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As of January 31, 2023, there are 4839 open recommendations that still need to be addressed. 470 of these are priority recommendations, those that we believe warrant priority attention. Learn more about our priority designation on our Recommendations page.

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1 - 7 of 7 Recommendations, including 0 Priority Recommendations

Military Health Care: Improved Procedures and Monitoring Needed to Ensure Provider Qualifications and Competence

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2 Open Recommendations
Agency Recommendation Status
Defense Health Agency The Director of the Defense Health Agency should revise the procedures manual for clinical quality management to better ensure requirements are clear and specific. Revisions should

  • clarify whether clinical references are required for providers whose privileges are being renewed.
  • specify how far in advance of privileging an MTF is allowed to verify licenses and query the NPDB and List of Excluded Individuals and Entities.
  • specify that MTF staff must document their consideration of information that raises concerns during the credentialing and privileging process.
  • clarify requirements for FPPEs for cause, including clear distinctions between requirements that apply to initial FPPEs and those that apply to FPPEs for cause.
  • specify how DHA defines commencing and completing a PCE review and how MTFs should document these milestones in DOD's centralized healthcare risk management database.

(Recommendation 1)

Open

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Defense Health Agency The Director of the Defense Health Agency should implement monitoring of clinical quality management procedures at MTFs and ensure that the monitoring approach includes

  • an assessment of MTF adherence to credentialing and privileging, FPPE for cause, and PCE review procedures.
  • a process for obtaining and evaluating information about all patient safety events that resulted in compensation and require DHA review.

(Recommendation 2)

Open

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Defense Health Agency: Oversight Needed to Better Ensure That Children Are Screened, Tested, and Treated for Lead Exposure

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1 Open Recommendations
Agency Recommendation Status
Defense Health Agency DHA should develop a plan, with time frames, to implement a process to oversee the extent to which MTF providers are adhering to DHA's guidelines related to pediatric lead screening, testing, treating, and reporting to ensure that these processes are implemented consistently across all MTFs. (Recommendation 1)
Open

When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

DOD Health Care: DOD Should Monitor Implementation of Its Clinical Practice Guidelines

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1 Open Recommendations
Agency Recommendation Status
Defense Health Agency The Director of DHA should collaborate with the Surgeons General of the military services to develop and implement a systematic process to monitor MTFs' implementation of VA/DOD CPGs. (Recommendation 1)
Open

The Department of Defense (DOD) concurred with GAO's recommendation. In May 2021, DOD stated that it will implement the recommendation with three major actions: 1) develop a communication plan to implement VA/DoD clinical practice guidelines (CPG) for the new Defense Health Agency (DHA) organizational structure; 2) develop a VA/DoD CPG implementation pilot for educating and training clinicians at the initial four DHA-certified markets; 3) develop a VA/DoD CPG implementation plan for education and training of clinicians to expand into all DHA military treatment facilities. DOD expects to

Defense Health Care: DOD Should Collect and Use Key Information to Make Decisions about Incentives for Physicians and Dentists

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3 Open Recommendations
Agency Recommendation Status
Defense Health Agency The Secretary of Defense should ensure that the Assistant Secretary of Defense for Health Affairs, in coordination with the military departments, collect consistent information on the replacement costs of military physicians and dentists and use this information to inform investment decisions in the package of incentives to recruit and retain military physicians and dentists. (Recommendation 1)
Open

DOD concurred with this recommendation, but has not yet implemented it. In a January 2023 status update, DOD stated that it had identified the type of information it needed to collect to implement this recommendation, but that such information would require alternate methods of collection as it was not readily available. DOD estimated that it would implement this recommendation by September 2026. We will continue to monitor DOD's actions to implement this recommendation.

Defense Health Agency The Secretary of Defense should ensure that the Assistant Secretary of Defense for Health Affairs, in coordination with the military departments, collect consistent information on current and historical retention data, to include data on the percentage of eligible physicians and dentists who accept retention bonuses, and use this information to inform investment decisions in the package of incentives to retain military physicians and dentists. (Recommendation 2)
Open

DOD concurred with this recommendation, but has not yet implemented it. In a January 2023 status update, DOD stated that it had identified the type of information it needed to collect to implement this recommendation, but that such information would require alternate methods of collection as it was not readily available. DOD estimated that it would implement this recommendation by September 2026. We will continue to monitor DOD's actions to implement this recommendation.

Defense Health Agency The Secretary of Defense should ensure that the Assistant Secretary of Defense for Health Affairs, in coordination with the military departments, collect consistent information on private sector civilian wages and use this information to help inform investment decisions in the package of incentives to recruit and retain military physicians and dentists. (Recommendation 3)
Open

DOD concurred with this recommendation, but has not yet implemented this recommendation. In an January 2023 status update, DOD stated that it plans to evaluate its current sources of private sector civilian wage information, consider alternatives, and develop a plan to use this information to help inform investment decisions in the package of incentives to recruit and retain military physicians and dentists. DOD estimates this recommendation will be fully implemented by September 2026. We will continue to monitor DOD's actions to implement this recommendation.

Have a Question about a Recommendation?

For questions about a specific recommendation, contact the person or office listed with the recommendation. For general information about recommendations, contact GAO's Audit Policy and Quality Assurance office at (202) 512-6100 or apqa@gao.gov.