Recommendations Tracker

We recommend that the State agency refund to the Federal Government $1,408,033 (Federal share) for claims for single-source physician-administered drugs that were ineligible for Federal reimbursement.

We recommend that the State agency work with CMS to determine the unallowable portion of $4,020,250 (Federal share) for other claims for covered outpatient physician-administered drugs that were submitted without NDCs and that may have been ineligible for Federal reimbursement and refund that amount.

We recommend that the State agency work with CMS to ensure that rebates associated with physician-administered drug claims totaling $30,463,044 ($20,007,447 Federal share) that were invoiced after the completion of our fieldwork are appropriately reported to the Medicaid program.

We recommend that the State agency strengthen its internal controls to ensure that all physician-administered drugs eligible for rebates are invoiced.

We recommend that the State agency ensure that the 64 instances of noncompliance with health and safety and administrative requirements identified in this report are corrected.

We recommend that the State agency review training opportunities available to providers and county licensors and improve or increase them as needed.

We recommend that the State agency develop and implement policies and procedures to ensure adjustments to Medicare crossover claims are correctly processed.

We recommend that FCSO increase the Medicare segment allocable pension costs used to calculate its indirect cost rates for CYs 2008 through 2010 by $147,268.

We recommend that FCSO increase its Medicare segment pension assets by $1,033,833, and recognize $34,600,992 as the Medicare segment pension assets as 12/31/2010.

We recommend that FCSO revise its FACPs for FYs 2008 and 2009 to reduce its claimed Medicare pension costs by $33,619.

We recommend that the State agency develop controls to ensure that allegations and referrals of abuse and neglect of children in foster care eligible for assistance under Title IV-E of the Act are recorded and investigated in accordance with State requirements. Specifically, we recommend that the State agency ensure that its cases, and, by working with the Justice Center, that Justice Center cases are recorded and investigated in accordance with State requirements; develop procedures to ensure required documentation is submitted timely and retained in case files and by the SCR; ensure that staff meet all required timeframes for submission of reports, and notification of investigations; and ensure that its staff, and, by working with the Justice Center, that Justice Center staff meet all required timeframes for determination of investigations.

We recommend that the State agency ensure that surveyors follow CMS guidance for verifying and documenting the correction of nursing home deficiencies in accordance with Federal requirements.

We recommend that Southeast Arkansas Community Action Corporation conduct a full physical inventory to ensure that inventory asset records are accurate and complete, and update the inventory asset records as assets are purchased, moved, or disposed.

We recommend that Southeast Arkansas Community Action Corporation limit future drawdowns from the Health and Human Services Payment Management System to past expenditures and immediate future needs as recorded in the general ledger.

We recommend that Southeast Arkansas Community Action Corporation update its cost allocation plan to include only the methodology that allocates vacation, holiday, and sick pay based on the percentage of hours worked for each program.

We recommend that Southeast Arkansas Community Action Corporation update its cost allocation plan to address how to allocate shared equipment costs to more than one program.

We recommend that Southeast Arkansas Community Action Corporation refund $4,784 in unallowable costs.

We recommend that CMS use the information in this report and the detailed data previously provided to recoup the $2,420,761 in capitation payments made to MA organizations for Medicare Parts A and B services on behalf of deceased beneficiaries.

We recommend that the State agency refund to the Federal Government $4,588,756 for Day Treatment Program services that were not claimed in accordance with Federal and District requirements.

We recommend that CMS continue to work with the Accredited Standards Committee X12 to ensure that the DI is included on the next version of claim forms.

CMS should identify strategies to increase MACs’ collection of ZPIC- and UPIC-referred overpayments.

We recommend that TMT refund to the Federal Government $587,248 in unsupported and unallowable LIHEAP funds.

We recommend that the State agency bill for and collect from manufacturers rebates for pharmacy drugs and refund to the Federal Government $8,045,840 (Federal share).

We recommend that the State agency work with CMS to determine whether the non-top-20 multiple-source physician-administered drugs were eligible for rebates and, if so, upon receipt of the rebates, refund up to $57,783 (Federal share) of rebates collected.

We recommend that the State agency determine which physician-administered drugs were not billed for rebates after our audit period, determine the rebates due, and upon receipt of the rebates refund the Federal share of the rebates collected.

FDA should improve the timeliness of FDA's actions, including warning letters, so that facilities do not continue to operate under harmful conditions.

We recommend that the State agency revise the State licensing requirement for the monitoring of vehicles used to transport children to ensure that the State agency monitors all vehicles at least annually.

We recommend that CMS set firm deadlines for marketplaces to fully develop system functionality for verifying applicants’ eligibility and resolving inconsistencies, assess potential enforcement mechanisms that would ensure that marketplaces meet those deadlines, and, if such mechanisms are identified, seek legislative authority to establish them.

We recommend that CMS require marketplaces to submit additional data elements related to average length of time to resolve inconsistencies, number of unresolved inconsistencies, and number of applicants for whom the marketplace received an FTR response code from the IRS and who were determined eligible for insurance affordability programs.

OHRP should request that HHS consider the adequacy of whistleblower protections for complainants who make disclosures to OHRP about human subjects protections.

We recommend that CMS determine whether the cost reports that had exceeded the 3-year reopening limit may be reopened due to similar fault and, if so, work with the Medicare contractors to reopen them.

We recommend that CMS maintain a system that identifies and tracks all cost reports that Medicare contractors have referred for reconciliation and that recalculates outlier payments on the basis of claim submissions made by hospitals.