Open Recommendations

We recommend the Under Secretary for Management require Coast Guard’s Nationwide Automatic Identification System program to implement an effective corrective action plan to identify (1) the root cause of the performance deficiencies and (2) the steps needed to meet the performance measure baselines identified in the Acquisition Program Baseline.

Correct the 33 cases with improper payments in accordance with Social Security Administration (SSA) policy.

Correct the 45 cases without improper payments per SSA policy.

Correct the 12 cases with large alleged lump-sum settlements in line with SSA policy.

Address the system limitation by expanding the field to allow settlements of or over $10 million.

Provide training based on workload deficiencies identified in WC Quality Today Management Information.

Evaluate the effectiveness of the strike team in processing center 5 and whether strike teams should be established in other processing centers.

Review the 193,950 worker’s compensation cases in our population to identify and correct the estimated 151,281 cases with errors.

We recommend the Principal Deputy Assistant Secretary for Employment and Training obtain evidence from the states that ensures all EURGENO refunds and credits to which reimbursing employers are entitled have been provided.

We recommend the Principal Deputy Assistant Secretary for Employment and Training work with states to reconcile remaining balances that factor in: (a) the actual EURGENO relief provided (or, in some cases, that still must be provided) to reimbursing employers and (b) excess EURGENO relief provided due to the impact of other unemployment insurance or CARES Act provisions or fraud.

We recommend the Principal Deputy Assistant Secretary for Employment and Training determine the proper disposition of excess funds and take necessary actions, including recovery of questioned costs.

Incorporate formal data-testing procedures (and data-matching as appropriate) of HR Smart and the VA Centralized Adjudication Background Investigation System (or any replacement systems) into the monitoring program discussed in recommendation 2.

The assistant secretary for information and technology and chief information officer improve vulnerability management processes to ensure system changes occur within organization timelines.

The VA medical center director ensure that hot and cold aisles in computer rooms, and electric and data cables are installed in accordance with VA standards.

The VA medical center director validate that appropriate physical and environmental security measures are implemented and functioning as intended.

We recommend that the Alabama Medicaid Agency refund to the Federal Government $14,960,673 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Alabama Medicaid Agency refund to the Federal Government $43,981 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Alabama Medicaid Agency work with CMS to determine and refund the unallowable portion of $290,455 (Federal share) for other claims for multiple-source physician-administered drugs that may have been ineligible for Federal reimbursement and consider invoicing drug manufacturers for rebates for those drug claims that CMS determines are allowable.

We recommend that the Alabama Medicaid Agency complete the process for rebating pharmacy drugs totaling $6,568 ($4,719 Federal share) for single-source and $219,220 ($157,395 Federal share) for multiple-source drugs that it had not previously collected a rebate on or refund the Federal share.

We recommend that the Alabama Medicaid Agency work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not invoiced for rebates after December 31, 2019.

We recommend that the Alabama Medicaid Agency strengthen its internal controls to ensure that all pharmacy and physician-administered drugs eligible for rebates are invoiced.

Develop and implement procedures to ensure that travelers have complied with all pre-travel training requirements.

Develop and implement procedures to ensure that travel vouchers are submitted within five business days upon return from travel.

Develop and implement training that ensures all staff and approving officials are aware of their roles, responsibilities, and requirements for the travel process.

Develop and implement a process to communicate travel policy and requirement updates to staff in a periodic manner.