Open Recommendations

Review Science’s updated policies and procedures to assure adequate project information is submitted to Department officials to enable sufficient review and verification of indirect funded minor construction projects prior to approval.

Engage with other federal regulators to evaluate the need for changes to rules under the safety and soundness standards, including the adoption of noncapital triggers that would require early and forceful regulatory actions tied to unsafe banking practices before they impair capital.

We recommend that SelectCare of Texas, Inc. identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before and after our audit period and refund any resulting overpayments to the Federal Government

We recommend that SelectCare of Texas, Inc. refund to the Federal Government the $482,601 in net overpayments

We recommend that SelectCare of Texas, Inc. review its existing compliance procedures to identify potential 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 any necessary steps to enhance those current procedures

We recommend that CMS continue to explore opportunities for using T-MSIS and SSA's DMF data to improve its oversight of the Medicaid program. Specifically, CMS should develop a process to match enrollment and payment information in T-MSIS with the DMF and provide the results of that match to States to help reduce Medicaid capitation payments made to MCOs on behalf of deceased enrollees.

We recommend that CMS ensure that states complete actions on our remaining recommendations to address the internal control weaknesses we indentified.

We recommend that CMS collect the outstanding unallowable payments totaling the estimated $41,003,804 we previously identified.

OIG recommends that the Bureau of Administration, in coordination with the Bureau of Overseas Buildings Operations, issue a directive (1) emphasizing the requirement to comply with Federal Acquisition Regulation 36.605(b), which states that access to information concerning the independent government cost estimate shall be limited to government personnel whose official duties require knowledge of the estimate and (2) underscoring accountability and identifying penalties for noncompliance.

OIG recommends that the Bureau of Administration, in coordination with the Bureau of Overseas Buildings Operations, develop, implement, and communicate a process to ensure that new work that is not within the general scope of the contract or task order is treated as a new procurement, preventing out-of-scope modifications, as required by federal regulations and Department requirements.

OIG recommends that the Bureau of Administration, in coordination with the Bureau of Overseas Buildings Operations, issue a directive (1) emphasizing that acquisition planning and market research are completed and documented prior to initiating new projects at overseas posts, as required by federal regulations and Department of State requirements, and (2) underscoring accountability and identifying penalties for noncompliance.

OIG recommends that the Bureau of Administration, in coordination with the Bureau of Overseas Buildings Operations, issue a directive (1) emphasizing that the most highly qualified Architect/Engineering firm shall be selected, as required by public law, federal regulations, and Department of State requirements, and (2) underscoring accountability and identifying penalties for noncompliance.

OIG recommends that the Bureau of Overseas Buildings Operations develop, implement, and communicate a requirement to complete an Owner's Project Requirements document that details the functional requirements of a project and the expectations of how it will be used and operated.

OIG recommends that the Bureau of Overseas Buildings Operations develop, implement, and communicate a process that ensures that reviews for all technical disciplines are completed and documented at all interim design submissions.

OIG recommends that the Bureau of Overseas Buildings Operations develop, implement, and communicate a process to (1) document a description of the design change, the necessity of the design change, the potential cost impact, the potential schedule impact, and management approvals when Department of State-initiated design changes require modification to the design contract and (2) ensure the Basis of Design includes all design changes.

OIG recommends that the Bureau of Overseas Buildings Operations develop, implement, and communicate a process requiring it to address significant design deficiencies in facilities when deficiencies are identified during construction rather than after the facilities have been constructed.

OIG recommends that the Bureau of Overseas Buildings Operations issue a directive (1) emphasizing Department of State policy that the commissioning process begins before the design phase and that the process continues until the expiration of the 1-year warranty period of the operations and maintenance phase and (2) underscoring accountability and identifying penalties for noncompliance.

OIG recommends that the Bureau of Overseas Buildings Operations (OBO) develop, implement, and communicate a process requiring responsible OBO officials to document specific and detailed reasons and associated risks, proportional to the level of specificity and detail in the commissioning testing results, if OBO disagrees with commissioning testing results.

OIG recommends that the Bureau of Overseas Buildings Operations (OBO) develop, implement, and communicate processes requiring responsible OBO officials to document specific and detailed reasons, proportional to the level of specificity detailed in the commissioning reports, if OBO disagrees with commissioning report recommendations. This process must include, at a minimum, written documentation of an assessment of the risks associated with dismissing commissioning report recommendations, a comprehensive plan to mitigate those risks, and management's approval of these actions.

OIG recommends that the Bureau of Overseas Buildings Operations develop an action plan and budget for implementing recommendations to improve the performance and correct deficiencies of U.S. Embassy Baghdad, Iraq's central power plant, as recommended in the technical study report by the Miller Hull Partnership, LLP, and Mason and Hanger, Inc. This action plan should include a timeline with milestones for implementation and should report progress to the Under Secretary of State for Management.

Remedy the $301,222 in unsupported questioned costs for Grant Number 2019-VM-BX-00014.

Remedy the remaining balance of Grant Number 2019-VM-BX-0014 totaling $191,690 in funds to be put to better use.

Determine the allowability of the questioned transactions and recover $6,464,590 if applicable.

For those DNP portal databases that OST deems appropriate, develop, and implement policies and procedures to ensure recipient eligibility is verified in the DNP portal prior to making payment.

Assess the appropriateness of the databases in the Do Not Pay (DNP) portal and document a reasonable justification for any databases that OST determines are not appropriate.