Open Recommendations

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.

We recommend that the Indian Health Service continue to take the actions described in the IHS Director's Letter to Tribal Leaders to identify best practices to protect the safety and security of Indian children and collect and share this information with all participants in the IHS health system.

Embassy Kuwait City should cross-train Consular Section locally employed staff in U.S. citizen services functions, in accordance with Department standards.

Embassy Kuwait City should implement and monitor controls to confirm compliance with the Department’s standards for time and attendance.

Embassy Kuwait City should comply with all Department overseas motor vehicle safety standards for chauffeurs and incidental drivers under chief of mission authority.

Embassy Kuwait City should record all embassy vehicle usage in accordance with Department standards.

Embassy Kuwait City should dispose of excess expendable and nonexpendable property, in accordance with Department guidelines.

Embassy Kuwait City should account for all expendable and nonexpendable property in the Integrated Logistics Management System, in accordance with Department guidelines.

Embassy Kuwait City should bring its furniture and appliance pool into compliance with Department standards.

Embassy Kuwait City should comply with Department standards related to the use of the shipping containers as permanent storage.