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Audit of the Reliability of the DoD Coronavirus Disease–2019 Patient Health Data
Rec. 1: The DoD OIG recommended that the Director of the Defense Health Agency work with the Program Executive Officer of the Program Executive Office, Defense Healthcare Management Systems to document and implement the process for identifying and collecting patient health data of DoD patients in the Military Health System in current and future registries within their purview in a written document, such as a standard operating procedure. The procedure should identify, at a minimum, the internal controls throughout the process, the relevant data sources, data fields, and diagnostic codes used in the computer scripts, and should be reviewed and approved when updates occur.
Rec. 2: The DoD OIG recommended that the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity and the Chief of the Joint Trauma System work with the Joint Trauma System contracting officer's representative to revise the quality assurance surveillance plan. The plan should include an appropriate sampling methodology for selecting patient health records from the Coronavirus Disease-2019 Registry to verify that the contractor is achieving the contract-required accuracy rate for entering patient data, and submit the revised quality assurance surveillance plan to the contracting officer.
Rec. 2: The DoD OIG recommended that the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity and the Chief of the Joint Trauma System work with the Joint Trauma System contracting officer's representative to revise the quality assurance surveillance plan. The plan should include an appropriate sampling methodology for selecting patient health records from the Coronavirus Disease-2019 Registry to verify that the contractor is achieving the contract-required accuracy rate for entering patient data, and submit the revised quality assurance surveillance plan to the contracting officer.
Rec. 3: The DoD OIG recommended that the Chief of the Joint Trauma System conduct an analysis to determine whether the patient data entered into the Coronavirus Disease-2019 Registry met the 90 percent accuracy rate requirement for contract W81XWH-20-P-0197 and contract W81XWH-22-C-0151.
Rec. 3.a: If the contractor did not meet the 90 percent accuracy requirement, the DoD OIG recommended that the Chief of the Joint Trauma System work with the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity to update the contractor's rating in the contractor's performance assessment reports for contract W81XWH-22-C-0151 and contract W81XWH-20-P-0197, when feasible.
Rec. 3.b: If the contractor did not meet the 90 percent accuracy requirement, the DoD OIG recommended that the Chief of the Joint Trauma System work with the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity to recoup any of the $3.9 million in questioned costs paid for services that did not comply with the terms of contract W81XWH-20-P-0197, if feasible.
Rec. 3.c: If the contractor did not meet the 90 percent accuracy requirement, the DoD OIG recommended that the Chief of the Joint Trauma System work with the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity to recoup any of the $2.3 million in questioned costs paid for services that did not comply with the terms of contract W81XWH-22-C-0151.
Rec. 3.d: If the contractor did not meet the 90 percent accuracy requirement, the DoD OIG recommended that the Chief of the Joint Trauma System work with the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity to consider all available contract remedies for contract W81XWH-22-C-0151, including modifying and, if necessary, terminating and re-competing the contract, and take action to ensure that the Department receives full value for the funds it expends for contract W81XWH-22-C-0151.
Rec. 3.e: If the contractor did not meet the 90 percent accuracy requirement, the DoD OIG recommended that the Chief of the Joint Trauma System work with the Senior Contracting Official of the U.S. Army Medical Research Acquisition Activity to delegate an official to review the concerns identified in this report, including the actions of the contracting officials, and take administrative actions, as necessary. The review should include a determination on whether the contractor's performance assessment reports were accurate and make updates as necessary.
Rec. 4.a: The DoD OIG recommended that the Director of the Defense Health Agency work with the Chief of the Joint Trauma System establish and implement a process for selecting Coronavirus Disease-2019 events for entry into the Coronavirus Disease-2019 Registry to limit selection bias.
Rec. 4.b: The DoD OIG recommended that the Director of the Defense Health Agency work with the Chief of the Joint Trauma System to include a bias disclosure notice on all reports generated from the Coronavirus Disease-2019 Registry until the Coronavirus Disease-2019 Registry data represent the population of DoD patients who had a Coronavirus Disease-2019 event.
Rec. 5.a: The DoD OIG recommended that the Assistant Secretary of Defense (Health Affairs) establish and implement a policy for developing and populating patient registries that aligns with the Department of Health and Human Services best practices, "Agency for Healthcare Research and Quality, Registries for Evaluating Patient Outcomes: A User?s Guide," current edition.
Rec. 5.b: The DoD OIG recommended that the Assistant Secretary of Defense (Health Affairs) conduct a review of all patient registries in the Military Health System to verify the reliability of data in each registry and implement corrective actions, as necessary.
Audit of DoD Actions Taken to Implement Cybersecurity Protections Over Remote Access Software in the Coronavirus Disease–2019 Telework Environment
Rec. A.1: The DoD OIG recommended that the Director of the U.S. Southern Command - Joint Interagency Task Force South Command, Control, Communications, Computers, Cyber and Intelligence direct its network administrators to scan the VMware Horizon main virtual desktop for malware in accordance with the McAfee Endpoint Security Technical Implementation Guide, develop compensating controls, or formally accept the risk of not scanning the main virtual desktop.
Rec. A.2.a: The DoD OIG recommended that the Chief Information Officer of the Department of the Air Force revise its policy to align with the Windows 10 Security Technical Implementation Guide requirement for disabling inactive user accounts after no more than 35 days.
Rec. A.2.b: The DoD OIG recommended that the Chief Information Officer of the Department of the Air Force direct network and system administrators to disable inactive user accounts after no more than 35 days of inactivity in accordance with the Windows 10 Security Technical Implementation Guide, develop compensating controls, or formally accept the risk of not disabling the inactive user accounts.
Rec. A.3: The DoD OIG recommended that the Chief Information Officer of the Naval Surface Warfare Center - Panama City Division direct network and system administrators to disable inactive user accounts after no more than 35 days of inactivity in accordance with the Windows 10 Security Technical Implementation Guide, develop compensating controls, or formally accept the risk of not disabling the inactive user accounts.
Rec. A.4.a: The DoD OIG recommended that the Chief Information Officer of the Defense Intelligence Agency revise its policy to align with the Windows 10 Security Technical Implementation Guide requirement for disabling inactive users after no more than 35 days.
Rec. A.4.b: The DoD OIG recommended that the Chief Information Officer of the Defense Intelligence Agency direct network and system administrators to disable inactive user accounts after no more than 35 days of inactivity in accordance with the Windows 10 Security Technical Implementation Guide, develop compensating controls, or formally accept the risk of not disabling the inactive user accounts.
Rec. A.5.a: The DoD OIG recommended that the Director of the Marine Corps Information Command, Control, Communications, and Computers revise the organization's policy to align with the Windows 10 Security Technical Implementation Guide requirement for disabling inactive users after no more than 35 days.
Rec. A.5.b: The DoD OIG recommended that the Director of the Marine Corps Information Command, Control, Communications, and Computers direct network and system administrators to disable inactive user accounts after no more than 35 days of inactivity in accordance with the Windows 10 Security Technical Implementation Guide, develop compensating controls, or formally accept the risk of not disabling the inactive user accounts.
Rec. A.6: The DoD OIG recommended that the Director of the Defense Information Systems Agency Joint Service Provider direct network and system administrators to disable inactive user accounts after no more than 35 days of inactivity in accordance with the Windows 10 Security Technical Implementation Guide, develop compensating controls, or formally accept the risk of not disabling the inactive user accounts.
Rec. B.1: The DoD OIG recommended that the Director of the Defense Information Systems Agency Joint Service Provider direct network and system administrators to revise the vulnerability management program to include mitigation timeframes for all vulnerabilities and develop plans of actions and milestones for all vulnerabilities that cannot be mitigated in a timely manner.
COVID-19: OSHA's Enforcement Activities Did Not Sufficiently Protect Workers From Pandemic Health Hazards
We recommend the Assistant Secretary for Occupational Safety and Health: provide additional training to CSHOs to enforce the recording and reporting standard for fatalities.
We recommend the Assistant Secretary for Occupational Safety and Health: update guidance or policy to include supervisory review of inspection files to ensure they contain adequate support for the reasons regarding citation issuance decisions before closing inspections.
We recommend the Assistant Secretary for Occupational Safety and Health: develop a plan for a future pandemic or epidemic to collaborate with external agencies on worksite case data and to use this data to maximize rapid response and enforcement actions in worksites.
We recommend the Assistant Secretary for Occupational Safety and Health: as part of OSHA's rulemaking on infectious diseases, require employers to notify all employees of all known positive cases at the worksite.
We recommend the Assistant Secretary for Occupational Safety and Health: develop and implement a tracking tool to ensure OSHA receives and reviews all items CSHOs request during inspections to ensure alleged hazards have been mitigated.
The Social Security Administration’s Enumeration Services During the COVID-19 Pandemic
Develop and periodically conduct comprehensive refresher training on topics including but not limited to:
- processing original Social Security Number (SSN) cards for individuals aged 12 or older and emphasize requirements and documentation of the in-person interview;
- acceptable forms of evidentiary documents, and
- processing new (different) and replacement SSN cards when adoption
Complete the privacy assessments for the WorkTrack application.
Update quality control reviews to include comparison of SSNAP inputs to an applicant-submitted Form SS-5 and evidentiary documents, and provide feedback to the technicians who made input errors (such as race and ethnicity) or did not use the appropriate evidentiary documents.
Revise enumeration policy to include clear instructions for when Form SSA-5002 is required and how to properly document the form.
Update Program Operations Manual System (POMS) to provide current instructions for enumeration notices and archive outdated policy.
Retain enumeration notices in the Online Retrieval System for individuals with assigned SSNs.
Create and implement automated tools to assist staff in navigating through enumeration evidentiary document requirements.
Take corrective action on all keying errors and cross-referencing errors we identified.
Require managers to verify that incident reports are submitted through the Personally Identifiable Information (PII) Loss Reporting Tool before they approve reimbursement to customers for replacing lost original documents.
Update the National Mail Handling Business Process to include standard Agency-wide mitigation steps for misdirected mail including original documents.
COVID-19: ETA and States Did Not Protect Pandemic-Related UI Funds from Improper Payments Including Fraud or from Payment Delays
We recommend the Acting Assistant Secretary for Employment and Training: Use data collected from monitoring and BAM reports to identify the areas of highest improper payments including fraud and create a plan to prevent similar issues in future temporary UI benefit programs.
We recommend the Acting Assistant Secretary for Employment and Training: Require states to have written policies and procedures, which apply lessons learned during the COVID-19 pandemic, to continue eligibility testing and BPC procedures during emergencies or other times of increased claims volume. These policies and procedures should include strategies to pay claimants timely.
We recommend the Acting Assistant Secretary for Employment and Training: Work with NASWA to update the IDH Participant Agreement to require state to submit the results of their UI fraud investigations.
We recommend the Acting Assistant Secretary for Employment and Training: Work with NASWA to ensure the IDH cross matches are effective at preventing the types of fraud that were detected during the pandemic and regularly update using the results of state fraud investigations.
We recommend the Acting Assistant Secretary for Employment and Training: Work with the OIG and states to recover the greatest practicable amount of the $7,092,604 paid to claimants connected to likely fraudulent claims.
The Social Security Administration’s Mail Processing During the COVID-19 Pandemic
If cost-effective, invest in software and equipment to reduce manual processing of incoming mail.
Expand the use of Post Office Boxes for long-term, high-volume workloads.
If cost-effective, outsource additional mail duties to contractors.
Incorporate centralized printing of forms and notices into SSA’s systems modernization efforts.
Implement policy and operational changes, where appropriate, to decrease reliance on original documents.
Implement options for customers to submit the most frequently used forms online.
Implement capabilities for employees to securely correspond with the public electronically.
Implement online versions of the most frequently sent notices.
COVID-19: To Protect Mission Critical Workers, OSHA Could Leverage Inspection Collaboration Opportunities with External Federal Agencies
We recommend the Assistant Secretary for Occupational Safety and Health develop an OSHA outreach plan to be activated during a large-scale safety and health crises such as the COVID-19 pandemic that (a) identifies external federal agencies with enforcement or oversight personnel who are active on worksites and (b) defines how OSHA will collaborate with those agencies. OSHA should consider incorporating into the plan: a process to identify and document highly visible, safety and health hazards for large-scale safety and health crises; a plan for how OSHA will conduct related outreach and training on those hazards and how to refer them to OSHA; and a tracking system for agency referrals and outcomes of those referrals, using that information to periodically inform the outreach plan on areas and types of guidance and training the agencies’ oversight and enforcement personnel need.
We recommend the Assistant Secretary for Occupational Safety and Health explore mechanisms to enhance collaboration, such as MOUs or other written agreements using GAO’s seven key features for collaboration, and incorporate a process to utilize those mechanisms into the outreach plan.
Audit of Entitlements for Activated Army National Guard and Air National Guard Members Supporting the Coronavirus Disease–2019 Mission
Rec. 1.a: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Under Secretary of Defense for Personnel and Readiness, update the DoD Financial Management Regulation, volume 7A, "Military Pay Policy - Active Duty and Reserve Pay," chapter 27, "Family Separation Allowance" to clearly state that the permanent duty station of a Reserve Component member on temporary duty status is the member's primary residence for the purpose of determining Family Separation Allowance entitlement.
Rec. 1.b: The DoD OIG recommended that the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with the Under Secretary of Defense for Personnel and Readiness, update the DoD Financial Management Regulation, volume 7A, "Military Pay Policy - Active Duty and Reserve Pay," chapter 27, "Family Separation Allowance" to clarify that Family Separation Allowance entitlement determination is based on the commuting distance between the member's primary residence and their temporary duty location.
Rec. 2.a: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to require the Army National Guard and Air National Guard to complete a review of proof of residency documentation when the member's primary residency is established or changed for the Basic Allowance for Housing entitlement to ensure consistency throughout all Army National Guard and Air National Guard units and organizations within every state, territory, and the District. The policies and procedures should also include requirements that: * document a member's primary residence address; * require members to provide proof of their primary residence address; * certify the primary address of members and review supporting documentation; and * provide oversight to ensure primary residence address information is complete and accurate.
Rec. 2.b: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to outline the process and frequency of recertification for Basic Allowance for Housing entitlement that Army National Guard and Air National Guard officials will use to verify and fully document the dependency status of members to provide clarification to the DoD Financial Management Regulation, volume 7A, chapter 26. These procedures should include: * how recertifications will be completed; * which members will complete a recertification; and * how Army National Guard and Air National Guard officials will provide oversight to ensure that information is complete and accurate.
Rec. 2.c: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to require Army National Guard and Air National Guard officials to review and document the status of a military member married to another military member regardless of which Military Service, Reserve or Active Component, or Army National Guard or Air National Guard unit the member's spouse belongs to, and identify which member will claim any applicable dependents.
Rec. 2.d: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to specify the methods for confirming eligibility and paying Family Separation Allowance for Army National Guard and Air National Guard members, in accordance with the DoD Financial Management Regulation, volume 7A, chapter 27, and include the: * timeliness of payments; * determination of Family Separation Allowance eligibility for back to back orders; * members assigned to their normal duty locations; and * requirement to track members to know when they return to their primary residence.
Rec. 2.e: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement policies and procedures to establish formal dissemination and communication procedures for National Guard Bureau policies related to entitlements provided to the Army National Guard and Air National Guard, including the policies in the preceding recommendations. The procedures should require: * creation of a central location where policies and procedures will be kept for easy access by all states, territories, and the District; and * confirmation of receipt from all of the states, territories, and the District when procedures are communicated or obtained.
Rec. 3: The DoD OIG recommended that the Chief, National Guard Bureau, in coordination with the Director of the Army National Guard and the Director of the Air National Guard, develop and implement additional internal control procedures for the review of transactions manually submitted by the Army National Guard and Air National Guard to the payment system prior to payment to ensure the completeness and accuracy of transactions.
COVID-19: Safety and Remote Learning Challenges Continue for Job Corps
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Implement continuous monitoring to ensure centers adhere to Job Corps COVID-19 safety protocols (e.g., use of social distancing markers, installation of barriers, and reconfiguration of furniture to accommodate social distancing).
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Develop and revise additional COVID-19 safety protocols as needed to align with current recommendations and advice from the CDC, other experts, and stakeholders to ensure the safety of students and staff at the campuses, including supporting efforts to attain a 100 percent vaccination rate for all students and staff.
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Identify learning gaps that occurred during campus closures and procedures Job Corps needs to take to help students fill in those gaps.
We recommend the Acting Assistant Secretary for Employment and Training require Job Corps: Increase oversight of remote instructional programs to ensure students receive the training and resources to complete their programs in a timely way.
Audit of the Reimbursement for Department of Defense Mission Assignments for Coronavirus Disease–2019 Pandemic Response in the U.S. Northern Command Area of Responsibility
Rec. 1: The DoD OIG recommended that the Deputy Comptroller (Program/Budget), Office of the Under Secretary of Defense (Comptroller)/Chief Financial Officer, DoD, in coordination with DoD Component comptrollers, initiate a review of all COVID-19 pandemic response mission assignments to ensure reimbursement requests for costs incurred are submitted in accordance with DoD policy.
Rec. 2.a: The DoD OIG recommended that the Director, Army Budget, Office of the Assistant Secretary of the Army (Financial Management and Comptroller), immediately require tasked units to review costs incurred for mission assignments 4480DR-NY-DOD-10, 4480DR-NY-DOD-11, 4480DR-NY-DOD-12, and 4481DR-WA-DOD-02 as of July 31, 2020, for completeness and accuracy, and submit reimbursement requests for those costs with required documentation to the Federal Emergency Management Agency in accordance with DoD policy.
Rec. 2.b: The DoD OIG recommended that the Assistant Director of the Office of Budget Fiscal Management, Office of the Assistant Secretary of the Navy (Financial Management and Comptroller), immediately require tasked units to review costs incurred for mission assignments 4482DR-CA-DOD-01, 4482DR-CA-DOD-02, and 4488DR-NJ-DOD-04 as of July 31, 2020, for completeness and accuracy, and submit reimbursement requests for those costs with required documentation to the Federal Emergency Management Agency in accordance with DoD policy.
Rec. 2.c: The DoD OIG recommended that the Deputy for Budget, Office of the Assistant Secretary of the Air Force (Financial Management and Comptroller), immediately require tasked units to review costs incurred for mission assignment 4480DR-NY-DOD-10 as of July 31, 2020, for completeness and accuracy, and submit reimbursement requests for those costs with required documentation to the Federal Emergency Management Agency in accordance with DoD policy.
Rec. 2.d: The DoD OIG recommended that the Comptroller of the United States Marine Corps immediately require tasked units to review costs incurred for 4482DR-CA-DOD-01, 4482DR-CA-DOD-02, and 4488DR-NJ-DOD-04 as of July 31, 2020, for completeness and accuracy, and submit reimbursement requests for those costs with required documentation to the Federal Emergency Management Agency in accordance with DoD policy.
Rec. 2.e: The DoD OIG recommended that the Comptroller of the National Guard Bureau immediately require tasked units to review costs incurred for mission assignments 4480DR-NY-DOD-05, 4481DR-WA-DOD-05, 4482DR-CA-DOD-07, and 4491DR-MD-DOD-01 as of July 31, 2020, for completeness and accuracy, as well as any additional costs incurred and identified after July 31, 2020, and submit reimbursement requests for those costs with required documentation to the Federal Emergency Management Agency in accordance with DoD policy.
Rec. 3.a.1: The DoD OIG recommended that the Director, Army Budget, Office of the Assistant Secretary of the Army (Financial Management and Comptroller), in coordination with the Financial Management Augmentation Team, develop and provide to tasked units, an Army-specific desk manual for mission assignments that includes, at a minimum, step-by-step procedures for initial set-up, real-time cost input, cost tracking, cost reporting, and submitting partial and final billings to ensure compliance with DoD policy.
Rec. 3.a.2: The DoD OIG recommended that the Director, Army Budget, Office of the Assistant Secretary of the Army (Financial Management and Comptroller) train tasked-unit personnel on how to navigate the Army-specific desk manual and apply the procedures appropriately.
Rec. 3.b.1: The DoD OIG recommended that the Assistant Director of the Office of Budget Fiscal Management, Office of the Assistant Secretary of the Navy (Financial Management and Comptroller), in coordination with the Financial Management Augmentation Team, develop and provide to tasked units, a Navy-specific desk manual for mission assignments that includes, at a minimum, step-by-step procedures for initial set-up, real-time cost input, cost tracking, cost reporting, and submitting partial and final billings to ensure compliance with DoD policy.
Rec. 3.b.2: The DoD OIG recommended that the Assistant Director of the Office of Budget Fiscal Management, Office of the Assistant Secretary of the Navy (Financial Management and Comptroller) train tasked-unit personnel on how to navigate the Navy-specific desk manual and apply the procedures appropriately.
Rec. 3.d.1: The DoD OIG recommended that the Comptroller of the United States Marine Corps, in coordination with the Financial Management Augmentation Team, develop and provide to tasked units, a Marine Corps-specific desk manual for mission assignments that includes, at a minimum, step-by-step procedures for initial set-up, real-time cost input, cost tracking, cost reporting, and submitting partial and final billings to ensure compliance with DoD policy.
Rec. 3.d.2: The DoD OIG recommended that the Comptroller of the United States Marine Corps train tasked-unit personnel on how to navigate the Marine Corps-specific desk manual and apply the procedures appropriately.
Rec. 3.e.1: The DoD OIG recommended that the Comptroller of the National Guard Bureau, in coordination with the Financial Management Augmentation Team, develop and provide to tasked units a National Guard-specific desk manual for mission assignments that includes, at a minimum, step-by-step procedures for initial set-up, real-time cost input, cost tracking, cost reporting, and submitting partial and final billing to ensure compliance with DoD policy.
Rec. 3.e.2: The DoD OIG recommended that the Comptroller of the National Guard Bureau train tasked-unit personnel on how to navigate the National Guard-specific desk manuals and apply the procedures appropriately.
Rec. 3.c.1: The DoD OIG recommended that the Deputy for Budget, Office of the Assistant Secretary of the Air Force (Financial Management and Comptroller), in coordination with the Financial Management Augmentation Team, develop and provide to tasked units, an Air Force-specific desk manual for mission assignments that includes, at a minimum, step-by-step procedures for initial set-up, real-time cost input, cost tracking, cost reporting, and submitting partial and final billings to ensure compliance with DoD policy.
Rec. 3.c.2: The DoD OIG recommended that the Deputy for Budget, Office of the Assistant Secretary of the Air Force (Financial Management and Comptroller) train taskeDODIG-unit personnel on how to navigate the Air Force-specific desk manual and apply the procedures appropriately.