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Inspector General Open Recommendations

09/12/2023 - Department of Veterans Affairs Inconsistent Guidance and Limited Oversight Contributed to Inaccurate Community Care Wait Time Eligibility Calculations at the C.W. Bill Young VA Medical Center in Bay Pines, Florida [Report Details] Review - Open Recommendations

09/12/2023 - Department of the Treasury Interim Audit Update ─ Audit of American Samoa’s Uses of Coronavirus Relief Fund Payment Open Recommendations

09/12/2023 - Department of the Treasury Interim Audit Update ─ Audit of American Samoa’s Uses of Coronavirus Relief Fund Payment [Report Details] Audit - Open Recommendations

09/12/2023 - Department of Health & Human Services Novitas Solutions, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals [Report Details] Audit - Open Recommendations

09/12/2023 - Department of Health & Human Services Kentucky Did Not Always Invoice Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations [Report Details] Audit - Open Recommendations

23-A-04-114.02
We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services work with CMS to determine whether the other claims for multiple-source physician-administered drugs, totaling $5,967,128 ($4,281,678 Federal share), were eligible for rebates and, if so, determine the rebates due and, upon receipt of the rebates, refund the Federal share of the rebates collected.
23-A-04-114.04
We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services ensure that all physician-administered drugs eligible for rebates after our audit period are processed for rebates.
23-A-04-114.03
We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services strengthen its internal controls to ensure that all eligible physician-administered drugs are invoiced for rebate.
23-A-04-114.01
We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services file invoices for and collect from manufacturers rebates totaling $15,611,770 ($11,209,642 Federal share) for single-source and top-20 multiple-source physician-administered drugs and refund the Federal share of rebates collected.

09/11/2023 - Department of Defense Evaluation of DoD Replenishment Plans for Equipment and Munitions Provided to the Government of Ukraine (Full Report is Classified) Open Recommendations

09/11/2023 - Tennessee Valley Authority Organizational Effectiveness – Magnolia Combined Cycle Plant [Report Details] Inspection / Evaluation - Open Recommendations

09/11/2023 - Department of Health & Human Services The Substance Abuse and Mental Health Services Administration Did Not Ensure That Clinics Fully Complied With Federal Requirements When Awarding and Monitoring Certified Community Behavioral Health Clinic Expansion Grants [Report Details] Audit - Open Recommendations

23-A-02-111.02
We recommend that the Substance Abuse and Mental Health Services Administration improve its policies and procedures for monitoring CCBHC-E grants to ensure that clinics comply with Federal requirements by establishing processes to verify that clinics filled key personnel positions, ensured key personnel met level-of-effort requirements, timely submitted FFRs, and properly reported cash on hand.
23-A-02-111.01
We recommend that the Substance Abuse and Mental Health Services Administration improve its policies and procedures for awarding CCBHC-E grants to ensure that clinics comply with Federal requirements by establishing required time frames to verify that clinics met certification eligibility requirements, and processes to verify whether clinics entered into agreements with DCOs to provide certain services.

09/11/2023 - Department of Health & Human Services Texas Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State [Report Details] Audit - Open Recommendations

09/11/2023 - Department of Health & Human Services Puerto Rico Claimed Over $7 Million in Federal Reimbursement for Medicaid Capitation Payments Made on Behalf of Enrollees Who Were or May Have Been Deceased [Report Details] Audit - Open Recommendations

23-A-02-112.02
We recommend that the Puerto Rico Department of Health identify capitation payments made on behalf of enrollees with a date of death in the DMF before the month covered by the capitation payments, estimated as $885,123 in Federal Medicaid funds, and refund to the Federal Government the Federal share of any unallowable payment.
23-A-02-112.04
We recommend that the Puerto Rico Department of Health develop written policies and procedures to ensure that DOH staff periodically update, at least monthly, DOH's eligibility system with data on deaths recorded in the Puerto Rico Demographic Registry.
23-A-02-112.06
We recommend that the Puerto Rico Department of Health establish a process with ASES to ensure ASES ceases making payments to MCOs on behalf of enrollees after their deaths are recorded in DOH's eligibility system and recoups unallowable payments made on behalf of deceased enrollees.

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