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As of May 9, 2024, there are 5120 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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5001 - 5020 of 5120 Recommendations, including 412 Priority Recommendations

Export Promotion: Small Business Administration Needs to Improve Collaboration to Implement Its Expanded Role

GAO-13-217
Loren Yager
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Small Business Administration
Priority Rec.
To more effectively implement SBA's expansion of OIT field staff as required by the SBJA, the Administrator of the SBA should update SBA's plan for additional OIT staff to include funding sources and time frames, as well as possible efficiencies from clearly defining roles and responsibilities and leveraging other entities' export assistance resources.
Open

SBA agreed with this recommendation. In December 2023, SBA officials said the Office of International Trade had filled 23 of the 30 Export Finance Manager positions required under the Small Business Jobs Act of 2010. According to SBA officials, its current staffing level adequately fills the export finance needs of small businesses due to SBA's use of technology to provide training and counseling to more exporters in the past 2 years and consolidation of the industry. In March 2024 SBA submitted a legislative proposal to Congress to reduce the Act's requirement of 30 export finance specialists

VA Health Care: Reliability of Reported Outpatient Medical Appointment Wait Times and Scheduling Oversight Need Improvement

GAO-13-130
Debra A. Draper
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Department of Veterans Affairs
Priority Rec.
To ensure reliable measurement of veterans' wait times for medical appointments, the Secretary of VA should direct the Under Secretary for Health to take actions to improve the reliability of wait time measures either by clarifying the scheduling policy to better define the desired date, or by identifying clearer wait time measures that are not subject to interpretation and prone to scheduler error.
Open – Partially Addressed

VA agreed with our recommendation. Since 2013, VA has taken actions intended to address the reliability of appointment wait times through improvements in appointment scheduling, including issuing a revised scheduling policy, providing and documenting scheduler training, and improving oversight through scheduler audits. While the revised scheduling policy and subsequent guidance changed the terminology of wait-time measures, they did not substantively clarify or define the wait time measurement. In February 2024, VA provided evidence to GAO that the department established "Third Next Available

Federal Rulemaking: Agencies Could Take Additional Steps to Respond to Public Comments

GAO-13-21
Melissa Emrey-Arras, Robert J. Cramer
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1 Open Recommendations
Agency Recommendation Status
Office of Management and Budget To better balance the benefits of expedited rulemaking procedures with the benefits of public comments that are typically part of regular notice-and-comment rulemakings, and improve the quality and transparency of rulemaking records, the Director of OMB, in consultation with the Chairman of Administrative Conference of the United States (ACUS), should issue guidance to encourage agencies to respond to comments on final major rules, for which the agency has discretion, that are issued without a prior notice of proposed rulemaking.
Open

OMB responded in 2021 that OIRA desk officers continue to work with agencies to promote appropriate responses to comments on final major rules. OMB stated that it agrees that agencies should respond to comments on final major rules, for which the agency has discretion, and that are issued without a prior notice of proposed rulemaking. OMB says it will continue to prioritize this issue during review of regulations under EO 12866. Further, the agency states it is considering whether additional guidance is appropriate and will consult with the staff of the Administrative Conference of the United

Consumer Product Safety Commission: Agency Faces Challenges in Responding to New Product Risks

GAO-13-150
Alicia Puente Cackley
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1 Open Recommendations
Agency Recommendation Status
Congress To better enable CPSC to target unsafe consumer products, Congress may wish to amend section 29(f) of CPSA to allow CPSC greater ability to enter into information-sharing agreements with its foreign counterparts that permit reciprocal terms on disclosure of nonpublic information.
Open

As of March 4, 2024, Section 29 of CPSA had not been amended since 2008. In the 117th Congress, two identical bills were introduced in the House (H.R. 2813) and Senate (S.1355) that would amend Section 29 and decrease the limitations on disclosure of information. No actions on these bills have been taken since April 2021. In the 118th Congress, one bill proposed a change to Sec. 29(F) on disclosure requirements for manufacturers or private lenders, but no further action had been taken. Prior to this, in 2013, a bill was introduced (S.1887) but not passed. That bill would have allowed "the

Highway Trust Fund: Pilot Program Could Help Determine the Viability of Mileage Fees for Certain Vehicles

GAO-13-77
Susan Fleming
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1 Open Recommendations
Agency Recommendation Status
Department of Transportation To ensure that up-to-date data are available on the road damages imposed by all vehicles types compared with the revenues each contributes to the Highway Trust Fund, the Secretary of Transportation should direct the FHWA Administrator to revise and publish the agency's Highway Cost Allocation Study and update it periodically as warranted.
Open

DOT neither agreed nor disagreed with this recommendation. The Infrastructure Investment and Jobs Act of 2021 (P.L. 117-58) directed DOT, in coordination with State departments of transportation, to conduct a highway cost allocation study to determine the direct costs of highway use by various types of users. In February 2024, DOT officials told GAO that they plan to begin the study by the end of 2024, and complete it by 2028. GAO will continue to monitor both DOT and FHWA efforts to implement GAO's recommendation.

Medicaid: More Transparency of and Accountability for Supplemental Payments Are Needed

GAO-13-48
Katherine Iritani
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1 Open Recommendations
Agency Recommendation Status
Congress To improve transparency of and accountability for Medicaid non-DSH supplemental payments, Congress should consider requiring the Administrator of CMS to (1) improve state reporting of non-DSH supplemental payments, including requiring annual reporting of payments made to individual facilities and other information that the agency determines is necessary to oversee non-DSH supplemental payments; (2) clarify permissible methods for calculating non-DSH supplemental payments; and (3) require states to submit an annual independent certified audit verifying state compliance with permissible methods for calculating non-DSH supplemental payments.
Open – Partially Addressed

In December 2020, Congress passed and the President signed into law legislation requiring additional state reporting on Medicaid supplemental payments. The annual reports are to include a description of how these payments are consistent with economy and efficiency, criteria used to determine which providers are eligible to receive these payments, and a comprehensive description of the methodology used to calculate the amount of, and to distribute, the payments to each eligible provider, among other things. As of March 2024, there had been no legislative action regarding required annual

Information Management: National Technical Information Service's Dissemination of Technical Reports Needs Congressional Attention

GAO-13-99
Valerie C. Melvin
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1 Open Recommendations
Agency Recommendation Status
Congress In light of the agency's declining revenue associated with its basic statutory function and the charging for information that is often freely available elsewhere, Congress should consider examining the appropriateness and viability of the fee-based model under which NTIS currently operates for disseminating technical information to determine whether the use of this model should be continued.
Open – Partially Addressed

Congress had taken a number of actions that affect the NTIS fee-based model for disseminating technical information, as GAO recommended in November 2012. Specifically, for the past 10 fiscal years, appropriations acts have prohibited NTIS from charging customers for reports generated by legislative branch offices unless the agency tells the customer how an electronic copy of the report can be accessed or downloaded for free online. This statutory language further states that, if a customer still requires such a report from NTIS, the agency should not charge more than what is needed to recover

Motorcycle Safety: Increasing Federal Funding Flexibility and Identifying Research Priorities Would Help Support States' Safety Efforts

GAO-13-42
Susan Fleming
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1 Open Recommendations
Agency Recommendation Status
Congress In order to provide states with greater flexibility to pursue a range of strategies to address the various factors contributing to motorcycle crashes and fatalities, Congress should consider allowing states to use the Motorcyclist Safety Grants for purposes beyond motorcyclist training and raising motorist awareness of motorcycles.
Open

As of March 2024, legislation has not been introduced into the 118th Session of Congress to expand the use of Motorcyclist Safety Grants beyond motorcyclist training and awareness efforts. GAO will continue to monitor Congressional actions related to this matter.

General Aviation Safety: Additional FAA Efforts Could Help Identify and Mitigate Safety Risks

GAO-13-36
Gerald L. Dillingham
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3 Open Recommendations
Agency Recommendation Status
Department of Transportation To enhance FAA's efforts to improve general aviation safety, the Secretary of Transportation should direct the FAA Administrator to improve measures of general aviation activity by requiring the collection of the number of hours that general aviation aircraft fly over a period of time (flight hours). FAA should explore ways to do this that minimize the impact on the general aviation community, such as by collecting the data at regular events (e.g., during registration renewals or at annual maintenance inspections) that are already required.
Open

FAA did not concur with this recommendation. FAA indicated that it does not require the collection of the number of hours that general aviation aircraft fly over a period of time (flight hours) because the collection of flight hour data during registration renewals or annual maintenance inspections would require rulemaking and potentially have a significant economic and paperwork impact on the general aviation community. FAA stated that non-regulatory approaches to enhancing the general aviation survey, such as targeted surveys and outreach to stakeholders, have produced results sufficiently
Department of Transportation To enhance FAA's efforts to improve general aviation safety, and to ensure that ongoing safety issues are addressed, the Secretary of Transportation should direct the FAA Administrator to set specific general aviation safety improvement goals--such as targets for fatal accident reductions--for individual industry segments using a datadriven, risk management approach.
Open

FAA did not concur with this recommendation. FAA told us that the General Aviation Joint Steering Committee (GAJSC) has undertaken a data-driven approach to resolving and mitigating the risks associated with all General Aviation (GA) fatal accidents. For example, FAA stated that segments of the GA community that have higher accident rates will appear proportionally in the accident databases they analyze, therefore adequately addressing our concerns about differences across industry segments. FAA also told us that they track and report internally on various segments within GA on a monthly basis
Department of Transportation To enhance FAA's efforts to improve general aviation safety, and to determine whether the programs and activities underlying the 5-year strategy are successful and if additional actions are needed, the Secretary of Transportation should direct the FAA Administrator to develop performance measures for each significant program and activity underlying the 5-year strategy.
Open

FAA did not concur with this recommendation. Although we did confirm that FAA had established performance metrics for the activities underlying the 5-year strategy, FAA did not provide documentation of how the metrics for those activities were tracked against safety outcomes, and this recommendation has remained open. FAA recently told us that their primary performance measure is the GA fatal accident rate, but the pillars of the original 5-year strategy, though still relevant, have been superseded. We still believe that the development of performance measures for each significant program

Medicare: Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions

GAO-12-966
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 advanced imaging services and help CMS address the increases in these services, the Administrator of CMS should insert a self-referral flag on its Medicare Part B claims form and require providers to indicate whether the advanced imaging services for which a provider bills Medicare are self-referred or not.
Open

HHS disagreed with our recommendation and, as of February 2024, had no plans to take further action. CMS believes that a new checkbox on the claim form identifying self-referral would be complex to administer and that providers may not characterize referrals accurately. We maintain that such a flag on Part B claims would likely be the easiest and most cost-effective way for CMS to identify self-referred advanced imaging services and monitor the behavior of those providers who self-refer these services.
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred advanced imaging services and help CMS address the increases in these services, the Administrator of CMS should determine and implement a payment reduction for self-referred advanced imaging services to recognize efficiencies when the same provider refers and performs a service.
Open

HHS disagreed with our recommendation and, as of February 2024, had no plans to take further action. CMS did not believe that a payment reduction would address overutilization that occurs as a result of self-referral and that the agency's multiple procedure payment reduction policy for advanced imaging already captures efficiencies inherent in providing multiple advanced imaging services by the same physician. Further, CMS does not think a payment reduction for self-referred services would be effective. We maintain that CMS should determine and implement a payment reduction to recognize
Centers for Medicare & Medicaid Services In order to improve CMS's ability to identify self-referred advanced imaging services and help CMS address the increases in these services, the Administrator of CMS should determine and implement an approach to ensure the appropriateness of advanced imaging services referred by self-referring providers.
Open

HHS initially stated that it would consider our recommendation, but as of February 2024, the agency disagreed and had no plans to take further action. However, we maintain that our recommendation is valid, in part because we found that providers who began to self-refer advanced imaging services substantially increased their referral of such services relative to other providers in 2010. To the extent that these additional referrals are unnecessary, they pose an unacceptable risk for beneficiaries, particularly in the case of computerized tomography (CT) services, which involve the use of

Federal Training Investments: Office of Personnel Management and Agencies Can Do More to Ensure Cost-Effective Decisions

GAO-12-878
Yvonne Jones
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2 Open Recommendations
Agency Recommendation Status
Office of Personnel Management To improve federal training investment decision-making processes, the Director of OPM should include in existing or new OPM guidance or technical assistance additional information in the following areas: (1) Steps agencies should take and factors they should consider when prioritizing federal training investments agency-wide, including developing a process to rank training using criteria, such as expected demand for the investment from internal sources, availability of resources to support the effort, potential for increased revenue, and risk of unfavorable consequences if investments are not made. (2) Steps agencies should take and factors they should consider for comparing the merits of different delivery mechanisms and determining the mix of mechanisms to use, in order to ensure efficient and cost-effective delivery of federal training. Such guidance could include requesting that agencies consistently utilize Standard Form-182 to document and report training costs associated with the different delivery mechanisms employed.
Open

According to OPM it has developed training prioritization criteria for agencies that also includes examples of how agencies could rank their training investments. In addition, OPM formed a working group to gain a better understanding of how agencies document, track, and report training information. The group consisted of members from USDA, EEOC, FMC, HUD, PTO, DOD, Energy, USAID, FTC, Treasury, and State. The working group recommended and OPM made changes to the SF 182 designed to help improve federal training investment decision-making. According to OPM, these changes include updating its
Office of Personnel Management To improve federal training investment decision-making processes, the Director of OPM should, in line with statutory and regulatory provisions on maintenance and reporting of training information, work with the CHCO Council to improve the reliability of agency training investment information by: (1) ensuring that agencies are familiar with and follow guidance outlined in OPM's Guide for the Collection and Management of Training Information regarding which training events should be documented as training and reported to OPM; (2) developing policies to strengthen the utilization of Standard Form- 182 to document and report training costs; (3) encouraging agencies through guidance and technical assistance, to develop policies that require consistent reporting of training data to their learning management systems; and (4) encouraging each agency to assess its existing training information system(s) and identify whether it is providing complete and reliable data and, if not, to develop approaches to improve the system(s), in order to do so.
Open

In response, OPM provided a refresher to the Chief Learning Officers Council on OPM's guidance on Reporting of Training Data. This included reviewing OPM's and agencies' responsibilities for the collection and reporting of data and reviewing the process of how agency data is transmitted to EHRI. Further, OPM says it highlighted the Guide to Human Resources Reporting as the source for the required format for reporting training data to EHRI and provided the Guide for Collection and Management of Training Information. Both guides are also located on OPM's website. OPM's training data report

Slot-Controlled Airports: FAA's Rules Could Be Improved to Enhance Competition and Use of Available Capacity

GAO-12-902
Susan Fleming
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2 Open Recommendations
Agency Recommendation Status
Department of Transportation To help maximize the use of available capacity at slot-controlled airports, enhance competition through greater airline access to slots, and enhance transparency of slot information, the Secretary of Transportation should direct the FAA Administrator to apply slot rules to individual slots, as opposed to pools of slots within a slot period.
Open

Previously, in January 2015, the FAA issued a Notice of Proposed Rulemaking (NPRM) for the New York City area airports. The proposal included changes to how the FAA would determine compliance with minimum slot usage rules similar to GAO's recommendation and the WSG. Under that concept, a slot would only be considered for a flight or series of flights in a single slot and not potentially applied or averaged to more than one slot. The NPRM was withdrawn by DOT and FAA in April 2016 to allow further evaluation of recent changes in demand, competition, operations, and other factors in the New York
Department of Transportation With respect to possible future regulatory action, the DOT Secretary should consider requiring airlines to schedule a certain percentage, or all, of their slot allocations, similar to practices maintained elsewhere in the world.
Open

The Department concurs that any future rulemaking should consider changes to the minimum slot usage rules to improve slot utilization at the slot controlled airports and provide greater harmonization with industry standards applied at airports outside the U.S. The FAA and the Department of Transportation stated that they will evaluate the circumstances at the New York City area airports and DCA and, if necessary, will consider steps to improve slot utilization, including future rulemaking. Previously, DOT said it continues to evaluate options, including potential future rulemaking activities

Federal Disaster Assistance: Improved Criteria Needed to Assess a Jurisdiction's Capability to Respond and Recover on Its Own

GAO-12-838
William O. Jenkins, Jr.
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1 Open Recommendations
1 Priority
Agency Recommendation Status
Federal Emergency Management Agency
Priority Rec.
To increase the efficiency and effectiveness of the process for disaster declarations, the FEMA Administrator should develop and implement a methodology that provides a more comprehensive assessment of a jurisdiction's capability to respond to and recover from a disaster without federal assistance. This should include one or more measures of a jurisdiction's fiscal capacity, such as TTR, and consideration of the jurisdiction's response and recovery capabilities. If FEMA continues to use the PA per capita indicator to assist in identifying a jurisdiction's capabilities to respond to and recover from a disaster, it should adjust the indicator to accurately reflect the annual changes in the U.S. economy since 1986, when the current indicator was first adopted for use. In addition, implementing the adjustment by raising the indicator in steps over several years would give jurisdictions more time to plan for and adjust to the change.
Open – Partially Addressed

FEMA has taken actions to update its methodology to provide a more comprehensive assessment of a jurisdiction's capability to respond to and recover from a disaster without federal assistance . In particular, FEMA has taken steps to update the factors considered when evaluating a request for a major disaster declaration for Public Assistance, specifically the estimated cost of assistance (i.e. the per capita indicator), via the federal rulemaking process three times--in 2016, 2017, and 2020. However, as of February 2024, the agency has not issued a final rule updating the estimated cost of

Management Report: Improvements Are Needed to Strengthen the American Battle Monuments Commission's Internal Controls and Accounting Procedures

GAO-12-830R
Cheryl E. Clark, Nabajyoti Barkakati
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1 Open Recommendations
Agency Recommendation Status
American Battle Monuments Commission The Commission should direct the appropriate officials to establish a mechanism to monitor implementation of existing Commission policy to perform biennial physical inventory counts of all items of equipment with an obligated balance of $500 or more.
Open

During our audit of the American Battle Monuments Commission's (ABMC) fiscal year 2011 financial statements, we found that ABMC had not performed independent physical inventory of equipment it owned at the various cemeteries across the world. We found that although ABMC had a policy to perform biennial physical inventory counts of all equipment over $500, this policy was not adhered to during fiscal year 2011. As a result, we recommended that ABMC establish a mechanism to monitor the implementation of existing ABMC policy to perform biennial physical inventory counts of all items of equipment
Note: the list of open recommendations for the last report may continue on the next page.

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