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Although the Centers for Medicare & Medicaid Services Has Made Progress, It Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements

Although the U.S. Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), has made significant progress in the timely resolution of audit recommendations since our previous review (of Federal fiscal years (FYs) 2006 and 2007), CMS did not always resolve audit recommendations in a timely manner during FYs 2015 and 2016. Specifically, CMS resolved 1,231 of the 1,371 recommendations that were outstanding during FYs 2015 and 2016. However, it did not resolve 405 of the 1,231 recommendations (32.9 percent) within the required 6-month resolution period. In addition, as of September 30, 2016, CMS had not resolved 140 audit recommendations that were past due for resolution. Some of the past-due recommendations had associated dollar amounts that totaled $138.6 million; others were procedural in nature.

CMS had policies and procedures in place to ensure that audit recommendations were resolved in compliance with Federal requirements. Although CMS did not always issue management decisions and submit the related clearance documents within the required 6-month resolution period, CMS did make progress in this respect (compared with the findings of our previous review) by significantly increasing the percentage of audit recommendations that were resolved in a timely manner and by significantly reducing both the total number and associated dollar amounts of unresolved audit recommendations that were past due for resolution.

Without resolving all audit recommendations in a timely manner, CMS runs the risk of noncompliance with Federal requirements and mismanagement of Federal funds. The prompt resolution of audit recommendations helps ensure that Federal funds are effectively and efficiently used to carry out the activities for which they were authorized.

We recommended that CMS continue to follow its policies and procedures related to the audit resolution process, and enhance them where possible, and promptly resolve the 140 outstanding audit recommendations that were past due as of September 30, 2016.

CMS concurred with our recommendations and described corrective actions that it had taken or planned to take. CMS stated that it would continue to assess and further refine its audit resolution process to ensure that recommendations are resolved within the required period. CMS also stated that it had already resolved 97 of the 140 open recommendations (with associated dollar amounts that totaled $109 million) and added that it expected to resolve the remaining 43 recommendations by early 2019.