Open Recommendations

We recommend that the Massachusetts Executive Office of Health and Human Services work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not invoiced for rebates after December 31, 2017.

We recommend that the Massachusetts Executive Office of Health and Human Services strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.

Coordinate with the Office of the Secretary to revise the National Infrastructure Protection Plan and other planning documents toincorporate current and evolving risks as well as mitigation strategies needed to secure the Nation’s election infrastructure.

Assign the staff resources needed to conduct timely cybersecurity and physical assessments to assist states and localities with securing the election infrastructure.

We recommend that the Minnesota Department of Human Services bill for and collect manufacturers’ rebates for pharmacy drugs and for single-source and top-20 multiple-source physician-administered drugs that we calculated to be $5,899,308 (Federal share) and refund the Federal Government

We recommend that the Minnesota Department of Human Services work with CMS to determine whether the non-top-20 multiple-source physician-administered drugs were eligible for rebates that we calculated to be at least $173,780 (Federal share) and, if so, upon receipt of the rebates, refund the Federal share of the rebates collected

We recommend that the Minnesota Department of Human Services work with CMS to ensure that all pharmacy and physician-administered drugs eligible for rebates after our audit period are processed for rebates

We recommend that the Minnesota Department of Human Services work with the contractor to confirm that DRAMS is properly identifying drug rebate eligibility to ensure that all rebate-eligible pharmacy and physician-administered drugs are identified and billed for rebates.

For the 11 MAC jurisdictions with a coverage limitation for the number of facet-joint injection sessions during a rolling 12-month period, we recommend that the Centers for Medicare & Medicaid Services direct the MACs that oversee the 11 jurisdictions to review claims for facet-joint injections after our audit period to identify instances in which Medicare paid physicians for more than 5 injection sessions received by beneficiaries during a rolling 12-month period and recover any improper payments identified.

To address the concerns identified in this report, we recommend that the Senior Advisor for Environmental Management to the Under Secretary for Science direct the Manager of the Office of River Protection/Richland Operations Office to:2. Develop the ability to transfer tank waste from the 200 West Area to the 200 East Area, such as upgrading the cross-site transfer system to ensure that it is operational;

Develop the ability to transfer tank waste from the 200 West Area to the 200 East Area, such as upgrading the cross-site transfer system to ensure that it is operational.

We recommend that Clinical Practices of the University of Pennsylvania based upon the results of this audit, exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.

• refund to the Federal Government $1,959,216 in Medicaid payments made and claimed on behalf of beneficiaries for whom services were improperly claimed and reimbursed

• identify and refund to the Federal Government any payments made on behalf of ineligible beneficiaries for whom services after our audit period were claimed and reimbursed past the termination dates of their eligibility

• establish adequate system controls that ensure that eligibility determinations transfer correctly from the CBMS to the MMIS to prevent payments from being made on behalf of ineligible beneficiaries.

We recommend that the U.S. Department of Health and Human Services ensure that HHS and its components fully implement the covered agency responsibilities found in GDA section 759(a).

We recommend that the U.S. Department of Health and Human Services maintain an inventory of all geospatial data assets, per section 759(b) of the GDA.

Develop a unified Strategy Implementation Plan or “Roadmap” that defines detailed action items, milestones, and responsibilities for geospatial data management in support of missions across NASA.

We recommend that the Deputy Secretary of Commerce and the Senior Agency Official for Geospatial Information develop Department-wide procedures to ensure operating units consistently implement the Department’s Policy on Planned Geospatial Acquisitions.

Disallow and recover $603,476 ($231,806 in Federal and $374,861 in match costs) from Sauk-Rapids Rice due to the lack of support for employee's time worked on the grant and $3,192 for other Federal costs claimed because of insufficient match contributions.

Disallow and recover $673,178 ($336,062 in Federal and $337,116 in match) from Guadalupe Alternative Programs due to being unable to verify the accuracy of employees' time worked on the grant because of the lack of time being segregated by project/program codes.

Disallow and recover $11,681 ($5,681 in Federal from Amherst H. Wilder, and $6,000 in match from Sauk-Rapids Rice) due to unsupported costs in its financial management systems

Ensure that its Correctional Services Manual includes policy on the required number of perimeter patrol vehicles at all types of institutions and implement a policy on the circumstances necessitating changes to the required number of perimeter patrol vehicles.

Establish a policy on the required assignment and use of Roving Alarm Notification System (RANS) hand-held radios.

Consider developing a national policy requiring institutional assessments of U.S. Penitentiaries (USP) on a prescribed, regular basis.