Open Recommendations

The Chief of Management and Administration develop, document, implement, and disseminate an organizational risk management strategy and policy, in accordance with NIST 800-39, and a process for coordination between cybersecurity and enterprise risk management.

We recommend that the Texas Health and Human Services Commission refund $83,833,972 in Federal funds it inappropriately received because it used IGTs derived from impermissible provider-related donations to fund the State share of DSRIP Program payments.

We recommend that the Texas Health and Human Services Commission provide its IGT entities with guidance about arrangements that may result in impermissible provider-related donations, such as those outlined in CMS’s clarifying letter.

We recommend that the Texas Health and Human Services Commission request that its IGT entities disclose if similar arrangements exist and provide the State agency with action plans on ending the arrangements.

Develop and implement a Department-wide structure and designate an office to manage and oversee forfeiture activities across DHS, including: - reviewing component policies and procedures to ensure alignment with CAFRA; - developing performance objectives, measures, and plans; and - periodically requesting and reviewing component administrative forfeiture data for alignment with departmental and component goals.

Develop Department-wide policies and procedures, including: - consistent CAFRA notices and forms that meet Federal plain language writing requirements; and - consistent interpretation on managing CAFRA claims and use of a Hold Harmless Agreement.

We recommend the Chief Financial Officer develop and apply effective solutions to improve the implementation and use of the government-wide financial data standards for data elements associated with the award description, place of performance, unique record identifier, legal entity information, program activity data, and financial assistance aggregate reporting.

CMS should establish and implement “reject edits” that (1) reject encounter records in which the ordering provider NPI is not present when required and (2) reject encounter records that contain an ordering provider NPI that is not a valid and active NPI in the NPPES registry.

CMS should require MAOs to submit the ordering provider NPI on encounter records for DMEPOS and for laboratory, imaging, and home health services.

Develop and implement an action plan that includes sufficient policies, procedures, and controls that address households living in multifamily housing units having a sufficient supply of safe drinking water ["|] Status

We recommend that the New Jersey Department of Human Services (NJDHS) work with the New Jersey Department of Health to reinforce guidance to nursing facilities for ensuring potential incidents of abuse or neglect are reported in accordance with Federal and State requirements.

We recommend that the New Jersey Department of Human Services work with the New Jersey Department of Health to develop additional procedures for its survey site visits, including reviewing nursing facilities’ records related to hospital transfers for certain beneficiary injuries or conditions that could be the result of potential abuse or neglect.

The U.S. Mint Director before processing any mutilated or uncurrent redemptions should ensure the Mint strengthens and finalizes standard operating procedures for all coin exchange programs before accepting any redemptions. This would include using tests and subject matter experts to authenticate the genuineness of coins redeemed, as well as working with the Board of Governors of the Federal Reserve System to develop appropriate interagency procedures to assure the integrity of the coin redemption process for uncurrent coins.

We recommend that the Rhode Island Department of Human Services conduct or renew all required criminal background checks for the 108 individuals we reviewed who did not have all required checks or who had expired background checks at the time of our data request and site visits

We recommend that the Rhode Island Department of Human Services determine whether it is feasible to increase the ratio of State licensing inspectors to child care providers to meet industry standards so that it can review all employee criminal background checks at all child care providers

We recommend that the Rhode Island Department of Human Services require the State licensing agency to increase the number of current employees it reviews at all child care centers to ensure child care provider compliance with criminal background check requirements

We recommend that the Rhode Island Department of Human Services determine whether it is feasible to develop a centralized process to monitor both family homes and childcare centers.

Rec. A.1.c: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to identify and recover all security assistance-related salary expenses for each DoD civilian employee between FYs 2014 and 2019 from the Defense Security Cooperation Agency.

Rec. A.1.h: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to identify and recover any storage costs that they did not recover for storing security assistance assets at all DoD facilities between FYs 2014 and 2019 from the Defense Security Cooperation Agency.

Rec. A.1.j: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to recover all operating costs that the implementing agencies did not recover for providing administrative space to security assistance personnel at all DoD facilities between FYs 2014 and 2019 from the Defense Security Cooperation Agency.

Rec. A.1.k: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to develop, document, and implement Component-level policies and procedures to identify, track, and recover all operating costs for DoD facilities used to support security assistance programs in future years. This includes identifying where employees who support security assistance programs sit at all DoD facilities.

Rec. B.1.a: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the Deputy Assistant Secretary of the Army for Defense Exports and Cooperation to recover funds from the Defense Security Cooperation Agency in the amount equal to the current market price of the chemical-biological masks that Army personnel shipped to foreign customers.

Rec. A.1.a: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to identify and track all the DoD civilian employees who provide any support to the security assistance programs.

Rec. A.1.b: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to determine whether their current staff level is adequate to support their security assistance mission and request additional security assistance-funded positions, as needed.

Rec. A.1.d: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, work with the DoD Components to develop, document, and implement Component-level policies and procedures to identify, track, and recover salary expenses for DoD civilians who support security assistance programs in future years.