Open Recommendations

Rec. 1.b: The DoD OIG recommended that the Under Secretary of Defense for Acquisition and Sustainment issue guidance for estimating and presenting munitions and explosives of concern clearance costs on DD Form 1391, "FY____ Military Construction Project Data," that will enable personnel to assess the accuracy of the munitions and explosives of concern clearance budget and enable DoD leaders to refine future military construction projects based on historical comparisons of methods used to develop munitions and explosives of concern clearance budgets.

We recommend the Office of the Chief Readiness Support Officer work with component vehicle fleet managers to establish a consistent process for funding the acquisition, leasing, and maintenance of vehicles to meet mission needs.

Rec. 1: The DoD OIG recommended that the Chief of the Joint Trauma Education and Training Branch continue efforts to complete and implement standardized medical training, to include an Austere Surgical Resuscitative Course, in accordance with the Fiscal Year 2017 National Defense Authorization Act and Joint Requirements Oversight Council Memorandum 125-17.

Rec. 2: The DoD OIG recommended that the Surgeons General of the Army, Navy, and Air Force issue guidance implementing the Joint Trauma Education and Training Branch's standardized training program for all mobile medical teams.

Rec. 3: The DoD OIG recommended that the Surgeons General of the Army, Navy, and Air Force update training curriculums at the Military medical training commands for tactical training of mobile medical teams.

Rec. 5: The DoD OIG recommended that the Surgeons General of the Army, Navy, and Air Force, in coordination with the Command Surgeons of the U.S. Indo-Pacific Command and U.S. Africa Command, require that all mobile medical team personnel individually complete standardized post-deployment after action reports, using the Joint Trauma System Performance Improvement Branch template, before redeploying to their home station, and submit them to the Joint Lessons Learned Information System for the purposes of the Lessons Learned program.

Rec. 5: The DoD OIG recommended that the Surgeons General of the Army, Navy, and Air Force, in coordination with the Command Surgeons of the U.S. Indo-Pacific Command and U.S. Africa Command, require that all mobile medical team personnel individually complete standardized post-deployment after action reports, using the Joint Trauma System Performance Improvement Branch template, before redeploying to their home station, and submit them to the Joint Lessons Learned Information System for the purposes of the Lessons Learned program.

We recommend that the AOC develop and publish a discipline policy for exempt personnel, for transparency and consistency with other employee groups.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by designing, implementing, and maintaining a comprehensive Medicare premium penalty rate calculation worksheet addressing each enrollment and health plan coverage option, including disability enrollment, for use by headquarters and field office staff to document the preparation and review of penalty rates of 10 percent or greater.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by establishing a procedure to capture and maintain claims examiner decisions and explanations including relevant supporting documentation and screen prints with each penalty rate calculation worksheet to enable timely recollection and understanding of the penalty rate decision and calculation.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by reevaluating the claims examiner staffing resources needed for the current Medicare premium penalty workload.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by evaluating the impact of planned system modernization efforts to determine if greater automation or other improvements can be made to the penalty rate calculation process.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by updating the RL-331, Notice of Change in Health Insurance Election to include a penalty calculation summary that explains how and why the penalty rate was calculated and includes the applicable calculation decision elements, such as the dates of employment, GHP coverage period, SBI Income Related Monthly Adjustment Amount, birthdate, retirement date, penalty period start and end dates, and the total monthly premium to enable the beneficiary to understand the reason for the penalty decision and how it was…

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by establishing a penalty and refund review process to include both the standard form worksheet and USTAR tracking. The worksheet and supporting calculation and documentation should be reviewed, authorized, and dated by a second claims examiner and/or supervisor (if over 100 percent) on the worksheet, and tracked within USTAR. The review authorization should attest to the accuracy and completeness of the penalty or refund calculation, electronic filing of supporting documents, and beneficiary notification and confirmation.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by strengthening the management control review process over Medicare premium penalty and refund authorizations by determining the reasons for the undetected errors identified during the audit and modifying the review process as needed to improve the detection and reporting of similar future errors.

We recommend that the New Jersey Department of Human Services improve its monitoring and follow-up activities to ensure that its MCOs comply with Federal and State requirements detailed in its contracts with the MCOs for providing services to beneficiaries according to personalized care plans and actively coordinating, monitoring, and documenting beneficiaries’ physical health, behavioral health, and long-term-care needs.

We recommend that the New Jersey Department of Human Services take actions, including imposing corrective action plans, fines, or other financial disincentives on MCOs, to address the MCOs’ noncompliance affecting $721 million ($386 million Federal share) in capitation payments in CY 2016 and ensure future compliance with contract requirements.

Identify the optimum Strategic Petroleum Reserve configuration and capabilities for the present and future needs of the United States.

Ensure that the Life Extension – Phase II project’s scope and completion criteria corresponds with the optimum Strategic Petroleum Reserve configuration.

Identify the optimum Strategic Petroleum Reserve configuration and capabilities for the present and future needs of the United States.

Ensure that the Life Extension – Phase II project’s scope and completion criteria corresponds with the optimum Strategic Petroleum Reserve configuration.

The Office of Aviation Analysis develop a process to regularly collect, maintain, and use information from airlines' website disclosures of all fees charged for optional or ancillary services as a screening mechanism for significant changes in these fees. For each mainline carrier and posted fee, this information should include"but not necessarily be limited to"identification of the type of each service and its price (or price range).

We recommend that The Ohio State University Hospital based on 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

We recommend that The Ohio State University Hospital strengthen controls to ensure full compliance with Medicare requirements; specifically, ensure that all IRF beneficiaries meet Medicare criteria for acute inpatient rehabilitation; all inpatient beneficiaries meet Medicare criteria for inpatient hospital services; diagnosis and discharge status codes are supported in the medical records and staff are properly trained, and medical records accurately document the appropriate number of units and distinct procedural services and that staff are properly trained.