Open Recommendations

Perform a thorough review of OIG-sampled CARES invoices with questionable costs, and request additional contractor documentation necessary to determine accuracy of CARES hours, rates, and contractor status. If any charges are not allowed, recover as appropriate.

Perform a risk assessment of all CARES invoices and process to determine, at a minimum, the nature and extent of testing required to sufficiently identify unsupported payments.

Develop a plan to fill and retain the allocated number of Office of Human Capital and Talent Management staff needed to fulfill its duties in the hiring and onboarding process.

Develop and disseminate policies for the revised civil service recruitment and hiring process and standard operating procedures for the modified Foreign Service staff hiring and onboarding processes.

Create a USAID-specific definition of skill gaps to address both competency and staffing skill gaps across its hiring mechanisms.

Finalize strategic workforce planning guidance, to include USAID's updated Strategic Workforce Plan, workforce planning Automated Directives System chapter, and materials to assist Agency operating units in identifying and addressing skill gaps.

Conduct an analysis to determine whether personnel tools-e.g., Talent Analytics, LaunchPad, the Workforce Planning Model, or the Competency Exploration for Development and Readiness-can be utilized to track skill gaps at both an Agency and operating unit level and implement changes as appropriate based on this analysis.

We recommend that Peoples Health Network refund to the Federal Government the $3,312,219 in estimated overpayments.

We recommend that Peoples Health Network identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.

We recommend that Peoples Health Network enhance its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.

We recommend that Vanderbilt University Medical Center improve procedures and provide education to staff to ensure that claims billed to Medicare are accurate

We recommend that Vanderbilt University Medical Center implement changes to its billing system to ensure that claims billed to Medicare are accurate.

The Bureau of Administration should direct its Contracting Officer for Foreign Service Selection Board public contracts to comply with all FAR requirements, including requirements on notices, justifications, and determination of pricing.

Embassy Budapest should comply with Department standards for grant file documentation.

Embassy Budapest should enter motor vehicle operational costs into the Fleet Management Information System and verify the integrity of data entered into the system in accordance with Department standards.

Embassy Budapest should administer and procure facility management expendable supplies in accordance with Department standards.

Embassy Athens should comply with Department standards for consular crisis preparedness.

Embassy Athens should require that safety certifications for all mission properties are conducted and documented in the Post Occupational Health and Safety Officer Certification Application and that any identified safety issues be corrected prior to occupancy, in accordance with Department standards.

Embassy Athens, in coordination with Bureau of Overseas Buildings Operations, should evaluate all mission residential properties for seismic risk in accordance with Department standards.

Embassy Athens, in coordination with the Bureau of Information Resource Management, should complete the systems authorization process for its locally developed applications.

Strengthen information system controls to make certain that complete and accurate claims information is transferred between applicable current and future Community Care payment systems and the Consolidated Patient Account Centers’ workflow tool and VistA patient treatment files.

Conduct an assessment to determine if staffing resources and workload are sufficiently aligned to process the anticipated volume of claims to be billed to veterans’ private health insurers and make adjustments as needed.

OIG recommends that the Bureau of Administration update guidance to clearly communicate to Department of State contracting personnel which training courses are approved and available to meet the annual trafficking in persons (TIP) training requirement.

OIG recommends that the Bureau of Administration update Department of State guidance including the Foreign Affairs Handbook (FAH) and applicable Procurement Information Bulletins (PIB) to clarify that trafficking in persons monitoring, including developing and implementing trafficking in persons (TIP) monitoring strategies, is required for all applicable contracts, not just those that employ third-country national or migrant labor.

OIG recommends that the Bureau of Administration develop and implement guidance that Contracting Officers (CO) and Contracting Officer’s Representatives (COR) review contractor trafficking in persons compliance plans to determine whether their content meets requirements of Federal Acquisition Regulation (FAR) 52.222-50(h) and to inform required trafficking in persons (TIP) monitoring strategies.