Open Recommendations

We recommend that the Centers for Medicare & Medicaid Services, for the four States we identified as not having fully complied with the DRA's TPL provisions, verify whether the States have since come into compliance; and pursue corrective actions for States that have not fully complied.

We recommend that the Centers for Medicare & Medicaid Services verify whether Virginia has refunded the $1.25 million Federal share of the Medicaid TPL collections underreported during two fiscal quarters and, if not, require Virginia to refund any remaining amount owed.

We recommend that the Centers for Medicare & Medicaid Services provide guidance to States to assist them with developing processes that improve the reporting of Medicaid TPL amounts on the form 64.9A.

We recommend that the Centers for Medicare & Medicaid Services ensure that States have current instructions on completing the form 64.9A.

We recommend that the Centers for Medicare & Medicaid Services ensure that States correctly report TPL amounts on the form 64.9A.

We recommend that the Centers for Medicare & Medicaid Services remove or disable lines from the form 64.9A that States are supposed to leave blank.

Ensure veterans service representatives are made aware of and follow steps as outlined in the manual for when to send required forms and conduct follow-up contact with veterans.

Complete the Supply Chain Visibility Data Requirement Description effort to gain supplier data from contractors.

Ensure data is regularly entered into a supplier database (e.g., Insight Central) to track supplierdata and ongoing challenges.

Incorporate a representative from the Logistics Management Division into each Artemis-related program and project at appropriate milestones, including at the onset of a contract and each life-cycle milestone.

Ensure an Artemis-specific study of the Agency’s industrial base and supply chain is completed on a recurring basis.

We recommend that the Mississippi Division of Medicaid work with CMS to calculate the rebate amount for claims identified in our findings, invoice drug manufacturers for the calculated rebates, and refund the Federal share of rebates collected for the years covered by our audit period and for years after our audit period.

We recommend that the Mississippi Division of Medicaid strengthen internal controls to facilitate the invoicing of all physician-administered drugs for rebate.

We recommend that the South Dakota Department of Social Services remediate the six control findings OIG identified.

We recommend the Assistant Secretary for Mine Safety and Health update MSHA policies to: (1) define a schedule for verifying mine statuses; (2) specify when visual verifications (e.g., E28 idle mine visits) are necessary; (3) limit deviations from the mine status criteria to defined exceptional situations; (4) define how “primary mine type” changes apply during calculation of inspection requirements; (5) define timeliness metrics for certification of E01 inspections; (6) require mandatory inspections start and end in the same fiscal year; and (7) define how to calculate the mandatory inspection completion rate annually.

We recommend the Assistant Secretary for Mine Safety and Health redesign monitoring processes to check Part 50 data reporting for mines on a quarterly basis, and verify timely certification of mandatory inspections and accuracy of activity codes and inspection dates.

We recommend the Assistant Secretary for Mine Safety and Health update supporting tools based on revisions to the mine status criteria.

We recommend the Assistant Secretary for Mine Safety and Health develop a process to verify if: (1) mines in “temporarily idle” status for extended periods need a change to “abandoned” status and (2) mines with underground openings are being timely sealed when their “primary mine type” is not listed as “underground.”

We recommend the Assistant Secretary for Mine Safety and Health verify all underground coal mines in abandoned status for more than 90 days are either sealed (and its status updated in MSHA’s system), in the process of sealing and are issued a violation for non-compliance with the regulation, or has a remark in MSHA’s system indicating why it will not be sealed. This may include verifying the mine was identified for future reclamation in the Abandoned Mine Lands program inventory.

We recommend the Assistant Secretary for Mine Safety and Health communicate to staff on: (1) the current version of mine status criteria, (2) MSHA reports and tools available for the mandatory inspection program, and (3) leadership’s expectations on districts correcting activity codes and when Part 50 data should be available to districts (including follow-up and violations for operators not reporting timely).

We recommend the Assistant Secretary for Mine Safety and Health update policy or procedures to: (1) clearly define when an inspection starts and ends and (2) ensure the inspection dates for an E01 mandatory inspection include any inspection work done on other events (e.g., E16 spot inspection) to make the E01 inspection an “entire mine” inspection adhering to requirements in the Mine Act.

We recommend the Assistant Secretary for Mine Safety and Health revise business rules used in MSHA reports for the mandatory inspections program to align with the Mine Act and MSHA policy, or update MSHA policy accordingly and consider raising the number of E28 idle mine visits and E27 denial of entry attempts used in MSHA reports to eliminate an inspection requirement.

We recommend the Assistant Secretary for Mine Safety and Health improve the design and execution of MSHA’s internal control system for the mandatory inspections program to align with the GAO Standards for Internal Control in the Federal Government, specifically by identifying key risks through a programmatic risk assessment and collecting MSHA workforce concerns to verify or improve the integrity of the program.

Treasury’s Acting Chief Recovery Officer should work with Treasury OIG to obtain adequate documentation from the Commonwealth of Massachusetts for the Department of Health and Human Services $300,000 in expenditures or begin recoupment proceedings for the disallowed costs.

We recommend that ASPR mitigate the risk presented by relying on foreign supply chains and JIT inventory strategies when determining annual Stockpile purchases.