Open Recommendations

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

[Description omitted; DOJ has determined that this recommendation contains information that is limited official use or classified.]

Ensure managers involved in the examination scheduling program adhere to examiner-in-charge rotation limits requirements to ensure timely examiner-in charge rotation in accordance with the National Supervision Policy Manual.

Ensure that Pathfinders develops and implements written policies and procedures on the reporting of PMT data, and has taken appropriate action to ensure its data system is capable of populating accurate reporting information.

Ensure that Pathfinders develops and implements comprehensive written financial policies and procedures that detail its fiscal activities and ensure compliance with the DOJ Grants Financial Guide and federal award requirements. These policies and procedures should include guidance on the appropriate allocation of costs to applicable funding sources.

Remedy the $1,800 in unsupported yoga consultant costs charged to the subawards through January 2024, as well as identify and remedy any additional unsupported yoga consultant costs charged to the subawards after January 2024.

Develop and implement guidance for DOT Operating Administrations and OST that addresses methods for estimating workforce needs-including appropriate data sources and methods for estimating workforce demand and the frequency or triggers for updating their estimates-and standards for documenting these planning procedures.

Revise departmental Infrastructure Investment and Jobs Act (IIJA) hiring reports to include the current number of onboard IIJA employees in addition to reports on IIJA hiring selections.

The Under Secretary for Health reviews Veterans Health Administration Directive 1400.01 to confirm that the supervision of PGY-1 surgery residents and guidance provided to Veterans Health Administration facilities aligns with Veterans Health Administration policy and Accreditation Council for Graduate Medical Education program requirements.

We recommend that USAID/Ethiopia verify that Mekdim Ethiopia National Association corrects the three instances of material noncompliance detailed on pages 35 to 38 of the audit report.

We recommend that the West Virginia Bureau for Medical Services refund to the Federal Government $2,159,071 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the West Virginia Bureau for Medical Services refund to the Federal Government $14,514 (Federal share) for claims for top-20 multiple-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the West Virginia Bureau for Medical Services work with CMS to determine the unallowable portion of $488,185 (Federal share) for other claims for multiple-source physician-administered drugs that may have been ineligible for Federal reimbursement, refund that amount, and consider invoicing drug manufacturers for rebates for these drugs if CMS determines that the drug claims are allowable.

We recommend that the West Virginia Bureau for Medical Services strengthen internal controls for non-crossover claims going forward, to better use collected data to invoice manufacturers and collect rebates for all eligible physician-administered drugs.

We recommend that the West Virginia Bureau for Medical Services consider revising its payment methodology going forward regarding payments for crossover claims, thereby allowing collection of manufacturers' rebates for associated physician-administered drugs.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to do the following: Recover $11,399 in overpayments made to suppliers for the 15 sample items that did not meet Medicare requirements.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to do the following: Perform additional medical reviews of claims for intermittent urinary catheters and sterile catheter kits, which could have saved Medicare an estimated $35,079,833 for our audit period.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to do the following: Provide additional education to suppliers on documenting eligibility for intermittent urinary curved-tip catheters and sterile catheter kits and on documenting refills of catheters and sterile catheter kits. For example, CMS could emphasize the following:

-Medical records that list only a diagnosis without adequate documentation of an enrollee's inability to use a straight-tip catheter are insufficient to support medical necessity for use of a curved-tip catheter.

-Notations of urinary tract infections in medical records are insufficient to support that an enrollee is eligible for…

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to recover $11,399 in overpayments made to suppliers for the 15 sample items that did not meet Medicare requirements.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to perform additional medical reviews of claims for intermittent urinary catheters and sterile catheter kits, which could have saved Medicare an estimated $35,079,833 for our audit period.

We recommend that the Centers for Medicare & Medicaid Services instruct DME MACs to provide additional education to suppliers on documenting eligibility for intermittent urinary curved-tip catheters and sterile catheter kits and on documenting refills of catheters and sterile catheter kits.

We recommend that NRC management investigate methods of identifying inactive user accounts and improving its internal controls over inactivity to ensure that it disables network user accounts after 90 days of inactivity.

We recommend that USAID's Office of Acquisition and Assistance Cost, Audit and Support Division/Contract Audit Management Branch determine the allowability of the $42,764 ineligible questioned costs on pages 25 to 37 of the audit report and recover any unallowable amount.

We recommend that USAID's Office of Acquisition and Assistance Cost, Audit and Support Division/Contract Audit Management Branch Verify that Yayasan Project HOPE corrects the seven instances of material noncompliance detailed on pages 25 to 37 of the audit report.

We recommend that APHIS identify and correct the RBIS algorithm to ensure inspection due dates are properly calculated and recorded in eFile.

We recommend that APHIS establish and provide additional training on dog breeder inspections to inspectors and supervisors, to include proper classification of NCIs and required inspection procedures for dog breeders.

We recommend that APHIS develop and implement a process to ensure that inspectors are consistent throughout their inspection of the dog breeder’s facility to reduce the occurrence of missed items for review.

We recommend that APHIS establish a formal process to track and review open complaints to ensure all complaints are closed prior to the established deadlines. If the complaint is not closed by the deadline, APHIS should ensure reasons are documented in eFile.

We recommend that APHIS perform a risk assessment of the complaint process to evaluate and determine whether APHIS has correctly prioritized resources to manage the identified risks. We also recommend APHIS implement additional processes as necessary to ensure adequate coverage.

Establish a mechanism to ensure that groups with disaster recovery responsibilities prioritize and enforce the company’s strategy and effectively communicate and coordinate with each other.

For each OT system, develop, document, and implement a comprehensive disaster recovery plan that includes a process to keep the plan current.

Develop and begin implementing a technology refresh plan with milestones for replacing outdated OT devices.

Review and take appropriate actions for the 30 beneficiaries we identified who had improper payments.

Obtain accurate WC data for the 357 beneficiaries with missing or inaccurate WC information, make necessary payment adjustments, and resolve any improper payments, if necessary.

We recommend the Vice President and Chief Information and Digital Officer, Technology and Innovation, (1) design and implement a documented process for maintaining an accurate inventory of internet accessible internet protocal addresses and update Cybersecurity and Infrastructure Security Agency within five days of changes.

Require Carrington to remedy HUD and the 27 borrowers in our sample with improper foreclosure filings and take administrative actions if appropriate.

Require Carrington to perform a review of loans affected by the system errors and when appropriate, remedy the borrowers or HUD.

Require Carrington to update its policies and procedures to comply with HUD requirements by reviewing eligible borrowers for streamlined options without unnecessary documents, notifying borrowers if they are ineligible for any loss mitigation options, and using best efforts to review borrowers for loss mitigation within 37 days of the foreclosure sale date.

Require Carrington to implement improved controls to prevent manual errors by performing additional review of all foreclosure actions and performing timely review of all documentation provided by the borrowers and third parties.

Use up-to-date contact center data and the recommended Veterans Health Administration call center staffing model to ensure the clinical contact center is operating within indicated target staffing goals.

Evaluate call center staffing and call data for clinical contact center staff based at the Atlanta facility to identify possible operational inefficiencies related to scheduling, handle time, and availability for calls, and address inefficiencies as needed.

Evaluate call data to ensure health administration services staff at the Atlanta facility who answer calls for the mental health and specialty care clinics meet Veterans Health Administration call center performance standards for timeliness and abandonment rate.

We recommend that USAID/West Africa verify that Nouvelle Pharmacie de la Sant Publique de Cte d'Ivoire corrects the four material weaknesses in internal control detailed on pages 26 to 28 of the audit report.

We recommend that USAID/West Africa verify that Nouvelle Pharmacie de la Sant Publique de Cte d'Ivoire corrects the four instances of material noncompliance detailed on pages 32 to 34 of the audit report.

USAID/Philippines determine the allowability of $86,195 in questioned costs ($1,046 of ineligible costs and $85,149 of unsupported) on pages 22 to 28 of the audit report and recover any amount that is unallowable.

USAID/Philippines verify that Ateneo de Manila University - School of Government correct two instances of material noncompliance detailed on pages 35 to 37 of the audit report.

OIG recommends that the Bureau of Administration, in coordination with the Bureau of Diplomatic Technology and Bureau of Diplomatic Security, assess the extent to which electronic messaging applications, including Signal, are used at posts worldwide to conduct Department of State business.

OIG recommends that the Bureau of Administration, in coordination with the Bureau of Diplomatic Technology and Bureau of Diplomatic Security, determine the availability of acceptable alternative procedures and methods for preserving federal records from electronic messaging applications by (1) identifying alternative methods for preserving records from electronic messaging applications without export functions and (2) determining whether replicating electronic messaging correspondence in cables, emails, or official reports is an acceptable alternative means of preserving records of these communications.