Federal Reports

This audit is part of a series of hospital compliance audits. Using computer matching, data mining, and other data analysis techniques, we identified hospital claims that were at risk for noncompliance with Medicare billing requirements. For calendar year (CY) 2017, Medicare paid hospitals $206 billion, which represents 55 percent of all fee-for-service payments; accordingly, it is important to ensure that hospital payments comply with requirements.

For a covered outpatient drug to be eligible for Federal reimbursement under the Medicaid program's drug rebate requirements, manufacturers must pay rebates to the States for the drugs. Previous OIG audits found that States did not always bill and collect all rebates due for drugs administered by physicians to enrollees of Medicaid managed-care organizations (MCOs).Our objective was to determine whether Minnesota complied with Federal Medicaid requirements for billing manufacturers for rebates for drugs dispensed to MCO enrollees.

We investigated allegations that a then senior political employee of the U.S. Department of the Interior (DOI) did not comply with his Federal ethics pledge under Executive Order No. 13770 when he communicated with a former employer during the required 2-year recusal period following the political employee’s Federal appointment in the fall of 2017.We identified a number of interactions between the senior political employee and representatives of the former employer—namely, several email exchanges, three phone calls, one in-person meeting, and one presentation at an event hosted by the former employer. While some of these interactions with the former employer may have been relatively minor in nature, we found that the senior political employee nonetheless did not comply with the ethics pledge because those interactions occurred during the 2-year recusal period. In contrast, we found that, under the circumstances, a presentation made by the senior political employee at an event hosted by the former employer was permissible under the ethics pledge because the senior employee attended in his official capacity.In making these findings, we note that the senior political employee told us he initially did not understand that his unpaid, volunteer position with an entity related to an organization (the former employer described above) was itself considered former employment under the ethics pledge. In fact, the organization itself as well as the related entity are considered a “former employer” under the pledge. After it was alleged that the senior political employee violated ethics rules in his interactions with the former employer, the Departmental Ethics Office (DEO) provided the senior political employee with written guidance about communications with former employers and specifically found that the organization in question qualified as a former employer under the ethics pledge. In its written guidance, the DEO acknowledged that the senior political employee had not received specific written or verbal guidance from the DEO identifying the organization as a “former employer” for purposes of the ethics pledge. We found no further communications between the senior political employee and representatives of the organization after the senior political employee received this guidance.We provided our report to the Chief of Staff for the Office of the Secretary for any action deemed appropriate.

What We Looked AtAs required by law, we report annually on the Department of Transportation’s (DOT) most significant challenges to meeting its mission. We considered several criteria in identifying DOT’s top management challenges for fiscal year 2021, including their impact on safety, documented vulnerabilities, large dollar implications, and the ability of the Department to effect change. In addition, we recognize that the Department faces the extraordinary task of meeting these challenges while also responding to the Coronavirus Disease 2019 (COVID-19) global pandemic, including implementing the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Accordingly, we included CARES Act and COVID-19 considerations in all eight of our top management challenges. What We FoundWe identified the following top management challenge areas for fiscal year 2021: Aviation safety. Key challenges: improving FAA’s oversight of aircraft certification processes and enhancing aviation safety oversight while working in a collaborative environment. Surface transportation safety. Key challenges: ensuring compliance with safety regulations and programs and continuing progress in safety monitoring and enforcement. Air traffic control and airspace modernization. Key challenges: modernizing new systems while introducing new capabilities and implementing new performance-based navigation flight procedures and delivering benefits to airspace users. Surface transportation infrastructure. Key challenges: enhancing oversight of surface transportation projects and employing effective asset and performance management. Contract and grant fund stewardship. Key challenges: awarding pandemic relief and other DOT contracts and grants efficiently, effectively, and for intended purposes and enhancing contract and grant management and oversight to achieve desired results and compliance with requirements. Information security. Key challenges: addressing longstanding cybersecurity weaknesses and developing Departmentwide policy to validate the proper adoption and security of cloud services. Financial management. Key challenges: strengthening procedures to monitor and report grantee spending and preventing an increase in improper payments. Innovation and the future of transportation. Key challenges: adapting oversight approaches for emerging vehicle automation technologies and ensuring the safe integration of Unmanned Aircraft Systems in the National Airspace System.