Open Recommendations

We recommend that the Centers for Disease Control and Prevention update its Provider Education, Assessment, and Reporting online system to include interactive reminders or alerts related to overdue site visits and followup actions.

We recommend that the Centers for Disease Control and Prevention complete the development and implementation of internal written policies and procedures for VFC program oversight activities, including oversight of program recipients' site visits to ensure that requirements are met.

We recommend that the Centers for Medicare & Medicaid Services instruct the MACs to, based on the results of this audit, notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.

We recommend that the Centers for Medicare & Medicaid Services direct the MACs to recover from acute-care hospitals the portion of the $41,401,244 in identified overpayments for our audit period that are within the 4-year reopening period in accordance with CMS's policies and procedures.

OIG recommends that the Bureau of International Narcotics and Law Enforcement Affairs develop a coversheet for performance progress reports to ensure that reports are signed and certified by an authorized representative of the recipient organization and distribute it for use to the National Center for State Courts.

Require the Office of Regulations, Appeals, and Policy, in coordination with the Office of General Counsel, to determine whether the Office of Dentistry and the Consolidated Patient Account Center Program have appealable benefits decisions governed by the AMA, and if so, to update program policies, processes, and procedures accordingly, including ensuring that claimants receive written decision notices that meet all act requirements.

Require the Office of Regulations, Appeals, and Policy to evaluate the program offices’ barriers to including all required elements in decision notices and take corrective action, seeking congressional relief if needed.

Using the evaluation findings from recommendation 2, require Payment Operations to update its systems to generate AMA-compliant decision notices to the extent possible.

Using the same evaluation findings, require the Veteran and Family Member Programs to update its systems to generate AMA-compliant decision notices to the extent possible.

Require the Office of Regulations, Appeals, and Policy and the program office for Member Services’ Eligibility and Enrollment Division to ensure that priority group assignment decision notices are provided with enrollment handbooks given to veterans.

Identify resources and assign duties to conduct quality control reviews of decision letters with program offices to remediate deficiencies.

Work with the Office of Information and Technology to update Caseflow to address identified VHA system requirements within specified deadlines, including adding a program identifier and facilitating entries for individuals and entities that are not veterans.

Establish interim tracking procedures with the program offices until Caseflow can be considered a reliable system for VHA oversight.

In coordination with the Office of General Counsel, seek clarification on how the reporting metrics sections of the Appeals Modernization Act apply to VHA, and then develop those measures.

Issue policy and other clear guidance that includes standard tracking processes and procedures, and oversight of that tracking.

Work with VBA and others to allow access to all VHA program offices, and ensure that those offices in turn require that staff use the Centralized Mail Portal for all decision reviews or establish another mechanism that ensures all decision reviews are tracked from request receipt through routing and processing.

Work with the Office of Information and Technology to determine the best way to create a central repository and identify the necessary resources to implement and maintain it.

Develop decision review retention standards and communicate to the relevant programs what types of claims and appeals documentation should be stored, for how long, and where.

Implement training on processing and tracking appeals that is mandatory for VHA staff who process decision reviews.

We recommend the Acting Director of U.S. Immigration and Customs Enforcement establish a policy for ICE field personnel to validate migrant addresses and to elevate address concerns, such as recurring or invalid migrant release addresses, recorded into U.S. Customs and Border Protection and ICE systems.

We recommend the Executive Associate Director of U.S. Immigration and Customs Enforcement’s Enforcement and Removal Operations analyze migrant U.S. release address data on a recurring basis to identify trends, such as recurring and uninhabitable addresses, and share known address concerns with U.S. Border Patrol.

Create a single Service-wide comprehensive digitalization strategy that identifies priorities, objectives, interim target dates, milestones, etc. The strategy should identify the IRS business units responsible for the applicable actions and should be updated annually.

Develop processes to require management to track digitalization efforts and compare results against the plans, goals, objectives, milestone dates, etc., and analyze any significant deviations to identify needed strategic changes.

Provide guidance to delegated authorities on what constitutes a violation of the benzene fenceline monitoring regulations to assist the delegated authorities in taking action when a violation may have occurred.

Update the agency's policies and procedures to reflect security controls identified in National Institute of Standards and Technology Special Publication 800-53, Revision 5.