Open Recommendations

We recommend that the Nebraska Department of Health and Human Services improve policies and procedures to ensure that MFCU-determined Medicaid overpayments are reported on line 2 of the Form CMS-64.9C1 if collected or on line 2 of the Form CMS-64.9OFWA if not collected within timelines specified by Federal requirements.

We recommend that Professional Healthcare at Home, LLC refund to the Federal Government the portion of the estimated $3,358,906 for hospice services that did not comply with Medicare requirements and that are within the 4-year reopening period.

We recommend that Professional Healthcare at Home, LLC strengthen its policies and procedures to ensure that hospice services comply with Medicare requirements.

(U) Rec. A.8: The DoD OIG recommended that the Commanders of U.S. Special Operations Command Europe, U.S. Special Operations Command Africa, and U.S. Marine Corps Forces Europe provide all units in the U.S. European Command area of responsibility with access to the applicable accountable property systems of record. In addition, the Commanders should enforce the requirements that units record all munitions inventory in a timely manner in the systems of record; conduct 100 percent semiannual inventories; and prescribe more frequent inventories for units with known deficiencies, including the units identified in this report.

(U) Rec. B.2: The DoD OIG recommended that the Executive Director of the DoD Explosives Safety Board develop and issue clarifying policy requiring DoD Components to conduct explosives and munitions risk assessments at grandfathered facilities or revise the Defense Explosives Safety Regulation 6055.09 to remove the grandfathering clause.

Establish and implement monitoring procedures in guidance requiring State officials to ensure district directors complete reviews and evaluate the results of the reviews to ensure ECP policies are being followed.

Establish and implement procedures in guidance to define how the district director reviews should be documented.

Establish and implement monitoring procedures in guidance requiring State officials to ensure county executive directors complete spot checks and evaluate the results of the reviews.

We recommend the State strengthen guidance to nursing facilities on reporting incidents of potential abuse or neglect of Medicaid beneficiaries.

We recommend that the California Department of Public Health ensure that its staff are regularly trained on updated Federal and State requirements to ensure that appropriate priorities are assigned to allegation of abuse or neglect.

The BOP should ensure that alarms on all exterior building doors in FPCs and SPCs are in working condition and should take appropriate measures to prevent them from being susceptible to tampering.

The BOP should ensure that all existing video cameras in FPCs and SPCs are in working condition.

The BOP should install video cameras on all exterior building doors at FPCs and SPCs, so that BOP Control Officers can observe the doors while Camp Officers are occupied with performing their duties, such as inmate counts.

We recommend that University of Michigan Health System refund to the Medicare program the estimated $12,520 overpayment for claims that it incorrectly billed that are within the 4-year reopening period.

We recommend that the University of Michigan Health System implement policies and procedures to ensure that Medicare claims for polysomnography services comply with Medicare requirements.

We recommend that the Director of the Office of Block Grant Assistance require the Texas GLO to provide its plan to continuously monitor Harris County's pace and performance in its remaining Hurricane Harvey CDBG-DR program and take appropriate action to ensure that program goals are met.

We recommend that the Director of the Office of Block Grant Assistance require the Texas GLO to set performance and financial milestones, including approval of Harris County's projects and obligation and expenditure of funds, for all programs and activities funded under the Harris County subrecipient agreement through the remainder of the contract and deadlines for Harris County to achieve those milestones.

We recommend that the Director of the Office of Block Grant Assistance require the Texas GLO to provide evidence of subrecipient monitoring of Harris County's capacity to manage its Hurricane Harvey grant funds to address duplicative, inefficient, and cost-prohibitive processes or positions. The evidence should include any corrective actions that have been imposed and Harris County's response.

We recommend that the Director of the Office of Block Grant Assistance require the Texas GLO to ensure that Harris County obtains adequate training for its program staff and that the staff continuously demonstrates their understanding of and competence to operate Harris County's programs within applicable requirements. This would include ensuring that Harris County takes appropriate steps to remedy situations where staff are not operating the program within applicable requirements.

We recommend that the Director of the Office of Block Grant Assistance require the Texas GLO to review Harris County's Housing Reimbursement Program policies, including assistance prioritization, to ensure compliance with the Texas GLO's action plan and amendments. This would include the Texas GLO analyzing the County's project pipeline to determine whether changes are warranted to ensure that those most in need are prioritized to receive limited Federal assistance.

Examine ways to implement the use of secure, internal network connections to transfer data between LIMS and other work systems with the goal of implementing a more secure method of data transfer than relying on external storage devices.

We recommend that the New Mexico Human Services Department bill for and collect manufacturers' rebates for the 44,790 claim lines related to single-source and top-20 multiple-source physician-administered drugs that we calculated to be at least $1,239,130 ($900,971 Federal share) and refund the Federal share of rebates collected.

We recommend that the New Mexico Human Services Department work with CMS to determine whether the 25,341 claim lines related to non-top-20 multiple-source physician-administered drugs that we calculated to be at least $226,644 ($164,793 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 the New Mexico Human Services Department work with CMS to determine whether the other physician-administered drugs, associated with 183,859 claim lines and rebates of at least $170,674 ($124,097 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 the New Mexico Human Services Department strengthen internal controls to ensure that all eligible physician-administered drugs are billed for rebate.