Open Recommendations

We recommend that the Centers for Medicare & Medicaid Services: review how hospitals are using diagnosis code E41 for nutritional marasmus and diagnosis code E43 for unspecified severe protein-calorie malnutrition and work with hospitals to ensure that they correctly bill Medicare when using severe malnutrition diagnosis codes.

To address the 164 incorrectly billed hospital claims in our sample, we recommend that the Centers for Medicare & Medicaid Services: collect the portion of the $914,128 for the incorrectly billed hospital claims that are within the reopening period.

Make a determination regarding the allowability of questioned costs identified in this report and recover those costs determined to be unallowable.

Make a determination regarding the allowability of questioned costs identified in this report and recover those costs determined to be unallowable;

We recommend that the Centers for Medicare & Medicaid Services issue guidance, such as an Informational Bulletin, to inform States that performing a data analysis to identify Medicaid claims containing one or more diagnosis codes indicating potential child abuse or neglect could help identify incidents of potential child abuse or neglect and help ensure compliance with the States’ mandatory reporting laws.

We recommend that the Centers for Medicare & Medicaid Services assess the sufficiency of existing Federal requirements to report suspected child abuse and neglect of Medicaid beneficiaries to determine whether it should strengthen those requirements or seek additional authorities to provide oversight over the reporting of suspected child abuse and neglect of Medicaid beneficiaries.

We recommend that the Texas Health and Human Services Commission implement a system to ensure that it can track complaints not closed within 10 days.

We recommend that the Texas Health and Human Services Commission implement procedures to ensure that ensure that procedures are followed to detect unreported deaths.

We recommend that the Texas Health and Human Services Commission implement procedures to ensure that investigations of abuse, neglect, and exploitation are entered in the Health and Human Services Enterprise Administration Reporting and Tracking system database.

We recommend that Sharon Baptist Head Start: refund to the Federal Government the $36,264 in unallowable rent expense charged to its direct Head Start grant during our audit period,

We recommend that Sharon Baptist Head Start: work with ACF to determine the portion of the $489,564 in rent expense from prior periods that should be refunded and refund the appropriate amount

We recommend that Sharon Baptist Head Start: refund to the Federal Government the $171,000 in embezzled funds.

We recommend that the FWS work with the NBCI to develop and implement policies and procedures that comply with Federal regulations.

We recommend that the FWS identify other similar programs or grantees receiving WSFR awards or subawards that may also have the issues outlined in this advisory, and take corrective action.

OIG recommends that the Bureau of the Comptroller and Global Financial Services update the Foreign Affairs Manual to reflect the requirements and exemptions found in the Federal Travel Regulation, 41 C.F.R., §§ 301-51.1, 301-51.2, 301-51.3, and 301-51.4.

OIG recommends that the Bureau of the Comptroller and Global Financial Services update the Foreign Affairs Handbook to reflect the requirements and exemptions found in the Federal Travel Regulation, 41 C.F.R., §§ 301-51.1, 301-51.2, 301-51.3, and 301-51.4.

OIG recommends that the Under Secretary for Management develop and publish specific guidance in the Foreign Affairs Manual to clarify guidance on obtaining a medical clearance based on educational needs, as it relates to the Special Needs Education Allowance. At a minimum, the guidance should describe the process to obtain medical clearances for children with special needs.

OIG recommends that the Bureau of Medical Services develop and implement internal policies and procedures to guide the effective use of eMED to document the Special Needs Education Allowance application status. The policies and procedures should ensure accurate, real-time data are available to appropriate Department of State officials.

(U) Rec. A.1.b: This recommendation is Controlled Unclassified Information

Rec. A.1.c: The DoD OIG recommended that the Under Secretary of Defense for Policy require and validate that the Assistant Secretary of Defense (Homeland Defense & Global Support) performs an annual review of the protection providing organization's performance of protective security details to ensure compliance with DoD Instruction O-2000.22.

Rec. B.1.a.i: The DoD OIG recommended that the Under Secretary of Defense for Policy establish a working group including representatives from each protection-providing organization to revise DoD Instruction O-2000.22 to include guidance on the size and number of days of advance work needed for protective security detail missions.

Rec. B.1.a.ii: The DoD OIG recommended that the Under Secretary of Defense for Policy establish a working group including representatives from each protection-providing organization to revise DoD Instruction O-2000.22 to include guidance on use of security control rooms.

Rec. B.1.b: The DoD OIG recommended that the Under Secretary of Defense for Policy require and validate that the Assistant Secretary of Defense (Homeland Defense and Global Security) perform an annual review of the protection-providing organizations' performance of protective security details to ensure compliance with DoD Instruction O-2000.22.

Rec. B.5.a: The DoD OIG recommended that the Commandant of the U.S. Army Military Police School update Army Techniques Publication 3-39.35, "Protective Services," May 2013, to comply with any changes to DoD Instruction O-2000.22 regarding the number of personnel and number of days of advance work, an agent should perform at the mission location.

Rec. B.5.b: The DoD OIG recommended that the Commandant of the U.S. Army Military Police School update Army Techniques Publication 3-39.35, "Protective Services," May 2013, to comply with any changes to DoD Instruction O-2000.22 regarding the use of security control rooms.