FY 2022 Good Accounting Obligation in Government Act Report

Executive Summary

The Good Accounting Obligation in Government Act (GAO-IG Act or “the Act”; Public Law 115-414) requires each agency to include, in its annual budget justification, a report identifying each public recommendation issued by the Government Accountability Office (GAO) and federal Offices of Inspectors General (OIG), that remains unimplemented for one year or more as of the annual budget justification submission date. In compliance with this law, the Department of Health and Human Services (HHS or the Department) developed this report listing the 865 public recommendations issued by GAO and the HHS OIG that have been open for more than one year as of September 30, 2022. Additionally, this report identifies the 17 recommendations that were closed, unimplemented in Fiscal Year (FY) 2022 with which HHS did not concur or are no longer valid due to the passage of time, or program changes, or changes in Office of Management and Budget (OMB) guidance.

Background

Congress enacted the GAO-IG Act to enhance transparency into open and unimplemented public recommendations issued by the GAO and agencies’ OIG. In addition to reporting on unimplemented public recommendations over one year old, the Act requires a reconciliation between the agency records and the OIG’s Semiannual Report to Congress (SAR report).

As of September 30, 2022, HHS recognized a total of 865 public recommendations that have been open for more than one year, i.e., issued on or before September 30, 2021. This includes 39 COVID-19 related recommendations. Of the 865 open recommendations,

• HHS recognized 363 open GAO recommendations issued during the period July 12, 2002 through September 30, 2021 compared to 362 open recommendations reported by GAO. This variance (of 1 recommendation) is the result of timing between HHS updates and GAO reporting.
• HHS recognized 502 open HHS OIG recommendations issued during the period August 1, 2005 through September 30, 2021 compared to 521 open recommendations in the HHS OIG Fall 2022 SAR. The variance (of 19 recommendations) is caused by timing between HHS updates and OIG reporting and HHS is working to resolve any differences in future reports.

For recommendations with which HHS concurred, this report provides timelines for full implementation of the planned corrective actions, as well as updates and constraints as of October 31, 2022 for the recommendations in Appendix 1: OIG-GAO Open Recommendations. These recommendations are considered “In Progress.” For recommendations HHS believes have been implemented, but the auditor lists as open, this report indicates the status as “Awaiting Disposition,” as these recommendations are pending auditor validation and close out. For recommendations with which HHS did not concur or did not implement and auditors closed, this report identifies the reasons for the “Closed, Unimplemented” status in Appendix 2: OIG-GAO Closed, Unimplemented Recommendations.

The Department continues to make a good faith effort to implement these recommendations. In many cases, HHS determined the corrective action to be complete and maintains that the auditors should close the recommendation as implemented. As shown in Figure 1, of the 865 open recommendations, 60 percent are “In Progress.” The remaining 40 percent are “Awaiting Disposition” and may be closed and removed from future reports once the auditors complete their review of HHS-provided information and updates.

Figure 1: Implementation Status of All GAO and OIG Public Recommendations

In accordance with OMB Circular A-50, “Audit Follow Up”, HHS is committed to preparing prompt, responsive, and constructive corrective actions to address OIG and GAO audit report findings and recommendations.  HHS considers audit recommendation follow-up an integral part of sound stewardship. Even in the midst of the Department’s intensive response to the ongoing COVID-19 public health emergency, HHS Divisions successfully closed 132 recommendations that were over a year old in FY 2022. Table 1 presents the changes in the number of recommendations since last year’s report.

*Includes all Operating Divisions (OpDivs) and Staff Divisions (StaffDivs) with less than 20 open recommendations at the end of FY 2022.

HHS is directing attention to aged recommendations that have not been closed by the auditor. With nearly 30 percent of recommendations over 5 years old, detailed in Figure 2 below, targeting this subset of open recommendations would greatly reduce the Department’s total open recommendation population. Often, recommendations reach this age because implementation is difficult, involving legislative action, additional resources, drastic programmatic changes, or a combination of complex factors that may be outside the agency’s purview. Additionally, some old recommendations have been superseded by policy and program changes since the auditor issued the original report. In FY 2023, HHS plans to work with OIG and GAO to identify the latter type of recommendation and work collaboratively to close these recommendations as-is, or better understand what the agency needs to do to close out such recommendations in future reporting years.

Figure 2: Recommendations by Years Open

GAO and OIG also identify top issues and recommendations (known as Priority Recommendations or Top Unimplemented Recommendations, respectively)¹ they believe could help significantly improve HHS’s program operations.  Appendix 1 includes the 192 GAO Priority Recommendations or OIG Top Unimplemented Recommendations among the open recommendations; of those 192 priority recommendations, 71 are awaiting disposition and the remaining 121 are in progress.

Read the HHS GAO-IG Act Report.

Endnotes

¹ GAO publishes an annual report highlighting priority open recommendations for HHS. The 2022 report can be found here: GAO-22-105646. The HHS OIG publishes an annual report identifying top unimplemented recommendations. The 2022 report can be found here: OIG’s Top Unimplemented Recommendations: Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs.