FY 2023 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 845 public recommendations issued by GAO and the HHS OIG that have been open for more than one year as of September 30, 2023. Additionally, this report identifies the 50 recommendations that were closed, unimplemented in Fiscal Year (FY) 2023 with which HHS did not concur or are no longer valid due to the passage of time, program changes, or changes in Office of Management and Budget (OMB) guidance. This is the fifth annual report HHS has completed to comply with this Act.

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, 2023, HHS recognized a total of 845 public recommendations that have been open for more than one year, i.e., issued on or before September 30, 2022. This includes 125 COVID-19 related recommendations. Of the 845 open recommendations,

• 353 were issued by GAO during the period July 12, 2002 through September 30, 2022. GAO reports the same number for this period.
• 492 were issued by HHS OIG during the period August 1, 2005 through September 30, 2022. In their Fall 2023 SAR, HHS OIG reported 504 open recommendations for the same period. The difference of 12 recommendations is due to timing differences in reporting systems and how HHS reports recommendations shared between Operating and Staff Divisions (OpDivs and StaffDivs). Furthermore, the SAR also includes 541 recommendations that are external to the Department, such as to States and hospitals, for a total of 1,045 recommendations over a year old.

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, 2023 for the recommendations in Appendix 1: OIG-GAO Open Recommendations. These recommendations are considered “In Progress.” For recommendations HHS has provided updates pending auditor response, 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 845 open recommendations, 58.2 percent are “In Progress.” The remaining 41.8 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 COVID-19 public health emergency, HHS Divisions successfully closed 238 recommendations that were over a year old in FY 2023. 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 2023.
** IHS reported 70 recommendations in the FY 2022 report but 8 were incorrectly reported and should not have been included.

HHS is directing attention to aged recommendations that have not been closed by the auditor. With over 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 2024, HHS plans to work with OIG and GAO to identify the latter type of recommendation and work collaboratively to close these recommendations, 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 also identifies Priority Recommendations¹ they believe could help significantly improve HHS’s program operations.  Appendix 1 includes the 42 GAO Priority Recommendations among the open recommendations; of those 42 priority recommendations, 25 are awaiting disposition and the remaining 17 are in progress. The GAO Priority Open Recommendation letter identifies 45 recommendations in FY 2023; however, HHS has closed 3 since issuance. Additionally, of the 245 OIG and GAO recommendations successfully closed, 13 were priority recommendations from the FY 2022 GAO Priority Open Recommendation letter.

Read the HHS GAO-IG Act Report.

Endnotes

¹  GAO publishes an annual report highlighting priority open recommendations for HHS. The 2023 report can be found here: GAO-23-106467.