Open Recommendations

Rec. A.4: The DoD OIG recommended that, after the update to DoD Instruction 4165.70 and Unified Facilities Criteria 2-100-01, the Commander of the U.S. Army Corps of Engineers, the Commander of the Naval Facilities Engineering Systems Command, and the Commander of the Air Force Civil Engineer Center update their respective guidance to include the requirement for each installation to assess all elements required by Public Law 116-92, "The National Defense Authorization Act for Fiscal Year 2020," section 2801, "Military installation resilience plans and projects," December 20, 2019, and outlined in the updated Unified Facilities Criteria 2-100-1, "Installation Master Planning," September…

Rec. A.4: The DoD OIG recommended that, after the update to DoD Instruction 4165.70 and Unified Facilities Criteria 2-100-01, the Commander of the U.S. Army Corps of Engineers, the Commander of the Naval Facilities Engineering Systems Command, and the Commander of the Air Force Civil Engineer Center update their respective guidance to include the requirement for each installation to assess all elements required by Public Law 116-92, "The National Defense Authorization Act for Fiscal Year 2020," section 2801, "Military installation resilience plans and projects," December 20, 2019, and outlined in the updated Unified Facilities Criteria 2-100-1, "Installation Master Planning," September…

We recommend the FEMA Administrator ensure that the EFSP National Board resolve the $7.4 million in questioned costs and incorporate controls in the American Rescue Plan Act of 2021 Humanitarian Relief Funding and Application Guidance to minimize future reimbursements of unsupported costs. Additionally, the FEMA Administrator should ensure the labor hour reimbursements made to the COVID-19 testing contractor are appropriately supported.

We recommend the FEMA Administrator ensure the EFSP National Board implements oversight measures to enforce the American Rescue Plan Act of 2021 Humanitarian Relief Funding and Application Guidance for future supplemental appropriations. Specifically, develop a risk-based methodology to review a sample of ongoing funding execution for future supplemental appropriations to ensure funds approved are: reviewed and reconciled for completeness and accuracy; and  supported with appropriate documentation, including rosters or other documentation for the number of people served.

Assess whether the Office of the Attorney General's case management system can be modified to fully meet the Unit's needs, and if appropriate, seek approval to implement its own case management system.

Establish policies and/or procedures to ensure that case files are maintained in an effective manner.

Develop a plan to ensure that case files include documentation of periodic supervisory reviews and update the Unit's policies and procedures manual to describe the Unit's current practices for periodic supervisory reviews.

Update its policies and procedures manual to reflect current practices.

Assess the duties of the Supervisor of Investigations, and if warranted, develop a plan to reduce his nonmanagerial duties.

Take steps to ensure that convictions and adverse actions are reported to Federal partners within the appropriate timeframes.

Take steps to track and verify that Unit staff meet requirements in its training plan.

Develop and implement an agencywide crisis readiness plan addressing likely hazards arising from a crisis. This guidance should include all key elements that meet CIGFO crisis guidance.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. refund to the Federal Government the $468,372 of overpayments.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.

We recommend that Cigna-HealthSpring Life & Health Insurance Company, Inc. continue its examination of its existing compliance procedures to identify 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 the necessary steps to enhance those procedures.

Rec. 2.a-d: The DoD OIG recommended that the Under Secretary for Personnel and Readiness, in coordination with the Assistant Secretary of Defense (Health Affairs), the Director of the Defense Health Agency, the Service Surgeons General, and the Joint Staff Surgeon, establish an oversight plan for the management of traumatic brain injury care within the Military Health System. At a minimum, the oversight plan should: a. Include the completion and tracking of required screening tools, including Military Acute Concussion Evaluation, Version 2. b. Include the completion and tracking of the Progressive Return to Activity protocol. c. Include the completion and tracking…

Rec. 3.a-b: The DoD OIG recommended that the Under Secretary for Personnel and Readiness, in coordination with the Assistant Secretary of Defense (Health Affairs), the Director of the Defense Health Agency, the Service Surgeons General, and the Joint Staff Surgeon, establish a Traumatic Brain Injury Program of Record for traumatic brain injury care within the Military Health System that: a. Establishes baseline resource requirements and guidance for personnel, equipment, and staffing and budget modeling. b. Standardizes programming, concept of operations, business practices, staffing, and referral standards.

Rec. 4: The DoD OIG recommended that the Under Secretary for Personnel and Readiness, in coordination with the Assistant Secretary of Defense (Health Affairs), the Director of the Defense Health Agency, the Service Surgeons General, and the Joint Staff Surgeon, establish a process by which Military Health System providers can access, create, and update Service members' profiles, regardless of their Service Component.

Develop a plan to analyze costs associated with the processing and delivery of Election Mail and explore opportunities to be compensated for the implementation of Election Mail key practices and extraordinary measures.

Strengthen controls over the development and approval of tree, bush, and vine prices, and expand current review to include verification of the sufficiency and accuracy of supporting information.

Establish a policy that, when using information or data from any outside entity, FSA will conduct an accuracy and applicability review with the outside entity to ensure that the information or data provided is being used in accordance with its intended purpose and with FSA regulations and policies.

We recommend that MCS Advantage, Inc. refund to the Federal Government the $220,577 of net overpayments.

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

We recommend that MCS Advantage, Inc. continue its examination of its existing compliance procedures to identify 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 the necessary steps to enhance those procedures.

We recommend that the Census Bureau revise Chapter D-5, Section 11 (b) Cost Moinitoring to address any unique procedures necessary for Fixed Fee projects.

Determine the allowability of the questioned transactions and recover
$5,538,037, if applicable.

Conduct a thorough assessment of single-celling policies and processes, including those applicable to inmates housed in quarantine and medical isolation units and to inmates vulnerable to suicide.

Assess how to improve staff and inmate compliance with healthcare protective equipment measures at its facilities and issue clear guidance to facilities about the importance of compliance.

Ensure that actions, including any policy revisions, the BOP takes to close the two open recommendations from our 2017 restrictive housing report that reference single-celling also apply to single-celling during quarantine and medical isolation.

Explore options for permanent changes to facility infrastructures that would allow for better implementation of social distancing and other infection control measures.

Immediately update guidance regarding (1) when staff should notify the families of inmates who become seriously ill or die, including a specific timeframe, and (2) uniform criteria for what constitutes a serious illness.

Ensure that inmate family information, or the inmate emergency contact form, is updated according to policy and readily available for BOP staff who need to notify next of kin in cases of inmate serious illness or death.

Create an RPS resource allocation and technology development strategic plan that includes an evaluation and mitigation of risks for each project through its completion and provide a communication plan to stakeholders and mission managers.

Conduct high quality, frequent, and routine self-assessment TRAs by project management beginning after the initial implementation of a technology development project as a basis for TRL assessment and risk management discussions.

Per Title 51 and NPR 7120.5F, recalculate the life-cycle costs for Next-Gen RTG and DRPS projects to include funding NASA provides to DOE.

Institute an EVM process for Next-Gen RTG and DRPS projects that conforms with NASA policy, FAR requirements, and industry best practices.

For Next-Gen RTG and DRPS development efforts that transition to a space flight project, execute a JCL analysis at the proper phases in accordance with NPR 7120.5F.

In coordination with DOE, develop a means for the RPS Program to obtain high-fidelity Pu-238 and fueled clad current and future inventory information.

Reevaluate the need and if appropriate reauthorize the organizational position of the Nuclear Power and Propulsion System Capability Leadership Team through the appropriate Mission Directorate and provide the Team responsibility for monitoring and advocating strategic nuclear power coordination across NASA.

We recommend that the FWS work with the Department to resolve the Federal share of questioned costs related to unsupported leave payouts totaling $53,262.

We recommend that the FWS require the Department to implement policies and procedures to ensure that leave payouts are allocated based on activity charged to specific grants, as required by Federal regulations.

We recommend that the FWS require the Department to establish policies and procedures that ensure the Department minimizes the time between the drawdown date and related expenditures.

We recommend that the FWS require the Department to implement a process with sufficient internal controls to provide for a reconciliation of all grant claims to actual expenditures recorded in FAMIS, the official Statewide accounting system.

We recommend that the FWS require the Department to develop a mechanism to hold Department employees accountable for timely submitting Federal financial and performance reports.

We recommend that the FWS require the Department to implement policies and procedures that ensure the Department is calculating and reporting indirect costs using the approved indirect cost rates.

We recommend that the FWS require the Department to develop and implement procedures to ensure compliance with Federal regulations related to subaward reporting.

We recommend that the FWS work with the Department to develop and implement guidance for determining whether WSFR funds pass through as subawards or contracts.

We recommend that Geisinger Health Plan refund to the Federal Government the $566,476 of net overpayments.

We recommend that Geisinger Health Plan 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 Geisinger Health Plan examine its existing compliance procedures to identify 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 the necessary steps to enhance those procedures.