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GAO-26-108997 1 (June 3, 2026)

handle is hein.gao/prpn0001 and id is 1 raw text is: U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Comptroller General Washington, DC 20548 of the United States June 3, 2026 The Honorable Robert F. Kennedy, Jr. Secretary U.S. Department of Health and Human Services 200 Independence Ave., SW Washington, D.C. 20201 Priority Open Recommendations: Department of Health and Human Services Dear Secretary Kennedy: The purpose of this letter is to call your personal attention to two areas where open recommendations to the Department of Health and Human Services (HHS) should be given high priority. In January 2026, we reported that, on a government-wide basis, 77 percent of our recommendations made 5 years ago were implemented.1 HHS's recommendation implementation rate was about 70 percent. As of May 2026, HHS had 436 open recommendations, including 38 priority recommendations.2 Since our May 2025 letter, HHS implemented four priority recommendations.3 Fully implementing the remaining open priority recommendations could significantly improve HHS's operations. We are highlighting the following areas that warrant your timely and focused attention: • Strengthen Medicare and Medicaid program integrity and oversight. Together, the Medicaid and Medicare programs accounted for over $1.6 trillion in federal spending and over $95 billion in improper payments in fiscal year 2025. To help ensure efficient use of federal resources, we recommended that the Centers for Medicare & Medicaid Services (CMS) account for Medicaid payments made to offset costs for services provided to uninsured or low-income individuals when making Medicare payments to individual hospitals. In addition, we found weaknesses in how CMS targets its oversight of state- reported Medicaid expenditures. For example, CMS devoted similar levels of staff resources to review expenditures despite differing levels of risk across states. We recommended that 1GAO, Performance and Accountability Report, Fiscal Year2025, GAO-26-900644 (Washington, D.C.: Jan. 29, 2026). 2GAO considers a recommendation to be a priority if when implemented, it may significantly improve government operations, for example, by realizing large dollar savings; eliminating mismanagement, fraud, and abuse; or making progress toward addressing a high-risk or duplication issue. 3GAO, Priority Open Recommendations: Department of Health and Human Services, GAO-25-108032 (Washington, D.C.: May 2, 2025). In this letter, we identified 35 priority recommendations. Since then, in addition to the four that were implemented, we added seven new priority recommendations. GAO-26-108997 HHS Priority Recommendations Page 1