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As of May 8, 2024, there are 5104 open recommendations that still need to be addressed. 412 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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4941 - 4960 of 5104 Recommendations, including 412 Priority Recommendations

Minority AIDS Initiative: Consolidation of Fragmented HIV/AIDS Funding Could Reduce Administrative Challenges

GAO-14-84
Marcia Crosse
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1 Open Recommendations
Agency Recommendation Status
Department of Health and Human Services In order to reduce the administrative costs associated with a fragmented MAI grant structure that diminishes the effective use of HHS's limited HIV/AIDS funding, and to enhance services to minority populations, HHS should seek legislation to amend the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 or other provisions of law, as necessary, to achieve a consolidated approach.
Open

HHS stated that it does not support the consolidation of Minority AIDS Initiative (MAI) funds into core funding. As of January 2024, HHS had not changed its position. We will update the status of this recommendation when we receive additional information.

2020 Census: Bureau Needs to Improve Scheduling Practices to Enhance Ability to Meet Address List Development Deadlines

GAO-14-59
Robert N. Goldenkoff
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1 Open Recommendations
Agency Recommendation Status
Department of Commerce To help maintain a more thorough and insightful 2020 Census development schedule in order to better manage risks to a successful 2020 Census, the Secretary of Commerce and Undersecretary of Economic Affairs should direct the U.S. Census Bureau to improve the credibility of schedules, including conducting a quantitative risk assessment.
Open

The Bureau agreed with this recommendation and stated that it had already begun maturing project schedules to ensure that the logical relationships between discrete schedules were put into place. Schedule integration sessions across projects and programs were held in late January 2014 and into February 2014 and periodically since then, where work was deconstructed into detailed schedules. The Bureau released its operational plan and other documentation in November 2015 and announced in June 2016 that it would finalize and release its 2020 Census schedule in July 2016. In 2015, the Bureau

Human Capital: Opportunities Exist to Further Improve DOD's Methodology for Estimating the Costs of Its Workforces

GAO-13-792
Brenda S. Farrell
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4 Open Recommendations
Agency Recommendation Status
Department of Defense To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's methodology for estimating and comparing the full cost of its various workforces, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation to further develop guidance for cost elements that users have identified as challenging to calculate, such as general and administrative, overhead, advertising and recruiting, and training.
Open

DOD concurred with our recommendation to further develop guidance for personnel cost elements that users identified as challenging to calculate. In a December 2020 memo, the Deputy Secretary of Defense stated that DOD will take timely and significant steps to achieve comprehensive fully burdened personnel cost estimates and directed the Cost Assessment and Program Evaluation (CAPE) office to update DOD Instruction 7041.04, Estimating and Comparing the Full Costs of Civilian and Active Duty Military Manpower and Contract Support. As of August 2021, CAPE was in the process of revising the
Department of Defense To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's methodology for estimating and comparing the full cost of its various workforces, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation to develop business rules for estimating the full cost of National Guard and Reserve personnel.
Open

DOD partially concurred with our recommendation to develop business rules for estimating the full cost of National Guard and Reserve personnel. In a December 2020 memo, the Deputy Secretary of Defense stated that DOD will take timely and significant steps to achieve comprehensive fully burdened personnel cost estimates and directed the Cost Assessment and Program Evaluation (CAPE) office to update DOD Instruction 7041.04, Estimating and Comparing the Full Costs of Civilian and Active Duty Military Manpower and Contract Support. As of August 2021, CAPE was in the process of revising the
Department of Defense To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's methodology for estimating and comparing the full cost of its various workforces, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation, in coordination with the department's Office of the Actuary and appropriate federal actuarial offices, to reevaluate the inclusion and quantification of pension, retiree health care costs, and other relevant costs of an actuarial nature and make revisions as appropriate.
Open

DOD concurred with our recommendation to coordinate with the department's Office of the Actuary and other appropriate federal actuarial offices to reevaluate the inclusion of pension, retiree health care, and other relevant actuarial costs in its methodology for estimating and comparing the full cost of its workforces. In a December 2020 memo, the Deputy Secretary of Defense stated that DOD will take timely and significant steps to achieve comprehensive fully burdened personnel cost estimates and directed the Cost Assessment and Program Evaluation (CAPE) office to update DOD Instruction 7041
Department of Defense To improve DOD's estimates and comparisons of the full cost of its military, civilian, and contractor workforces and to improve DOD's ability to estimate contractor support costs, the Secretary of Defense should direct the Office of Cost Assessment and Program Evaluation, consistent with established practices for developing credible cost estimates, to research the data sources it is currently using and reassess its contractor support data sources for use when determining contractor support costs.
Open

DOD concurred with our recommendation to research the data sources currently used for determining contractor support costs. In a December 2020 memo, the Deputy Secretary of Defense stated that DOD will take timely and significant steps to achieve comprehensive fully burdened personnel cost estimates and directed the Cost Assessment and Program Evaluation (CAPE) office to update DOD Instruction 7041.04, Estimating and Comparing the Full Costs of Civilian and Active Duty Military Manpower and Contract Support. As of August 2021, CAPE was in the process of reviewing and updating all data sources

Information Resellers: Consumer Privacy Framework Needs to Reflect Changes in Technology and the Marketplace

GAO-13-663
Alicia Puente Cackley
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1 Open Recommendations
Agency Recommendation Status
Congress Congress should consider strengthening the current consumer privacy framework to reflect the effects of changes in technology and the marketplace--particularly in relation to consumer data used for marketing purposes--while also ensuring that any limitations on data collection and sharing do not unduly inhibit the economic and other benefits to industry and consumers that data sharing can accord. Among the issues that should be considered are: (1) the adequacy of consumers' ability to access, correct, and control their personal information in circumstances beyond those currently accorded under FCRA; (2) whether there should be additional controls on the types of personal or sensitive information that may or may not be collected and shared; (3) changes needed, if any, in the permitted sources and methods for data collection; and (4) privacy controls related to new technologies, such as web tracking and mobile devices.
Open

As of March 2024, Congress has not enacted comprehensive privacy legislation that would address this matter.

FHA Mortgage Insurance: Applicability of Industry Requirements Is Limited, but Certain Features Could Enhance Oversight

GAO-13-722
Matthew Scirè
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1 Open Recommendations
Agency Recommendation Status
Congress To strengthen FHA accountability for complying with the Fund's statutory capital requirement, Congress should consider requiring that FHA submit a capital restoration plan and regular updates on plan implementation whenever the capital ratio falls below 2 percent as calculated in the annual actuarial review of the Fund, or the Fund's financial condition does not meet other congressionally-defined requirements.
Open

As of March 2024, Congress had not yet acted on this matter for consideration.

Oil and Gas Development: BLM Needs Better Data to Track Permit Processing Times and Prioritize Inspections

GAO-13-572
Frank Rusco
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1 Open Recommendations
Agency Recommendation Status
Department of the Interior The Secretary of the Interior should direct the Director of the Bureau of Land Management to take steps, including making changes to AFMSS, and in any new system that replaces AFMSS, to improve the ability of staff to identify wells that are a high priority for environmental inspection and to incorporate information on the inspection history of wells into the environmental inspection prioritization process.
Open

As of March 2024, we are following up on this recommendation and will update it when we receive information. BLM concurred with the recommendation and has initiated action to update its application for permit to drill (APD) permit processing system. This new system will be known as Automated Fluid Minerals Support System II (AFMSS II) and, when fully implemented, may address GAO's recommendations. Currently, BLM's actions are insufficient to close this recommendation because they have not completed the updates to AFMSS. Specifically, BLM has not completed its update of AFMSS II to cover

Pesticides: EPA Should Take Steps to Improve Its Oversight of Conditional Registrations

GAO-13-145
J. Alfredo Gómez
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1 Open Recommendations
Agency Recommendation Status
Environmental Protection Agency To improve EPA's management of the conditional registration process, the Administrator of EPA should direct the Director of the Office of Pesticide Programs to complete plans to automate data related to conditional registrations to more readily track the status of these registrations and related registrant and agency actions and identify potential problems requiring management attention.
Open

As of July 2023, we are keeping this recommendation open. GAO is awaiting additional documentation that the Office of Chemical Safety and Pollution Prevention agreed to provide.

Medicare: Higher Use of Costly Prostate Cancer Treatment by Providers Who Self-Refer Warrants Scrutiny

GAO-13-525
James Cosgrove
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2 Open Recommendations
Agency Recommendation Status
Congress To increase beneficiaries' awareness of providers' financial interest in a particular treatment, Congress should consider directing the Secretary of Health and Human Services to require providers who self-refer IMRT services to disclose to their patients that they have a financial interest in the service.
Open

In August 2013, to increase beneficiaries' awareness of providers' financial interest in a particular treatment, we suggested that Congress should consider directing the Secretary of Health and Human Services to require providers who self-refer IMRT services to disclose to their patients that they have a financial interest in the service. As of March 2024, Congress has not implemented this suggestion.
Centers for Medicare & Medicaid Services The Administrator of CMS should insert a self-referral flag on its Medicare Part B claims form, require providers to indicate whether the IMRT service for which a provider bills Medicare is self-referred, and monitor the effects that self-referral has on costs and beneficiary treatment selection.
Open

In August 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) insert a self-referral flag on its Medicare Part B claims form, require providers to indicate whether the intensity-modulated radiation therapy (IMRT) service for which a provider bills Medicare is self-referred, and monitor the effects that self-referral has on costs and beneficiary treatment selection. The Department of Health and Human Services (HHS) did not concur with this recommendation, noting that CMS does not believe that this recommendation will address overutilization that

Export Promotion: Better Information Needed about Federal Resources

GAO-13-644
Kimberly Gianopoulos
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Department of Commerce
Priority Rec.
To improve the consistency, comprehensiveness, and transparency of information provided to Congress and policymakers on the federal investment in export promotion programs, the Secretary of Commerce, as chair of the TPCC, should report in its National Export Strategies on how resources are allocated by agency and aligned with priorities.
Open

The Export Enhancement Act [15 U.S.C. Section 4727(c)] states that the Trade Promotion Coordinating Committee's (TPCC) strategies should establish a set of priorities for federal export promotion activities and propose a unified federal trade promotion budget that supports the plan. In written comments on GAO's report, the Director of the TPCC Secretariat generally concurred with the recommendation on behalf of the Secretary. Nevertheless, the Director noted the TPCC's limited authority over budget reporting and resource allocations and gave examples of some challenges they faced, including

Management Report: Improvements Needed in Controls over the Preparation of the U.S. Consolidated Financial Statements

GAO-13-540
Gary T. Engel
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2 Open Recommendations
2 Priority
Agency Recommendation Status
Department of the Treasury
Priority Rec.
To improve the reliability of the information presented in the CFS budget statements, the Secretary of the Treasury should direct the Fiscal Assistant Secretary, working in coordination with the Controller of OMB's Office of Federal Financial Management, to establish and implement effective procedures for identifying and reporting all items needed to prepare the CFS budget statements.
Open

As of the completion of our fiscal year 2023 audit of the consolidated financial statements of the U.S. government (CFS), this recommendation remained open. Treasury continued to develop its process for preparing the Reconciliation Statements, such as continuing to implement procedures and encourage federal entities to fully utilize newly developed loan activity transaction codes established to improve the accounting for and reporting of General Fund transactions and balances. Treasury is also in the process of reviewing line items related to federal debt securities and other General Fund
Department of the Treasury
Priority Rec.
To improve the reliability of the information presented in the CFS budget statements, the Secretary of the Treasury should direct the Fiscal Assistant Secretary, working in coordination with the Controller of OMB's Office of Federal Financial Management, to establish and implement effective procedures for reporting amounts in the CFS budget statements that are fully consistent with the underlying information in significant federal entities' audited financial statements and other financial data.
Open

As of the completion of our fiscal year 2023 audit of the consolidated financial statements of the U.S. government (CFS), this recommendation remained open. Treasury continued to develop its process for preparing the Reconciliation Statements, such as continuing to implement procedures and encourage federal entities to fully utilize newly developed loan activity transaction codes established to improve the accounting for and reporting of General Fund transactions and balances. Treasury is also in the process of reviewing line items related to federal debt securities and other General Fund

Medicaid Demonstration Waivers: Approval Process Raises Cost Concerns and Lacks Transparency

GAO-13-384
Katherine Iritani
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1 Open Recommendations
Agency Recommendation Status
Department of Health and Human Services To improve the transparency of the process for reviewing and approving spending limits for comprehensive section 1115 demonstrations, the Secretary of Health and Human Services should reconsider adjustments and costs used in setting the spending limits for the Arizona and Texas demonstrations, and make appropriate adjustments to spending limits for the remaining years of each demonstration.
Open – Partially Addressed

As of February 2024, the Department of Health and Human Services (HHS) had taken steps to address GAO's 2013 recommendation, but more actions are needed for GAO to consider this recommendation implemented. In May 2016, the Centers for Medicare & Medicaid Services (CMS) announced changes to its budget neutrality policies, which it formalized in a Letter to State Medicaid Directors in 2018. CMS applied the first of its policy changes: limiting the extent to which states can accrue unused demonstration spending authority. This initial policy change has been implemented for all section 1115

Medicare: Action Needed to Address Higher Use of Anatomic Pathology Services by Providers Who Self-Refer

GAO-13-445
James Cosgrove
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3 Open Recommendations
Agency Recommendation Status
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred anatomic pathology services and help CMS avoid unnecessary increases in these services, the Administrator of CMS should determine and implement an approach to ensure the appropriateness of biopsy procedures performed by self-referring providers.
Open

In June 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) implement an approach to ensure the appropriateness of biopsy procedures performed by self-referring providers. The Department of Health and Human Services (HHS) did not concur with this recommendation and does not believe it would address overutilization that occurs as a result of self-referral. In November 2017, CMS officials noted that the agency does not have the ability to identify self-referred anatomic pathology services during medical reviews. As of March 2023, CMS has not provided
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred anatomic pathology services and help CMS avoid unnecessary increases in these services, the Administrator of CMS should develop and implement a payment approach for anatomic pathology services that would limit the financial incentives associated with referring a higher number of specimens--or anatomic pathology services--per biopsy procedure.
Open

In June 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) develop and implement a payment approach for anatomic pathology services under the Physician Fee Schedule that would limit the financial incentives associated with referring a higher number of specimens--anatomic pathology services--per biopsy procedure. Although health care providers have discretion in determining the number of tissue samples from biopsy procedures that become specimens (anatomic pathology services), CMS's current payment system under the Physician Fee Schedule provides a
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred anatomic pathology services and help CMS avoid unnecessary increases in these services, the Administrator of CMS should insert a self-referral flag on Medicare Part B claim forms and require providers to indicate whether the anatomic pathology services for which the provider bills Medicare are self-referred or not.
Open

In June 2013, we recommended that the Administrator of the Centers for Medicare & Medicaid Services (CMS) insert a self-referral flag on Medicare Part B claim forms and require providers to indicate whether the anatomic pathology services for which the provider bills Medicare are self-referred or not. The Department of Health and Human Services (HHS) did not concur with this recommendation, noting that CMS does not believe that this recommendation will address overutilization that occurs as a result of self-referral. Although CMS has taken initial steps relevant to self-referral, the steps do

Managing for Results: Leading Practices Should Guide the Continued Development of Performance.gov

GAO-13-517
J. Christopher Mihm
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1 Open Recommendations
Agency Recommendation Status
Office of Management and Budget To enhance the value of Performance.gov for intended audiences and improve the ability to identify and prioritize potential improvements, the Director of the Office of Management and Budget--working with the Performance Improvement Council and the General Services Administration--should seek to ensure that all performance, search, and customer satisfaction metrics, consistent with leading practices outlined in HowTo.gov, are tracked for the website, and, where appropriate, create goals for those metrics to help identify and prioritize potential improvements to Performance.gov.
Open

As of July 2023, the Office of Management and Budget (OMB) and General Services Administration (GSA) had taken some actions toward addressing this recommendation. According to information that OMB staff provided in April 2021, OMB and GSA are tracking 15 out of 24 metrics for Performance.gov that are recommended for federal websites, and they are working to collect information related to the remaining 9 metrics. In addition, in March 2021 they began using a Google Analytics account. OMB staff told us in April 2021 that the features and information available through that account should allow
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