Open Recommendations

We recommend that BIE assist Havasupai Elementary School with developing and implementing a staffing plan that considers alternative options to fill vacancies (e.g., interfacing with nongovernmental organizations to broaden the pool of available applicants).

We recommend that BIE require Havasupai Elementary School to develop and implement a plan to repair the other safety and health concerns identified in this report related to the heating, ventilation, and air conditioning and roof conditions, as well as institute an injury reporting system.

We recommend that BIE require Havasupai Elementary School to complete a memorandum of understanding with local emergency organizations as required by Indian Affairs policy.

We recommend that BIE require Havasupai Elementary School to implement fire safety procedures, track all required fire equipment maintenance, and train all staff on the use of fire extinguishers and other related fire safety equipment as required by the National Fire Protection Association and Federal regulations.

We recommend that BIE require Havasupai Elementary School to develop and implement a security plan as required by DOI policy.

We recommend that BIE expand its annual safety and health inspection guidance to include security requirements and measures.

We recommend that BIE require Havasupai Elementary School to until a dedicated maintenance worker is hired, ensure designated staff are trained to update the work orders.

We recommend that USAID's Office of Acquisition and Assistance Cost, Audit and Support Division/Contract Audit Management Branch verify that Crown Agents USA, Inc., corrects the three material
weaknesses in internal control detailed on pages 9 to 13 of the audit report.

We recommend that the Millennium Challenge Corporation verify that MCA-Nepal corrects the two instances of material noncompliance detailed on pages 65 to 68 of the audit report.

We recommend that the Centers for Medicare & Medicaid Services work with its plan sponsors to adjust or delete PDEs, as necessary, and determine the impact to the Federal Government related to the Medicare Part D total costs of $953,370 for drugs associated with our sample items for which payment was available under the Medicare Part A SNF benefit, which included $541,652 for drugs that were administered during Part D enrollees' Part A SNF stays.

We recommend that the Centers for Medicare & Medicaid Services work with its plan sponsors to adjust or delete PDEs, as necessary, and determine the impact to the Federal Government related to the Medicare Part D total costs of $953,370 for drugs associated with our sample items for which payment was available under the Medicare Part A SNF benefit, which included $541,652 for drugs that were administered during Part D enrollees' Part A SNF stays.

We recommend that the Centers for Medicare & Medicaid Services work with its plan sponsors to identify similar instances of noncompliance that occurred during our audit period and determine the impact to the Federal Government, which could have amounted up to an estimated $465,077,908 in Part D total cost, including $245,365,324 for drugs that were administered during enrollees' Part A SNF stays.

We recommend that the Centers for Medicare & Medicaid Services work with its plan sponsors to identify similar instances of noncompliance that occurred before and after our audit period and determine the impact to the Federal Government related to Part D total costs for drugs for which payment was available under the Medicare Part A SNF benefit.

We recommend that the Centers for Medicare & Medicaid Services provide plan sponsors with timely and accurate information, such as dates of covered Part A SNF stays, to reduce instances of inappropriate Part D payment for drugs for which payment is available under the Part A SNF benefit.

We recommend that the Centers for Medicare & Medicaid Services instruct SNFs to cooperate with plan sponsors to identify and prevent improper Part D payments for drugs for which payment was available under the Part A SNF benefit.

Rec. 1: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Under Secretary of Defense for Policy, develop and implement guidance for supplemental funding that includes a requirement for DoD Components to document the purpose of payments that use supplemental funds that are appropriated with a specific purpose, such as documentation supporting the use of the Disaster Emergency Fund Code value.

Rec. 2: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the DoD Components, develop and implement effective internal controls to support fast-paced emergency payments that implement the supporting documentation requirements of the DoD 7000.14-R, "DoD Financial Management Regulation.

Rec. 3: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Assistant Secretary of the Army (Financial Management and Comptroller); the Assistant Secretary of the Navy (Financial Management and Comptroller); the Assistant Secretary of the Air Force (Financial Management and Comptroller); the Assistant Director, Office of Business Operations Chief Operating Officer and Chief Financial Officer and Comptroller for Defense Security
Cooperation Agency; and the Chief Financial Officer and Director, Program Analysis and Financial Management for the U.S. Transportation Command, review the supporting documentation of the 309 disbursement transactions, totaling $1 billion…

Rec. 3.a: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Assistant Secretary of the Army (Financial Management and Comptroller), review the supporting documentation of the 118 disbursement transactions, totaling $523.7 million in questioned costs, to determine whether the payments were accurate and supported the Ukraine assistance mission, and take appropriate actions to resolve any unsupported payments or payments that are not in support of the Ukraine mission.

(U) Rec. 3.b: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Assistant Secretary of the Navy (Financial Management and Comptroller), review the supporting documentation of the 112 disbursement transactions, totaling $303.4 million in questioned costs, to determine whether the payments were accurate and supported the Ukraine assistance mission, and take appropriate actions to resolve any unsupported payments or payments that are not in support of the Ukraine mission.

Rec. 3.c: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Assistant Secretary of the Air Force (Financial Management and Comptroller), review the supporting documentation of 62 disbursement transactions, totaling $166.8 million in questioned costs, to determine whether the payments were accurate and supported the Ukraine assistance mission, and take appropriate actions to resolve any unsupported payments or payments that are not in support of the Ukraine mission.

(U) Rec. 3.d: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Assistant Director, Office of Business Operations Chief Operating Officer and Chief Financial Officer and Comptroller for Defense Security Cooperation Agency, review the supporting documentation of the 15 disbursement transactions, totaling $424,171 in questioned costs, to determine whether the payments were accurate and supported the Ukraine assistance mission, and take appropriate actions to resolve any unsupported payments or payments that are not in support of the Ukraine mission.

Rec. 3.e: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Chief Financial Officer and Director, Program Analysis and Financial Management for the U.S. Transportation Command, review the supporting documentation of the 2 disbursement transactions, totaling $13.3 million in questioned costs, to determine whether the payments were accurate and supported the Ukraine assistance mission, and take appropriate actions to resolve any unsupported payments or payments that are not in support of the Ukraine mission.

Rec. 4: The DoD OIG recommended that the Assistant Secretary of the Navy (Financial Management and Comptroller) initiate a preliminary review of the potential Antideficiency Act violations resulting from our samples, and take appropriate actions based on the results of the review. The preliminary review should be completed in accordance with DoD Regulation 7000.14?R, "DoD Financial Management Regulation."

We recommend that USAID's Office of Acquisition and Assistance Cost, Audit and Support Division/Contract Audit Management Branch verify that Kimetrica, LLC, corrects the one material weaknesses in
internal control detailed on pages 8 and 9 of the audit report.