Open Recommendations

We recommend that the Centers for Medicare & Medicaid Services notify 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 at-risk payments made to at-risk providers during and after our audit period to determine whether payments for procedure code G0483 complied with Medicare requirements and recover any overpayments.

We recommend that the Centers for Medicare & Medicaid Services expand program safeguards to prevent and detect at-risk payments to at-risk providers for the definitive drug testing service with the highest reimbursement amount (procedure code G0483), which could have saved up to $215.8 million for our audit period.

Rec. 1: The DoD OIG recommended that the Commander of the Army Materiel Command conduct a review to determine whether an update to the maintenance processes is required to include and track the mission capability of Army pre-positioned stock equipment in storage, and implement the results of the review.

(U) Rec. 2: The DoD OIG recommended that the Commander of the 405 Army Field Support Brigade, in coordination with the Commander of the Army Materiel Command, identify and implement ways to exercise Army Pre-Positioned Stocks-2 equipment, in accordance with care of supplies in storage and Technical Manual 38-470 requirements.

(U) Rec. 4.c: The DoD OIG recommended that the Commander of the Army Sustainment Command provide guidance to the Army Field Support Brigades on identifying and ensuring the availability of sufficient and appropriate personnel to support surge requirements for Armored Brigade Combat Team rapid deployments.

CMS should require MAOs to definitively indicate on MA encounter data records when they have denied payment for a service on a claim.

Add fields to the Discipline and Administration Reintegration Tracking System that can be easily queried to identify the type of victim (inmate, staff, or other) and gender of the victim for all incidents involving prohibited acts by inmates, and identify the specific inmate behavior under each prohibited act code.

Ensure that staff are trained on the updated fields in the Discipline and Administration Reintegration Tracking System and that staff understand which inmate behaviors are associated with each prohibited act code, as well how to articulate the behavior in the corresponding field.

Ensure that policies and program statements that address inmate-on-staff sexual harassment are consistent with updates to systems and data tracking mechanisms.

Conduct regular risk assessments of the prevalence and severity of inmate-on-staff sexual harassment within individual institutions and across BOP institutions, with a particular emphasis on the risks for female staff.

We recommend that the Missouri Department of Social Services refund $34,171,397 (Federal share) in overpayments to the Federal Government.

We recommend that the Missouri Department of Social Services work with CMS to determine the allowability of $87,018,594 (Federal share) that we have set aside, and refund to the Federal Government any amount that is determined to be unallowable.

We recommend that the Missouri Department of Social Services monitor consumer-directed PCA providers to ensure compliance with the State agency's established policies and procedures such that timesheets are completed and the tasks performed are described accurately and in sufficient detail; units of service charged on timesheets do not exceed the units allowable on the recipients' plans of care; consumer-directed PCA providers maintain documentation showing that attendants are registered, screened, and employable pursuant to the FCSR; and plans of care are signed.

We recommend that the Missouri Department of Social Services establish policies and procedures to ensure that timesheets include fully accurate and complete details on the specific tasks performed.

We recommend that the Missouri Department of Social Services establish and implement policies and procedures to specify what consumer-directed PCA providers must include in their emergency backup plans for recipients and require development of pandemic preparedness plans and implement training to educate consumer-directed PCA providers on these plans.

Work with CLL to develop and implement comprehensive written policies and procedures to help ensure CLL's compliance with the DOJ Grants Financial Guide and federal award requirements, including financial reporting, subaward expenditures (payroll and non-payroll), and matching costs.

Remedy $127,915 in unsupported costs for the personnel and fringe benefits charged to the subawards.

We recommend that the Health Resources and Services Administration implement policies and procedures to periodically identify and assess whether security controls are in place and operating effectively in accordance with the most current NIST SP 800-53 and remediate weak controls timely.

We recommend that the Health Resources and Services Administration update security configurations to align with the most current NIST SP 800-53 security controls.

We recommend that the Health Resources and Services Administration remediate the nine security control findings we identified.

We recommend that USAID/Mozambique determine the allowability of $745,479 in questioned costs ($130,596 ineligible, $614,883 unsupported) on pages 17 and 18 of the audit report and recover any amount that is unallowable.

(U) Rec. 3: Recommendation is Classified.

Identify short- and long-term plans for the RPA program that align its capabilities, staffing needs, funding projections, and mission needs.

Implement procedures to capture and monitor centralized logs to maintain appropriate visibility into bot activities and provide for auditability of bot actions.