GAO’s recommendations database contains report recommendations that still need to be addressed.
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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: 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 June 2019, SSA reported that it continues to work on updating its Debt Management System and that it will release its waiver application by fiscal year 2020. According to SSA, this application will include controls to prevent users from administratively waiving overpayments that are over $1,000. We will close this recommendation once SSA has implemented these controls to prevent staff from improperly waiving debts.
Recommendation: To meet its fiduciary responsibility of ensuring that section 1115 waivers are budget neutral, the Secretary of Health and Human services should better ensure that valid methods are used to demonstrate budget neutrality, by developing and implementing consistent criteria for consideration of section 1115 demonstration waiver proposals.
Agency: Department of Health and Human Services Status: Open Priority recommendation
Comments: As of January 2020, the Department of Health and Human Services (HHS) had taken some action to address GAO's 2002 recommendation. In August 2018, HHS issued written guidance through a State Medicaid Directors Letter documenting four key changes it made in 2016 to its budget neutrality policy. These changes addressed some, but not all of the questionable methods GAO identified in its reports. To fully address this recommendation, HHS should also address these other questionable methods, such as setting demonstration spending limits based on hypothetical costs-what the state could have paid-rather than payments actually made by the state. GAO has found that the use of hypothetical costs has the potential to inflate spending limits and thus threatens budget neutrality of demonstrations