Open Recommendations

We recommend FTA recovers $76,572 from the Authority, if applicable.

Implement written procedures to include the confirmation of match funds as part of its annual monitoring reviews of each subgrantee.

Develop and implement a written plan for its subgrantees to provide and submit supporting documentation for match funds at the end of each grant term.

Identify retroactive payroll for remaining grants (CA1162L9D011504, CA1024L9D011501, CA0694L9D011508, and CA0693L9D011508) and provide adequate documentation to support the cost or repay HUD from non-Federal funds.

Develop and implement additional procedures and controls to ensure that payroll costs charged to the grant reconcile to actual hours worked on the grants.

We recommend that the State agency develop and implement written policies and procedures to ensure that applicants who did not want or did not intend to apply for Medicaid are not determined eligible.

We recommend that the State agency ensure that all eligibility requirements are properly verified.

We recommend that the State agency ensure that eligibility caseworkers properly input applicant information.

We recommend that the State agency ensure that CalHEERS and SAWS have the system functionality to: deny or discontinue Medicaid for an ineligible beneficiary after a previous determination has already been made on the basis of the beneficiary’s MAGI, properly process cases for beneficiaries who were formerly in the foster-care youth program, use SSA data to verify whether a beneficiary is entitled to or enrolled in Medicare, properly redetermine eligibility when a beneficiary is no longer a child, and retrieve and use information from the Department of Homeland Security to determine whether a beneficiary has met the 5-year-bar requirement to…

We recommend that the State agency ensure that eligibility determinations are made in accordance with Federal and State requirements for beneficiaries: who do not provide the required information, e.g., citizenship or lawful presence status, whose presumptive eligibility period has ended, and who may not have met the residency requirement.

We recommend that the State agency develop and implement written policies and procedures, as necessary, to ensure that all payments for nonemergency and non-pregnancy-related services are adjusted for beneficiaries who are subject to the 5-year bar.

Rec. A.1.c: The DoD OIG recommended that the Deputy Chief Management Officer, in coordination with the Armed Forces Retirement Home Chief Operating Officer, quantify the impact each major capital project has on the Armed Forces Retirement Home Trust Fund balance and describe the effects on the resident population of the Armed Forces Retirement Home. In addition, the Deputy Chief Management Officer should establish a threshold in which it considers a capital project to be a major capital project and require that the Armed Forces Retirement Home detail how the major capital project risks will be isolated, minimized, monitored, and controlled…

The Commissioner, Small Business/Self-Employed Division, should evaluate whether provisions of the MOU require amendment, revision, or termination and ensure that the duties and responsibilities of the IRS, as outlined in the MOU, are executed as required.

We recommend that the State agency bill for and collect from manufacturers rebates for single-source and top-20 multiple-source physician-administered drugs and refund to the Federal Government the estimated $18,326,775 (Federal share).

We recommend that the State agency strengthen the NDC edit (implemented on October 1, 2012) to ensure that NDCs are captured and valid for all drug utilization data.

We recommend that the State agency ensure that all physician-administered drugs eligible for rebates are processed for rebates.

We recommend that the State agency work with CMS to determine whether the other physician-administered drugs were eligible for rebates and, if so, upon receipt of the rebates, refund up to an estimated $7,307,853 (Federal share) of rebates collected.

In coordination with the Office of Enforcement and Compliance Assurance, develop and implement a methodology to evaluate the impact of the revised Agricultural Worker Protection Standard on pesticide exposure incidents among target populations.

We recommend that WPS notify the 208 providers responsible for the remaining 44,820 nonsampled claims, with potential overpayments estimated at $42.3 million, so that those providers can investigate and return any identified overpayments in accordance with the 60-day rule and track any returned overpayments.

Take action, as appropriate, for the 41 beneficiaries identified by our audit.