Open Recommendations

Develop and maintain an accurate list of active return delivery units in the Facilities Database.

Enhance the Parcel Return Service refund review process to include an automated validation to verify that refunds are warranted, including an assessment of whether the return delivery units that received the packages were active at the time of mailing.

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CDC should take further steps to ensure the quality of nursing home reporting of COVID-19 data to NHSN.

CDC should consider how quality assurance checks can be enhanced to ensure data accuracy, as appropriate.

CDC should improve the user support the NHSN Help Desk provides to nursing homes.

Risk Management

Risk Management

Identity and Access Management

Identity and Access Management

We recommend that Cahaba Government Benefits Administrators, LLC, work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare PRB costs of $1,085,470 for CYs 2017 through 2019.

We recommend that Cahaba Safeguard Administrators, LLC, work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare PRB costs of $9,806 for CYs 2017 through 2019.

The Under Secretary for Health ensures the identified national program office responsible for oversight of alcohol withdrawal management consider requiring the development and implementation of written guidance for the management of alcohol withdrawal across all inpatient settings, to include: (a) expectations for determining alcohol withdrawal severity, level of care, and when transfer of care is indicated; (b) expected actions of nurses to communicate with prescribers based on patients’ changes in symptoms or alcohol withdrawal severity and when that communication should be followed by a prescribers face-to-face evaluation of a patient; (c) expectations for the evaluation of co-occurring conditions, expert consultation…

The Under Secretary for Health consider the implementation of training for inpatient staff on the administration of standardized alcohol withdrawal severity scales.

Re-evaluate aged seized digital assets to consider whether risks of misstatement related to accurate valuation, existence, and ownership of assets have been adequately addressed considering the evolving nature of digital asset seizures. Based on the results of the evaluation, design and implement processes, procedures, and controls to appropriately account for aged digital assets. (New)

Assess reconciliation, financial reporting review, and other monitoring controls to increase the precision with which period end financial reporting is performed, including the identification and investigation of significant variances for all financial statements. (New)

We recommend that Cahaba Safeguard Administrators, LLC, develop quality assurance procedures, to include improved policies and procedures, to ensure that going forward, it calculates Medicare segment pension assets in accordance with Federal requirements.

We recommend that Cahaba Government Benefits Administrators, LLC, work with CMS to ensure that its final settlement of contract costs reflects an increase in Medicare pension costs of $348,929 for CYs 2017 through 2019.

We recommend that Cahaba Safeguard Administrators, LLC, work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare pension costs of $146,658 for CYs 2017 through 2019.

We recommend that Cahaba Government Benefits Administrators, LLC, decrease Medicare's share of the Medicare segment excess pension liabilities as of December 31, 2018, by $135,979 and recognize $2,111,600 as Medicare's share of the pension liabilities as a result of the benefit curtailment.

We recommend that Cahaba Safeguard Administrators, LLC decrease the Medicare segment pension assets by $94,960 and recognize $10,970,030 as the Medicare segment pension assets as of January 1, 2020.