Open Recommendations

We recommend the Vice President, Planning and Investor Relations, verify back testing is performed annually.

We recommend the Vice President, Pricing and Contracts, evaluate the program objective to balance operational and financial risks to determine if it should be eliminated or rewritten to clarify intent.

We recommend the Vice President, Pricing and Contracts, report annually the financial hedging program’s impact on fuel rate volatility and its hedging gains/losses in a more transparent manner to the Tennessee Valley Authority Board of Directors, Tennessee Valley Public Power Association, and Tennessee Valley Industrial Committee.

OIG recommends the under secretary for health implement procedures to monitor the data used to measure productivity to ensure the data accurately reflect the complete work of clinical resource hub physicians.

OIG recommends the under secretary for health work with appropriate officials, such as Office of Primary Care and clinical resource hub leaders, to determine whether hub physicians should be subject to existing productivity measures. If so, issue clear hubs guidance requiring adherence; if not, clearly define what should be used, and issue thorough guidance on the steps hubs must take to measure physician productivity consistently.

OIG recommends the under secretary for health clarify oversight responsibilities for monitoring productivity measures, including detailed procedures and actions that should be taken when thresholds are not met.

We recommend the Senior Vice President, Generation Projects and Fleet Services, establish steps to verify implementation estimates include the complete scope of work and are developed using definitive costs.

We recommend the Senior Vice President, Generation Projects and Fleet Services obtain additional support for the five project change requests with insufficient details to determine if the approval amounts should be revised.

We recommend the Senior Vice President, Generation Projects and Fleet Services take steps to reinforce the (1) need for adequate support before approving project change requests and (2) requirement for project change requests to document project estimate revisions.

We recommend that the Senior Vice President, Generation Projects and Fleet Services, in conjunction with the Office of the General Counsel, educate the appropriate individuals on the importance of not sharing confidential contractor information.

The VA Fayetteville Coastal Healthcare System Director reviews the endocrine consult management process and takes actions as needed to ensure compliance with current Veterans Health Administration directives and guidance.

The VA Fayetteville Coastal Healthcare System Director implements a strategy to review patients affected by delayed endocrine consults to evaluate whether harm occurred and the appropriateness of institutional disclosures.

The VA Fayetteville Coastal Healthcare System Director ensures a sustainable and effective service line agreement between endocrine and primary care services is developed and agreed upon by both services, and monitors implementation.

The VA Fayetteville Coastal Healthcare System Director confirms effective utilization of endocrine clinic appointments to ensure timely access to care.

The VA Fayetteville Coastal Healthcare System Director ensures a process is in place for monitoring and tracking clinic profile modification requests.

The VA Mid-Atlantic Health Care Network Director reviews the leadership performance of the chief of medicine related to communication and collaboration and takes action as necessary.

The VA Fayetteville Coastal Healthcare System Director evaluates communication gaps identified in this report between leaders of primary care and the Medicine Service and takes action to ensure consistency with Veterans Health Administration High Reliability Organization goals.

We recommend MSAC document its procedures for completing award Federal Financial Reports, including how to calculate indirect costs.

We recommend MSAC establish controls to ensure its Federal financial reporting procedures are followed.

We recommend MSAC document and implement payroll reconciliation procedures that verify recorded payroll costs are accurate and supported (2 CFR 200.430(g)(1)(i)).

We recommend MSAC establish controls to ensure its payroll reconciliation procedures are followed.

We recommend MSAC establish document retention controls that ensure its policy is followed.

We recommend MSAC establish and implement Federal financial reporting controls that ensure honorifics are excluded from
all costs included in award financial reports (General Terms 13).

We recommend MSAC document and implement procedures that ensure prompt and accurate compliance with
Federal Financial Accountability and Transparency Act requirements (2 CFR 170, Appendix A).

We recommend MSAC establish controls that ensure its Federal Financial Accountability and Transparency Act procedures are followed.