Recommendations Tracker

We recommend that the State agency obtain the POA codes for inpatient hospital types that were excluded due to the State agency's misinterpretation of the Federal requirements and identify and adjust any paid claims that were subject to payment reduction as a result of treating a PPC.

We recommend that the State agency identify any paid claims that had an improper payment reduction from diagnosis codes that were not considered a CC or MCC and make the proper adjustments.

We recommend that HHS and ACF continue working with states to (1) provide technical assistance and training related to policy updates and (2) support the Foster Care program in reaching its overall reduction goal target through appropriate implementation of corrective action plans at the state-level.

We recommend that HHS focus on the root causes of the improper payment percentage and evaluate critical and feasible action steps to assist states with their compliance efforts for these new requirements. This would include working with the states to bring their respective systems into full compliance with the requirements to decrease the improper payment rate percentage below 10 percent. For states that are being measured a second time, HHS should work with the states to follow up on repeat root causes for errors and enhance the CAPs for implementation. In addition, as HHS only reviews 17 states each year for the Medicaid improper payment rate, HHS should continue to follow up with states during the interim period to verify that corrective actions identified after the improper payment error rate measurement review are being implemented.

Consistent with our FY 2015 performance audit, we recommend HHS correct the method for calculating the standard error to estimate the improper payments at the state level. In addition, HHS may need to increase the sample size at the state level to refine its calculation to meet OMB precision requirements at the national level.

We recommend that UAB work with HHS's CAS to ensure that appropriate officials review future F&A cost proposals for compliance with Federal requirements prior to submitting the proposals to CAS.

We recommended that DFAS update its policies and procedures to require consideration of all FAR requirements for assessing the allowability of proposed costs including the support of proposed costs with adequate documentation and the appropriateness of data elements within direct cost bases for the fair distribution of indirect costs to applicable cost objectives.

We recommended that DFAS ensure that indirect cost rate ceilings are properly applied for current or future rate proposals in which rate ceilings had been established under provisional rate agreements.

We recommended that DFAS work with ASFR and OAMP, as applicable, to formally adopt a set of professional auditing standards, such as generally accepted government auditing standards.

We recommend that the State agency update information system controls to ensure that survey system data is protected against unauthorized or unintended modification or loss.

We recommend that Cahaba GBA establish policies and procedures to ensure compliance with Federal requirements and the pension segmentation language of the Medicare contracts.

We recommend that Cahaba CSA establish policies and procedures to ensure compliance with Federal requirements.

Reinforce with the local districts Medicaid requirements related to claiming Federal reimbursement for PERS.

We recommend that the Colorado marketplace develop and implement written policies, reinforced by adequate internal controls, that explain how to develop a CAP based on relative benefits received, expected transactions, and expected population; how to provide formal input to HCPF and CMS during the development of cost allocation ratios; and how to adequately document the development of those ratios.

We recommend that CMS continue to implement system enhancements to identify, adjust, and recoup improper capitation payments in the future.

We recommend that IHS ensure that travel card usage is adequately monitored for compliance with the travel card requirements.

We recommend that the Institute, implement an adequate accounting system that complies with 45 CFR § 92.20(b)(1) and allows it to accurately manage and account for Federal funds; reconcile accounting records to the FFR; segregate PEPFAR expenditures from other expenditures; allocate expenditures across projects; account for funds advanced to subrecipients; and accurately classify transactions in the correct budget category.

We recommend that the Institute, ensure that it maintains documentation to fully support expenditures.

We recommend that the Institute, allocate expenses across all projects to ensure that award funds are used solely for authorized purposes.

We recommend that the Institute, work with CDC to obtain VAT reimbursement from the Government of Mozambique.

We recommend that the Institute, implement policies and procedures that address the payment of VAT using PEPFAR funds.

We recommend that CMS work with Medicare contractors to implement all telehealth claims edits listed in the Manual.

We recommend that Texas work with the Centers for Medicare & Medicaid Services to determine the portion of the $1.1 million that it received for payments that exceeded providers' billed charges should be refunded to the Federal Government.

We recommend that the State agency strengthen its policies and procedures to ensure that TCM providers maintain documentation to document that case managers are qualified to perform TCM services, TCM providers maintain documentation to support the TCM services provided, it does not pay TCM providers or claim Federal reimbursement for services that are not TCM services, and TCM providers maintain documentation for eligibility determinations for recipients of TCM services.