Open Recommendations

We recommend that Cigna HealthSpring of Florida, Inc. refund to the Federal Government $39,612 of net overpayments

We recommend that Cigna HealthSpring of Florida, Inc. improve its policies and procedures to prevent, detect, and correct noncompliance with Federal requirements for diagnosis codes that are used to calculate risk-adjusted payments.

Embassy Tallinn, in coordination with the Bureau of Overseas Buildings Operations and the Bureau of Consular Affairs, should bring the Consular Section’s physical space into compliance with Department standards.

Classified Report. Recommendation is SSI.

Classified Report. Recommendation is SSI.

Classified Report. Recommendation is SSI.

We recommend that OPM revise or replace the FEHBP MLR requirements to provide a reliable measure of the premium dollars spent on the FEHBP program, including the impact of carrier corporate structure and the current community-rated product market.

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

Develop and publish a public description of the purposes and benefits of, and the controls on, the drop-in meeting process.

Once the new guidance is developed, train all managers on the new guidance and controls for drop-in meetings and related interactions with external stakeholders.

Refund to the Federal Government $14,281,626 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement

Refund to the Federal Government $241,533 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement

Work with CMS to determine the unallowable portion of $1,328,195 (Federal share) for other claims for multiple-source physician-administered drugs that may have been ineligible for Federal reimbursement, refund that amount, and consider invoicing drug manufacturers for rebates for these drugs if CMS determines that the drug claims are allowable

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, 2019

Continue to review and strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced

(U) Rec. 2.a: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to standardize active shooter incident response procedures and planning, equipment, and training requirements for all Department and Service law enforcement organizations.

(U) Rec. 2.c: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to identify the roles, responsibilities, and actions to be taken by armed non-first responder law enforcement organization personnel during active shooter incidents.

(U) Rec. 2.d: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to require installation active shooter incident response plans to include the roles and responsibilities of armed non-first responder law enforcement organization personnel, such as the Defense Criminal Investigative Organization personnel.

(U) Rec. 2.e: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to require installation commanders at all military installations initiate, update, validate, and exercise installation support agreements with local law enforcement organizations for the joint response to active shooter incidents on military installations.

(U) Rec. 2.f: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to require Defense Criminal Investigative Organization personnel participation in active shooter incident response exercises using scenarios where the armed non-first responder law enforcement organization personnel are already at the scene of an active shooter incident.

(U) Rec. 2.g: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to require installation armed non-first responder law enforcement organization personnel, such as the Defense Criminal Investigative Organization field offices, to develop memorandums of understanding with installation law enforcement organizations, which describe the role and responsibilities of Defense Criminal Investigative Organization personnel during an active shooter incident response.

(U) Rec. 2.h: The DoD OIG recommended that the Under Secretary of Defense for Intelligence and Security update DoD Directive 5210.56, or other appropriate DoD policy, to require law enforcement active shooter incident response training be provided to Defense Criminal Investigative Organization personnel.

We recommend the Office of Strategy, Policy, and Plans develop a unified strategy to improve DHS’ coordinated actions among the components and with other agencies to counter disinformation campaigns that appear in social media.

CMS should encourage Part D plans to increase access to and use of the authorized generic versions of Epclusa and Harvoni, within the authorities granted under statute.

CMS should pursue additional strategies—such as educating providers and pharmacies—to increase access to and use of lower-cost hepatitis C drugs in Medicare Part D.