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As of May 30, 2024, there are 5146 open recommendations that still need to be addressed. 411 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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4861 - 4880 of 5146 Recommendations, including 411 Priority Recommendations

Telecommunications: Agencies Need Better Controls to Achieve Significant Savings on Mobile Devices and Services

GAO-15-431
Carol R. Cha
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4 Open Recommendations
Agency Recommendation Status
National Aeronautics and Space Administration To help the agency effectively manage spending on mobile devices and services, the Administrator of the National Aeronautics and Space Administration should ensure a complete inventory of mobile devices and associated services is established.
Open

As of January 2024, NASA had not demonstrated that it has implemented the recommendation. In June 2021, NASA's Office of the Chief Information Officer (OCIO) provided an inventory of mobile devices and services; however, the OCIO did not demonstrate that the inventory was complete. Specifically, the OCIO did not demonstrate that it had accounted for all NASA devices. We will continue to monitor NASA's efforts to implement the recommendation.
National Aeronautics and Space Administration To help the agency effectively manage spending on mobile devices and services, the Administrator of the National Aeronautics and Space Administration should ensure a reliable inventory of mobile service contracts is developed and maintained.
Open

As of January 2024, NASA had not demonstrated that it has implemented the recommendation.
National Aeronautics and Space Administration To help the agency effectively manage spending on mobile devices and services, the Administrator of the National Aeronautics and Space Administration should ensure procedures to monitor and control spending are established agency-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.
Open

As of January 2024, NASA had not implemented the recommendation. We will continue to monitor the agency's efforts to implement the recommendation.
Department of the Treasury To help the department effectively manage spending on mobile devices and services, the Secretary of the Treasury should ensure procedures to monitor and control spending are established department-wide. Specifically, ensure that (1) procedures include assessing devices for zero, under, and over usage; (2) personnel with authority and responsibility for performing the procedures are identified; and (3) the specific steps to be taken to perform the process are documented.
Open

As of January 2024, the Department of the Treasury had not demonstrated that it has implemented the recommendation. We will continue to monitor the department's efforts to implement this recommendation.

Medicare Physician Payment Rates: Better Data and Greater Transparency Could Improve Accuracy

GAO-15-434
James Cosgrove
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3 Open Recommendations
Agency Recommendation Status
Centers for Medicare & Medicaid Services To help improve CMS's process for establishing relative values for Medicare physicians' services, the Administrator of CMS should incorporate data and expertise from physicians and other relevant stakeholders into the process as well as develop a timeline and plan for using the funds appropriated by the Protecting Access to Medicare Act of 2014.
Open – Partially Addressed

To help improve the Centers for Medicare & Medicaid Service's (CMS) process for establishing relative values for Medicare physicians' services, in May 2015 we recommended that the Administrator of CMS incorporate data and expertise from physicians and other relevant stakeholders into the process, as well as develop a timeline and plan for using the funds appropriated by the Protecting Access to Medicare Act of 2014 (PAMA). CMS concurred with this recommendation, stating that stakeholders have the opportunity each year to nominate potentially misvalued services for review through a public
Centers for Medicare & Medicaid Services To help improve CMS's process for establishing relative values for Medicare physicians' services, the Administrator of CMS should better document the process for establishing relative values for Medicare physicians' services, including the methods used to review RUC recommendations and the rationale for final relative value decisions.
Open

To help improve the Centers for Medicare & Medicaid Service's (CMS) process for establishing relative values for Medicare physicians' services, in May 2015 we recommended that the Administrator of CMS better document the process, including the methods used to review recommendations from the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) and the rationale for final relative value decisions. CMS concurred with this recommendation, stating that CMS establishes relative values for new, revised, and potentially misvalued physicians' services based on its
Centers for Medicare & Medicaid Services To help improve CMS's process for establishing relative values for Medicare physicians' services, the Administrator of CMS should develop a process for informing the public of potentially misvalued services identified by the RUC, as CMS already does for potentially misvalued services identified by CMS or other stakeholders.
Open

To help improve the Centers for Medicare & Medicaid Service's (CMS) process for establishing relative values for Medicare physicians' services, in May 2015 we recommended that the Administrator of CMS develop a process for informing the public of potentially misvalued services identified by the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC), as CMS already does for potentially misvalued services identified by CMS or other stakeholders. CMS did not concur with this recommendation, asserting that the RUC is completely independent of CMS, and as such

Unmanned Aerial Systems: Actions Needed to Improve DOD Pilot Training

GAO-15-461
Brenda S. Farrell
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1 Open Recommendations
Agency Recommendation Status
Department of Defense To increase opportunities to improve the effectiveness and efficiency of UAS pilot training across DOD, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to address how the services should coordinate with one another in the strategy on UAS pilot training that the Office of the Under Secretary of Defense for Personnel and Readiness is current drafting.
Open

DOD concurred with this recommendation and stated the Office of the Under Secretary of Defense for Personnel and Readiness was in the process of revising its draft "Department of Defense Training Strategy for Unmanned Aircraft Systems(UAS)" to address inter-service coordination to enable the department to train more efficiently and effectively as a whole. In October 2016, the Director stated that RAND had completed the draft strategy and that the Office of the Assistant Secretary of Defense (Readiness) had begun revising the strategy. An Office of the Assistant Secretary of Defense (Readiness)

Electricity Generation Projects: Additional Data Could Improve Understanding of the Effectiveness of Tax Expenditures

GAO-15-302
Frank Rusco
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2 Open Recommendations
Agency Recommendation Status
Congress If Congress wishes to evaluate the effectiveness of the ITC and the PTC as incentives for the development of renewable utility-scale electricity generation projects as it considers proposals to extend the ITC or reauthorize the PTC, it should consider directing the Commissioner of Internal Revenue to provide Congress with project-level data currently collected from taxpayers who claim the ITC in lieu of the PTC--such as the number of projects for which they are claiming the credit, the technology of the projects taking the credit, and the total generating capacity added--and make such data available for analysis. Additionally, take steps to collect and report the same data from all taxpayers claiming the ITC.
Open

Congress has not taken action on this matter as of March 2024.
Congress If Congress wishes to evaluate the effectiveness of the ITC and the PTC as incentives for the development of renewable utility-scale electricity generation projects as it considers proposals to extend the ITC or reauthorize the PTC, it should consider directing the Commissioner of Internal Revenue to take steps to collect project-level data from taxpayers claiming the PTC--such as the number of projects for which they are claiming the credit, the technology of the projects taking the credit, and the total generating capacity--and make these data available for analysis.
Open

Congress has not taken action on this matter as of March 2024.

Defense Inventory: Services Generally Have Reduced Excess Inventory, but Additional Actions Are Needed

GAO-15-350
Zina Merritt
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1 Open Recommendations
Agency Recommendation Status
Department of the Navy To help ensure that the Navy has adequate oversight of on-order excess inventory termination decisions and necessary performance measures consistent with DOD guidance, the Secretary of the Navy should direct the Commander, Naval Supply Systems Command, to incorporate the graduated management reviews and the ability to track and review the reasons for not canceling and modifying on-order excess items into its automated termination module that is under development.
Open

DOD concurred with our recommendation. As of August 2019, Naval Supply Systems Command has taken some steps, such as defining the requirement and piloting some aspects of the effort, to incorporate graduated management reviews and the ability to track and review the reason for not canceling and modifying on-order excess items into its automated termination module. However, this capability is not implemented into the automated termination module, according to Naval Supply Systems Command officials. Navy Supply Systems Command provided information on its plans to implement this capability in

Medicaid Demonstrations: Approval Criteria and Documentation Need to Show How Spending Furthers Medicaid Objectives

GAO-15-239
Katherine Iritani
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2 Open Recommendations
Agency Recommendation Status
Department of Health and Human Services To improve the transparency and accountability of HHS's section 1115 Medicaid demonstration approval process, and to ensure that federal Medicaid funds for the demonstrations do not duplicate other federal funds, the Secretary of Health and Human Services should issue criteria for assessing whether section 1115 expenditure authorities are likely to promote Medicaid objectives.
Open – Partially Addressed

The Department of Health and Human Services (HHS) partially concurred with this recommendation and has taken some steps to address the problems GAO identified. Initially, in August 2015, HHS posted on its website general criteria for assessing whether Medicaid section 1115 demonstration expenditure authorities are likely to promote Medicaid objectives, but GAO found the general criteria were not sufficiently specific. HHS later removed these criteria from its website and replaced them with six broad areas of reform that HHS encouraged states to consider. In 2021, HHS removed these broad areas
Department of Health and Human Services To improve the transparency and accountability of HHS's section 1115 Medicaid demonstration approval process, and to ensure that federal Medicaid funds for the demonstrations do not duplicate other federal funds, the Secretary of Health and Human Services should ensure the application of these criteria is documented in all HHS's approvals of section 1115 demonstrations, including those approving new or extending or modifying existing expenditure authorities, to inform internal and external stakeholders, including states, the public, and Congress, of the basis for the agency's determinations that approved expenditure authorities are likely to promote Medicaid objectives.
Open – Partially Addressed

HHS agreed with this recommendation and, as of May 2021, had taken some steps to ensure that the bases for its approval decisions are documented in all approvals of section 1115 demonstrations. In December 2017, CMS issued a letter to state Medicaid officials, stating that the agency had begun requesting additional documentation of the demonstration purposes being served by certain types of previously approved funding in demonstration proposals. Additionally, the agency noted it was taking certain steps to ensure that only allowable costs were matched by federal Medicaid funds. In April 2018

Medicaid: CMS Oversight of Provider Payments Is Hampered by Limited Data and Unclear Policy

GAO-15-322
Katherine Iritani
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3 Open Recommendations
Agency Recommendation Status
Centers for Medicare & Medicaid Services To improve CMS's oversight of Medicaid payments, the Administrator of CMS should take steps to ensure that states report accurate provider-specific payment data that include accurate unique national provider identifiers (NPI).
Open – Partially Addressed

As of February 2024, this recommendation remains partially addressed. In May 2021, CMS officials reported on a recent effort to validate the NPI--a unique 10-digit identification number assigned to health care providers--for each provider a state reports. At that time, officials said that they had recently implemented checks to validate the accuracy of provider-specific payment data, including the unique national provider identifiers states submit. According to CMS officials, some of these checks had identified data quality issues that had subsequently been resolved, while the results of other
Centers for Medicare & Medicaid Services To improve CMS's oversight of Medicaid payments, the Administrator of CMS should develop a policy establishing criteria for when such payments at the provider level are economical and efficient.
Open

As of February 2024, this recommendation remains not addressed. CMS confirmed it is not currently engaged in any efforts to address payment at the individual provider level. In December 2020, Congress passed and the President signed into law legislation requiring additional state reporting on Medicaid supplemental payments, including requiring states to describe how these payments are consistent with economy and efficiency. In December 2021, CMS issued guidance on these new supplemental payment reporting requirements beginning with information about payments made on or after October 1, 2021
Centers for Medicare & Medicaid Services To improve CMS's oversight of Medicaid payments, the Administrator of CMS should, once criteria are developed, develop a process for identifying and reviewing payments to individual providers in order to determine whether they are economical and efficient.
Open

As of February 2024, this recommendation remains not addressed. CMS confirmed it is not currently engaged in any efforts to address payment at the individual provider level. In December 2021, CMS issued guidance on new supplemental payment reporting requirements beginning with information about payments made on or after October 1, 2021. However, in January 2022, CMS officials said that neither the law nor the guidance establish criteria for economy and efficiency for Medicaid supplemental payments at the provider level. GAO maintains that developing a process, once criteria are developed, for

Library of Congress: Strong Leadership Needed to Address Serious Information Technology Management Weaknesses

GAO-15-315
Joel C. Willemssen
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2 Open Recommendations
Agency Recommendation Status
Library of Congress To effectively plan and manage its acquisitions of IT systems and increase the likelihood of delivering promised system capabilities on time and within budget, the Librarian should establish and implement an organization-wide policy for developing cost estimates that includes key practices as discussed in this report.
Open

The Library of Congress generally agreed with, and has begun to take steps to implement, this recommendation. Specifically, in January 2017 the Library established a centralized Library-wide Project Management Office, located within the Office of the Chief Information Officer (OCIO). Additionally, in June 2017 the Library updated its regulations to give the Project Management Office the authority to establish organization-wide policy for developing cost estimates for IT projects. However, in February 2021, the Library's Office of the Inspector General (OIG) reported that the Library did not
Library of Congress To effectively plan and manage its acquisitions of IT systems and increase the likelihood of delivering promised system capabilities on time and within budget, the Librarian should establish a time frame for finalizing and implementing an organization-wide policy for developing and maintaining project schedules that includes key practices as discussed in this report, and finalize and implement the policy within the established time frame.
Open

The Library of Congress generally agreed with, and has begun to take steps to implement, this recommendation. Specifically, in January 2017 the Library established a Project Management Office within the Office of the Chief Information Officer (OCIO) and tasked the office with communicating and enforcing Library requirements for IT project management and systems development. Additionally, in June 2017 the Library updated its regulations to give the Project Management Office the authority to establish organization-wide policy for developing and maintaining IT project schedules. However, in

Military Personnel: Actions Needed to Address Sexual Assaults of Male Servicemembers

GAO-15-284
Brenda S. Farrell
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2 Open Recommendations
Agency Recommendation Status
Office of the Assistant Secretary of Defense (Health Affairs) To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to help ensure that all of DOD's medical and mental health providers are generally aware of any gender-specific needs of sexual assault victims, and that victims are provided the care that most effectively meets those needs, the Assistant Secretary of Defense for Health Affairs should, in collaboration with the services' Surgeons General, develop and issue guidance for the department's medical and mental health providers--and other personnel, as appropriate--based on the results of this evaluation that delineates these gender-specific distinctions and the care regimen that is recommended to most effectively meet those needs.
Open

DOD concurred with this recommendation in written comments on our report. In August 2018, the Office of the Assistant Secretary of Defense for Health Affairs stated that DOD is writing an Instruction and two accompanying Defense Health Agency Procedural Instructions that will delineate gender-specific distinctions and care regimens where appropriate. The guidance will incorporate the findings of a report by the Psychological Health Center of Excellence of the Defense Health Agency resulting from a planned study of the patterns of health care utilization of servicemembers reporting a sexual
Department of Defense To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to help DOD's sexual assault prevention and response program realize the full benefit of the data it collects on sexual assault incidents, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military services, to develop a plan for data-driven decision making to prioritize program efforts.
Open

DOD concurred with this recommendation in written comments on our report. In October 2016, DOD published its plan for preventing and responding to sexual assaults of military men. In that plan, DOD generally outlined its intent to develop metrics to assess prevention and response efforts pertaining to males who experience sexual assault. In July 2022, DOD officials stated that the department has built a foundation of data sources on sexual assaults experienced by men, and that completion of the plan's objectives, including metrics to measure implementation, is estimated to occur by December 30
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