Open Recommendations

CMS should ensure that a physician is involved in the decisions to start and continue general inpatient care;

CMS should analyze claims data to identify hospices that engage in practices or have characteristics that raise concerns;

CMS should implement a comprehensive prepayment review strategy to address lengthy general inpatient care stays so that beneficiaries do not have to endure unnecessarily long periods of time in which their pain and symptoms are not controlled;

CMS should seek statutory authority to establish additional remedies for hospices with poor performance

CMS should develop other claims-based information and include it on Hospice Compare

CMS should adjust payments based on these analyses, if appropriate, to ensure that the payment system is aligned with beneficiary needs and quality of care

CMS should assess the current payment system to determine what changes may be needed to tie payments to beneficiaries’ care needs and quality of care to ensure that services rendered adequately serve beneficiaries’ needs;

CMS should modify the payments for hospice care in nursing facilities.

CMS should work with its partners, such as hospitals and caregiver groups, to make available consumer-friendly information explaining the hospice benefit to beneficiaries and their families and caregivers;

CMS should analyze claims data to inform the survey process.

We recommend the Administrator of the Transportation Security Administration develop performance measures for all activities in FAMS' strategic plan as well as improve measurements for its Visible Intermodal Prevention and Response operations by fiscal year 2019.

We recommend the Administrator of the Transportation Security Administration develop a method for tracking the Office of Law Enforcement/Federal Air Marshal Service's funding by operations.

Provide regular training for EPA drinking water staff, managers and senior leaders on Safe Drinking Water Act tools and authorities; state and agency roles and responsibilities; and any Safe Drinking Water Actamendments or Lead and Copper Rule revisions.

Create a system that tracks citizen complaints and gathers information on emerging issues. The system should assess the risk associated with the complaints, including efficient and effective resolution.

The Management Control Review Committee should implement formal internal control activities in the Current Risk Response portion of their risk profile.

Management Control Review Committee should document and maintain current support for Risk Profile determinations.

Management Control Review Committee should include assessable units in risk profile that are critical to the Railroad Retirement Board’s strategic goals.

Management Control Review Committee should acknowledge material weaknesses and revise assessments accordingly in the next risk profile.

Management Control Review Committee should monitor audit recommendations on a regular basis and take action to ensure they are closed in the required timeframe.

Complete a cost analysis to 1) determine the efficacy of relocating CI assets in each of the field offices to existing IRS computer rooms versus upgrading the CI computer rooms to ensure that assets are protected in accordance with Federal and IRM security requirements and 2) implement the most cost-effective solution.

Determine if the newly standardized LDR data are reliable for direct maintenance workloads in the Technical Operations Staffing Model, and if so, develop and implement an action plan with milestones to replace the workload assessments with LDR data.

USDA OIG has determined that this recommendation contains sensitive information and will not be publicly released due to privacy concerns.

Reclassify $2,331,902 ($1,165,951 Federal share) in administrative costs that directly benefited Virginia’s CHIP programs, not the Waiver program

Refund to the Federal government $7,674,911 for administrative costs that were not identified in the CAP