Open Recommendations

Rec. A.3: The DoD OIG recommended that the Deputy Assistant Secretary of Defense for Construction in coordination with the Commanders of the U.S. Army Corps of Engineers, Naval Facilities Engineering Systems Command, and Air Force Civil Engineer Center update Unified Facilities Criteria 2-100-01, "Installation Master Planning," September 30, 2020, and then the Military Departments update their respective handbooks to include the policy updates for Recommendations A.2.a through A.2.e and the requirement for each installation to assess the climate hazards outlined in the updated Unified Facilities Criteria 2-100-01, "Installation Master Planning," September 30, 2020.

Rec. A.3: The DoD OIG recommended that the Deputy Assistant Secretary of Defense for Construction in coordination with the Commanders of the U.S. Army Corps of Engineers, Naval Facilities Engineering Systems Command, and Air Force Civil Engineer Center update Unified Facilities Criteria 2-100-01, "Installation Master Planning," September 30, 2020, and then the Military Departments update their respective handbooks to include the policy updates for Recommendations A.2.a through A.2.e and the requirement for each installation to assess the climate hazards outlined in the updated Unified Facilities Criteria 2-100-01, "Installation Master Planning," September 30, 2020.

Rec. A.4: The DoD OIG recommended that, after the update to DoD Instruction 4165.70 and Unified Facilities Criteria 2-100-01, the Commander of the U.S. Army Corps of Engineers, the Commander of the Naval Facilities Engineering Systems Command, and the Commander of the Air Force Civil Engineer Center update their respective guidance to include the requirement for each installation to assess all elements required by Public Law 116-92, "The National Defense Authorization Act for Fiscal Year 2020," section 2801, "Military installation resilience plans and projects," December 20, 2019, and outlined in the updated Unified Facilities Criteria 2-100-1, "Installation Master Planning," September…

Rec. A.4: The DoD OIG recommended that, after the update to DoD Instruction 4165.70 and Unified Facilities Criteria 2-100-01, the Commander of the U.S. Army Corps of Engineers, the Commander of the Naval Facilities Engineering Systems Command, and the Commander of the Air Force Civil Engineer Center update their respective guidance to include the requirement for each installation to assess all elements required by Public Law 116-92, "The National Defense Authorization Act for Fiscal Year 2020," section 2801, "Military installation resilience plans and projects," December 20, 2019, and outlined in the updated Unified Facilities Criteria 2-100-1, "Installation Master Planning," September…

Rec. A.4: The DoD OIG recommended that, after the update to DoD Instruction 4165.70 and Unified Facilities Criteria 2-100-01, the Commander of the U.S. Army Corps of Engineers, the Commander of the Naval Facilities Engineering Systems Command, and the Commander of the Air Force Civil Engineer Center update their respective guidance to include the requirement for each installation to assess all elements required by Public Law 116-92, "The National Defense Authorization Act for Fiscal Year 2020," section 2801, "Military installation resilience plans and projects," December 20, 2019, and outlined in the updated Unified Facilities Criteria 2-100-1, "Installation Master Planning," September…

We recommend the FEMA Administrator ensure that the EFSP National Board resolve the $7.4 million in questioned costs and incorporate controls in the American Rescue Plan Act of 2021 Humanitarian Relief Funding and Application Guidance to minimize future reimbursements of unsupported costs. Additionally, the FEMA Administrator should ensure the labor hour reimbursements made to the COVID-19 testing contractor are appropriately supported.

We recommend the FEMA Administrator ensure the EFSP National Board implements oversight measures to enforce the American Rescue Plan Act of 2021 Humanitarian Relief Funding and Application Guidance for future supplemental appropriations. Specifically, develop a risk-based methodology to review a sample of ongoing funding execution for future supplemental appropriations to ensure funds approved are: reviewed and reconciled for completeness and accuracy; and  supported with appropriate documentation, including rosters or other documentation for the number of people served.

Assess whether the Office of the Attorney General's case management system can be modified to fully meet the Unit's needs, and if appropriate, seek approval to implement its own case management system.

Establish policies and/or procedures to ensure that case files are maintained in an effective manner.

Develop a plan to ensure that case files include documentation of periodic supervisory reviews and update the Unit's policies and procedures manual to describe the Unit's current practices for periodic supervisory reviews.

Update its policies and procedures manual to reflect current practices.

Assess the duties of the Supervisor of Investigations, and if warranted, develop a plan to reduce his nonmanagerial duties.

Take steps to ensure that convictions and adverse actions are reported to Federal partners within the appropriate timeframes.

Take steps to track and verify that Unit staff meet requirements in its training plan.

Instruct the State to conduct monitoring reviews of its CDBG-DR HIM activities and subrecipients that satisfy monitoring requirements.

Develop and implement an agencywide crisis readiness plan addressing likely hazards arising from a crisis. This guidance should include all key elements that meet CIGFO crisis guidance.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. refund to the Federal Government the $468,372 of overpayments.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. 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 Cigna-HealthSpring Life & Health Insurance Company, Inc. continue its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that 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.

Rec. 2.a-d: The DoD OIG recommended that the Under Secretary for Personnel and Readiness, in coordination with the Assistant Secretary of Defense (Health Affairs), the Director of the Defense Health Agency, the Service Surgeons General, and the Joint Staff Surgeon, establish an oversight plan for the management of traumatic brain injury care within the Military Health System. At a minimum, the oversight plan should: a. Include the completion and tracking of required screening tools, including Military Acute Concussion Evaluation, Version 2. b. Include the completion and tracking of the Progressive Return to Activity protocol. c. Include the completion and tracking…

Rec. 3.a-b: The DoD OIG recommended that the Under Secretary for Personnel and Readiness, in coordination with the Assistant Secretary of Defense (Health Affairs), the Director of the Defense Health Agency, the Service Surgeons General, and the Joint Staff Surgeon, establish a Traumatic Brain Injury Program of Record for traumatic brain injury care within the Military Health System that: a. Establishes baseline resource requirements and guidance for personnel, equipment, and staffing and budget modeling. b. Standardizes programming, concept of operations, business practices, staffing, and referral standards.

Rec. 4: The DoD OIG recommended that the Under Secretary for Personnel and Readiness, in coordination with the Assistant Secretary of Defense (Health Affairs), the Director of the Defense Health Agency, the Service Surgeons General, and the Joint Staff Surgeon, establish a process by which Military Health System providers can access, create, and update Service members' profiles, regardless of their Service Component.

Develop a plan to analyze costs associated with the processing and delivery of Election Mail and explore opportunities to be compensated for the implementation of Election Mail key practices and extraordinary measures.

Strengthen controls over the development and approval of tree, bush, and vine prices, and expand current review to include verification of the sufficiency and accuracy of supporting information.

Establish a policy that, when using information or data from any outside entity, FSA will conduct an accuracy and applicability review with the outside entity to ensure that the information or data provided is being used in accordance with its intended purpose and with FSA regulations and policies.