Open Recommendations

We recommend that the Texas Health and Human Services Commission work with CMS to determine whether the non-top-20 multiple-source physician-administered drugs were eligible for rebates and, if so, bill manufacturers for the $629,967 ($366,578 Federal share) in rebates and refund the Federal share of rebates collected.

We recommend that the Texas Health and Human Services Commission strengthen internal controls to ensure that all eligible physician-administered drugs are billed for rebate.

We recommend that the Agency refund to the Medicare program the portion of the $1,262,887 in estimated overpayments received during CYs 2014 and 2015 for claims incorrectly billed that are within the reopening and recovery periods

We recommend that the Food and Drug Administration reconcile each month the OIG stewardship reports (or the HHS electronic Single Audit recommendation listing for audits processed on or after October 1, 2018) with FDA’s audit resolution records and follow up on any differences noted.

We recommend that the Food and Drug Administration finalize and implement formal policies and procedures for resolving program and IT audit recommendations, similar to the Framework that FDA has implemented for resolving Single Audit recommendations, which include issuing management decisions and submitting related OCDs to OIG within the required 6-month resolution period.

We recommend that the Food and Drug Administration promptly resolve the 32 outstanding audit recommendations (166 that were past due as of September 30, 2016, less 134 resolved after the end of our audit period).

We recommend that the Connecticut Department of Social Services work with CMS to determine the unallowable portion of $2,380,355 (Federal share) for other claims for outpatient physician-administered drugs that were submitted without NDCs or with invalid NDCs and that may have been ineligible for Federal reimbursement and refund that amount.

We recommend that the Connecticut Department of Social Services refund to the Federal Government $1,065,387 (Federal share) for claims for singlesource physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Connecticut Department of Social Services work with CMS to determine and refund the unallowable portion of Federal reimbursement for physician-administered drugs that were not invoiced for rebates after December 31, 2016.

We recommend that the Connecticut Department of Social Services strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.

We recommend that the Connecticut Department of Social Services refund to the Federal Government $46,210 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Connecticut Department of Social Services work with CMS to determine whether the remaining $387,761 (Federal share) of other physician-administered drug claims could have been invoiced to the manufacturers to receive rebates and, if so, upon receipt of the rebates, refund the Federal share of the manufacturers’ rebates for those claims.

We recommend that Southwest Key comply with ORR staffing ratios to ensure that children receive the necessary case manager and clinician services.

We recommend Southwest Key complete all required background checks on employees and volunteers, with results received and reviewed prior to hire, and complete all follow-up background checks timely.

CMS should ensure the correct submission of prescriber National Provider Identifiers

CMS should analyze the effectiveness of strategies for improving rates of followup care for children treated for ADHD.

CMS should collaborate with partners to develop strategies for improving rates of followup care for children treated for ADHD

CMS should provide technical assistance to States to implement strategies for improving rates of followup care for children treated for ADHD

HHS should develop large-scale international response plans;

HHS should develop various means of obtaining and using quality data for decision making

HHS should develop policies and procedures that clearly define HHS components’ roles and responsibilities for responding to international public health emergencies;

HHS should develop department-wide objectives and a strategic framework for responding to international public health emergencies

HHS should work with other U.S. Government agencies to develop a flexible multiagency international response framework

ACL should perform the required onsite compliance reviews of independent living programs.

Develop and implement a financial management system in accordance with HUD requirements, including but not limited to permitting the disbursement of funds in a timely manner.