GAO-20-552PR 1 (2020-04-23)

handle is hein.gao/gaobaebax0001 and id is 1 raw text is: 

441 G St. N.W.                                                        Comptroller General
Washington, DC 20548                                                   of the United States

April 23, 2020

The Honorable Alex M. Azar II
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 provide an update on the overall status of the U.S. Department of
Health and Human Services' (HHS) implementation of GAO's recommendations and to call your
personal attention to areas where open recommendations, including some related to the
Coronavirus Disease 2019 (COVID-19) pandemic, should be given high priority.1 We recognize
that HHS and its component agencies are focused on the nation's efforts to respond to and
recover from the COVID-19 pandemic. As HHS is able to refocus its efforts, addressing the high
priority recommendations identified below has the potential to substantially improve HHS's

In November 2019, we reported that on a government-wide basis, 77 percent of our
recommendations made 4 years ago were implemented.2 As of April 2020, HHS had 405 open
recommendations with an implementation rate of 61 percent. Fully implementing all open
recommendations could significantly improve HHS's operations.

In our March 2019 letter, we designated 54 recommendations as priorities for HHS. HHS has
implemented 13 of these recommendations. In doing so, HHS has, for example, improved
tracking of Medicare beneficiaries at high risk of harm from opioids; issued guidance for states
about overpayments and setting rates in Medicaid managed care, which should help reduce
financial risks to the Medicaid program; and has strengthened controls over the determination of
eligibility for the premium tax credit used to help individuals purchase health insurance coverage
through health insurance marketplaces. In addition to the 13 priority recommendations HHS
implemented, four recommendations are no longer open priority recommendations, primarily
because they became a lower priority due to recent policy changes or agency actions, as
discussed below.

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 operation;
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 2019, GAO-20-1 SP (Washington, D.C.: Nov.19, 2019).

GAO-20-552PR HHS Priority Recommendations

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