Open Recommendations

We recommend that the Colorado Department of Health Care Policy and Financing refund $6,012,198 to the Federal Government, consisting of $3,509,358 (Federal share) of capitation payments made on behalf of deceased enrollees who had a date of death recorded in SSA's DMF but not in the State agency's eligibility system; $293,890 (Federal share) of capitation payments made on behalf of deceased enrollees who had a date of death recorded in SSA's DMF and in the State agency's eligibility system; and $2,208,950 (Federal share) in other Medicaid expenditures that the State agency had previously overreported.

We recommend that the Department require FWS, IBC, NPS, OSMRE, and OWPO to reevaluate the risk for current grants awarded to the Illinois Department of Natural Resources in accordance with 2 C.F.R. 200.206(c).

We recommend that the Department require FWS, IBC, NPS, OSMRE, and OWPO to develop and implement a monitoring plan that sufficiently addresses the increased risk with the Illinois Department of Natural Resources and determine the necessary adjustments or enhancements to oversight mechanisms on future DOI awards in accordance with 2 C.F.R. 200.206(b).

Establish a plan to use VAs cost accounting system information to identify additional ways to reduce costs, enhance efficiency, and inform business decisions as identified by VA financial policy

Ensure the facility has a process to identify cost outliers, such as using the Intermediate Product Cost Outlier report to identify cost outliers that may occur at the healthcare system on a regular basis.

Ensure healthcare system service lines review and update the national labor mapping tool to the Veterans Integrated Service Network managerial cost accounting team as required by VA financial policy to ensure workload is being captured correctly.

Ensure that healthcare system staff and responsible finance office staff review all open obligations to ensure balances are valid and should remain open or are closed in a timely manner as required by VA Financial Policy, Obligations, as updated in March 2024.

Ensure that the healthcare system uses appropriated funds in the manner intended by Congress, as required by the VA Financial Policy, Obligations, as updated in March 2024.

Consult with the Office of General Counsel and the Office of Acquisitions, Logistics, and Construction to determine whether a bona fide needs or other appropriations law violation occurred and, if any violations did occur, take appropriate remedial and preventive actions to address them.

Ensure cardholders comply with prior approval, segregation of duties, and record retention requirements as required by VA Financial Policy, volume 16, chapter 1B, Government Purchase Card for Micro-Purchases.

Ensure cardholders and approving officials are aware of the requirement to review purchases and determine when it is in the best interest of the government to use strategic sourcing.

Develop and implement a plan to ensure data accuracy and reliability in the Generic Inventory Package and ensure processes are in place to monitor performance metrics in accordance with Veterans Health Administration policy.

Develop and maintain an effective standardized training program for new and current inventory staff and monitor the staffs knowledge and skill level.

In coordination with the Strategic Acquisition Center, ensure that the Medical Surgical Prime Vendor facility-level contracting officers representatives and ordering officers are appointed and delegated properly and perform all required duties according to the scope and limitation of the designees authority.

In coordination with the Strategic Acquisition Center, submit ratifications for any Medical Surgical Prime Vendor unauthorized commitments in accordance with the Federal Acquisition Regulation.

The VA Northern Indiana Healthcare System Director evaluates the system clinic cancellation policy and service chief notification to the Chief of Staff of urgent clinic cancellations, and takes action as appropriate.

The VA Northern Indiana Healthcare System Director reviews short-notice clinical cancellations for social work mental health clinics, including the providers clinic, to evaluate patient impact and takes actions as appropriate.

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]