Open Recommendations

Develop and implement a plan to increase Medicaid fraud referrals from the Medicaid agency and other stakeholders

USAID's Chief Information Officer Conduct a risk-assessment for Agency staff using personal devices to access the external cloud system and determine what actions Agency officials need to take to mitigate any identified risks. This includes updating relevant policies to reflect the acceptable use of personal devices consistently as deemed appropriate by management and providing training to staff on those new policies.

The Chief Privacy Officer should develop a standard form for all pseudonym requests, approval, registration, and recordkeeping of pseudonym information.

The Chief Privacy Officer should perform a full inventory to develop a complete and accurate list of active pseudonyms.

The Chief Privacy Officer should establish processes to maintain a complete and fully supported list of pseudonyms.

The Chief Privacy Officer should periodically solicit pseudonym holders to determine whether each employee still needs a pseudonym, and advise those that no longer need a pseudonym that they have the option to withdraw from the program.

Review, update, and implement revised NARA Directive 273, Administrative Procedures for Security Clearances, NARA Directive 273 Supplement, Supplement Administrative Procedures Related to Security Clearances and Applicant and Employee Rights, NARA Directive 275, Background and Identity Verification Process for Access Privileges, and NARA Directive 276, Employment or Service Suitability Determinations.

Ensure all Security Management Personnel Security staff is familiar with updated policies.

Implement the preventative and detective internal controls over PGI (developing PGI spend plans, timely 90-day reviews, and quarterly headquarters examination of financial activity) as prescribed by the Department's Risk Mitigation Policy Memorandum, the AG FBI Undercover Guidelines, and the Agents Manual.

Formally determine whether the policies within the AG FBI Undercover Guidelines apply, in their entirety or in specific instances, to all DOJ law enforcement components; or if the Department must issue new guidance to govern undercover operations that are initiated by DOJ law enforcement components outside of the FBI.

Ensure that the DEA's policies reflect necessary measures and controls stipulated in applicable Department undercover guidance.

ACF should work with ORR to conduct a review to determine whether to enhance required physical security measures.

ACF should work with ORR to systematically collect key information about incidents that allows for efficient and effective oversight to ensure that facilities are taking appropriate actions to protect minors.

ACF should work with ORR to work with care provider facilities to address staffing shortages of youth care workers that impact the ability to prevent, detect, and report incidents.

ACF should work with ORR to track and trend incident report information to better safeguard minors in ORR care.

ACF should work with ORR to improve ORR’s guidance to facilities to help them consistently identify and report significant incidents.

We recommend the Office of the Chief Readiness Support Officer work with component vehicle fleet managers to establish a consistent process for funding the acquisition, leasing, and maintenance of vehicles to meet mission needs.

We recommend that the AOC develop and publish a discipline policy for exempt personnel, for transparency and consistency with other employee groups.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by designing, implementing, and maintaining a comprehensive Medicare premium penalty rate calculation worksheet addressing each enrollment and health plan coverage option, including disability enrollment, for use by headquarters and field office staff to document the preparation and review of penalty rates of 10 percent or greater.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by establishing a procedure to capture and maintain claims examiner decisions and explanations including relevant supporting documentation and screen prints with each penalty rate calculation worksheet to enable timely recollection and understanding of the penalty rate decision and calculation.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by evaluating the impact of planned system modernization efforts to determine if greater automation or other improvements can be made to the penalty rate calculation process.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by updating the RL-331, Notice of Change in Health Insurance Election to include a penalty calculation summary that explains how and why the penalty rate was calculated and includes the applicable calculation decision elements, such as the dates of employment, GHP coverage period, SBI Income Related Monthly Adjustment Amount, birthdate, retirement date, penalty period start and end dates, and the total monthly premium to enable the beneficiary to understand the reason for the penalty decision and how it was…

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by establishing a penalty and refund review process to include both the standard form worksheet and USTAR tracking. The worksheet and supporting calculation and documentation should be reviewed, authorized, and dated by a second claims examiner and/or supervisor (if over 100 percent) on the worksheet, and tracked within USTAR. The review authorization should attest to the accuracy and completeness of the penalty or refund calculation, electronic filing of supporting documents, and beneficiary notification and confirmation.

We recommend that the Office of Programs strengthen its controls over the penalty calculation process and the accuracy of supporting data by strengthening the management control review process over Medicare premium penalty and refund authorizations by determining the reasons for the undetected errors identified during the audit and modifying the review process as needed to improve the detection and reporting of similar future errors.

We recommend that the New Jersey Department of Human Services improve its monitoring and follow-up activities to ensure that its MCOs comply with Federal and State requirements detailed in its contracts with the MCOs for providing services to beneficiaries according to personalized care plans and actively coordinating, monitoring, and documenting beneficiaries’ physical health, behavioral health, and long-term-care needs.

We recommend that the New Jersey Department of Human Services take actions, including imposing corrective action plans, fines, or other financial disincentives on MCOs, to address the MCOs’ noncompliance affecting $721 million ($386 million Federal share) in capitation payments in CY 2016 and ensure future compliance with contract requirements.

Identify the optimum Strategic Petroleum Reserve configuration and capabilities for the present and future needs of the United States.

Ensure that the Life Extension – Phase II project’s scope and completion criteria corresponds with the optimum Strategic Petroleum Reserve configuration.

Identify the optimum Strategic Petroleum Reserve configuration and capabilities for the present and future needs of the United States.

Ensure that the Life Extension – Phase II project’s scope and completion criteria corresponds with the optimum Strategic Petroleum Reserve configuration.

The Office of Aviation Analysis develop a process to regularly collect, maintain, and use information from airlines' website disclosures of all fees charged for optional or ancillary services as a screening mechanism for significant changes in these fees. For each mainline carrier and posted fee, this information should include-but not necessarily be limited to-identification of the type of each service and its price (or price range).

We recommend that The Ohio State University Hospital based on the results of this audit, 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 recommend that The Ohio State University Hospital strengthen controls to ensure full compliance with Medicare requirements; specifically, ensure that all IRF beneficiaries meet Medicare criteria for acute inpatient rehabilitation; all inpatient beneficiaries meet Medicare criteria for inpatient hospital services; diagnosis and discharge status codes are supported in the medical records and staff are properly trained, and medical records accurately document the appropriate number of units and distinct procedural services and that staff are properly trained.

In coordination with the assistant administrator for Mission Support, complete the development and implementation of the electronic clearance system for scientific products across the Agency.

With the assistance of the Scientific Integrity Committee, finalize and release the procedures for addressing and resolving allegations of a violation of the Scientific Integrity Policy, and incorporate the procedures into scientific integrity outreach and training materials.

With the assistance of the Scientific Integrity Committee, develop and implement a process specifically to address and resolve allegations of Scientific Integrity Policy violations involving highprofile issues or senior officials, and specify when this process should be used.

The Acquisition Program Management Assistant Administrator to develop an effective monitoring strategy and implementation plan, including necessary policies and procedures for ensuring probability of detection through defined continued monitoring and assessment of the deployed AIT system.

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

We recommend that the Assistant Secretary for the Office of Elementary and Secondary Education require Texas to require Houston to return to the Restart grant $34,065 in personnel expenditures that it charged for four teachers whose extra duty work was not for the purposes of the grant.

We recommend that the Assistant Secretary for the Office of Elementary and Secondary Education require Texas to review a random, statistically valid sample of the remaining payroll expenditures for teachers whose extra duty pay Houston charged to the Restart grant, determine whether the personnel expenditures were allowable under the grant, and require Houston to return funds to the grant for unallowable costs

We recommend that the Assistant Secretary for the Office of Elementary and Secondary Education require Texas to provide additional guidance to ESCs providing equitable services and assistance to nonpublic schools that specifies how to handle items purchased by nonpublic schools using Federal funds. The instructions should ensure that the appropriate public agency holds the title to materials and equipment.

We recommend that the Assistant Secretary for the Office of Elementary and Secondary Education require Texas to verify transfer of the title for the materials and equipment purchased by the Region 4 ESC on behalf of nonpublic schools using Restart program funds or require the ESC to return funds to the grant for unallowable costs.

We recommend that the Assistant Secretary for the Office of Elementary and Secondary Education require Texas to review the other ESCs that are providing equitable services and assistance to nonpublic schools to ensure that the ESCs have maintained control and ownership to materials and equipment purchased using Restart program funds.

We recommend that HHS focus on the root causes of the improper payment percentage and evaluate critical and feasible action steps to assist states with their compliance efforts for these new requirements.

We recommend that HHS continue to work with OMB and other stakeholders to develop and implement an approach to reporting on TANF improper payments in FY 2020.

We recommend that HHS focus on the root causes of the improper payment percentage and evaluate critical and feasible action steps to assist states with their compliance efforts for these new requirements.

We recommend that HHS continue to explore alternative vehicles to conduct recovery audits that will fit into the larger Medicare Part C

We recommend that HHS develop and publish corrective action plans after implementing an approach.  HHS continue to focus on developing and implementing an approach to reporting on TANF improper payments, as this process will aid in identifying root causes of TANF improper payments.