Open Recommendations

We recommend the Administrator for the Federal Emergency Management Agency revise FEMA's approach to ensure equitable and timely distribution of mitigation funding. At a minimum, FEMA should: - devise a plan and conduct outreach to communities with a large number of SRL properties to identify and address barriers to their participation in the Flood Mitigation Assistance (FMA) grant program; - update regional, state, and community training to address inconsistent practices and requirements that hinder NFIP-insured participation in the FMA grant program; and - develop and implement policies and procedures to monitor and enforce grant requirements.

We recommend the Administrator for the Federal Emergency Management Agency devise a plan to strengthen its management of SRL properties and ensure the accuracy of the SRL list. The plan should: - assign specific roles and responsibilities to ensure cross-division integration, implementation, and monitoring of FEMA's SRL strategy; - improve its workflow tracking system to monitor all requested changes to the SRL list and capture resulting outcomes; and - evaluate alternatives for updating the SRL list apart from Form AW-501, such as permitting updates to a property's mitigation status based on submission of a proper elevation certificate.

CMS should require that participating States consistently submit data that allow for CMS and each State to calculate determinations of ineligibility.

update the CBMS by implementing an automatically accessible eligibility history that retains all beneficiary histories when retroactive changes occur, thereby eliminating the need for manual interventions to identify changes in eligibility status

ensure that the MMIS retains all beneficiary eligibility changes and reconcile the beneficiaries’ data contained in the MMIS to the data in the CBMS to determine whether discrepancies in Medicaid eligibility groups are occurring

ensure that the CBMS has automated edits to enroll Transitional Medicaid beneficiaries in the correct eligibility group

(U) Rec. 2: This recommendation is Controlled Unclassified Information

1. We recommend NCUA management continue its efforts to work with appropriate Congressional committees regarding amending the Federal Credit Union Act to grant the NCUA the authority to subject credit union service organizations and credit union vendors to examination and enforcement authority to the same extent as if they were an insured credit union.

Embassy London, in coordination with the Bureau of Overseas Buildings Operations, should bring Consulate General Edinburgh’s consular waiting room into compliance with current Department standards.

Embassy London, in coordination with the Bureaus of the Comptroller and Global Financial Services, Global Talent Management, and European and Eurasian Affairs, should implement a plan to fund current liabilities and reduce future liabilities in the locally employed staff defined benefit pension plan in order to comply with local labor law and address long-term funding concerns.

The Chief of Management and Administration and the Chief Operating Officer ensure the Risk Executive, Chief of Management and Administration, Chief Operating Officer, and Senior Accountable Official for risk management roles and responsibilities are fully and accurately defined in NARA policies.

The Chief of Management and Administration develop, document, implement, and disseminate an organizational risk management strategy and policy, in accordance with NIST 800-39, and a process for coordination between cybersecurity and enterprise risk management.

We recommend that the Texas Health and Human Services Commission refund $83,833,972 in Federal funds it inappropriately received because it used IGTs derived from impermissible provider-related donations to fund the State share of DSRIP Program payments.

We recommend that the Texas Health and Human Services Commission provide its IGT entities with guidance about arrangements that may result in impermissible provider-related donations, such as those outlined in CMS’s clarifying letter.

We recommend that the Texas Health and Human Services Commission request that its IGT entities disclose if similar arrangements exist and provide the State agency with action plans on ending the arrangements.

Develop and implement a Department-wide structure and designate an office to manage and oversee forfeiture activities across DHS, including: - reviewing component policies and procedures to ensure alignment with CAFRA; - developing performance objectives, measures, and plans; and - periodically requesting and reviewing component administrative forfeiture data for alignment with departmental and component goals.

Develop Department-wide policies and procedures, including: - consistent CAFRA notices and forms that meet Federal plain language writing requirements; and - consistent interpretation on managing CAFRA claims and use of a Hold Harmless Agreement.

We recommend the Chief Financial Officer develop and apply effective solutions to improve the implementation and use of the government-wide financial data standards for data elements associated with the award description, place of performance, unique record identifier, legal entity information, program activity data, and financial assistance aggregate reporting.

CMS should establish and implement “reject edits” that (1) reject encounter records in which the ordering provider NPI is not present when required and (2) reject encounter records that contain an ordering provider NPI that is not a valid and active NPI in the NPPES registry.

CMS should require MAOs to submit the ordering provider NPI on encounter records for DMEPOS and for laboratory, imaging, and home health services.

Develop and implement an action plan that includes sufficient policies, procedures, and controls that address households living in multifamily housing units having a sufficient supply of safe drinking water ["|] Status

We recommend that the New Jersey Department of Human Services (NJDHS) work with the New Jersey Department of Health to reinforce guidance to nursing facilities for ensuring potential incidents of abuse or neglect are reported in accordance with Federal and State requirements.

We recommend that the New Jersey Department of Human Services work with the New Jersey Department of Health to develop additional procedures for its survey site visits, including reviewing nursing facilities’ records related to hospital transfers for certain beneficiary injuries or conditions that could be the result of potential abuse or neglect.

The U.S. Mint Director before processing any mutilated or uncurrent redemptions should ensure the Mint strengthens and finalizes standard operating procedures for all coin exchange programs before accepting any redemptions. This would include using tests and subject matter experts to authenticate the genuineness of coins redeemed, as well as working with the Board of Governors of the Federal Reserve System to develop appropriate interagency procedures to assure the integrity of the coin redemption process for uncurrent coins.

We recommend that the Rhode Island Department of Human Services conduct or renew all required criminal background checks for the 108 individuals we reviewed who did not have all required checks or who had expired background checks at the time of our data request and site visits