Federal Reports

In 2010, Congress passed the Patient Protection and Affordable Care Act (ACA). The ACA established enhanced Federal reimbursement rates for services provided to nondisabled, low-income adults without dependent children (new adult group). The enhanced reimbursement rates established under the ACA have raised concerns about the possibility that States could improperly enroll individuals for Medicaid coverage in the new adult group and, as a consequence, the potential for improper payments.Our objective was to determine whether Colorado complied with Federal and State requirements when claiming Federal Medicaid reimbursement for Medicaid services provided to beneficiar

At the request of the Tennessee Valley Authority's (TVA) Supply Chain, we examined a cost proposal for engineering, design, and construction support services. Our examination objective was to determine if the cost proposal was fairly stated for a planned 5-year, $300 million contract.In our opinion, the cost proposal was overstated. Specifically, we found the proposed labor markup rates, for recovery of indirect costs, were overstated compared to recent actual costs. We estimated TVA could save about $4 million over the planned $300 million contract spend by negotiating reduced labor markup rates to more accurately reflect recent actual costs.(Summary Only)

The objectives were to determine whether USPTO (1) achieved its small business utilization goals, (2) contracting officials provided small businesses with adequate contract award opportunities, and (3) took appropriate actions to ensure contracting officials met small business contracting goals. We contracted with Booth Management Consulting, LLC (BMC)—an independent firm—to perform this audit of USPTO. Our office oversaw the progress of this audit to ensure that BMC performed the audit in accordance with generally accepted government auditing standards and contract terms. However, BMC is solely responsible for the attached report and conclusions expressed in it. As discussed in the attached report, BMC concluded that USPTO did not (1) meet its small business utilization goals, (2) provide small businesses with adequate contract award opportunities, and (3) take appropriate actions to meet small business contracting goals. BMC recommended in the report that the Under Secretary of Commerce for Intellectual Property and Director of the U.S. Patent and Trademark Office direct the Director of the Office of Procurement to ensure that the following occur: (1) Contract specialists verify small business eligibility prior to awarding small business contracts. (2) Contract specialists perform and appropriately document small business set-aside reviews. (3) Historically Underutilized Business Zones small business consideration is included in its annual acquisition forecasting activities and marketing efforts to maximize contracting opportunities. (4) The Office of Procurement uses the Forecasting and Advanced Acquisition Planning System and establishes clear lines of communication between the Office of Procurement, small business specialists, and contracting specialists for all procurement requests.

During our unannounced inspections of five U.S. Customs and Border Protection (CBP) facilities in the Laredo and San Antonio areas of Texas in February 2020, three Border Patrol stations and two Office of Field Operation ports of entry we visited appeared to be operating in compliance with the Transport, Escort, Detention, and Search (TEDS) standards we evaluated. We verified accessibility to water, food, toilets, sinks, basic hygiene supplies, and bedding. We observed clean facilities and verified that temperatures and ventilation in holding rooms were appropriate. Of the five facilities we visited, only one could provide on-site showers to detainees, but during our visits, no detainees were approaching the detention time threshold where a shower would be required. Because Border Patrol leadership directed all Border Patrol stations to implement Phase 2 of the enhanced medical screening ahead of the prescribed schedule outlined in CBP Directive 2100-004, the Border Patrol stations we visited were conducting alien intake health assessments using CBP Form 2500. These Ports of Entry had implemented Phase 1, but were not yet required to conduct Phase 2 assessments at the time of our inspection. We did not make any recommendations in this report.

We are issuing this management alert to advise the Department of Homeland Security and CBP of the urgency and short timeframe to award a new medical services contract. During two ongoing projects, we learned that CBP’s current contract for medical services will expire on September 29, 2020. As of September 3, 2020, CBP had not issued a solicitation for a new contract, leaving fewer than 30 days for necessary funding, reviews, and approvals before CBP can award the contract. A lapse in this contract could jeopardize the health and safety of migrants in CBP custody, as well as that of U.S. Border Patrol agents, CBP officers, and staff, during the current pandemic. We recommended that CBP dedicate all available resources necessary to its planning and communication to ensure continuity of CBP’s onsite medical services and that CBP conduct future contract planning and communication in a timely manner. CBP concurred with this recommendation.

The National Credit Union Administration (NCUA) Office of Inspector General (OIG) conducted this self-initiated audit to assess the NCUA’s examination and oversight authority of credit union service organizations (CUSOs) and third party vendors. The objectives of our audit were to determine whether: 1) the NCUA complied with applicable laws, regulations, policies, and procedures for CUSO and other (non-CUSO) third-party vendor reviews; and 2) the NCUA’s vendor review process effectively helps to assess the adequacy of credit union management’s due diligence reviews, and identify and reduce the risks vendor relationships pose to credit unions. The scope of our audit covered the period of January 1, 2013, through December 31, 2019.

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Tuesday, September 1, 2020We investigated allegations that a building management employee working in the Office of the Assistant Secretary – Indian Affairs misused their official position and engaged in unethical or illegal behavior.We found that the building management employee misused their Government charge card, participated in bid rigging, took a Government laptop for personal use, and failed to properly follow the DOI parking pass process policy, in violation of U.S. Department of the Interior policy and Federal regulations.The U.S. Department of Justice declined prosecution. The building management employee was removed from Federal service. We provided this final report to the Assistant Secretary for Indian Affairs.

The Veterans Health Administration (VHA) took measures to protect patients and employees from COVID-19 by canceling face-to-face appointments that were not urgent and converting some of them to virtual appointments. The VA Office of Inspector General (OIG) assessed VHA’s appointment management strategies and the status of canceled appointments. The review team found that about five million appointments (68 percent) canceled from March 15 through May 1, 2020, had evidence of follow up or other tracking. Patients completed appointments predominantly by telephone and some by video. Other appointments were tracked for future follow-up in VA’s scheduling system. However, about 2.3 million cancellations (32 percent) had no indication of follow up or tracking at the time of review. The review team also examined whether medical facilities followed VHA’s guidance on annotating the appointment cancellations. Doing so consistently would have allowed facilities to better determine which appointments needed to be rescheduled. However, VHA’s guidance changed over time, and facilities applied it inconsistently. Facilities also did not consistently follow guidance on leaving consults open so that medical providers could reschedule them. In addition, the team noted that canceling appointments in batches could mask the instances where patients were not contacted about the cancellations. The OIG’s ongoing surveillance of VHA data shows that overall, from March 15 through June 15, 2020, VHA has canceled nearly 11.2 million appointments and needs to follow up on about 3.3 million of those cancellations. The OIG recommended that VHA coordinate a well defined rescheduling strategy with all facilities and provide oversight to facilities that have a significant rate of appointments with no evidence of follow up or tracking. The OIG also recommended VHA ensure facilities do not solely rely on appointment annotations when rescheduling. Finally, the OIG recommended that facilities take appropriate action on canceled or discontinued consults.