Open Recommendations

STB management should review the current version of the Office of Management and Budget (OMB) Circular A-136 to independently verify that all required footnotes are included and bring any omissions to the service providers attention so that errors or omissions can be corrected.

STB management should review the service providers Financial Statement and Notes Review Checklist to verify that the checklist is up to date and includes all required elements per OMB and Treasury guidance and then complete the checklist independently. Alternatively, STB management should develop and complete its own review checklist based on current Treasury and OMB reporting requirements.

STB management should request its financial management service provider to: Reevaluate the inclusion of account balances that were excluded in the Other Liabilities footnote, or Disaggregate (i.e., separately report) intragovernmental other liabilities balances reported as a single line item on the balance sheet that are not included in the footnote so that the total amounts reported for Other Liabilities on the Balance Sheet and in the footnote agree.

STB management should ensure that its review process includes procedures to disaggregate material balances reported in the financial statements and footnotes, agree balances to source documents, agree the footnotes to the principal financial statements, and verify the mathematical accuracy of all statements and schedules included in the financial statement package.

STB should perform routine reviews of employee benefit elections and Official Personnel Folders (OPFs) to ensure they are complete and accurate.

STB should address missing or unavailable supporting documentation with its shared service provider to ensure that document retrieval tools are available and are working properly to allow retrieval of all stored documents.

STB should obtain replacement documentation for employee forms and other documentation that has been determined to be incomplete or irretrievable from databases and other electronic sources.

KPMG recommends FAA design and implement procedures to consistently and timely perform and document user account access reviews as required by standards for effective internal control systems and/or internal policy.

KPMG recommends FAA design and implement procedures to consistently and timely notify account administrators of separations as required by internal policy.

We recommend that California Physicians' Service, Inc. refund to the Federal Government the $2,033,039 of estimated net overpayments.

We recommend that California Physicians' Service, 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 California Physicians' Service, Inc. examine 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.

Ensure that TRLA’s Employee Handbook is updated to reflect the current policies described in the Collective Bargaining Agreement.

CMS should use data to identify nursing homes or nursing home characteristics that are associated with a higher use of psychotropic drugs and focus oversight on nursing homes in which trends may signal inappropriate use.

CMS should expand the required data elements on Medicare Part D claims to include a diagnosis code.

CMS should evaluate the use of psychotropic drugs among nursing home residents to determine whether additional action is needed to ensure that use among residents is appropriate.

Recommendation not publically available.

We recommend that the Houlton Band of Maliseet Indians perform background investigations, as required by the Act, on individuals who currently have contact with Indian children and determine whether the individuals meet the required minimum character standards.

We recommend that the Houlton Band of Maliseet Indians develop and implement policies and procedures that ensure the Tribe conducts FBI fingerprint background investigations using FBI-approved procedures for individuals in contact with Indian children, conducts inquiries to State and Tribal law enforcement agencies based on the 5 years of residency information on each application, and assesses criminal history results to verify that applicants meet the required minimum character standards.

We recommend that the Houlton Band of Maliseet Indians request on employment applications information about each applicant's criminal history involving children, per the Tribe's policies and procedures related to the 1990 Crime Control Act.

We recommend that the Passamaquoddy Tribe at Indian Township perform background investigations, as required by the Act, on individuals who currently have contact with Indian children and determine whether the individuals meet the required minimum character standards.

We recommend that the Passamaquoddy Tribe at Indian Township develop and implement policies and procedures that ensure the Tribe requests information on each applicant's application about the prior 5 years of residency, conducts FBI fingerprint background investigations using FBI-approved procedures for individuals in contact with Indian children, conducts inquiries to State and Tribal law enforcement agencies based on the 5 years of residency information on each application, and assesses criminal history results to verify that applicants meet the required minimum character standards.

We recommend that the Narragansett Indian Tribe perform background investigations, as required by the Act, on individuals who currently have contact with Indian children and determine whether the individuals meet the required minimum character standards.

We recommend that the Narragansett Indian Tribe develop and implement policies and procedures that ensure the Tribe requests information on each applicant's application about the prior 5 years of residency, conducts FBI fingerprint background investigations using FBI-approved procedures for individuals in contact with Indian children, conducts inquiries to State and Tribal law enforcement agencies based on the 5 years of residency information on each application, and assesses criminal history results to verify that applicants meet the required minimum character standards.

We recommend that the Indian Health Service continue to provide additional training and technical assistance, in collaboration with other organizations as needed, to ensure that Tribes understand and comply with the requirements to conduct background investigations and the character assessment requirements of the Act.