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GAO Reports

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GAO: Five State MMRCs Drove 12-Month Postpartum Medicaid Extensions Through Mortality Reviews

In a report released September 24, 2026, the Government Accountability Office found that Maternal Mortality Review Committees in five states successfully recommended extending Medicaid postpartum coverage to 12 months, which those states subsequently adopted. GAO reviewed 10 MMRCs and found all consider federal and state laws as factors affecting maternal mortality, with committees commonly making recommendations on care coordination, mental health and substance use, health equity, reproductive health, and health care workers. CDC provides approximately $134 million over 2024-2029 to support 52 state and territorial MMRCs and monitors performance through regular meetings, required reports, and site visits. The findings demonstrate how state-level mortality review processes directly influence Medicaid coverage policy decisions aimed at reducing preventable maternal deaths, particularly those linked to chronic conditions like severe hypertension in the postpartum period.

GAO

Federal Policy·10d ago

GAO Finds State Coordination Gaps in VR and Medicaid HCBS Employment Services

In a September 2026 report, GAO examined how vocational rehabilitation (VR) and Medicaid home- and community-based services (HCBS) programs fund employment services for individuals with intellectual or developmental disabilities in Georgia, Pennsylvania, and Washington. Employment service providers reported administrative burden and service gaps when navigating two separate state agencies, including confusion over when VR closures must occur before Medicaid HCBS employment services can begin. States typically fund services sequentially — VR first, then Medicaid HCBS — rather than braiding multiple funding streams simultaneously. Federal agencies issued joint guidance in 2022 encouraging coordination strategies, but provider-reported challenges persist.

GAO

Federal Policy·16d ago

GAO Finds CMS Oversight of State Medicaid Eligibility Error Corrective Actions Inadequate

The Government Accountability Office concluded that CMS inconsistently enforces required evaluations and conducts limited analysis of state corrective action plans (CAPs) addressing Medicaid eligibility errors identified through Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) programs. CMS accepted CAPs missing federally required elements and does not systematically analyze errors and corrective actions across states to determine effectiveness. GAO reviewed PERM reports from 2019-2025 and MEQC results from seven states, finding caseworkers were the most prevalent root cause of errors, with specific causes falling into four categories including verification failures and system processing errors. GAO recommends CMS collect all required CAP elements and conduct cross-state analyses to better support states in reducing eligibility errors and improper payments.

GAO

Federal Policy·78d ago

GAO Finds CMS Marketplace Controls Fail to Prevent Unauthorized Agent Enrollment Actions

A Government Accountability Office report released July 13, 2026 finds that CMS lacks adequate controls to prevent health insurance agents and brokers from making unauthorized enrollments and plan switches in the federal Health Insurance Marketplace. Consumer complaints of confirmed unauthorized activity grew more than fourfold from 2023 through 2025, with at least 160,000 applications in plan year 2024 showing likely unauthorized changes. While CMS implemented new consent procedures in 2024, GAO found they do not prevent all unauthorized actions because they are not consistently applied and identity verification is limited. CMS is exploring additional controls for the 2027 open enrollment period but has not finalized decisions.

GAO

Federal Policy·94d ago

GAO Reports $12 Billion in Federal Medicaid and Medicare Spending for Assisted Living in 2024

The Government Accountability Office reports that federal Medicaid and Medicare spending for services provided in assisted living facilities totaled at least $12 billion in 2024, including $3.5 billion in federal Medicaid spending and $8.5 billion in Medicare spending. Forty-four states cover assisted living services through their Medicaid programs, with 29 states using home- and community-based services (HCBS) waivers as of March 2025. GAO notes the $12 billion figure is likely an undercount due to data limitations, as assisted living facilities are not uniformly defined or consistently identified in program data. Medicare generally does not cover assisted living services but covers other health care such as hospice in these settings.

GAO

Federal Policy·96d ago

GAO Adds Fourth Priority Recommendation for Social Security Administration

The Government Accountability Office identified one additional priority recommendation for the Social Security Administration in June 2026, bringing the total to four open priority recommendations. SSA has not implemented any of the three recommendations GAO identified in May 2025. The priority areas include preventing potential overpayments in Disability Insurance, improving online application access for Social Security benefits, and managing IT investments cost-effectively. GAO emphasizes these recommendations warrant urgent attention from SSA leadership to strengthen internal controls, improve service delivery, and identify opportunities for efficiency and cost savings.

GAO

Federal Policy·97d ago

GAO Faults HHS for Lacking Near-Term Goals in National Alzheimer's Project

The Government Accountability Office found that HHS has not set near-term, measurable goals for the National Alzheimer's Project despite having long-term objectives like reducing Alzheimer's risk. Without these goals, HHS cannot effectively collect performance data, assess progress across the multi-agency initiative, or communicate results to stakeholders. GAO acknowledged the project has contributed to achievements including FDA-approved disease-modifying treatments and diagnostic advances. The report recommends HHS adopt key performance management practices to better track federal investments spread across multiple agencies through 2035, when the project's current authorization expires.

GAO

Federal Policy·114d ago

GAO Projects Federal Debt Will Reach 251% of GDP by 2056 Without Policy Changes

The Government Accountability Office projects that under current spending and revenue policies, federal debt held by the public will reach 106% of GDP by 2029 and 251% of GDP by 2056. Projected deficits are driven primarily by growth in Social Security, Medicare, and other federal health care programs, with net interest costs becoming the fastest-growing portion of the federal budget. GAO recommends Congress and the administration establish fiscal rules, build consensus on deficit reduction, and address Social Security and Medicare trust fund shortfalls before depletion in 2032 and 2033. The report emphasizes that delayed action will require more dramatic policy changes.

GAO

Federal Policy·114d ago

GAO Finds DOJ Adult Trafficking Program Lacks Measurable Performance Goals

A January 2025 GAO report found that the Department of Justice does not set measurable near-term goals for its adult human trafficking survivor assistance program, unlike HHS programs and DOJ's minor survivor program which follow leading performance assessment practices. In fiscal year 2025, HHS awarded $7.5 million across two programs serving approximately 2,600 survivors, while DOJ awarded $45 million across two programs serving approximately 11,300 survivors. The report identifies provider shortages and other access barriers for behavioral health services. GAO recommends DOJ establish measurable near-term goals with targets and timeframes to better assess program effectiveness and progress toward supporting adult trafficking survivors.

GAO

Federal Policy·115d ago

GAO Identifies 38 Priority Recommendations for HHS, Including Medicare and Medicaid Program Integrity

The Government Accountability Office has identified 38 priority recommendations for the Department of Health and Human Services as of May 2026, with seven new recommendations added in the past year. HHS has implemented four recommendations since May 2025. GAO is prioritizing two areas: strengthening Medicare and Medicaid program integrity and oversight, and improving public health program oversight and coordination. The recommendations aim to increase efficiency, reduce fraud and waste, and improve federal health care program operations. GAO sends these priority letters to agencies whose implementation could save significant federal funds or address high-risk issues.

GAO

Federal Policy·121d ago

GAO Finds Seven Agencies Failed to Meet Payment Integrity Reporting Requirements for High Improper Payment Rates

The Government Accountability Office identified seven federal agencies with programs reporting improper payment rates of 10 percent or higher for 2-4 consecutive years from fiscal years 2021-2024, including HHS Medicaid programs. Five of seven agencies lacked documented policies to ensure timely reporting to Congress as required under the Payment Integrity Information Act of 2019. GAO found that OMB guidance does not direct noncompliant agencies to submit required annual reports, limiting congressional oversight. The report recommends agencies establish formal procedures to ensure compliance with PIIA reporting requirements for programs with persistent improper payment issues.

GAO

Federal Policy·124d ago

GAO Finds HUD Cannot Track Service Coordinators Due to Data Quality Failures

A GAO report found that HUD lacks uniform data entry procedures for service coordinators in multifamily housing and cannot determine how many properties employ them or whether properties comply with program requirements. HUD also does not routinely analyze performance reports from service coordinators. Stakeholders reported service coordinators help residents avoid eviction and apply for Medicaid, but five studies showed mixed results on health, financial, and housing outcomes. Rural challenges include managing multiple funding sources, limited service providers, and long distances to services.

GAO

Federal Policy·129d ago

GAO: VA Improved Cybersecurity for Million Veteran Program After 2025 Recommendations

The Government Accountability Office found that VA has implemented 9 of 13 cybersecurity recommendations made in September 2025 to protect veterans' health information in the Million Veteran Program system. While VA's business associate agreements with external entities fully comply with HIPAA Privacy Rule requirements, GAO identified deficiencies in asset management, configuration management, and access controls that reduced assurance of data confidentiality. The improvements are significant given that MVP contains sensitive health data for approximately 1 million veterans in the nation's largest veteran biorepository. GAO continues monitoring VA's progress on the remaining four recommendations.

GAO