Open Recommendations

We recommend the Principal Deputy Assistant Secretary for Employment and Training work with states to reconcile remaining balances that factor in: (a) the actual EURGENO relief provided (or, in some cases, that still must be provided) to reimbursing employers and (b) excess EURGENO relief provided due to the impact of other unemployment insurance or CARES Act provisions or fraud.

We recommend the Principal Deputy Assistant Secretary for Employment and Training determine the proper disposition of excess funds and take necessary actions, including recovery of questioned costs.

Incorporate formal data-testing procedures (and data-matching as appropriate) of HR Smart and the VA Centralized Adjudication Background Investigation System (or any replacement systems) into the monitoring program discussed in recommendation 2.

The assistant secretary for information and technology and chief information officer improve vulnerability management processes to ensure system changes occur within organization timelines.

The assistant secretary for information and technology and chief information officer develop and approve an authorization to operate for the special-purpose system.

The assistant secretary for information and technology and chief information officer include system personnel during the security categorization process to ensure that all necessary information types are considered when determining the security categorization for special-purpose systems.

The VA medical center director ensure that hot and cold aisles in computer rooms, and electric and data cables are installed in accordance with VA standards.

The VA medical center director validate that appropriate physical and environmental security measures are implemented and functioning as intended.

We recommend that the Alabama Medicaid Agency refund to the Federal Government $14,960,673 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Alabama Medicaid Agency refund to the Federal Government $43,981 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the Alabama Medicaid Agency work with CMS to determine and refund the unallowable portion of $290,455 (Federal share) for other claims for multiple-source physician-administered drugs that may have been ineligible for Federal reimbursement and consider invoicing drug manufacturers for rebates for those drug claims that CMS determines are allowable.

We recommend that the Alabama Medicaid Agency complete the process for rebating pharmacy drugs totaling $6,568 ($4,719 Federal share) for single-source and $219,220 ($157,395 Federal share) for multiple-source drugs that it had not previously collected a rebate on or refund the Federal share.

We recommend that the Alabama Medicaid Agency 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.

We recommend that the Alabama Medicaid Agency strengthen its internal controls to ensure that all pharmacy and physician-administered drugs eligible for rebates are invoiced.

Develop and implement procedures to ensure that travelers have complied with all pre-travel training requirements.

Develop and implement procedures to ensure that travel vouchers are submitted within five business days upon return from travel.

Develop and implement training that ensures all staff and approving officials are aware of their roles, responsibilities, and requirements for the travel process.

Develop and implement a process to communicate travel policy and requirement updates to staff in a periodic manner.

Revise policy to require employees add remarks, or upload proof, in its system when they release more than the allowable installment amount.

Ensure policy provides clear and consistent instruction on employees’ processing a current month or subsequent month’s Supplemental Security Income (SSI) payments that are included in children’s large, past-due SSI payment computations.

Establish a control to ensure employees timely document their review and approval of the annual Form SSA-6233-BK, Representative Payee Report of Benefits and Dedicated Account.

Cross-reference the 1,185 non-citizens’ records with multiple Social Security Numbers (SSN).

Revise policy to require that technicians conduct additional research for existing SSN records of non-citizens.

Implement a control to ensure employees follow policy when they clear alerts that result in improper assignment of SSNs.

Work with the U.S. Department of Homeland Security (DHS) and U.S. Department of State (State) to update the Memorandums of Understanding (MOU) to include a quality review program that ensures accurate data are provided. Additionally, the MOUs should include training of DHS and State employees, when needed.