Open Recommendations

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to do the following: Provide additional education to suppliers on documenting eligibility for intermittent urinary curved-tip catheters and sterile catheter kits and on documenting refills of catheters and sterile catheter kits. For example, CMS could emphasize the following:

-Medical records that list only a diagnosis without adequate documentation of an enrollee's inability to use a straight-tip catheter are insufficient to support medical necessity for use of a curved-tip catheter.

-Notations of urinary tract infections in medical records are insufficient to support that an enrollee is eligible for…

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to recover $11,399 in overpayments made to suppliers for the 15 sample items that did not meet Medicare requirements.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to perform additional medical reviews of claims for intermittent urinary catheters and sterile catheter kits, which could have saved Medicare an estimated $35,079,833 for our audit period.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to provide additional education to suppliers on documenting eligibility for intermittent urinary curved-tip catheters and sterile catheter kits and on documenting refills of catheters and sterile catheter kits.

Embassy Kinshasa, in coordination with the Bureau of Democracy, Human Rights, and Labor and the Bureau of African Affairs, should bring its Leahy vetting practices into compliance with the embassy's standard operating procedure and Department guidance.

Embassy Kinshasa should bring the Economic Section's records management program into compliance with Department standards.

Embassy Kinshasa should provide consular applicants with a waiting area that meets Department standards.

Embassy Kinshasa should issue guidance to sections and bureaus implementing foreign assistance advising them on the travel policy and requiring that monitoring plans for proposed programs take into account limitations on travel and staff capacity.

Embassy Kinshasa should close out expired federal assistance awards in accordance with Department standards.

Embassy Kinshasa should implement standard operating procedures in the PEPFAR Coordination Office for the management of federal assistance awards in accordance with Department standards.

Embassy Kinshasa should develop and implement a plan to supervise the locally employed staff in Goma on a regular basis.

Embassy Kinshasa should require all acquisition agreements and procurements be authorized by a warranted contracting officer in accordance with Department standards.

Embassy Kinshasa should develop and implement standard operating procedures for the purchase of official vehicles to adhere to Department acquisition rules for official vehicles.

Embassy Kinshasa should bring its contracting administration program into compliance with Department standards.

Embassy Kinshasa should close out procurement files in accordance with Department standards.

Embassy Kinshasa should record all operational and maintenance data and costs for the embassy's watercraft in accordance with the Department's forthcoming Foreign Affairs Manual guidance.

Embassy Kinshasa should adhere to all Department Motor Vehicle Safety Management Program standards for chauffeurs and incidental drivers under chief of mission authority.

Embassy Kinshasa should bring its property management program into compliance with Department standards.

Embassy Kinshasa should bring its furniture and appliance pool program into compliance with Department standards.

Embassy Kinshasa should bring its warehouse operations into compliance with Department standards.

Embassy Kinshasa should manage its armored vehicles in accordance with Department standards.

Embassy Kinshasa should document its actions taken to recover the $245,000 improper payment for two official vehicles. If the embassy determines the improper payment to be unrecoverable, Embassy Kinshasa should report it as a fiscal irregularity in accordance with Department standards.

Embassy Kinshasa should review and de-obligate all unliquidated obligations without activity for more than one year in accordance with Department standards, so that funds of up to $2.8 million can be put to better use.

Embassy Kinshasa should bring the travel advance process into compliance with Department standards, including clearing overdue travel advances, and put funds of up to $107,000 to better use.

Embassy Kinshasa should develop and implement a standard operating procedure to accurately monitor and collect employee receivables for excess cell phone charges in accordance with Department standards.