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Open Recommendations (138 total)

COVID-19 Contracting: Opportunities to Improve Practices to Assess Prospective Vendors and Capture Lessons Learned

GAO-21-528
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should direct the Assistant Secretary for Preparedness and Response to review and fully communicate the resources available to contracting officers for assessing prospective vendors—including resources to assess financial capability. (Recommendation 1)
Open
HHS agreed with this recommendation. As of April 2023, HHS officials said that the Assistant Secretary for Preparedness and Response is in the process of updating its Audit Review Standard Operating Procedure to provide additional guidance to staff on financial information and advice related to determining the effectiveness of a contractor's financial operations. Additionally, HHS officials said the update will communicate the resources available to contracting officers for assessing prospective vendors, including vendor's financial capabilities. As of April 2024, HHS reported that they continue to work on updating the standard operating procedure. We will continue to monitor HHS's efforts to provide guidance and communicate available resources to staff.

Autism Research and Support Services: Federal Interagency Coordination and Monitoring Efforts Could Be Further Strengthened

GAO-24-106446
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should ensure that NIH documents the procedures the Office of National Autism Coordination uses, in its support of the IACC and the National Autism Coordinator, to help ensure federal autism activities are not unnecessarily duplicative. Such documentation should describe the roles and responsibilities of different entities, sources of information used, the time frames for conducting analyses, and how outcomes will be reported. (Recommendation 2)
Open
HHS agreed with GAO's recommendation. We will update the status of this recommendation when HHS provides its 180 day letter (expected in summer 2024).

Scientific Integrity: HHS Agencies Need to Develop Procedures and Train Staff on Reporting and Addressing Political Interference

GAO-22-104613
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should ensure that procedures for reporting and addressing potential political interference in scientific decision-making are documented, including adding a definition of political interference, and that the procedures are communicated to the Assistant Secretary for Preparedness and Response. (Recommendation 6)
Open
As of April 2024, HHS was updating its departmental scientific integrity policy and its operating divisions were also updating their individual scientific integrity policies. The updated policies will include specific provisions prohibiting political interference and will establish procedures for reporting and handling allegations of scientific integrity violations, including those involving alleged political interference. HHS plans to finalize its policy in 2024 and will make the policy publicly available on its website.

Clinical Data Registries: HHS Could Improve Medicare Quality and Efficiency through Key Requirements and Oversight

GAO-14-75
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services To help ensure that qualified CDRs promote improved quality and efficiency of physician care for Medicare beneficiaries, the Secretary of Health and Human Services should direct CMS to establish a process for monitoring compliance with requirements for qualified CDRs that draws on relevant expert judgment. This process should assess CDR performance on each requirement in a way that takes into account the varying circumstances of CDRs and their available opportunities to promote quality and efficiency improvement for their target populations.
Open – Partially Addressed
As of August 2023, CMS's website documents its process for monitoring qualified CDRs. Based on the available information, this monitoring focuses on ensuring qualified CDR compliance with expectations such as having relevant measure development expertise, incorporating medical knowledge, and not submitting false or inaccurate data. However, this approach differs from our recommendation that CMS draw on expert judgment to take account of the different circumstances and opportunities for improving quality and efficiency across qualified CDRs. Incorporating expert judgment into CMS's oversight of qualified CDRs could help ensure that qualified CDRs take advantage of available opportunities for improvement that are specific to care for their target populations.

Health Insurance Exchanges: HHS Should Enhance Its Management of Open Enrollment Performance

GAO-18-565
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of HHS should establish numeric enrollment targets for healthcare.gov, to ensure it can monitor its performance with respect to its objectives. (Recommendation 2)
Open
HHS does not concur with this recommendation. In October 2018, the agency noted that there are numerous external factors, such as the state of the economy and plan premiums, that may affect the number of people who decide to enroll in coverage. HHS also stated that it does not believe that numeric enrollment targets are relevant to assess the performance of objectives related to a successful open enrollment period. We continue to believe that the development of numeric enrollment targets is important for effective monitoring of the program and management of its resources. As of July 2023, HHS had not provided any additional information about steps to implement this recommendation. The status of this recommendation will be reconsidered once relevant action is taken.

Critical Infrastructure: Actions Needed to Better Secure Internet-Connected Devices

GAO-23-105327
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services, as SRMA for the healthcare and public health sector, should direct the Assistant Secretary for Preparedness and Response to use the National Plan to develop a sector-specific plan that includes metrics for measuring the effectiveness of their efforts to enhance the cybersecurity of their sector's IoT and OT environments. (Recommendation 3)
Open
In May 2023, HHS stated that the Assistant Secretary for Preparedness and Response (ASPR) is awaiting the release of the National Infrastructure Protection Plan to update the Sector Specific Plan for the Healthcare and Public Health Sector. According to the Department of Homeland Security, the National Plan is estimated to be completed by September 2025. HHS also stated that while ASPR does not have the authorities to mandate reporting or the resources to support a comprehensive effort to track the implementation or success of any activities related to IoT and OT, it will include considerations about IoT and OT as part of its all-hazards approach when it updates the Sector Specific Plan. In addition, the agency stated that it will continue to consult and coordinate with ASPR, other relevant HHS offices, and other federal agencies such as DHS/CISA and DOC/NIST to promote a collaborative approach to the larger cross-sector landscape.

Buy Indian Act: Bureau of Indian Affairs and Indian Health Service Need Greater Insight into Implementation at Regional Offices

GAO-15-588
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services To ensure consistent implementation of the Buy Indian Act procurement authority across the agencies and to enhance oversight of implementation of the Act at regional offices, the Secretaries of the Interior and Health and Human Services should direct the Bureau of Indian Affairs and Indian Health Service respectively, to collect data on regional offices' implementation of key requirements, such as challenges to self-certification.
Open
The Department of Health and Human Services (HHS) concurred with this recommendation. HHS's Indian Health Service (IHS) informed GAO that in order to clarify and codify policies related to priority for use of the Buy Indian Act, formal rulemaking was required. In January 2022, IHS announced the publication of a final rule on the Buy Indian Act, which took effect on March 14, 2022. Additionally, IHS is working to update its Indian Health Manual to supplement the Buy Indian Act final rule to address how IHS will report and collect data across regional offices related to Buy Indian Act requirements. GAO requested an update to the status of changes to the Indian Health Manual in 2023, but as of September 2023, HHS did not provide a response.

Federal Real Property: Agencies Should Provide More Information About Increases in Deferred Maintenance and Repair

GAO-24-105485
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should ensure that the department works with its component agencies to evaluate the costs and benefits of increasing the use of models for predicting the outcome of investments, analyzing tradeoffs, and optimizing among competing investments, and employ models when the benefits outweigh the costs. (Recommendation 9)
Open
Health and Human Services agreed with the recommendation. Health and Human Services noted that models used for investments in its real property portfolio may encounter limitations given the vastly different missions carried out in different facilities. As of March 2024, Health and Human Services officials said that the Department had aligned ongoing efforts of updating policies and frameworks to guide the Department's components in implementing the recommendation. GAO will continue to monitor these efforts.

COVID-19 Contracting: Opportunities to Improve Practices to Assess Prospective Vendors and Capture Lessons Learned

GAO-21-528
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should direct the Assistant Secretary for Preparedness and Response to develop internal guidance that includes information for contracting officers related to contracting and assessing prospective vendors during emergencies. (Recommendation 2)
Open
HHS agreed with this recommendation. As of April 2023, HHS officials said the Office of the Assistant Secretary for Preparedness and Response is developing a new document, the Emergency Operations Guide, that will provide processes and establish organizational priorities when responding to emergencies. HHS officials said the guide will include guidance for contracting officers on contracting and assessing prospective vendors during emergencies. As of April 2024, HHS reported that they are continuing to work on developing the emergency operations guide. We will continue to monitor HHS's efforts to develop guidance during emergencies.

Public Health Preparedness: Mpox Response Highlights Need for HHS to Address Recurring Challenges

GAO-24-106276
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Health and Human Services The Secretary of Health and Human Services should develop and implement a coordinated, department-wide after-action program that encourages collaboration between HHS's component agencies, including integrating the existing public health emergency after-action programs of these component agencies. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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