Open Recommendations

Work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not billed for rebates after December 31, 2017.

We recommend that the PBM return $834,425 to the Carrier (to be credited to the FEHBP) for failing to provide pass-through pricing to the FEHBP at the full value of the PBM’s negotiated discounts with Walgreens and Rite Aid retail pharmacy claims for CYs 2014 through 2016.

We recommend that the PBM continue researching this issue and identify all other pharmacies whose full value of the negotiated discounts were not passed through to the FEHBP.

We recommend that the Carrier require the PBM to pay FEHBP pharmacy claims based on the full value of the PBM’s negotiated discounts with retail pharmacies at the time of adjudication. The guarantee found in the Agreement (between the Carrier and the PBM) should only be applied as a true-up when that guaranteed discount exceeds the pass-through transparent pricing for the period being analyzed.

We recommend that the Chief Financial Officer and Assistant Secretary for Administration update the PPMM to include guidance for OS commercial leasing. The Department should ensure other PPMM requirements do not similarly exclude OS.

We recommend that the Chief Financial Officer and Assistant Secretary for Administration update policies and procedures to include requirements for bureaus to maintain adequate documentation of vehicle usage.

We recommend that the Regional Administrator, FEMA Region IV direct the State of Florida to recover the $84,681 in unsupported and ineligible force account equipment costs from the County.

We recommend that the Regional Administrator, FEMA Region IV direct the State of Florida to require the County to either provide adequate support to validate the hours invoiced or remove the $1,080 in unsupported costs from its RFR.

Rec. 1: The DoD OIG recommended that the Office of the Under Secretary of Defense for Acquisition and Sustainment issue policy requiring all DoD biological select agents and toxins?registered laboratories to implement an internal technical and scientific peer review function that addresses both biosafety and biosecurity.

To the extent practicable, adjust the production schedules for Artemis 4 and 5 to better align with the successful demonstration of Artemis 2 to reduce schedule delays associated with potential rework.

We recommend HHS provide training to political appointees and senior leaders related to proper contract administration.

We recommend HHS determine whether any HHS contractors or subcontractors are performing inherently governmental functions and whether any active CMS service contracts or task orders are being administered as personal services contracts, and take action to correct their administration.

We recommend that the Regional Administrator, FEMA Region IV, assess the status and adequacy of FDEM's corrective actions with respect to establishing a subrecipient monitoring program and reviewing subrecipient Single Audit reports.

Resolve the $164,313 in questioned subaward costs and direct UNC to repay or otherwise remove the sustained questioned costs from its NSF awards.

To address the 164 incorrectly billed hospital claims in our sample, we recommend that the Centers for Medicare & Medicaid Services: CMS notifies appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can 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 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,