Federal Reports

Some chiropractic services that Etheredge billed were not allowable in accordance with Medicare requirements. Of the 100 chiropractic services in our sample, 67 were allowable in accordance with Medicare requirements. However, the remaining 33 were not allowable: 31 services were medically unnecessary and 2 were not documented. As a result, Etheredge received $1,042 in unallowable payments. On the basis of our sample results, we estimated that Etheredge received unallowable Medicare payments of at least $169,737 for 2014 and 2015. As of the publication of this report, this unallowable amount includes claims outside of the 4-year claims reopening period.

In a previous audit - the Performance Audit of USCP Controls Over Evidence, Report Number OIG-2015-03, dated March 2015 - the Office of Inspector General (OIG) found that the United States Capitol Police (USCP or the Department) should improve internal controls for ensuring the integrity of physical evidence collected, secured, and processed. As a part of its general oversight responsibility for USCP, OIG conducted a follow-up analysis of the Department's implementation of recommendations contained in Report Number OIG-2015-03. Our objective was to confirm the Department took the corrective actions in implementing the recommendations. Our scope included existing controls over evidence related to the implementation of recommendations as outlined in our previous report.

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The OIG’s data analysis identified Raleigh, NC, Westgate Passport Facility had local purchases totaling $12,725, or 41 percent of all local purchases in the Greensboro District, for the period January 1 through March 31, 2018. It is unusual for one office to have such a high percentage of local purchases as it relates to other offices in the same district. Our objective was to determine whether local purchases and payments were valid and properly supported at the Raleigh, NC, Westgate Passport Facility.

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The VA Office of Inspector General (OIG) conducted a healthcare inspection to assess allegations regarding quality of care issues in two Community Living Centers (CLC) at the Northport VA Medical Center, New York. The OIG substantiated Patient A died at the facility after choking on food, but found insufficient evidence to attribute the cause of the choking to the lack of nurse staffing. The OIG substantiated the facility operator called the wrong code, leading to multiple responders, role confusion, and a delay in transporting Patient A to the Emergency Department. The OIG did not substantiate managers misrepresented the cause of death as cardiac arrest. OIG inspectors found inconsistent emergency medical response policies, post-code debriefings, and medical oversight and determined Patient A’s case warranted additional facility review. The evidence was insufficient for the OIG to substantiate or not substantiate whether patients were regularly left unsupervised while eating. The OIG did not substantiate one CLC lacked security due to malfunctioning door locks. The OIG substantiated a lack of consistent documentation of rounds but was unable to ascertain if this condition reflected an absence of completed rounds and decreased unit security. The OIG was unable to substantiate or not substantiate a lack of staff vigilance. The OIG substantiated Patient B’s wrists were bound together by a palm protector strap but did not find evidence to suggest an intentional act done by staff due to a lack of available nursing staff. The OIG did not substantiate that CLC nursing managers were often unavailable and failed to provide adequate response to unit issues. The OIG made eight recommendations to the Facility Director and one recommendation to the Veterans Integrated Service Network Director related to emergency medical response processes and policies, CLC meal staffing and delivery processes, safety rounds, and reviews of Patient A’s care.