Open Recommendations

OIG recommends that the Bureau of Intelligence and Research finalize the draft “Large Scale International Boundary Update Process Documentation” and approve the document for use.

Sensitive But Unclassified

We recommend that the Administration for Strategic Preparedness and Response: • establish written policies and procedures regarding the roles and responsibilities for organizational communication between ASPR and federally established emergency response team lead agencies;

We recommend that the Administration for Strategic Preparedness and Response make corrections in the FPDS for the four contracts for which ASPR reported inaccurate contract data, as detailed in our report.

We recommend that the Administration for Strategic Preparedness and Response: develop and implement policies and procedures to help ensure the accurate reporting of contract data in FPDS.

We recommend that the Administration for Strategic Preparedness and Response strengthen its policies and procedures to ensure CORs monitor contractor performance in accordance with duties detailed in COR appointment memos, including timely completing interim evaluations of performance and determining whether delays were excusable in accordance with specific contract terms and conditions.

(U) Rec. 1: This recommendation is Controlled Unclassified Information

(U) Rec. 7.a: This recommendation is Controlled Unclassified Information

(U) Rec. 7.b: This recommendation is Controlled Unclassified Information

Develop and implement outreach efforts to ensure that the Unit regularly receives referrals of patient abuse and neglect

Seek approval from the Office of the Chief State's Attorney to implement a new case management system

Conduct and document supervisory reviews of case files in accordance with Unit policy

Ensure that all convictions and adverse actions are reported to Federal partners within the appropriate timeframes

We recommend that the Municipality of Barceloneta complete its integration of the Head Start program's accounting system to the Municipality's electronic accounting system.

We recommend that the Municipality of Barceloneta maintain complete and accurate accounting records and ensure that reconciliation of accounting records is conducted prior to the submission of Head Start program FFRs.

We recommend that the Municipality of Barceloneta reinforce existing policies and procedures to ensure that drawdowns for the Head Start program are based on a valid voucher.

We recommend that the Municipality of Barceloneta reinforce existing policies and procedures to ensure that Head Start program bank reconciliations are completed in a timely manner.

We recommend that the Municipality of Barceloneta ensure that criminal background checks on employees and contractors that have direct contact with children are completed within required time frames.

CMS should lower Medicare's payment rates for intermittent urinary catheters.

We recommend that WellCare of Florida, Inc. refund to the Federal Government the $3,518,465 of estimated net overpayments.

We recommend that WellCare of Florida, 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 WellCare of Florida, Inc. continue its examination of 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.

CMS should take appropriate steps to enable a successful transition from current pandemic-related flexibilities to well-considered longterm policies for the use of telehealth for beneficiaries in urban areas and from the beneficiary's home.

CMS should temporarily extend the use of audio-only telehealth services and evaluate their impact.

CMS should require a modifier to identify all audio-only telehealth services provided in Medicare.