Recommendations Tracker

We recommend that the State agency strengthen its policies and procedures to ensure that transportation services are provided only to recipients who are receiving Medicaid-covered services on the dates that they are receiving NET services; NET providers maintain records documenting that recipients are actually transported in the vehicles for all trips on the dates that NET services are rendered; NET providers maintain records to document the services provided; it does not pay NET providers or claim Federal reimbursement for non-covered transportation services; NET providers complete the required background checks on all potential drivers before permitting them to render NET services and annually thereafter, and maintain documentation of these checks; NET providers maintain records of all vehicle maintenance checks; and NET providers maintain documentation verifying that their drivers are qualified with current and valid driver's licenses.

We recommended that the University strengthen oversight of payroll charges to Federal awards by ensuring that suitable means exist for a PI to verify that salary charges made to an award are reasonable in relation to the work performed.

We recommended that the University strengthen oversight of payroll charges to Federal awards by requiring and documenting prior approval and justification for adjustments made after grant expenditures have been reported to the Federal Government.

We recommended that the University strengthen oversight of payroll charges to Federal awards by requiring and documenting prior approval and justification for cost transfers.

We recommended that the University strengthen oversight of payroll charges to Federal awards by following Federal requirements for supporting payroll costs claimed.

We recommended that the University strengthen its general IT controls for systems used to support the pilot PCS by implementing a password setting that requires password changes periodically.

We recommended that the University strengthen its general IT controls for systems used to support the pilot PCS by implementing procedures to ensure that vendor support does not expire on the University's operating system.

We recommend that the State agency refund $25.5 million to CMS that was misallocated to the establishment grants by not using updated, better data, or work with CMS to resolve the amount misallocated to the establishment grants, from April 16 through December 31, 2014.

We recommend that the State agency work with CMS to ensure that costs claimed after our audit period were allocated correctly using updated, better data, and refund any unallowable amount.

We recommend the State agency strengthen its controls over its process for reporting expenditures claimed for NEMT services.

We recommend that the State agency ensure that MCOs submit drug utilization data containing NDCs for all physician-administered drugs.

CMS should identify and target for review the short inpatient stays that are potentially inappropriate under the 2-midnight policy.

CMS should explore ways of protecting beneficiaries in outpatient stays from paying more than they would have paid as inpatients.

We recommend that the Minnesota marketplace refund to CMS $933,582 consisting of $929,582 that was paid for additional marketing work performed without a contract amendment.

We recommend that the Minnesota marketplace work with CMS to ensure that costs we did not review for the audit period and costs claimed after our audit period are allocated correctly using updated cost allocation methodology.

We recommend that the Minnesota marketplace strengthen senior management oversight to ensure that additional contract work is not performed before an amendment is in place.

We recommend that the Minnesota marketplace create a complete and accurate inventory record, develop procedures to ensure that it maintains complete and accurate inventory records for equipment purchased with establishment grant funds, and conduct a physical inventory at least biennially.

We recommend that the State agency refund to CMS $55,261,734, consisting of $49,493,613 that was misallocated to the establishment grants by not using updated, better data and $5,768,121 that was misallocated to the establishment grants for in-person enrollment assistance costs that also benefited Medicaid, or work with CMS to resolve the amounts misallocated to the establishment grants.

We recommend that the State agency work with CMS to ensure that costs claimed after our audit period are allocated correctly using an updated cost allocation methodology.

We recommend that the State agency develop a written policy that explains how to perform cost allocations and emphasizes the necessity to use updated, better data when available.

We recommend that the State agency follow established procedures to ensure that only costs resulting from obligations of the funding period are claimed for Federal reimbursement.

We recommended that the State agency refund $3,121,544 to the Federal Government for the additional Federal reimbursement received for NEMT expenditures improperly claimed at the FMAP rate.

IHS should establish standards and expectations for how Area Offices/ Governing Boards oversee and monitor hospitals and monitor adherence to those standards.

IHS should continue to invest in training for hospital administration and staff, and assess the value and effectiveness of training efforts.