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GAO-23-106467 1 (2023-05-10)

handle is hein.gao/gaooqi0001 and id is 1 raw text is: G U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Comptroller General Washington, DC 20548 of the United States May 10, 2023 The Honorable Xavier Becerra Secretary U.S. Department of Health and Human Services 200 Independence Ave., SW Washington, D.C. 20201 Priority Open Recommendations: Department of Health and Human Services Dear Mr. Secretary: The purpose of this letter is to update you on the overall status of the U.S. Department of Health and Human Services' (HHS) implementation of our recommendations and call your continued personal attention to areas where recommendations should be given high priority.1 In November 2022, we reported that, government-wide, 77 percent of our recommendations made 4 years ago were implemented.2 HHS's recommendation implementation rate was 90 percent.3 As of April 2023, HHS had not implemented 491 recommendations. Implementing all of our recommendations could significantly improve HHS's operations. In our May 2022 letter to the department, we designated 56 recommendations as priorities for HHS, and HHS has since implemented 12 of them.4 In doing so, HHS has taken steps to 1Priority recommendations are those that GAO believes warrant priority attention from heads of key departments or agencies. They are highlighted because, upon implementation, they may significantly improve government operations, for example, by realizing large dollar savings; eliminating mismanagement, fraud, and abuse; or making progress toward addressing a high-risk or duplication issue. 2GAO, Performance and Accountability Report: Fiscal Year 2022, GAO-23-900398 (Washington, D.C.: Nov. 15, 2022). 3HHS's implementation rate increased in each of the past 4 years, from 61 percent for fiscal year 2019 to 90 percent for fiscal year 2022. 4We also determined that three recommendations no longer warrant priority attention. The first was for HHS to work with stakeholders to help states track supply requests and plan for supply for the remainder of the COVID-19 pandemic response. The global medical supply chain was severely constrained at the time the recommendation was made; however, it has since recovered from initial shortages. While we no longer believe this recommendation warrants priority attention, we believe it still needs to be addressed. GAO, COVID-19: Federal Efforts Could Be Strengthened by Timely and Concerted Actions, GAO-20-701 (Washington, D.C.: Sept. 21, 2020). The second recommendation was for the Centers for Medicare & Medicaid Services (CMS) to expand its review of states' screening and enrollment requirements for providers. CMS has taken some actions to address the recommendation, such as by introducing a series of tools to enhance monitoring and oversight. In addition, during the pandemic, CMS used additional authorities available in certain emergency circumstances to waive Medicaid requirements to help ensure the availability of care. Thus, states have used federal flexibilities to waive certain provider screening and enrollment requirements to help respond to the COVID-19 pandemic. Based on the actions CMS has taken and states' use of flexibilities, we no longer believe this recommendation warrants priority attention, GAO-23-106467 HHS Priority Recommendations Page 1

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