Open Recommendations

Work with OAs to update privacy risk management procedures to ensure the completion, tracking, review, and approval of privacy plans and compliance documentation prior to system authorization or reauthorization. Components should engage the Departmental Chief Privacy Officer as appropriate.

Work with the Departmental Chief Privacy Officer to establish processes and procedures to determine Component compliance with Departmental policy requiring Privacy Risk Management plans be established prior to system authorization or reauthorization.

Coordinate with appropriate offices within the Office of Secretary to develop and implement a strategy and solution(s) to ensure that supervisors, contracting officers, and contracting officer representatives enforce personnel onboarding and off boarding procedures, completion of the DOT Rules of Behavior and other IT requirements prior to being granted access to DOT networks, systems, and information, or have existing access revoked upon separation, in accordance with DOT policy.

Strengthen its oversight of the configuration management processes performed by OAs to ensure configuration management plans are developed, kept up-to-date, and document requirements for each system.

Work with OAs to implement oversight to address configuration change weaknesses and to ensure configuration changes to the information systems are properly documented and tracked through implementation, and undergo a post-implementation review to verify procedures are followed.

Ensure that baseline configuration deviations are monitored and deviations are approved to ensure that baseline compliance reports demonstrate a consistent and accurate application of baseline standards.

We recommend that the Massachusetts Executive Office of Health and Human Services refund to the Federal Government $10,518,114 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Massachusetts Executive Office of Health and Human Services refund to the Federal Government refund $882,892 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Massachusetts Executive Office of Health and Human Services work with CMS to determine the unallowable portion of $4,154,511 (Federal share) for other claims for covered outpatient physician-administered drugs that were submitted without NDCs or with invalid NDCs and that may have been ineligible for Federal reimbursement and refund that amount, and whether the remaining $782,917 (Federal share) of other physician-administered drug claims could have been invoiced to the manufacturers to receive rebates and, if so, upon receipt of the rebates, refund the Federal share of the manufacturers’ rebates for those claims.

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).