The objectives of the legislation have not been fully achieved. While the purpose of the legislation is to curb the misuse of aid instruments in obtaining situations, federal officials sometimes misinterpret the law and choose support instruments when the GAO believes that public procurement is appropriate. As a result, federal government market obligations to protect the interests of the federal government and to ensure that competition is not applied can be applied. Due to vague guidelines and less aggressive implementation of the law by many agencies, support relationships are often not verified to ensure that the federal government`s involvement is consistent with the intent of Congress and the Agency`s experience with a recipient; The legal instrument used corresponds to the proposed report; The terms of the selected instrument are the minimum necessary to ensure that federal funds are spent effectively and for authorized purposes; and these conditions clearly define the roles and responsibilities of the federal government and the recipient. The Office of Management and Budget (OMB) must clarify its procurement policies and encourage more aggressive implementation by federal authorities. There is a need to better define subsidies and cooperation agreements. The OMB and federal authorities need to put in place better coordination and oversight mechanisms to increase the awareness of the law among federal officials, identify and resolve different practices and procedures, and meet the objectives of the legislation. This practice allows the use of grants or cooperation agreements rather than conventional contracts and may, in a number of cases, constitute an abuse of subsidies. However, the OMB is reluctant to present concrete guidelines for what would justify the choice of an aid instrument.
See project “OMB Report on Federal Systems Management Pursuant to P.L. 95-224, January 14, 1980, at pages 25 and 34. Because of the position of the OMB or the absence of such an agency, the choice between instruments in third-party situations. It is clear that the program is intended to help states provide medical services to those in need.