Open Recommendations

Rec. 1.j: The DoD OIG recommended that the Principal Director, Defense Pricing and Contracting establish requirements to vet consortium members upon membership to identify which members meet applicable security requirements for future opportunities.

Rec. 1.m: The DoD OIG recommended that the Principal Director, Defense Pricing and Contracting develop procedures to require security reviews of solicitation and supplementary information, including the aggregate of all information being provided in the solicitations to ensure potential sensitive information is not revealed by the compilation of information.

We recommend that Humana, Inc. refund to the Federal Government the $197,720,651 of net overpayments

We recommend that Humana, Inc. enhance its policies and procedures to prevent, detect, and correct noncompliance with Federal requirements for diagnosis codes that are used to calculate risk-adjusted payments.

Establish a data strategy implementation project plan with milestones that consider mission priorities and current and expected staffing levels to track the progress of the data management program maturation against the current Data and Analytics Strategy Implementation Plan.

Develop and implement a Data Quality Plan that supports the collection and maintenance of data related to identified key CPSC open data sets.

Identify and assign responsibilities to all of the resources who have data governance roles and responsibilities. These resources should include, at a minimum, data owners and data stewards, and those resources should be trained on their responsibilities.

Dedicate resources to the data management program based on a needs assessment, which should be revisited as the FDS action plans are published. Supplementary resources to consider adding may include data architects, data scientists, data analysts, and training resources.

Update information security procedures to make them consistent with current federal directives, including the National Institute of Standards and Technology Special Publication 800-53, Revision 5, Security and Privacy Controls for Information Systems and Organizations.

OIG recommends that the Assistant Secretary for the Bureau of Near Eastern Affairs develop and execute an action plan that dedicates appropriate resources to implement Recommendations 1, 2, and 4 from OIG report Audit of the Bureau of Near Eastern Affairs Selection and Management of Contract Oversight Personnel in Iraq (AUD-MERO-19-10, November 2018). The plan should outline the steps and resources necessary to determine the technical expertise in the contract subject matter for Contracting Officer's Representatives (COR) and Government Technical Monitors (GTM), provide those determinations and requirements to Contracting Officers, and ensure only CORs and GTMs that meet the requirements…

We recommend that the Georgia Department of Community Health remind nursing facilities of Federal and State requirements for reporting incidents of potential abuse or neglect.

We recommended that the Georgia Department of Community Health strengthen its procedures for monitoring nursing facilities and follow up with those that may not be following required policies and procedures.

We recommended that the State agency ensure that it documents actions it takes when nursing facilities fail to report incidents and fail to report incidents on time.

We recommended that the State agency ensure that it assigns a priority level to all incidents or complaints by the mandatory deadline.

We recommend that Palmetto Government Benefits Administrator, LLC decrease its Excess Plan Medicare segment pension assets by $9,196 and recognize $737,271 as the Excess Plan Palmetto Medicare segment pension assets as of January 1, 2017.

We recommend that Palmetto Government Benefits Administrator, LLC improve policies and procedures to ensure that going forward, it calculates Medicare segment pension assets in accordance with Federal requirements.

We recommend that Palmetto Government Benefits Administrator, LLC decrease its Excess Plan Medicare segment pension assets by $9,196 and recognize $737,271 as the Excess Plan Palmetto Medicare segment pension assets as of January 1, 2017.

We recommend that Palmetto Government Benefits Administrator, LLC improve policies and procedures to ensure that going forward, it calculates Medicare segment pension assets in accordance with Federal requirements.

Rec. C.1: The DoD OIG recommended that the Assistant Secretary of Defense for Manpower and Reserve Affairs, in coordination with the Director of Manpower and Personnel for the National Guard Bureau, establish and implement a plan to identify whether the Challenge Program is achieving long-term benefits of providing opportunities for cadets to be productive citizens. The plan should include a process for collecting data beyond 1 year.

CMS should encourage MAOs to perform program integrity oversight using ordering NPIs.

We recommend EEOC's Office of Information Technology (OIT) review and remediate criticalrisk and high-risk vulnerabilities in accordance with EEOC OIT’s assessment of risk. Where risk acceptance is required for vulnerabilities based on EEOC's network operation, we recommend thatEEOC formally document the risk acceptance along with any associated mitigation activities.

We recommend that OPM modify FEHBP contract lanugage for all applicable records retention clauses to require the retention and accessibility of claims for 10 years plus the current year in a manner of OPM/HI's choosing.

We recommend OPM modify or add language in Section 1.9 of all FEHBP contracts to inlcude all relevant sections and attachments of CL 2017-13, or modify all FEHBP contracts to add relevant language stating that all CLs are an addendum to the contract language and enforceable as a contract requirement.

We recommend OPM modify or add language to the appropriate Section of the FFS and ER-HMO FEHBP contracts to state that all FWA-related recoveries must be deposited into the working capital or investment account within 30 days and returned to or accounted for in the FEHBP contingency reserve fund account within 60 days after receipt by the carrier.

We recommend that OPM add language to all FEHBP contracts requiring carriers to notify the OIG's Office of Investigations regarding their intention to share FEHBP fraudulent activity with outside parties, and obtain approval from OIG's Office of Investigations before sharing this information.