Internal controls (11 - 20 of 43 items) in Past Year
Skilled Nursing Facilities: CMS Should Improve Accessibility and Reliability of Expenditure Data
GAO-16-700: Published: Sep 7, 2016. Publicly Released: Oct 6, 2016.
The Centers for Medicare & Medicaid Services (CMS)—the agency within the Department of Health and Human Services (HHS) that administers Medicare—collects and reports expenditure data from skilled nursing facilities (SNF), but it has not taken key steps to make the data readily accessible to public stakeholders or to ensure their reliability. SNFs are required to self-report their expenditures...
NIH Biomedical Research: Agencies Involved in the Indirect Cost Rate-Setting Process Need to Improve Controls
GAO-16-616: Published: Sep 7, 2016. Publicly Released: Sep 28, 2016.
Research organizations that apply for National Institutes of Health (NIH) funding participate in an indirect cost rate-setting process, which involves submitting a rate proposal; reviewing the proposal and having it audited by a third-party agency at the cognizant agency's request; and finalizing (negotiating) the rate for the organization. The Office of Management and Budget (OMB) and the Departm...
High-Containment Laboratories: Improved Oversight of Dangerous Pathogens Needed to Mitigate Risk
GAO-16-642: Published: Aug 30, 2016. Publicly Released: Sep 21, 2016.
The total number of incidents involving incomplete inactivation—a process to destroy the hazardous effects of pathogens while retaining characteristics for future use—that occurred from 2003 through 2015 is unknown for several reasons. One key reason is that the Select Agent Program—operated by the Departments of Health and Human Services (HHS) and Agriculture (USDA) to oversee certain dange...
Veterans' Health Care: Improved Oversight of Community Care Physicians' Credentials Needed
GAO-16-795: Published: Sep 19, 2016. Publicly Released: Sep 19, 2016.
GAO found that the Department of Veterans Affairs' (VA) contractors—Health Net Federal Services (Health Net) and TriWest Healthcare Alliance (TriWest)—complied with contractual requirements to verify the credentials of physicians under one community care program, but were deficient in doing so under another program. Based on GAO's review of selected physicians, GAO found that the contractors a...
Patient Protection and Affordable Care Act: Final Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015
GAO-16-792: Published: Sep 9, 2016. Publicly Released: Sep 12, 2016.
Under the Patient Protection and Affordable Care Act (PPACA), health-insurance marketplaces are required to verify application information to determine eligibility for enrollment and, if applicable, determine eligibility for income-based subsidies or Medicaid. Verification steps include reviewing and validating an applicant's Social Security number, if one is provided; citizenship, status as a U.S...
Female Genital Mutilation/Cutting: Existing Federal Efforts to Increase Awareness Should Be Improved
GAO-16-645: Published: Jun 30, 2016. Publicly Released: Aug 1, 2016.
The Centers for Disease Control and Prevention (CDC) estimated that 513,000 women and girls in the United States were at risk of or had been subjected to female genital mutilation/cutting (FGM/C) in 2012, a threefold increase from its 1990 estimate. CDC attributes this change primarily to increased immigration from countries where FGM/C is practiced, rather than an increase in the occurrence of FG...
Medicare Part B: CMS Should Take Additional Steps to Verify Accuracy of Data Used to Set Payment Rates for Drugs
GAO-16-594: Published: Jul 1, 2016. Publicly Released: Aug 1, 2016.
In 2014, the most recent year for which data were available, the Medicare program and its beneficiaries spent about $21 billion on approximately 46 million administrations of 551 Part B drugs paid based on average sales price (ASP). Six drugs—each exceeding $1 billion in expenditures—accounted for 36 percent of all expenditures on Part B ASP drugs, while a different 10 drugs—each administere...
Military Health Care: Army Needs to Improve Oversight of Warrior Transition Units
GAO-16-583: Published: Jul 12, 2016. Publicly Released: Jul 12, 2016.
The Army has not assessed the effectiveness of the Triad of Care model, the core structure of the Warrior Transition Unit (WTU) program, consisting of a team of three key staff that provide medical case management. The Army established the Triad of Care model at a time when WTU soldiers' diagnoses were primarily for physical conditions. Since then, the composition of diagnoses has changed signific...
Veterans Crisis Line: Additional Testing, Monitoring, and Information Needed to Ensure Better Quality Service
GAO-16-373: Published: May 26, 2016. Publicly Released: Jun 27, 2016.
GAO found that the Department of Veterans Affairs (VA) did not meet its call response time goals for the Veterans Crisis Line (VCL), although extended call wait times were not common. VA's goal is to answer 90 percent of VCL calls at the VCL primary center within 30 seconds. Currently, calls not answered within 30 seconds route to VCL backup call centers; however, for 5 months of fiscal year 2015,...
Controlled Substances: DEA Should Take Additional Actions to Reduce Risks in Monitoring the Continued Eligibility of Its Registrants
GAO-16-310: Published: May 26, 2016. Publicly Released: Jun 21, 2016.
The Drug Enforcement Administration (DEA) has established controls for determining registrant eligibility to handle and prescribe controlled substances. However, GAO found limitations in DEA's controls to help ensure that individual registrants are and remain eligible and do not present issues that may increase the risk of illicit diversion. GAO's examination of DEA's controlled substances databas...