Open Recommendations

San Bernardino County management should provide missing supporting documentation and make necessary reporting corrections. Additionally, Treasury OIG should determine if a focused audit over Grants Greater Than or Equal to $50,000 is feasible.

San Bernardino County management should provide missing supporting documentation and make necessary reporting corrections. Additionally, Treasury OIG should determine if a focused audit over Grants Greater Than or Equal to $50,000 is feasible.

San Bernardino County management should provide missing supporting documentation and make necessary reporting corrections. Additionally, Treasury OIG should determine if a focused audit over Direct Payments Greater Than or Equal to $50,000 is feasible.

Improve usability of the staffing assessment tool by implementing policy to address the inconsistencies with staffing data entry and review the reported data for accuracy.

We recommend that the Virginia Medicaid Department of Medical Assistance Services continue to pursue development and implementation of an automated matching and eligibility update process.

We recommend that the Virginia Medicaid Department of Medical Assistance Services identify and recover unallowable capitaiton payments, which we estimate to be at least $21,849,401, made to MCOs during our audit period on behalf of deceased enrollees.

We recommend that the Virginia Medicaid Department of Medical Assistance Services implement additional supervisory review to ensure that State agency personnel completely and accurately update the State agency's eligibility system based on information provided by the Virginia Department of Health's Office of Vital Statistics.

We recommend that the Virginia Medicaid Department of Medical Assistance Services identify and recover unallowable capitation payments made on behalf of deceased enrollees in 2018 and 2022 (the years before and after our audit period) and repay the Federal share of amounts recovered.

We recommend that the Virginia Medicaid Department of Medical Assistance Services refund $15,702,584 to the Federal Government.

The VA Healthcare System Serving Ohio, Indiana and Michigan Network Director evaluates and ensures all Veterans Integrated Service Network 10 facilities comply with Veterans Health Administration requirements regarding resident supervision, specifically related to post-graduate year one on-site direct supervision.

Enhance existing processes to ensure that all substantially completed projects completed projects are transferred from CWIP to PP&E for financial reporting purposes.

Develop policies and procedures for evaluating identified cases for required recognition and disclosure in the SWFPS's combined financial statements including the impact, if any, the U.S. Treasury Judgment Fund has on the recognition.

Work with Corps to establish policies and procedures to evaluate hydroelectric power liabilities and communicate that information to Southwestern.

Develop and implement a hazardous waste training schedule, as well as internal policies and SOPs for supervisors and staff that handle hazardous waste.Train employees in accordance with GPO Directive 670.58D.

Develop and implement end-of-day cleaning procedures that are in alignment with manufacturer specifications, and verify that end-of-day cleaning is performed on all pollution prevention equipment.

Develop and implement written procedures for handling hazardous materials for day-to-day operations that could release hazardous substances.

Record daily VOC emissions for Press Groups 97, 40, and 69. If unable to follow permit guidance, work with the DC DOEE to amend permits to eliminate the daily recording requirement, or for an exception to the policy with regard to the daily VOC recording requirements outlined in the Title V permits.

Incorporate the Environmental Manager into the planning phase of all Capital Investments to ensure potential environmental impacts are addressed.

CMS should Work with States on actions to identify and address MCOs that may be issuing inappropriate prior authorization denials.

CMS should Issue guidance to States on the use of MCO prior authorization data for oversight.

CMS should Require States to review the appropriateness of a sample of MCO prior authorization denials regularly.

CMS should Require States to implement automatic external medical reviews of upheld MCO prior authorization denials.

CMS should Require States to collect data on MCO prior authorization decisions.

Conduct a comprehensive study to identify how the company can support the development and use of more detailed and standardized work breakdown structures in accordance with common industry practices. At minimum, this analysis should determine the following for the Capital Delivery department:a. how many levels of cost detail project managers need to effectively track and manage costs for a diverse capital portfoliob. the extent to which projects or programs should have work breakdown structures with standardized cost elementsc. based on the above decisions, the people, systems, and processes necessary to develop more detailed and standardized work breakdown structures and sustain…

Based on the results of the study, develop a proposal specifying the people, processes, and systems needed to implement more detailed and standardized work breakdown structures and submit it to the Executive Leadership Team for consideration.