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Open Recommendations

Medicare Telehealth: Actions Needed to Strengthen Oversight and Help Providers Educate Patients on Privacy and Security Risks

GAO-22-104454
Sep 26, 2022
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4 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare & Medicaid Services The Administrator of CMS should develop an additional billing modifier or clarify its guidance regarding billing of audio-only office visits to allow the agency to fully track these visits. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare & Medicaid Services The Administrator of CMS should require providers to use available site of service codes to indicate when Medicare telehealth services are delivered to beneficiaries in their homes. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare & Medicaid Services The Administrator of CMS should comprehensively assess the quality of Medicare services, including audio-only services, delivered using telehealth during the public health emergency. Such an assessment could include leveraging evidence from related efforts led by other HHS agencies. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Office for Civil Rights for the Department of Education OCR should provide additional education, outreach, or other assistance to providers to help them explain the privacy and security risks to patients in plain language when using video telehealth platforms to provide telehealth services. (Recommendation 4)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

COVID-19 in Nursing Homes: CMS Needs to Continue to Strengthen Oversight of Infection Prevention and Control

GAO-22-105133
Sep 14, 2022
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3 Open Recommendations
Agency Affected Recommendation Status
Centers for Medicare & Medicaid Services The Administrator of CMS should establish minimum infection preventionist training standards. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare & Medicaid Services The Administrator of CMS should collect infection preventionist staffing data and use these data to determine whether the current infection preventionist staffing requirement is sufficient. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Centers for Medicare & Medicaid Services The Administrator of CMS should provide additional guidance in the State Operations Manual on making scope and severity determinations for IPC-related deficiencies. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

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

GAO-22-104668
Aug 11, 2022
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2 Open Recommendations
Agency Affected 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.

World Trade Center Health Program: Quality Assurance Program Should Include Monitoring of Access to Health Services

GAO-22-105303
Jul 29, 2022
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3 Open Recommendations
Agency Affected Recommendation Status
National Institute for Occupational Safety and Health The Director of NIOSH should update the WTCHP Quality Assurance Plan's strategic priorities to include ensuring timely access to the five types of WTCHP health services and update program activities to align with this priority. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
National Institute for Occupational Safety and Health The Director of NIOSH should establish quality assurance metrics related to the timeliness with which members can access WTCHP health services provided through the Nationwide Provider Network, and as appropriate the Clinical Centers of Excellence. Such metrics should account for the five types of WTCHP health services and include wait time standards and benchmarks. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
National Institute for Occupational Safety and Health The Director of NIOSH should ensure that the WTCHP Quality Assurance Committee review data on the timeliness with which members can access WTCHP health services provided through the Nationwide Provider Network, and as appropriate the Clinical Centers of Excellence, on at least an annual basis to identify and take steps to address any needed improvements. At a minimum, this should include reviewing the data on the quality assurance metrics related to access to care for the five types of WTCHP health services after they are established. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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