Open Recommendations

Improve Agency systems to automate benefit computations and reduce the need for manual processing.

Develop a plan to fill and retain the allocated number of Office of Human Capital and Talent Management staff needed to fulfill its duties in the hiring and onboarding process.

Develop and disseminate policies for the revised civil service recruitment and hiring process and standard operating procedures for the modified Foreign Service staff hiring and onboarding processes.

Create a USAID-specific definition of skill gaps to address both competency and staffing skill gaps across its hiring mechanisms.

Finalize strategic workforce planning guidance, to include USAID's updated Strategic Workforce Plan, workforce planning Automated Directives System chapter, and materials to assist Agency operating units in identifying and addressing skill gaps.

Conduct an analysis to determine whether personnel tools-e.g., Talent Analytics, LaunchPad, the Workforce Planning Model, or the Competency Exploration for Development and Readiness-can be utilized to track skill gaps at both an Agency and operating unit level and implement changes as appropriate based on this analysis.

We recommend that Peoples Health Network refund to the Federal Government the $3,312,219 in estimated overpayments.

We recommend that Peoples Health Network identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.

We recommend that Peoples Health Network enhance its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements (when submitted to CMS for use in CMS's risk adjustment program) and take the necessary steps to enhance those procedures.

We recommend that Vanderbilt University Medical Center improve procedures and provide education to staff to ensure that claims billed to Medicare are accurate

We recommend that Vanderbilt University Medical Center implement changes to its billing system to ensure that claims billed to Medicare are accurate.

Strengthen information system controls to make certain that complete and accurate claims information is transferred between applicable current and future Community Care payment systems and the Consolidated Patient Account Centers’ workflow tool and VistA patient treatment files.

Conduct an assessment to determine if staffing resources and workload are sufficiently aligned to process the anticipated volume of claims to be billed to veterans’ private health insurers and make adjustments as needed.

Establish controls to ensure staff and contractors follow existing requirements to test single adults for COVID-19 before transfer usingdomestic commercial flights.

Clarify existing COVID-19 testing policies to include modes of transportation and timeframes for mandatory testing beforetransport.

We recommend that the FWS resolve the questioned costs related to unsupported indirect costs totaling $435,624.

We recommend that the FWS work with the Department to develop and implement a mechanism to hold its staff accountable for following Federal regulations related to indirect costs and record retention, and its own SOPs.

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.

The Chief Privacy Officer should establish a process that complies with Office of Management and Budget requirements regarding the selection, implementation, assessment, and continuous monitoring of privacy controls.