possess a controlled substance registration and that practitioners who pose an increased risk of illicit diversion are identified, the Acting Administrator of DEA should take additional actions to strengthen verification controls. Specifically, the Acting Administrator of DEA should identify and implement a cost-effective approach to monitor state licensure and disciplinary actions taken against its registrants; such an approach could include using data sources that contain this information, such as the National Practitioner Data Bank or the Federation of State Medical Boards.

Agency: Department of Justice: Drug Enforcement Administration
Status: Open

Comments: In July 2018, DEA provided a copy of its purchase order award to the Federation of State Medical Boards (FSMB); however, as of August 2020, DEA has not provided documentation to demonstrate how use of FSMB will be implemented. Also, in April 2018, DEA said it was exploring how to establish a cost-effective system to obtain National Practitioner Data Bank (NPDB) information and will reevaluate the need to obtain NPDB information after DEA has had the opportunity to process the FSMB information. In June 2020, DEA stated it will not be taking additional action on obtaining NPDB. We will continue to monitor DEA's progress in implementing this recommendation.