Federal Reports

The Federal Emergency Management Agency (FEMA) did not balance its Manufactured Housing Unit (MHU) program costs with disaster-related housing needs. In response to Hurricane Harvey in Texas, FEMA overestimated the number of MHUs it needed by nearly 2,600, which amounted to purchase, transportation, and storage costs of at least $152 million. The agency also overestimated the number of tank and pump systems (TPS) it needed to operate the fire sprinklers, by nearly 2,400, which amounted to purchase and transportation costs of approximately $29 million. Following Hurricane Harvey, FEMA focused on providing prompt assistance and did not emphasize financial accountability and recordkeeping. Had FEMA better managed and overseen the MHU program, it could have put an estimated $182 million to better use to assist survivors from Hurricane Harvey or other disasters. We made four recommendations that will help FEMA better manage its MHU program. FEMA concurred with the recommendations.

Medicare makes supplemental payments to hospitals, known as outlier payments, which are designed to protect hospitals from significant financial losses resulting from patient-care cases that are extraordinarily costly. Unlike predetermined payment amounts for most Medicare hospital claims, outlier payments are directly influenced by hospital charges. We selected CHI St. Vincent Infirmary (St. Vincent) based on outpatient outlier payments increasing from $216,484 in 2013 to $1.4 million in 2014.