Recommendations Tracker

AHRQ should take steps to encourage PSOs to participate in the NPSD, including accepting data into the NPSD in other formats, in addition to the Common Formats.

NIH should work with the HHS Office of National Security to develop a risk-based approach for identifying those peer reviewer nominees who warrant additional vetting.

NIH should use information regarding foreign affiliations and support that it collects during the pre-award process to decide whether to revise its FCOI review process to address concerns regarding foreign influence.

We recommend NIH enhance its FCOI monitoring program to ensure institutions resolve identified deficiencies

We recommend NIH implement procedures to ensure that institutions have FCOI policies and make them publicly accessible.

We recommend that OS implement a process to ensure that all OS political appointees, employees, and contractors complete the required security awareness trainings in a timely manner.

We recommend that CMS consider the results of these reviews when implementing similar programs to ensure that timely and accurate data are available for adequate oversight, followup, and verification.

CMS should take action to reduce inappropriate pharmacy rejections.

CMS should provide beneficiaries with clear, easily accessible information about sponsor performance problems, including those relate to inappropriate pharmacy rejections and coverage denials.

CMS should assess the costs and benefits of implementing a targeted process to review certain assumptions.

New Mexico Human Services Department should take steps to expand New Mexico's overall behavioral health workforce.

New Mexico Human Services Department should review its standards governing access to care and determine whether additional standards are needed for behavioral health providers.

New Mexico Human Services Department should work with State partners to strengthen access to broadband in rural and frontier counties.

New Mexico Human Services Department should take steps to increase adoption of electronic health records and participation in the State Health Information Exchange by behavioral health providers.

New Mexico Human Services Department should expand initiatives to integrate behavioral and primary healthcare.

We recommend that the Ohio Department of Medicaid test monthly capitation payment data to determine whether Ohio Benefits controls added after our audit period are effectively preventing duplicative monthly capitation payments.

We recommend that the Ohio Department of Medicaid implement system prompts in Ohio Benefits that encourage users to verify the beneficiary's date of birth or gender before making changes in the system

We recommend the State agency develop policies and procedures to prevent incorrect rates from being paid and ensure supporting documentation and invoices are reviewed and approved prior to the payment to the court administrator's office and strengthen internal controls to ensure these invoice-review processes are followed.

We recommend the State agency develop policies and procedures for allocating salaries to the individual family courts which ensures the allocation is supported and accurately reflects the relative benefits received. Specifically ensure the courts report their Title IV-D activities each pay period as described within the cooperative agreement, and ensure the IAG performs its functions as outlined within the cooperative agreement to maintain the key internal control of segregation of key duties by reviewing job positions, employee activity, and interviews managing supervisors and staff to determine the reasonable amount of resources (time and effort) that staff devotes to the Family Division.

We recommend the State agency work with the court administrator's office to improve the MPR processing system and establish policies and procedures and application controls to ensure duplicates can be prevented or detected or establish policies and procedures to ensure a manual review of all MPRs is performed.

ORR should develop and implement strategies to assist care provider facilities in overcoming obstacles to hiring and retaining qualified mental health clinicians.

ORR should help care provider facilities improve their access to mental health specialists.

ORR should take all reasonable steps to minimize the time that children remain in ORR custody.

We recommend the State agency work with CMS to determine whether the other pharmacy and physician-administered drugs were eligible for rebates and, if so, upon receipt of the rebates, refund up to an estimated $47,426,944 (Federal share) our audit period and $119,561,574 (Federal share) for the nearly 4-year period before our audit period.

We recommend that the State agency develop and implement written policies and procedures for its drug rebate program.

We recommend that Twin Palms exercise reasonable diligence for the remaining portion of the estimated $317,038 overpayment for claims that are outside of the 4-year claims reopening period to identify and return the overpayments in accordance with the 60-day rule and identify any returned overpayments as having been made in accordance with this recommendation.

We recommend that Twin Palms establish policies and procedures to ensure that chiropractic services billed to Medicare are medically necessary, adequately documented in the medical records, and correctly coded.