Open Recommendations

We recommend that NTIA's Associate Administrator for the Office of Internet Connectivity and Growth design quality assurance procedures and implement them throughout the application review process.

The Under Secretary for Health ensures Veterans Health Administration prescribers assess risks and contraindications associated with stimulant prescribing.

The Under Secretary for Health considers establishing policy and clinical practice guidance related to attention deficit hyperactivity disorder diagnostic assessment and treatment with a stimulant and takes action as warranted.

2. We recommend the Under Secretary of Commerce for Oceans and Atmosphere and NOAA Administrator determine roles and responsibilities for oversight between NOAA and BIA. NOAA should ensure biannual progress reports for CAA funding for Tribes are collected and reviewed for compliance and take corrective action as necessary, including expediting funding that has not yet been distributed.

The Medical Center Director ensures staff keep patient care areas safe and clean.

Develop and implement procedures to routinely conduct a staffing needs assessment throughout a disaster to ensure recovery centers are adequately staffed based on customer demand and workload.

Provide FHWA Division Offices and State DOTs with all planned IIJA guidance areas and associated targeted completion dates.

Identify a list of any outstanding technical assistance requests from Division Offices and State DOTs for IIJA guidance clarifications and fulfill them.

Develop and implement a policy to require Headquarters' concurrence when Division Offices are making procedural revisions to their standard operating procedures for reviewing and approving STIPs to ensure continued alignment with the Agency's standards prescribed in its template.

We recommend that Indian Affairs incorporate the Department's definition of deferred maintenance into the Indian Affairs Manual, the facility management system's work order approval process, and the system training guidance.

We recommend the Bureau of Indian Education, in coordination with Indian Affairs and Many Farms schools, inspect and immediately address the foundation and boiler issues identified in the report.

We recommend the Bureau of Indian Education, in coordination with Indian Affairs, conduct a workforce study to ensure BIE has the capacity to oversee the transferred facility management responsibilities in its regions.

We recommend the Bureau of Indian Education close or cancel the 14 work orders that we concluded had been addressed (work order IDs AB157793, AB157794, AB155209, AB154396, AB381236, AB147686, AB159719, AB152087, AB385474, AB488840, AB207746, AB701825, AB664814, AB343991).

We recommend the Bureau of Indian Education develop and implement a review process to assess the status of all open work orders and make appropriate updates in the facility management system.

We recommend the Bureau of Indian Education, in coordination with Indian Affairs, develop and implement a continual monitoring process to assess the statuses of and close deferred maintenance work orders in the facility management system that have been addressed.

We recommend the Bureau of Indian Education, in coordination with Indian Affairs, ensure that every school has staff trained on managing work orders in the facility management system, including procedures for properly classifying, updating, and closing work orders.

We recommend that OPM's Contracting Officer require the PBM and Carrier to return $12,484,472 to the FEHBP for its portion of retail pharmacy pricing discounts not received from the PBM for CYs 2016 through 2021.

We recommend that OPM's Contracting Officer require the PBM and Carrier to return the FEHBP's portion of the PBM's "non-specific drug discounts" going back to the start of the Carrier's transparent agreement with the PBM, specifically for the period of CYs 2012 through 2015. The PBM has already identified an additional $1,397,520 in drug inventory purchasing discounts for CY 2015 that should be returned to the FEHBP as overcharges.

We recommend that OPM's Contracting Officer assess the PBM and Carrier $1,884,412 for LII on the questioned costs due back to the FEHBP for this finding, calculated through December 31, 2023. The LII should be adjusted to account for the date the questioned costs are returned to the program.

We recommend that OPM's Contracting Officer require the PBM and Carrier to return $5,911,973 to the FEHBP for its portion of the PBM's non-specific drug inventory purchasing discounts that were not received for CYs 2016 through 2021.

We recommend that OPM's Contracting Officer assess the PBM and Carrier $911,290 for LII on the questioned costs due back to the FEHBP for this finding, calculated through December 31, 2023. The LII should be adjusted to account for the date the questioned costs are returned to the program.

We recommend that Carrier collect $2,279,264 in claim transaction fees that were credited back to the PBM by retail pharmacies for the Carrier's CY 2016 through 2021 prescription drug benefits.

We recommend that OPM's Contracting Officer assess the PBM and Carrier $289,501 for LII on the questioned costs due back to the FEHBP for this finding, calculated through December 31, 2023. The LII should be adjusted to account for the date the questioned costs are returned to the program.

We recommend that FWS require the Department to implement controls that include maintaining records sufficient to determine the accurate impact of any future labor mischarging.

We recommend that the Secretary for the U.S. Department of the Interior or a designee coordinate with the U.S. Department of Agriculture to assign responsibility for the required annual report and ensure that each annual report is completed and that all components required in the report are addressed after the publication of the performance metric mentioned in Recommendation 2, as established in IIJASection 40206(f), "Annual Reports."