Federal Reports

We audited the Philadelphia, PA, Housing Authority’s use of public housing program operating funds because we received a complaint alleging that the Authority misused U.S. Department of Housing and Urban Development (HUD) funds. Our objective was to determine whether allegations from the complaint had merit. We focused the audit on whether the Authority properly procured (1) relocation services, (2) job training services, (3) a vehicle, (4) tablet computers, and (5) an office chair in accordance with HUD requirements. We also wanted to determine whether it was owed funds from its agent, the City’s Redevelopment Authority, for past projects and followed its procedures for approving its chief executive officer’s salary.Of the seven allegations in the complaint, two allegations had merit. The Authority could not show that proposals for relocation services were evaluated based on the established evaluation criteria. It also violated conflict-of-interest requirements when procuring job training services. These conditions occurred because the Authority (1) lacked procedures to monitor its agent’s compliance with procurement requirements, (2) believed that an intergovernmental agreement was sufficient to address the conflict-of-interest situation, and (3) lacked controls to ensure that it obtained a waiver from HUD to avoid conflict-of-interest situations. As a result, (1) HUD had no assurance that the proposal of the vendor that the Authority paid $860,132 for relocation services was the most advantageous to the project, and (2) the Authority made ineligible payments totaling $156,675 for job training services. The Authority properly procured a vehicle for its chief executive officer, tablet computers, and an office chair. It also was not owed funds from its agent, and it followed its procedures for approving its chief executive officer’s salary.We recommend that HUD require the Authority to (1) provide documentation to show that the proposal of the vendor that it selected and paid $860,132 was the most advantageous or reimburse its program from non-Federal funds for any amounts that it cannot support, (2) develop and implement controls to monitor its agent to ensure that it procures products and services in accordance with procurement requirements, (3) reimburse its program $156,675 from non-Federal funds for the ineligible payments it made due to the conflict-of-interest situation identified by the audit, and (4) develop and implement controls to ensure that it obtains waivers from HUD before entering into agreements that create conflict-of-interest situations.

Medicare paid approximately $2 billion for psychotherapy services provided to Medicare beneficiaries from January 2017 through December 2018 (audit period). Prior OIG reviews found that Medicare had made millions in improper payments for mental health services, including psychotherapy services. These reviews also identified problems with psychotherapy services that were billed in conjunction with evaluation and management (E&M) services. After analyzing Medicare claim data, we selected for audit Grand Desert Psychiatric Services (Grand Desert). Our analysis showed that during our audit period, 80 percent of Grand Desert's psychotherapy services were paid in conjunction with E&M services.

As part of our annual audit plan, we performed an audit of costs billed to Tennessee Valley Authority (TVA) by BlueCross BlueShield of Tennessee, Inc. (BCBST) under Contract <br> No. 11022 for medical administrative services. Our objective was to determine if the costs billed to TVA under Contract No. 11022 for medical administrative services were in accordance with the contract's terms. The audit covered claim costs and associated fees totaling $262,707,081 billed to TVA during calendar years (CY) 2017 and 2018.In summary, we determined BCBST overbilled TVA an estimated $88,163, including (1) a net $36,991 related to shared savings for which BCBST has reimbursed TVA a net $18,166, (2) $21,259 for claims that exceeded chiropractic plan limits, (3) an estimated $17,503 in excess costs due to established patients being billed as new patients, and (4) $12,410 in credits not received by TVA.In addition, we found TVA paid from $369,116 to $836,232 more for administrative fees and various services, such as provider audits and other shared saving services, than it would have under TVA's prior contract with BCBST. The additional payments could have occurred because TVA was not aware of a BCBST underwriting guideline regarding the effect of shared savings on administrative fees.(Summary Only)

This report was submitted to the Comptroller General in accordance with Section 5 of the Government Accountability Office Act of 2008. The report summarizes the activities of the Office of Inspector General (OIG) for the six-month reporting period ending March 31, 2020. During the reporting period, the OIG initiated work on three audits designed to assess the effectiveness of GAO operation in three distinct areas. The OIG closed eight investigations and opened 11 new investigations. One significant investigation closed during the reporting period involved falsification of documents by GAO’s maintenance contractor, resulting in a government settlement of almost $300,000, of which GAO received about $230,000 as recompense for its losses. In addition, the OIG processed 79 hotline complaints, many of which were referred to other OIGs for action because the matters involved were within their jurisdictions. The OIG continues to focus on GAO management challenge areas—including human capital management and information technology. The OIG remained active in the GAO and OIG communities by briefing new GAO employees on its audit and investigative missions, and participating in committees and working groups of the Council of Inspectors General on Integrity and Efficiency. Details of these activities and other accomplishments are provided in the report.