Federal Reports

What We Looked AtWe performed a quality control review (QCR) on the single audit that Baker Tilly Virchow Krause, LLP (Baker Tilly) performed for the Delaware Valley Regional Planning Commission’s (Commission) fiscal year that ended June 30, 2018. During this period, the Commission expended approximately $19.2 million from the U.S. Department of Transportation’s (DOT) grant programs. Baker Tilly determined that DOT’s major program was the Highway Planning and Construction Cluster.Our QCR objectives were to determine (1) whether the audit work complied with the Single Audit Act of 1984, as amended, and the Office of Management and Budget’s Uniform Guidance, and the extent to which we could rely on the auditors’ work on DOT’s major program; and (2) whether the Commission’s reporting package complied with the reporting requirements of the Uniform Guidance. What We FoundBaker Tilly’s audit work complied with the requirements of the Single Audit Act, the Uniform Guidance, and DOT’s major program. We found nothing to indicate that Baker Tilly’s opinion on DOT’s major program was inappropriate or unreliable. However, we identified deficiencies in the Commission’s reporting package that required correction and resubmission.

The OIG investigated an allegation that an information technology services contractor intentionally diverted a payment made by the Interior Business Center (IBC) away from the contractor’s assignee—an entity to which the contractor owed money—into its own bank account. As a result, the IBC paid the contractor instead of the assignee, and the U.S. Department of the Interior (DOI) lost more than $300,000.We found that the contractor changed its default bank account information in the system of award management to its own bank account, which caused the payment diversion, but we could not show the contractor changed the account information with the intent of diverting the payment. Furthermore, we found the IBC paid the wrong entity because it did not properly enter the assignee as the payment recipient in its contract management system.We presented this matter to the U.S. Attorney’s Office, which declined prosecution. The contractor filed for bankruptcy protection and could not return the money to the DOI or the assignee. As a result, the DOI paid an additional $324,544 to the assignee to fulfill the money owed under the contract.

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Among its provisions, the CARES Act provided the U.S. Department of the Interior (DOI) with $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas.This report presents the DOI’s progress as of April 28, 2020, in spending CARES Act appropriations. Specifically:• Total expenditures are $168,719,791 and total obligations are $387,887,389.• A total of 491 grants and contracts have been awarded, with total value of $390,845,278.• Expenditures by charge card total $2,409,399.We will also be monitoring the DOI’s meeting of required reporting milestones established by the CARES Act and the Office of Management and Budget.We anticipate issuing updated status reports monthly.

The VA Office of Inspector General (OIG) conducted a healthcare inspection at the request of Senator Tammy Duckworth on behalf of a constituent to assess concerns regarding the appropriateness of facility leaders’ response to a radiologist’s alleged four radiologic errors. The OIG determined that one of the four patients met criteria for institutional disclosure. Alerted to the radiologist’s potential errors, facility leaders conducted an expanded review, with Veterans Integrated Service Network and National Teleradiology Program assistance and found a high error rate in the radiologist’s exams. A second, further-expanded review ensued. The OIG concluded that Radiology Service lacked an effective early detection and identification process for radiologic errors. Once radiologic errors were identified, Veterans Integrated Service Network and facility leaders took appropriate actions. The Radiology Service Chief inadequately assessed the radiologist’s performance due to a small exam sample size and lack of consideration to the modalities and complexities of exams. VA’s National Guidelines for Radiology Professional Competency provide facility leaders with direction to assess radiologists’ clinical competence. Because radiologic exams vary in complexity and risk to patients, a risk stratification methodology would further and better inform professional practice evaluations. The OIG made six recommendations: one to the Under Secretary for Health regarding guidelines to better inform radiologists’ professional practice evaluations; one to the Veterans Integrated Service Network Director regarding continued oversight of the facility’s response to National Teleradiology Program findings; and four to the Facility Director regarding disclosures to patients or families as warranted, Radiology Service improvements in quality assurance and performance plans, consideration for radiologist competency reviews based on VA’s National Guidelines for Radiology Professional Competency, and evaluation of the National Teleradiology Program final findings to determine what additional steps are required.