Open Recommendations

Establish system controls to identify cases likely to have incorrect WC/PDB offsets and/or reverse offset determinations.

Update policy to require that employees process Modernized Development Worksheet (MDW) requests within set timeframes.

Implement controls to ensure employees take all actions requested before they close MDWs.

FDA should give greater weight to retailers' past noncompliance when taking enforcement actions against retailers with histories of violations.

FDA should determine whether variation in inspection activity on the basis of neighborhoods' socioeconomic status is appropriate and the extent to which it is meeting FDA's objective for protecting vulnerable populations.

Develop additional strategies and solutions to manage delays in detainee transfers to partners and implement these improvements throughout the El Paso sector when the holding facilities in the sector are over capacity.

Establish performance targets aligned with the key objectives of a new loyalty program and establish parameters to actively monitor progress for effective program management.

Develop a comprehensive communication strategy for a new loyalty program that promotes awareness of functionality for prospective, and once enrolled, ongoing customers.

The auditors recommend that Chief Information Officer require the Department and FSA to take immediate correctiveactions to implement enhanced monitoring procedures to allow for timely review of system authorization packages andappropriate authorization prior to submission into CSAM.

The auditors recommend that the Chief Information Officer require the Department to develop and implement an effectivequality control review process for its policies and procedures.

The auditors recommend that the Chief Information Officer require the Department and Federal Student Aid to takeimmediate corrective actions to remove users from the PIV exempt list.

The auditors recommend that the Chief Information Officer require the Department to take immediate corrective actions forestablishing quality control policies, procedures, and additional processes to ensure that user onboarding, elevated andnon-elevated user access forms are properly completed, tracked, and maintained for records.

The auditors recommend that the Chief Information Officer require that the Department and FSA to take immediatecorrective actions to ensure appropriate resources and funding are available and dedicated to complete implementation ofthe required EL1 and EL2 event logging maturities.

The auditors recommend that the Chief Information Officer require the Department to update Department PIA processes,quality control procedures, and monitoring controls to validate, track, and enforce the timely completion and review ofPIAs.

We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services file invoices for and collect from manufacturers rebates totaling $15,611,770 ($11,209,642 Federal share) for single-source and top-20 multiple-source physician-administered drugs and refund the Federal share of rebates collected.

We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services strengthen its internal controls to ensure that all eligible physician-administered drugs are invoiced for rebate.

We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services ensure that all physician-administered drugs eligible for rebates after our audit period are processed for rebates.

We recommend that the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services work with CMS to determine whether the other claims for multiple-source physician-administered drugs, totaling $5,967,128 ($4,281,678 Federal share), were eligible for rebates and, if so, determine the rebates due and, upon receipt of the rebates, refund the Federal share of the rebates collected.

We recommend that Novitas Solutions, Inc., work with CMS to ensure that its final settlement of contract costs reflects a decrease in Medicare nonqualified costs of $84,291 for CYs 2016 through 2018.

Bureau for Asia coordinate with USAID/Regional Development Mission for Asia, USAID/Central Asia Regional, and USAID/Philippines, Pacific Islands, and Mongolia to review and revise each mission's procedures to incorporate guidance on integrating C-TIP during strategy, project, and activity design.

We recommend that the Puerto Rico Department of Health develop written policies and procedures to use sources other than the Puerto Rico Demographic Registry to identify deceased enrollees.

We recommend that the Puerto Rico Department of Health identify capitation payments made after the audit period on behalf of deceased enrollees and refund to the Federal Government the Federal share of any unallowable payments.

We recommend that the Puerto Rico Department of Health refund $6,979,822 to the Federal Government.

We recommend that the Puerto Rico Department of Health establish a process with ASES to ensure ASES ceases making payments to MCOs on behalf of enrollees after their deaths are recorded in DOH's eligibility system and recoups unallowable payments made on behalf of deceased enrollees.

We recommend that the Puerto Rico Department of Health develop written policies and procedures to ensure that DOH staff periodically update, at least monthly, DOH's eligibility system with data on deaths recorded in the Puerto Rico Demographic Registry.