Open Recommendations

We recommend that the FWS resolve the questioned costs related to unsupported other direct costs totaling $201,708.

We recommend that the FWS work with the Department to develop a mechanism to hold staff accountable for following its SOPs related to purchase requests and documentation retention.

We recommend that the FWS resolve the questioned costs related to drawdowns totaling $169,989.

We recommend that the FWS work with the Department to develop a mechanism to hold staff accountable for following its SOPs for conducting drawdowns and maintaining adequate documentation for expenditures in the accounting system.

We recommend that the FWS resolve the questioned costs related to unallocated leave payouts totaling $6,480.

We recommend that the FWS require the Department to update and implement its SOPs to ensure that leave payouts are properly allocated in accordance with Federal regulations.

On June 15, 2021, we alerted IRS management of our concerns with the systemic calculation of the allowable RRC amount. We recommended that IRS management review the returns we identified and provide us with any corrective actions they intended to take.

Determine the allowability of the questioned transactions and recover $3,534,794, if applicable.

Include additional terms and conditions within future AmeriCorps General Grant and Cooperative Agreement Terms and Conditions policy documents aimed at addressing the root causes of improper payments.

Implement financial consequences or additional reporting requirements for grantees that have confirmed improper payments.
Modified repeat recommendation

We recommend that the Washington State Health Care Authority review all managed-care health home encounters from July 1, 2013, through March 31, 2017, to determine the enhanced Federal reimbursement that should have been claimed for Medicaid managed-care health home service expenditures based on the portion of the MCOs' capitation payment rate that was specifically attributable to health home services and refund to the Federal Government any unallowable amounts.

We recommend that the Washington State Health Care Authority review all managed-care health home encounters from July 1, 2013, through March 31, 2017, to identify whether the encounters used to support claims for enhanced Federal reimbursement have since been removed from the encounter data and refund to the Federal Government any amounts that are no longer supported.

We recommend that the Washington State Health Care Authority review all managed-care health home encounters from July 1, 2013, through March 31, 2017, to identify whether the encounters exceeded the number of reportable encounters that were allowed for an enrolled beneficiary and refund to the Federal Government any amounts related to unallowable encounters.

We recommend that the Washington State Health Care Authority implement a procedure to identify whether encounters used to support journal vouchers have been removed from the encounter data and refund to the Federal Government any Federal reimbursement that was claimed and is no longer supported.

We recommend that the Washington State Health Care Authority strengthen its MMIS edits to limit the reporting of an encounter for a tier-1 health home service to only once in a beneficiary's lifetime and ensure that only one encounter per beneficiary is reported each month.

We recommend that the Washington State Health Care Authority determine the portion of the remaining $1,367,120 that should have been claimed for managed-care health home service expenditures based on the portion of the MCOs' capitation payment rate that was specifically attributable to health home services, and refund any unallowable amounts.

We recommend the DHS OCHCO designate, direct, and oversee component representatives to maintain rosters of essential employees in each category defined by existing DHS policy.

We recommend the DHS OCHCO designate, direct, and oversee component representatives to maintain rosters of essential employees in each category defined by existing DHS policy.

(U) Rec. 1: The DoD OIG recommended that the Secretary of Defense establish policy and procedures for implementing basing actions of a unified combatant command. The policy should include potential internal controls to ensure that basing action decisions are transparent and based on verified data. The policy should direct that a candidate location's ability to achieve "Full Operational Capability" within a specific timeframe or other appropriate measurement be incorporated for all future basing actions.

CMS should ensure that participating States submit accurate quarterly reports.

Update the AHTF Program application guide with the revised performance measures and implement processes to assess the outcome of its AHTF Program performance measures.

Establish procedures to enhance the review process of progress reports to analyze the completeness, accuracy, and success of the AHTF Program.

Rec. 2.b: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan for migrating legacy patient health care information needed for a patient's complete electronic health record once the Federal Electronic Health Record Modernization Program Office determines the health care data domains of patient health care information that constitutes a complete patient electronic health record.

Rec. 2.c: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan for creating interfaces that would allow medical devices to connect and transfer patient health care information to Cerner Millennium.

Rec. 2.d: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan to modify Cerner Millennium user roles to ensure users are granted access to only the patient health care information necessary to perform their job responsibilities.

CMS should update and broaden its lists of hospital-acquired conditions to capture common, preventable, and high-cost harm events.

CMS should explore expanding the use of patient safety metrics in pilots and demonstrations for health care payment and service delivery, as appropriate.

CMS should develop and release interpretive guidance to surveyors for assessing hospital compliance with requirements to track and monitor patient harm events.

AHRQ should, with support from HHS leadership, coordinate agency efforts to update agency-specific Quality Strategic Plans.

AHRQ should optimize use of the Quality and Safety Review System (QSRS), including assessing the feasibility of automating data capture for national measurement and to facilitate local use.

AHRQ should develop an effective model to disseminate information on national clinical practice guidelines or best practices to improve patient safety.

AHRQ should continue efforts to identify and develop new strategies to prevent common patient harm events in hospitals.

Record death information on the Numident, as appropriate, for the 40 deceased beneficiaries in our sample.

Take action, as appropriate, to record death information in the Numident for the 15,714 beneficiaries identified by our current audit.

Take appropriate action to record death information to the Numident for the 595,514 beneficiaries identified by our prior audits.

Working with the Office of the Secretary and “group of four” oversight entities as appropriate, identify and implement changes to thereview and dissemination process for I&A’s election-related intelligence products to ensure they are in accordance with applicable policies andguidelines.

We recommend that the FWS work with the Department to require the electronic system for volunteer work to limit the number of hours that can be claimed on a specific day to ensure hours are reported daily.

We recommend that the FWS work with the Department to update policies and procedures to include guidance for daily entry of hours.

We recommend that the FWS work with the Department to develop and implement training for supervisors and volunteers to ensure proper documentation and approval of volunteer time.

(U) Rec. 1: The DoD OIG recommended that the Under Secretary of Defense for Research and Engineering update the Joint Federated Assurance Center Charter and the Joint Federated Assurance Center Concept of Operations and develop a process to prioritize the quantifiable assurance method efforts of the supporting DoD laboratories.

We recommend CBP and CWMD key stakeholders develop an agreed to support plan to monitor and sustain RPM systems that includes: • An assessment of RPM panel condition; and • Operational Analysis to assess RPM system performance and operations to identify evolving requirements and future capability needs, and changes to sustainment approach.

Use a system-approach that complies with Public Law 116-92, EEO MD-715, and 29 CFR 1614.

Review and evaluate current processes, procedures, and practices, make revisions, and implement guidance to improve efficiencies associated with obtaining contract award for conducting investigations and drafting final agency decisions.

Develop and implement processes and procedures to ensure the contractors adhere to the Statement of Work for Equal Employment Opportunity services, to include, but not limited to (1) completing investigations timely, (2) submitting authorizations for extensions, if necessary, and (3) submitting weekly status reports; and where applicable enforce any associated penalties for delays.

Define and formalize the roles and responsibilities of the Office of General Counsel in the processing of discrimination complaints. Specifically, implement policies and procedures to demonstrate the agency has a fair and impartial Equal Employment Opportunity process, to include but not limited to, ensuring: a clear separation between the agency’s Equal Employment Opportunity complaint program and its defensive function, and the agency representative does not intrude or have the appearance of intruding upon Equal Employment Opportunity counseling, investigations, and final agency decisions.

Establish and implement procedures to ensure agency responses submitted to Equal Employment Opportunity Commission in its EEO MD-715 submissions are accurate, complete, and supported by documentation.

Develop and implement controls to ensure standard operating procedures are kept up to date to reflect subsequent organizational, policy, or procedural changes that can affect processing of discrimination complaints.

Ensure the continuity of operations plan is tested annually, as required by Federal Continuity Directive 1.

(U) Rec. 1.a: The DoD OIG recommended that the Under Secretary of Defense (Acquisition and Sustainment) review and identify DoD issuances related to forecasting logistics demand for campaign planning.

(U) Rec. 1.b.i: The DoD OIG recommended that the Under Secretary of Defense (Acquisition and Sustainment), by no later than the next periodic review process, identify and recommend updates to the DoD issuances identified in Recommendation 1.a. or the creation of new issuances to assign roles and responsibilities across the Joint Logistics Enterprise. At a minimum, the recommended updates should establish a DoD wide executive agent or management action group to track and monitor ongoing development and implementation of interoperable systems and tools (as defined in DoD Instruction 8330.01) for forecasting logistics demand across the Joint Logistics Enterprise, with the…