Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection regarding allegations of patient and radiation safety concerns at the John D. Dingell VA Medical Center, Detroit, Michigan. To reduce the risk of unnecessary radiation exposure, the Veterans Health Administration (VHA) requires that radiology staff ensure equipment is operating properly, follow appropriate procedures, use shielding and engineered safety features, and ensure radiation doses are as low as reasonably achievable. The OIG substantiated annual radiologic equipment inspections were not performed for most of fiscal years 2015 through 2017, although inspections were current as of April 5, 2018. The OIG substantiated that a radiologist performed fluoroscopy procedures without having current training or privileging and the radiology department did not conform to VHA radiation safety standards. The OIG substantiated that the Chief of Radiology changed the Radiology privileging form; however, the OIG did not substantiate that the form was changed to request and grant authorized user status. Although the OIG substantiated that facility staff were not permitted to perform nuclear medicine studies because the Master Materials License permit was revoked in 2009, it was reinstated in 2010. During the inspection, facility leaders identified portions of the radiation safety program that were not completed in a consistent and timely manner, including deficient equipment testing, lack of lead aprons and shields annual inspections, and dosimeter badges processing. The OIG also identified issues with the nuclear medicine waiting room dosimeter, radiology technicians’ training records, and a tracking matrix. Although the OIG found deficiencies in the Facility’s radiation safety program and made recommendations, the OIG did not identify deficiencies that put patients and staff at immediate risk or warranted stopping patient care. The OIG made six recommendations related to equipment testing, fluoroscopy training, clinical privileges, radiation safety, and tracking and monitoring corrective actions to completion.

The objective of our audit was to determine whether the Utah State Board of Education (Utah Education) implemented a system of internal control over calculating and reporting graduation rates sufficient to provide reasonable assurance that reported graduation rates were accurate and complete. We reviewed Utah Education’s system of internal control related to the calculating and reporting of the adjusted cohort graduation rate (ACGR). The audit period covered the ACGR for school year (SY) 2014–15, which included students who were first-time ninth graders in SY 2011–12. We found that Utah Education’s system of internal control did not provide reasonable assurance that reported graduation rates were accurate and complete during our audit period. Specifically, Utah Education did not have sufficient processes to ensure that (1) ACGR data received from the local educational agencies (LEAs) were accurate and complete, (2) students who the LEAs identified as graduates in the cohort met State graduation requirements, and (3) LEAs maintained adequate documentation for students removed from the cohort. Further, we found that Utah Education did not calculate its ACGR in accordance with Federal requirements. Utah Education’s methodology for calculating its ACGR (1) improperly included students as graduates who earned an alternative award and (2) did not include all students who should have been reported in the SY 2014−15 cohort.

Our audit objectives were to determine whether MiraCosta College (MiraCosta) completed verification of applicant data in accordance with Federal requirements and accurately reported verification results to Federal Student Aid (FSA). The audit covered award year 2016–2017 (July 1, 2016, through June 30, 2017). We found that MiraCosta generally completed verification of applicant data in accordance with Federal requirements. Specifically, MiraCosta did not complete verification after a subsequent Institutional Student Information Record was received for 1 of the 60 students sampled. We also found that MiraCosta did not accurately report verification results to FSA. Specifically, for 10 of the 60 students sampled, MiraCosta did not accurately report new Central Processing System transaction numbers to the Common Origination and Disbursement System after MiraCosta completed verification.

Our audit objectives were to determine whether College of Southern Nevada completed verification of applicant data in accordance with Federal requirements and accurately reported verification results to Federal Student Aid (FSA). The audit covered award year 2016–2017 (July 1, 2016, through June 30, 2017). We found that the College of Southern Nevada completed verification of applicant data in accordance with Federal requirements for all 60 students included in our sample. We also found that the College of Southern Nevada accurately reported verification results to FSA for 57 of the 60 students included in our sample. Although the school did not accurately report verification results for three students, the inaccurate reporting did not affect the amount of Title IV funds disbursed for the students.

The steps the Centers for Medicare & Medicaid Services (CMS) has taken to address terminated drug utilization in Medicare Part D were not entirely effective and, as a result, CMS continued to accept some prescription drug event (PDE) data for terminated drugs in calendar years (CYs) 2014 and 2015. Although CMS has made improvements to prevent terminated drug utilization in Part D, it accepted PDE data totaling $31.9 million in gross drug costs for 3,705 terminated drugs in CYs 2014 and 2015. CMS did not compare the information on termination dates in its quarterly Medicaid drug rebate files with the Food and Drug Administration's (FDA) file, did not investigate the discrepancies that existed between these two data sources, and did not update its system edits in a timely manner.