Open Recommendations

We recommend that the Kansas Department of Health and Environment improve its estate recovery program by confirming that all deceased Medicaid recipients who are subject to estate recovery are identified and by providing relevant information on those recipients to the contractor in a timely manner so as to give the contractor adequate time to file liens and initiate probate.

We recommend that the Kansas Department of Health and Environment improve its oversight of the estate recovery contractor's performance by: verifying that the contractor files liens and initiates probate in a timely manner; confirming that the contractor's current process for MMIS claims verification is accurate; and verifying that the contractor performs applicable estate recovery procedures (including the opening of cases, sending of notices, and independent asset research) for deceased Medicaid recipients.

Comply with PBNDS 2011 standards by: a) providing documentation for the new open sick call system and reduction in wait times; b) continuing efforts to fill vacant positions; c) ensuring that urgent dental needs are met in a timely manner; and d) devising and executing a plan to eliminate the medical documentation scanning backlog.

Identify and work with amenable private property owners within Operable Unit 3 of the American Creosote Works Inc. (Pensacola Plant) Superfund site and appropriate local governments to establish restrictive covenants on contaminated private parcels to prevent the disturbance and removal of impacted soil. Restrictive covenants not only would protect the public but also could protect the $5.4 million Infrastructure Investment and Jobs Act-funded remediation by keeping hard surfaces and foundations in place over unremediated soil.

We recommend that EAC work with Mississippi to: a. Correct the interest income reported on the September 30, 2022, and any subsequently filed, Election Security Federal Financial Reports. b. Implement procedures to ensure accurate reporting on future Federal Financial Reports and to ensure that supporting documentation is maintained to support the amounts reported to EAC on the Federal Financial Reports. c. Ensure the implementation of proper written policies and procedures regarding the calculation and reporting of interest income. d. Determine the amount of any lost interest due to the delays in the earning of interest on the 2022 Election Security…

We recommend that EAC work with Puerto Rico to ensure that interest is now being properly credited to HAVA grant funds in a timely manner and that all lost interest is properly calculated and deposited into the election fund.

We recommend that EAC work with South Dakota to: a. Correct the interest income reported on the September 30, 2022, and any subsequently filed, Section 251 Federal Financial Reports. b. Implement procedures to ensure accurate reporting on future Federal Financial Reports.

Update and implement guidance applicable to the NRC's current timekeeping system

Periodically review and update the RTR inspection guidance in accordance with IMC 0040.

The open recommendation relates to strengthening access controls.

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The Under Secretary for Health reviews the criteria and processes used to identify and exclude healthcare providers removed from VA employment for violation of policy related to safe and appropriate care of veterans, and takes action as warranted.

The Under Secretary for Health reviews previous removals of healthcare providers from VA employment as required by VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 § 108 to determine whether the reason(s) for those removals were for violation of policy related to the safe and appropriate care of veterans, and takes action as warranted.

The Under Secretary for Health reviews the criteria and processes used to identify and exclude healthcare providers removed from VA employment for violation of policy related to safe and appropriate care of veterans, and takes action as warranted.

The Under Secretary for Health reviews previous removals of healthcare providers from VA employment as required by VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 108 to determine whether the reason(s) for those removals were for violation of policy related to the safe and appropriate care of veterans, and takes action as warranted.

We recommend that NTIA's Associate Administrator for the Office of Internet Connectivity and Growth develop and implement formal policy and procedures for validating self-certifications to determine applicants' eligibility for future broadband grant program awards.

We recommend that NTIA's Associate Administrator for the Office of Internet Connectivity and Growth update the office's internal policies and procedures to require reviewers to document detailed justifications for each stage of the review and award processes, and maintain these justifications in the official award files.

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.

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.

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.