Open Recommendations

Develop and implement an internal process"including roles and responsibilities, timeframes, and criteria"to ensure contract requirements are met, and overpayments made to contractors are recovered.

Repay Federal matching funds spent on the case that was ineligible for Federal funding.

Update the FEMA Recovery Standard OperatingProcedure, SOP 9570.24 – Strategic Funds Management – ImplementationProcedures for the Public Assistance Program, at a minimum, to: provide criteria for documentation required for subreceipients’drawdown schedule for funding projections to determine whether fundsare needed within 180 days; and require Regions document the basis for decisions and maintain supportfor these decisions in Grants Manager and in Emergency ManagementMission Integrated Environment (EMMIE).

Develop a mechanism to ensure that the Office ofResponse and Recovery monitors the implementation of the Strategic FundsManagement Initiative in accordance with policy

Finalize the Grant Operations policies and procedures to reflect the current state and post‐reorganization.

Update the testing of design and effectiveness attributes to be consistent with the new policies and procedures.

Assess and document the known errors in the Trust Model and whether or not they could lead to material misstatements if not corrected. Document the rationale and procedures used to correct the data in the Trust Model.

The Office of Programs should ensure that the Disability Benefits Division works with Policy and Systems to implement system modifications to D-BRIEF to ensure that the Disability Briefing Document for decisions changed from occupational to total and permanent disabilities do not contain the incorrect statement that the (railroad) employee (applicant) was rated using Independent Case Evaluation.

We recommend that the Centers for Medicare & Medicaid Services review the findings in this report and, if it determines that a separate payment methodology for capital costs at new hospitals is no longer warranted, change its regulations to require new hospitals to have their Medicare capital costs paid through the IPPS with an option for payment adjustments or supplemental payments if necessary

Develop and implement a plan to increase fraud referrals from the Medicaid agency and other sources.

Revise its MOU with the Mississippi Division of Medicaid to reflect current law.

Repay Federal matching funds spent on cases that were ineligible for Federal funding.

Develop a procedure to ensure that it reports all program income properly on its Federal financial reports.

Work with the Mississippi Division of Medicaid to ensure the return of the Federal Government's share of all recoveries.

We recommend that the Oklahoma Health Care Authority consider whether more of an emphasis on counseling could improve OUD outcomes and, if so, take steps to increase the appropriate use of counseling with OUD drugs in outpatient OUD treatment

We recommend that the Oklahoma Health Care Authority develop policies and procedures to ensure that Medicaid behavioral health services are reviewed on an ongoing basis.

We recommend that the Missouri Department of Social Services refund $3,411,531 to the Federal Government.

We recommend that the Missouri Department of Social Services improve its monitoring of the health home program to ensure that health home providers comply with Federal and State requirements for maintaining documentation to support the services for which the providers billed and received PMPM payments.

OIG recommends that the Bureau of Information Resource Management conduct an in-depth review of the entire agency IT portfolio to identify potential duplicative systems.

OIG recommends that the Bureau of Information Resource Management develop and implement, to the extent practicable, a strategy to combine, eliminate, or replace the duplicative systems identified during its review of the entire agency IT portfolio (Recommendation 2).

OIG recommends that the Bureau of Administration develop and implement a methodology for identifying requisitions of or exceeding $10,000 that have not been properly identified as IT-related acquisitions.

Track progress on implementing the Office Workload List, including milestones to show when the Agency anticipates using information from the system to assist with inspector staffing decisions.

Update information regarding implementation of the Designee Management System, including milestones to show when FAA anticipates fully integrating individual designees into the system and how it intends to use the system's data to determine whether to adjust its inspector workforce staffing levels and responsibilities.

We recommend that the FWS work with the Division to reconcile their respective records of lands purchased with WSFR grant funds.

Based on the results of this audit, notify appropriate providers (i.e., those for whom CMS determines that this audit constitutes credible information of potential overpayments) so that the providers can 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.