Open Recommendations

(U) Rec. 7: The DoD OIG recommended that the Under Secretary of Defense for Policy, in conjunction with U.S. Special Operations Command, develop a plan of action and milestones to implement the Counter Threat Finance Department of Defense Instruction as outlined in the approved Doctrine, Organization, Training, Materiel, Leadership, Personnel, Facilities, and Policy Change recommendation, which includes: 1. Developing a common lexicon for Counter Threat Finance. 2. Establishing procedures for nominating targets for sanctions and designations. 3. Establishing procedures for coordinating and executing Counter Threat Finance activities across organizational and geographic boundaries. 4. Developing clearly stated objectives for use in…

For the MF-RAP, PIH-TRA, and CPD-HIM programs, ensure that the program's improper payments rate estimates adequately test for and include improper payments of Federal funding that are made by State, local, and other organizations administering these programs and adequately disclose any limitations imposed or encountered when reporting on improper payments, to a degree that fairly informs users of the respective reported information. Status

The Office of Programs should publish Railroad Medicare program payment integrity information in accordance with the Payment Integrity Information Act of 2019 and the Office of Management and Budget's data call requirements until it formalizes an agreement with the Centers for Medicare and Medicaid Services to take over reporting for Railroad Medicare.

The Office of Programs should publish improper payment estimates for the Railroad Medicare program in the Office of Management and Budget's data calls, until the Office of Management and Budget formally approves the Railroad Retirement Board's discontinuation of reporting or approves an agreement between the Centers for Medicare and Medicaid Services and the Railroad Retirement Board on how Railroad Medicare will be reported.

The Office of Programs should develop and publish corrective action plan information in accordance with the Office of Management and Budget directives.

The Office of Programs should publish reduction targets for the Railroad Medicare program in accordance with the annual Office of Management and Budget Data Call requirements.

The Office of Programs should meet the published reduction targets for the Railroad Medicare program.

The Office of Programs should report an improper payment rate of less than 10 percent for the Railroad Medicare program in accordance with applicable laws and recommendations.

The Office of Programs should fully complete and publish all required payment integrity information as requested by the Office of Management and Budget's annual and supplemental data calls, until it formalizes an agreement with the Centers for Medicare and Medicaid Services to take over reporting for Railroad Medicare.

The Office of Programs should describe in its Performance and Accountability Report or Office of Management and Budget supplemental data call submission, the internal controls, human capital, its information systems and infrastructure needs, as well as its other program needs for reducing Railroad Medicare improper payments to the targeted levels, in accordance with the Office of Management and Budget's supplemental data call requirements.

Recommendation 4 (Rolled Forward from FYs 2017 to 2019)11 We recommend that Retirement Services develop and implement additional cost effective corrective actions, aimed at the root causes of improper payments, to further reduce the improper payments rate.

We recommend the DHS Office of the Secretary establish an oversight structure with central policy guidance and direction to ensure DHS law enforcement components comply with the DNA Fingerprint Act of 2005and 28 C.F.R. § 28.12.

We recommend the DHS Office of the Secretary ensure ICE, FPS, CBP, and TSA fully implement DNA collection for arrestees and nonU.S. detainees to comply with the DNA Fingerprint Act of 2005 and 28 C.F.R § 28.12.

We recommend the DHS Office of the Secretary ensure ICE, FPS, CBP, and TSA implement internal controls, including modifying booking systems to track and verify DNA collection. If components pursue memorandums of agreement with other agencies to collect DNA samples, they must implement internal controls to track and verify DNA collection.

We recommend the Acting Director of ICE ensure that before removing parents who have minor children in the United States, ICE staff document and obtain supervisory acknowledgement for each parent’s preference for whether the children should remain in the United States or be removed with the parent.

We recommend that Alive Hospice, Inc.: • refund to the Federal Government the portion of the estimated $7,389,854 for hospice services that did not comply with Medicare requirements and that are within the 4-year reopening period

We recommend that Alive Hospice, Inc.: • based upon the results of this audit, 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; and

We recommend that Alive Hospice, Inc. strengthen its policies and procedures to ensure that hospice services comply with Medicare requirements.

We recommend that Ambercare Hospice, Inc. based upon the results of this audit, 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; and

We recommend that Ambercare Hospice, Inc. strengthen its policies and procedures to ensure that hospice services comply with Medicare requirements.

HHS should continue to work with OMB and other stakeholders to develop and implement an approach to reporting on CDC and OHS Disaster Relief improper payments in FY 2021

HHS should continue to work with OMB and other stakeholders, including considering recommendations from recent OIG audits, to develop and implement an approach to reporting on APTC improper payments in FY 2021

HHS should continue to explore a vehicle to conduct recovery audits that will fit into the larger Medicare Part C program in FY 2021

HHS should continue to follow up with States during the interim period to verify that corrective actions identified after the improper payment error rate measurement review for the Medicaid and CHIP programs are being implemented. NOTE: The current COVID-19 public health emergency may impact the ability of States to analyze and follow up on corrective action plans. Consequently, this will impact the information reported to CMS.

HHS should focus on the root causes of the improper payment percentage and evaluate critical and feasible action steps to assist States with their compliance efforts for new requirements of the Medicaid and CHIP programs