Federal Reports

EAC OIG, through the independent public accounting firm of Clifton Gunderson LLP, conducted this audit to determine whether (1) the necessity of using personally identifiable information for processing was properly evaluated; (2) the EAC had established adequate procedures governing the collection, use and security of personally identifiable information; and (3) EAC had properly complied with the prescribed procedures to prevent unauthorized access to and the unintended use of personally identifiable information.

Following are observations from the review of documentation for 30 claims:Of the 12 claims that were disputed, 2 of the dispute letters were not submitted within 30 days after the notice of injury, as required by federal code.One claim did not include the supervisor's signature on the form.In one instance, the claim was not submitted to the Office of Workers' Compensation Programs within ten business days, due to a supervisor not forwarding his/her completed portion of the form within the allotted eight days, as required by federal code and TVA policy, respectively.We found prescribed services for TVA's Workers' Compensation (WC) department and assigned site personnel go beyond the Federal Employees' Compensation Act's WC requirements. However, when we interviewed selected managers, nurses, TVA site WC contacts, and other staff at seven TVA site locations, we were told the WC program support could be improved by: (1) increasing the expertise in the WC department, including medical knowledge of personnel; (2) improving education and training for personnel responsible for facilitating the WC process at TVA sites; (3) enhancing communications from the WC department; and (4) addressing the abundance of hearing loss claims.

Audit of the OCIO's controls for laptop security.

We audited $211.6 million of costs billed to TVA by a contractor from January 1, 2006, through December 31, 2007, for the administration of TVA's medical benefit program. Our objective was to determine if the costs billed to TVA were in compliance with the contract terms and conditions. In summary, we found TVA had potentially been overbilled up to an estimated $473,024. The overbilling included (1) $327,513 in potentially duplicate line item charges; (2) $71,518 for unallowable procedures and services; (3) $4,659 for claims that exceeded plan limits; (4) $61,840 of audit recoveries that had not been credited to TVA; and (5) $7,494 of miscalculated claim payments.In addition, we found TVA had been billed an additional $1 million due to payment provisions the contractor had negotiated with some of the providers in its preferred provider organization network. These provisions, referred to as stop-loss provisions, effectively offset discounts TVA would have otherwise received when providers' costs exceeded specified amounts. Summary Only