Open Recommendations

OIG recommends that the Global Engagement Center design and implement controls, rather than relying only on the State Assistance Management System, to ensure that Grants Officers designate a Grants Officer Representative prior to awarding cooperative agreements or grants and throughout the award’s period of performance.

OIG recommends that Global Engagement Center (GEC) Grants Officers implement controls to comply with GEC’s Policies and Procedures Manual (Version 1.6, December 2020), “Post-Award: Changes,” requirements to notify award recipients about changes to Grants Officer Representative (GOR) assignments and furnish award recipients with fully-executed copies of GOR designation memoranda.

Develop a standard operating procedure that instructs program offices and regions on tracking and documenting grant flexibilities and exceptions, and their impacts, due to unanticipated events in order toassure consistency in the information needed to manage grants.

Develop a plan to implement, by December 2022, a uniform electronic record-keeping system for grants to meet the Office of Management and Budget direction in M-19-21, Transition to Electronic Records, that all federal records must be created, retained, and managed in electronicformats with appropriate metadata.

Direct program offices and regions to use a uniform official electronic file system that would allow consistency in agencywide access and storage of electronic grant files.

We recommend that the Centers for Medicare & Medicaid Services do the following, which could have saved Medicare an estimated $47.8 million during our audit period:   -Educate hospitals on the NCD requirements for bariatric surgeries if the NCD has been updated in response to our first recommendation.

(U) Rec. 3.c: The DoD OIG recommended that the Commander of the Naval Sea Systems Command direct contracting officers to verify that Contractor C enforces multifactor authentication; encrypts controlled unclassified information stored on workstations; and implements technical security controls to protect controlled unclassified information stored on removable media.

The Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors and facility senior leaders, ensures that employees complete initial suicide risk and intervention training within 90 days of hire and annual suicide prevention refresher training.

The Bureau of Fiscal Operations funding for conducting employer audits should be put to better use by redirecting the focus of the Audit and Compliance Section's FTEs to accomplish their mission and provide adequate Class I and non-Class I railroad audit coverage. Additionally, the Bureau of Fiscal Operations should establish a group solely responsible for completing railroad employer audits.

The Bureau of Fiscal Operations should acquire a team outside of and independent of the Audit Compliance Section (ACS) to conduct an external peer review as soon as possible, and at least every three years thereafter. The Bureau of Fiscal Operations should disclose ACS' lack of peer reviews to auditee organizations whose engagements were initiated after the three-year timeframe following ACS' last external peer review.

The Bureau of Fiscal Operations should update the Audit Compliance Section's Audit Guide and Audit Procedures Manual to reflect the most recent guidance.

The Bureau of Fiscal Operations should provide at least 80 hours of CPE accredited training for Audit Compliance Section employees in each 2-year cycle.

Rec. 2: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security develop procedures for sharing derogatory information on Afghan evacuees with the Department of Defense and interagency stakeholders.

Direct the Office of Infrastructure to follow the FHWA Emergency Relief (ER) Manual regarding deallocations of unobligated funds.

Update the ER Manual's quick release procedures to clarify the documentation needed for funding approval and the responsibilities to maintain sufficient evidence of required approvals for quick release requests submitted in accordance with emergency relief policy and program requirements.

Update the ER Manual to incorporate the requirements in FHWA Order 5182.1, including the routine review of unobligated balances so that funds can be deallocated when no longer needed.

Implement a standard process to approve initial business plans and monitor to ensure that business plans are reviewed annually, to include appropriate updates for specific targets, objectives, and goals for the business development of program participants, in accordance with 13 CFR 124.403(a) and section 7(j)(10)(D) of the Small Business Act.

Implement a standard process to capture, track, and recognize substantial achievement of the specific targets, objectives, and goals for the areas of finance, marketing, and management on 8(a) program participant business plans, in accordance with 13 CFR 124.112(f) and section 7(j)(10)(A) of the Small Business Act.

Establish outcome-based performance goals and measurements to assess whether the program achieved business development objectives, including the number of graduated 8(a) firms in accordance with the measure of success in section 101(b)(2) of the Business Opportunity Development Reform Act of 1988.

Implement a process to ensure the systematic collection of accurate and complete data on program results and operations to make sure all program reporting requirements are met,in accordance with section 7(j)(16)(A) of the Small Business Act and Standards for Internal Control in the Federal Government Principles for Information and Communication.

Implement requirements for management to monitor that Business Opportunity Specialists consistently assess program participant’s development needs, counsel participants, conduct annual field visits, and maintain required documentation, as required by standard operating procedures.

We recommend that Tufts Health Plan refund to the Federal Government the $3,758,335 of net overpayments.

We recommend that Tufts Health Plan 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 Tufts Health Plan continue to improve its existing compliance procedures to identify areas where improvements can be made to ensure 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.

OIG recommends that the Bureau of the Comptroller and Global Financial Services develop and implement a methodology to periodically review and update the budget object codes (BOC) included in the Foreign Affairs Handbook (4 FAH-1 H-613). This methodology should include collaborating with other bureaus to assist in identifying BOCs that are not needed, new BOCs that bureaus believe would be beneficial, or changes to the definitions of existing BOCs.