Open Recommendations

Document and implement network segmentation to reduce the attack surface or susceptibility of vulnerable and sensitive OA assets in the Common Operating Environment.

We recommend that the State agency ensure all MCOs implement edits to appropriately reduce or deny claims for other PPCs.

We recommend that the State agency work with the five MCOs to determine the portion of the $16,734,145 that was unallowable for claims containing PPCs and its impact on current- and future-year capitation payment rates.

We recommend that the State agency consider enforcing the provision in its contracts that allows liquidated damages to be imposed on the five MCOs due to their failure to process claims in accordance with Federal laws and regulations.

We recommend that the State agency require all its MCOs to implement policies and procedures to prohibit payments for inpatient hospital services related to treating PPCs for all provider payment methodologies.

We recommend that the State agency require all its MCOs to review all claims for inpatient hospital services that were paid after our audit period to determine whether any payments for services related to treating PPCs were unallowable and adjust future capitation payment rates for any unallowable payments identified.

We recommend that the State agency include specific measures in its contracts that would allow the State agency to recoup funds from all MCOs when contract provisions and Federal and State requirements are not met—a measure that, if incorporated, could result in cost savings for Medicaid.

We recommend that the State agency strengthen its monitoring of all its MCOs to ensure the MCOs comply with Federal and State requirements and its managed-care contracts relating to the nonpayment of PPCs.

Coordinate with the Office of the General Counsel to standardize the carrying of firearms by NASA civil servants in an Agency-wide policy while also addressing the appropriate situations when NASA contractors may carry their government-issued weapons off NASA property.

Require ADSEF to regularly perform checks against SSA national death information to ensure deceased individuals are not receiving benefits. Review cases identified through the audit and establish claims for overpayments, as appropriate.

Determine the allowability of the questioned transactions and recover $1,005,222.00, if applicable.

Coordinate with the Corps to Further establish review controls where power accountants review individual projects at year end to ensure Construction in Progress projects are placed in service in a timely manner. Coordinate with the Corps to Establish review controls to ensure IDC is recorded only for eligible projects. Coordinate with the Corps to enhance existing procedures over review of power reports to ensure that all applicable revenue is included for each project. Coordinate with the Corps to Enhance existing procedures and related controls to ensure that items in the Construction in Progress accounts are placed in service in a…

Require that all suspicious orders reports be sent to DEA headquarters.

We recommend that the Minnesota Department of Human Services refund $3,243,531 to the Federal Government

We recommend that the Minnesota Department of Human Services identify capitation payments made on behalf of deceased beneficiaries before and after our audit period and repay the Federal share of amounts recovered

We recommend that the Minnesota Department of Human Services utilize additional sources to identify dates of death to help reduce unallowable payments

Require lenders to obtain the borrowers' consent to verify the existence of delinquent Federal taxes with the IRS during loan origination and deny any applicant with delinquent Federal tax debt and no payment plan or a noncompliant payment plan or an applicant refusing to provide consent from receiving FHA insurance to put at least $6.1 billion to better use by avoiding potential future costs to the FHA insurance fund.

Status

We recommend the FEMA Assistant Administrator for Recovery strengthen FEMA's transportation assistance policies and procedures and coordinate with FEMA Assistant Administrator for Mission Support to: a) require the collection and retention of eligibility documentation or where applicable, document the steps taken to validate applicant statements in FEMA's system of record, and b) ensure future information technology updates support the collection, use, and retention of unique Vehicle Identification Numbers to enable FEMA to cross-reference national databases to confirm insurance coverage and identify applicants' second vehicles.

We recommend the FEMA Assistant Administrator for Recovery, in accordance with the Stafford and Improper Payments Acts; develop controls to identify payments not used for critical transportation needs.

Comply with DOT Order 1200.9's financial completion and IAA closeout process requirements for the IAAs identified in table 3 of this report, and determine whether to close them and deobligate the appropriate portions of the $5,966,933 we identified. Implementing this recommendation across the 854 IAAs in our audit universe could potentially put up to $33.3 million in funds to better use.

We recommend that the Office of Administration/Division of Acquisition Management update Administrative Circular OA-14 and implement the necessary updates to align procurement procedures with current federal acquisition regulation and agency practices.

We recommend that the Office of Administration/Division of Acquisition Management update standard policies and procedures to clearly convey the documentation required to be maintained in the contract file in order to support the solicitation phase.

We recommend that the Office of Administration/Division of Acquisition Management develop and implement standard checklist guidance to be included in the contract file that lists the required solicitation documentation, identifies if the documentation was applicable to the solicitation, and indicates the section in which the supporting documents are located.

We recommend that the Office of Administration/Division of Acquisition Management update standard policies and procedures to clearly convey the documentation required to be maintained in the contract file in order to support the award and administration phase.

We recommend that the Office of Administration/Division of Acquisition Management develop and implement standard checklist guidance to be included in the contract file that lists the required award and administration documentation, identifies if the documentation was applicable to the award, and indicates the section in which the supporting documents are located.

We recommend that the Office of Administration/Division of Acquisition Management establish a checklist or other control process to ensure that the required conflict of interest statement is presented to vendors.

We recommend that the Office of Administration/Division of Acquisition Management establish standard procedures for identifying and tracking contracts that have been physically completed.

We recommend that the Office of Administration/Division of Acquisition Management take steps to ensure the remaining balances are de-obligated in Financial Management Integrated System in a timely manner.

We recommend that the Office of Administration/Division of Acquisition Management review the established control process used to transmit information to the Federal Procurement Data System and update the process in order to report information more accurately.

We recommend that the Office of Administration/Division of Acquisition Management revise the information previously reported in the Federal Procurement Data System to reflect the correct contract numbers and amounts.

We recommended that the Office of Programs in coordination with the RRB Executive Committee establish a permanent entity within RRB responsible for continuously assessing fraud risk, implementing corrective actions, and monitoring the effectiveness of those actions as they relate to the Railroad Retirement Board disability programs. There are two existing entities, the Fraud Prevention Task Force and the Internal Controls Assessment Team that could be considered for this designation.

We recommended that the Office of Programs in coordination with the Railroad Retirement Board Executive Committee establish an on-going fraud risk assessment process that regularly gathers information about disability programs fraud risk, assesses the potential likelihood and impact, determines fraud risk tolerance, examines the suitability of existing fraud and documents the fraud risk profile specifically for the disability programs.

We recommended that the Office of Programs in coordination with the Railroad Retirement Board Executive Committee conduct risk-based monitoring tied to the fraud risk profile of the disability programs to evaluate the effectiveness of preventive activities and use the results to improve the design and implementation of fraud risk management activities within the disability programs.

USAID/Kenya and East Africa determine the allowability of $1,089,453 in ineligible questioned costs on page 17 of the audit report and recover any amount that is unallowable.

We recommend NIH enhance its FCOI compliance program to review grantee websites and ensure that they have FCOI policies.

We recommend NIH enhance the FCOI program to ensure that institutions resolve identified deficiencies.

We recommend that the Next Door Foundation, Inc. refund $142,104 in unallowable indirect costs and work with its HHS funding agencies to ensure proper claiming of indirect costs,

Complete the heating, ventilation, and cooling equipment upgrade subproject at Metropolitan Detention Center Brooklyn and ensure that the equipment is capable of maintaining temperatures at BOP targets. Further, ensure that upgraded hardware and Building Management System software allow facilities staff to accurately monitor building temperatures and heating, ventilation, and cooling equipment performance.

Take further action to diagnose the sources of temperature regulation issues and remedy them, if the upgraded Metropolitan Detention Center Brooklyn heating, ventilation, and cooling system cannot maintain building temperatures at BOP targets.

Ensure that, in the absence of Building Management System software, institutions use a consistent and sound method to measure and document temperatures and record all maintenance performed on heating, ventilation, and cooling equipment.

Require institutions to maintain a list of inmates who use continuous positive airway pressure machines, or other electronic medical devices, in their cells so that institution staff can make every effort to accommodate those inmates in the event of a power outage.

M/OAA/CAS/CAM determine the allowability of $2,516,933 in ineligible questioned costs on page 19 of the audit report and recover any amount that is unallowable.

Establish a process to identify overpayments that exist on suspended or terminated Social Security numbers that the Re entitled Beneficiaries process does not detect, so the Agency can transfer and recover them via benefit withholding.

For the fifth NAS recommendation, provide (a) cost estimates that account forstaffing, enforcement, and data collection; and (b) benchmarks for completion.

For the fourth and sixth NAS recommendations, provide (a)cost estimates that account for staffing, enforcement, and data collection; (b)benchmarks for completion; and (c) potential programmatic reforms, revisions toregulations, or proposals for legislation.