Open Recommendations

We recommend the FEMA Administrator establish robust transportation, supply chain, and general logistics contingency contracts to provide more timely and effective delivery of disaster support.

We recommend the FEMA Administrator develop internal controls over contract administration from initiation to closeout. These controls should: 1) ensure all contract requirements are met in accordance with the Federal Acquisition Regulation and corresponding DHS and FEMA policies and procedures; 2) ensure training needs are met by procurement personnel and appropriate approvals are obtained prior to the award or modification of contracts; and 3) ensure contract oversight officials adequately review invoices, including verifying costs, to theextent possible, based on source documentation to ensure billed costs are supported and allowed.

We recommend the FEMA Administrator Investigate FEMA’s transportation contracts in response to the Puerto Rico disaster for potential Anti-Deficiency Act violations and appropriately report the results of the review.

The Deputy Commissioner for Services and Enforcement should continue efforts to close the virtual currency information gap by issuing guidance clarifying the proper information reporting associated with virtual currency transactions.

We recommend the DHS Chief Information Officer identify and apply the resources needed in the Geospatial Management Office to the Department to fulfill covered agency responsibilities under Section 759 of the Geospatial Data Act of 2018.

We recommend the DHS Chief Information Officer work with the Geospatial Information Officer tocoordinate with internal and external stakeholders to ensure a commondefinition of geospatial data, including the classification of Law EnforcementSensitive Information, as it applies to the DHS mission and operatingenvironment.

CMS should ensure that all States receive training on CMS’s updated triage guidance.

CMS should identify new approaches to address those States that are consistently failing to meet the required timeframes for investigating the most serious nursing home complaints.

We recommend CBP’s Assistant Commissioner for the Office of Information and Technology implement all mitigation and policy recommendations to resolve the 2019 data breach identified in CBP’s Security Threat Assessments, including implementing USB device restrictions and applying enhanced encryption methods.

We recommend the Deputy Executive Assistant Commissioner, Office of Field Operations coordinate with the CBP Office of Information and Technology to ensure that all additional security controls are implemented on relevant devices at all existing Biometric Entry-Exit program pilot locations.

We recommend the Deputy Executive Assistant Commissioner, Office of Field Operations establish a plan for the Biometric Entry-Exit Program to routinely assess third-party equipment supporting biometric data collection to ensure partners’ compliance with Department security and privacy standards.

We recommend that the Oregon Health Authority provide additional guidance to CCOs on the processes for provider credentialing and for beneficiary grievances and appeals.

We recommend that the Oregon Health Authority provide additional guidance to CCOs on monitoring subcontractors.

We recommend that the Oregon Health Authority take actions to ensure that CCOs do not subcontract the adjudication of final appeals.

We recommend that the Oregon Health Authoritytake actions to ensure that the data that CCOs submit on grievances and appeals in the grievance workbooks are accurate and complete.

We recommend that the Connecticut Department of Social Services work with CMS to review Medicaid payments made to HPS after our audit period and refund any overpayments.

We recommend that the Connecticut Department of Social Services strengthen its oversight of the SBCH program by working with DAS to develop a detailed review process for claims submitted by the LEAs to ensure that all claims meet Federal and State requirements.

We recommend that the Connecticut Department of Social Services refund $761,179 to the Federal Government.

Implement controls, such as systems alerts and management reports, to identify beneficiaries in miscellaneous suspense status and ensure employees take corrective actions timely.

Include a Numident match in the Death Information Processing System, or similar process, to assess Online Verification System discrepancies before rejecting an Electronic Death Registration report.

We recommend that the North Carolina Department of Health and Human Services follow up with the 18 nursing homes to verify that corrective actions have been taken. regarding the life safety and emergency preparedness deficiencies identified in this report;

We recommend that the North Carolina Department of Health and Human Services work with CMS to develop life safety training for nursing home staff.

We recommend that the North Carolina Department of Health and Human Service conduct more frequent site surveys at nursing homes with a history of multiple high-risk deficiencies.

We recommend that the North Carolina Department of Health and Human Service work with LEM agencies to develop a process to monitor the submission of emergency plans.

5. We recommend that the North Carolina Department of Health and Human Services increase collaboration with LEM agencies to: clarify roles and responsibilities; make them aware of pending, or newly licensed, nursing homes in their counties; provide LEM agencies with survey results, to the extent possible, from individual nursing homes to identify specific vulnerabilities.