Open Recommendations

We recommend that the Food and Drug Administration consider streamlining the process for writing and reviewing EIRs to minimize potential delays due to unexpected events.

We recommend that the Food and Drug Administration conduct an analysis of the workloads of individuals responsible for: (1) determining final classification, (2) issuing warning letters, and (3) holding regulatory meetings, and address any potential issues identified by this analysis.

We recommend that the Food and Drug Administration implement policies and procedures to ensure that lead investigators assigned to inspections have completed the Level 1 Investigator Certification Process.

We recommend that the Food and Drug Administration ensure that supervisors review investigators' qualifications and document that they meet applicable training requirements when the investigator training records do not exist.

We recommend that the Food and Drug Administration review the training records of the lead investigators that were outside the scope of the audit to verify that documentation supports either: o that the investigators completed the required training courses, Level 1 Performance Audit, and Level 1 Investigator Certification, or o that investigators are recommended as "experienced investigators" by supervisors and have completed training courses equivalent to the current required training courses.

We recommend that Retirement Services develop and implement additional cost-effective corrective actions, aimed at the root causes of improper payments, to further reduce the improper payments rate.

We recommend the Acting Deputy Assistant Administrator for Resilience implement management procedures to ensure HMGP property acquisition project applications and project information are complete and accurate when submitted, reviewed, closed, and maintained by FEMA.

The OIG recommends the Under Secretary for Benefits, in conjunction with the Assistant Secretary for Information and Technology, establish a mechanism to gain assurance that proper Office of Information Technology project management processes and protocols are followed when establishing information technology systems and applications.

Given the sensitivity of our review, this recommendation is restricted.

Rec. 2.a: The DoD OIG recommended that the Army's Deputy Chief of Staff, G-4 (Logistics); Navy's Deputy Chief of Naval Operations for Fleet Readiness and Logistics; and Chief of the Logistics Readiness Division, Headquarters Air Force (Logistics, Engineering, and Force Protection) reinforce and periodically communicate to ordering activities DoD and Service-specific reuse policies promoting maximizing reuse of excess property as a supply source. As part of this communication, the Military Services should provide ordering activities details regarding the newly established Defense Logistics Agency Disposition Services educational sessions, reuse website information, and instructions on how to search and place orders for…

Rec. 2.b: The DoD OIG recommended that the Army's Deputy Chief of Staff, G-4 (Logistics); Navy's Deputy Chief of Naval Operations for Fleet Readiness and Logistics; and Chief of the Logistics Readiness Division, Headquarters Air Force (Logistics, Engineering, and Force Protection) establish a process to ensure that activity ordering personnel comply with DoD and Service-specific policy for completing reuse training, including ensuring that all staff complete the training, and newly?hired ordering personnel are trained on the reuse of excess property within a few months of starting their duties.

Rec. 2.c: The DoD OIG recommended that the Army's Deputy Chief of Staff, G-4 (Logistics); Navy's Deputy Chief of Naval Operations for Fleet Readiness and Logistics; and Chief of the Logistics Readiness Division, Headquarters Air Force (Logistics, Engineering, and Force Protection) reinforce DoD and Service-specific policy and guidance to assist Military Service activities on proper assignment of condition codes when turning property in to Defense Logistics Agency Disposition Services.

Rec. 2.d: The DoD OIG recommended that the Army's Deputy Chief of Staff, G-4 (Logistics); Navy's Deputy Chief of Naval Operations for Fleet Readiness and Logistics; and Chief of the Logistics Readiness Division, Headquarters Air Force (Logistics, Engineering, and Force Protection) collaborate with Defense Logistics Agency Disposition Services to identify and implement training, educational sessions, or another solution to address the lack of trust in the accuracy of the condition codes for items the Military Services turn in to Defense Logistics Agency Disposition Services.

Rec. 2.e: The DoD OIG recommended that the Army's Deputy Chief of Staff, G-4 (Logistics); Navy's Deputy Chief of Naval Operations for Fleet Readiness and Logistics; and Chief of the Logistics Readiness Division, Headquarters Air Force (Logistics, Engineering, and Force Protection) establish an internal control mechanism such as monitoring or periodic assessments to ensure assignment of accurate condition codes on turn-in documentation to Defense Logistics Agency Disposition Services.

Rec. 2.f: The DoD OIG recommended that the Army's Deputy Chief of Staff, G-4 (Logistics); Navy's Deputy Chief of Naval Operations for Fleet Readiness and Logistics; and Chief of the Logistics Readiness Division, Headquarters Air Force (Logistics, Engineering, and Force Protection) review the Defense Logistics Agency Disposition Services report on inaccurate condition codes, take action to identify why the inaccurate condition codes occurred, and mitigate future inaccurate condition code assignments.

We recommend that the Deputy Secretary of Commerce ensure that the Chief Information Officer implement multi-factor authentication for access to all of the Department's NSS according to Committee on National Security Systems requirements.

Rec. 4.b: The DoD OIG recommended that the Army Deputy Chief of Staff for Logistics develop and implement clear and comprehensive implementation guidance for condition-based maintenance plus and predictive maintenance, ensuring to detail the roles and responsibilities of stakeholders, based on guidance provided by DoD Instruction 4151.22, "Condition-Based Maintenance Plus for Materiel Maintenance," August 14, 2020.

Rec. 4.c: The DoD OIG recommended that the Army Deputy Chief of Staff for Logistics develop and tailor training to the appropriate levels necessary to achieve effective condition-based maintenance plus and predictive maintenance implementation.

We recommend that CMS pursue legislative or regulatory changes to lower costs for both the Medicare program and beneficiaries, by equalizing payments as appropriate between provider based facilities and freestanding facilities for E&M services.

We recommend the DHS Chief Financial Officer comply with the PIIA requirement to report an improper payment and unknownpayment estimate of less than 10 percent for each program for which an estimate was published in the materials accompanying the annual financial statement by ensuring that FEMA continues to enhance internal control procedures over the Disaster Case Management and Urban Search & Rescue programs by:a. developing and implementing policies and procedures for establishingand defining documentation requirements;b. providing appropriate training to personnel responsible for developingand operating internal controls;c. ensuring the implementation and operating effectiveness of policies andprocedures over labor rate review and…

We recommend the DHS Chief Financial Officer ensure that DHS’ Risk Management and Assurance Division follow OMB requirementsfor agencies that do not comply with PIIA, as defined in OMB Circular A-123.

We recommend that the NOAA Deputy Under Secretary for Operations update policies and procedures to ensure user observation requirements are validated in advance of next-generation satellite system acquisitions.

We recommend that the NOAA Deputy Under Secretary for Operations assign responsibility and design a process for determining the relative priority of each NOAA user observation requirement.

We recommend that the NOAA Deputy Under Secretary for Operations ensure that NESDIS revises policies and procedures for assigning requirements to next-generation satellite programs.

CMS should develop its own source of race and ethnicity data.

CMS should use self-reported race and ethnicity information to improve data for current beneficiaries.

CMS should develop a process to ensure that the data are as standardized as possible.

CMS should educate beneficiaries about CMS's efforts to improve the race and ethnicity information.

We recommend that CAS update its Review Guide to conform with applicable Federal regulations and CAS internal policies and procedures.

We recommend that CAS take steps to ensure that branch chiefs and negotiators follow all Federal and internal CAS requirements.

We recommend that CAS include all federally required documents on checklists provided to the nonprofit organizations and on checklists used by CAS officials.

We recommend that CAS review its staffing levels and determine whether resources are aligned efficiently, and adjust as needed, to ensure that the indirect cost rate-setting process is conducted in a timely manner.

We recommend that CAS seek clarification on whether the policy of including executive compensation higher than the Level II statutory cap in its indirect cost pool calculation complies with Federal law and governmentwide policy.

We recommend that CAS ensure that negotiated final indirect cost rates are calculated based on actual costs.

NIH should specifically require grantees to provide trainings and maintain a written policy regarding investigators' disclosure of other support.

NIH should modify reporting mechanisms to require grantees to report whether investigators' significant financial interests and other support involve foreign entities.

NIH should conduct outreach to grantees with R13 conference grants to clarify requirements regarding the disclosure and review of investigators' significant financial interests and other support.

We recommend that the Centers for Medicare & Medicaid Services instruct the DME MACs to recover $41,137 in overpayments for PMD repairs made to PMDs that belonged to 76 sampled beneficiaries.

We recommend that the Centers for Medicare & Medicaid Services instruct the DME MACs to based upon the results of this audit, notify appropriate suppliers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the suppliers can exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.

We also recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which could have saved Medicare an estimated $7,948,182 during our audit period; Implement a system edit that applies to all PMD repairs and identifies PMD repairs for review of supplier documentation to help ensure that PMD repairs are adequately documented and that the PMD repair charges are reasonable and necessary.

We also recommend that the Centers for Medicare & Medicaid Services work with the DME MACs to do the following, which could have saved Medicare an estimated $7,948,182 during our audit period; Implement a system edit to determine whether PMD repair charges exceed the estimated cost to replace the PMDs being repaired.

We recommend that the Centers for Medicare & Medicaid Services establish Medicare requirements that: (1) include the documentation standards established by guidance for PMD repairs; (2) specify that accumulated costs of repairs made to power wheelchairs during their 5 year RUL must not exceed a certain threshold; and (3) specify that suppliers must provide warranties for repairs made to PMDs, which could have saved Medicare an estimated $3,739,346 during our audit period.

The FBI should clarify its policies regarding the approved methods for transmitting child sexual abuse material (CSAM) and other contraband to prosecutors and other government employees with a need to view the material in their official capacity.

Establish clearly defined and detailed roles, responsibilities, and processes for all SBA offices and officials responsible for managing and handling potentially fraudulent PPP loans to reduce the risk of ineligible applicants receiving PPP forgiveness and the risk of fraud and financial loss in the PPP and when implementing similar future programs.

Provide lenders formal guidance to effectively and consistently handle potentially fraudulent PPP loans and ensure lenders have sufficient guidance when implementing similar future programs.

Improve Agency systems to automate benefit computations and reduce the need for manual processing.

Develop a plan to fill and retain the allocated number of Office of Human Capital and Talent Management staff needed to fulfill its duties in the hiring and onboarding process.

Develop and disseminate policies for the revised civil service recruitment and hiring process and standard operating procedures for the modified Foreign Service staff hiring and onboarding processes.

Create a USAID-specific definition of skill gaps to address both competency and staffing skill gaps across its hiring mechanisms.

Finalize strategic workforce planning guidance, to include USAID's updated Strategic Workforce Plan, workforce planning Automated Directives System chapter, and materials to assist Agency operating units in identifying and addressing skill gaps.