Railroad Retirement Board Medicare Contract Oversight Did Not Effectively Mitigate Chiropractic Services Risks

View Report

Date Issued

Thursday, June 4, 2015

Submitting OIG

Railroad Retirement Board OIG

Other Participating OIGs

Railroad Retirement Board OIG

Agencies Reviewed/Investigated

Railroad Retirement Board

Report Number

15-07

Report Type

Audit

Agency Wide

Yes

Number of Recommendations

Questioned Costs

$14,000,000

Funds for Better Use

Open Recommendations

This report has 4 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use	Additional Details
7	No	$0	$0	Management concurred with this recommendation.
The Office of Programs should ensure that Palmetto applies statistical analysis and stratified random sampling where practical to the high volume risk categories.
9	No	$0	$0	Management does not concur with this recommendation. This recommendation remains open because the Office of Inspector General for the Railroad Retirement Board continues to see the need for the recommended corrective action.
The Office of Programs should work with Palmetto and the Centers for Medicare and Medicaid Services to conduct a thorough cost benefit analysis that will identify the resources needed to maximize timely and efficient recovery of improper payments for chiropractic services over the five year recovery period.
10	No	$14,000,000	$0	Management does not concur with this recommendation. This recommendation remains open because the Office of Inspector General for the Railroad Retirement Board continues to see the need for the recommended corrective action.
The Office of Programs should work with Palmetto and the Centers for Medicare and Medicaid Services to recover the improper chiropractic service payments for the five year period, where determined to be cost effective based on an accurate cost benefit analysis.
11	No	$0	$0	Management concurred with this recommendation.
The Office of Programs should work with Palmetto and the Centers for Medicare and Medicaid Services to share information identified during the post-payment reviews as appropriate with the Recovery Audit Contractors and Zone Program Integrity Contractors where it can be used to identify improper or fraudulent non-Railroad Medicare chiropractic service payments.