Page 1 GAO-25-108153 CFS Issues for HHS
August 21, 2025
Ms. Caitrin Shuy
Principal Deputy Assistant Secretary for Financial Resources
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
U.S. Consolidated Financial Statements: Key Issues for the Department of Health and
Human Services
Dear Ms. Shuy:
As the Department of Health and Human Services’ (HHS) Principal Deputy Assistant Secretary
for Financial Resources with the responsibility to perform the duties of HHS’s Chief Financial
Officer, you have an important role in helping to ensure that reliable and complete federal
financial information is available. The purpose of this letter is to highlight important issues for
your awareness related to financial management in the federal government.
GAO is responsible for conducting the annual audit of the U.S. government’s consolidated
financial statements, or CFS.
1
On January 16, 2025, we issued a disclaimer of opinion on these
statements for fiscal years 2024 and 2023.
2
The consolidated financial statements are compiled
from federal entity financial statements and other federal entity information. As such, federal
entities, including HHS, have a key role in supporting financial reporting at the government-wide
level.
While HHS’s auditor issued an unmodified audit opinion on HHS’s fiscal years 2024 and 2023
accrual-based financial statements,
3
the auditor identified significant deficiencies in internal
control over financial reporting and made recommendations to help address them. HHS’s strong
and sustained commitment is critical to addressing these recommendations and the following
key issues that affect the U.S. government’s consolidated financial statements.
Intragovernmental activity and balances: In our fiscal year 2024 audit of the consolidated
financial statements, we continued to report that the federal government was unable to
adequately account for intragovernmental activity and balances between federal entities. This is
1
The Secretary of the Treasury, in coordination with the Director of the Office of Management and Budget, is required
to annually submit audited financial statements for the executive branch of the U.S. government to the President and
Congress. These statements, as submitted, also include the legislative and judicial branches.
2
GAO, Financial Audit: FY 2024 and FY 2023 Consolidated Financial Statements of the U.S. Government, GAO-25-
107421 (Washington, D.C.: Jan. 16, 2025).
3
HHS’s auditor disclaimed an opinion on HHS’s 2024, 2023, 2022, 2021, and 2020 Statements of Social Insurance
(SOSI) and 2024 and 2023 Statements of Changes in Social Insurance Amounts (SCSIA). This disclaimer
contributed to us being unable to express an opinion on the government-wide sustainability financial statements,
which include the Statements of Long-Term Fiscal Projections, SOSI, and SCSIA.
