Open Recommendations

Develop and implement an agencywide crisis readiness plan addressing likely hazards arising from a crisis. This guidance should include all key elements that meet CIGFO crisis guidance.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. refund to the Federal Government the $468,372 of overpayments.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. continue its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.

Develop a plan to analyze costs associated with the processing and delivery of Election Mail and explore opportunities to be compensated for the implementation of Election Mail key practices and extraordinary measures.

Strengthen controls over the development and approval of tree, bush, and vine prices, and expand current review to include verification of the sufficiency and accuracy of supporting information.

Establish a policy that, when using information or data from any outside entity, FSA will conduct an accuracy and applicability review with the outside entity to ensure that the information or data provided is being used in accordance with its intended purpose and with FSA regulations and policies.

Based on established guidance, assess the actual production value for all questioned insured production losses totaling $15,681,325 identified by OIG. Recover any disallowed costs from the producers and issue payments to the producers for any underpayments

We recommend that MCS Advantage, Inc. refund to the Federal Government the $220,577 of net overpayments.

We recommend that MCS Advantage, Inc. identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.

We recommend that MCS Advantage, Inc. continue its examination of its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.

We recommend that the Census Bureau revise Chapter D-5, Section 11 (b) Cost Moinitoring to address any unique procedures necessary for Fixed Fee projects.

Determine the allowability of the questioned transactions and recover
$5,538,037, if applicable.

Conduct a thorough assessment of single-celling policies and processes, including those applicable to inmates housed in quarantine and medical isolation units and to inmates vulnerable to suicide.

Assess how to improve staff and inmate compliance with healthcare protective equipment measures at its facilities and issue clear guidance to facilities about the importance of compliance.

Ensure that actions, including any policy revisions, the BOP takes to close the two open recommendations from our 2017 restrictive housing report that reference single-celling also apply to single-celling during quarantine and medical isolation.

Explore options for permanent changes to facility infrastructures that would allow for better implementation of social distancing and other infection control measures.

Immediately update guidance regarding (1) when staff should notify the families of inmates who become seriously ill or die, including a specific timeframe, and (2) uniform criteria for what constitutes a serious illness.

Ensure that inmate family information, or the inmate emergency contact form, is updated according to policy and readily available for BOP staff who need to notify next of kin in cases of inmate serious illness or death.

Create an RPS resource allocation and technology development strategic plan that includes an evaluation and mitigation of risks for each project through its completion and provide a communication plan to stakeholders and mission managers.

Conduct high quality, frequent, and routine self-assessment TRAs by project management beginning after the initial implementation of a technology development project as a basis for TRL assessment and risk management discussions.

Per Title 51 and NPR 7120.5F, recalculate the life-cycle costs for Next-Gen RTG and DRPS projects to include funding NASA provides to DOE.

Institute an EVM process for Next-Gen RTG and DRPS projects that conforms with NASA policy, FAR requirements, and industry best practices.

For Next-Gen RTG and DRPS development efforts that transition to a space flight project, execute a JCL analysis at the proper phases in accordance with NPR 7120.5F.

In coordination with DOE, develop a means for the RPS Program to obtain high-fidelity Pu-238 and fueled clad current and future inventory information.