Federal Reports

In 2019, Congress enacted the Payment Integrity Information Act (PIIA) to update required reporting on agencies’ improper payments. PIIA requires agencies to review and identify programs and activities that may be susceptible to significant improper payments, to estimate the rate and amount of improper payments in agency programs, and to report on their actions to reduce and recover those payments. The Inspector General of each agency assesses compliance with these requirements annually.Despite continuing work to improve its compliance with PIIA and preceding improper payment legislation, AmeriCorps remains non-compliant and did not meet four of the six PIIA requirements. Specifically, three of the four programs reported that more than ten percent of their payments were improper. AmeriCorps did not appropriately establish its published reduction targets, nor did it publish a complete and appropriate corrective action plan to reduce improper payments. Furthermore, AmeriCorps did not estimate reliably the amount and the rate of improper payments made in the AmeriCorps State and National Program, Foster Grandparent Program (FGP), Senior Companion Program (SCP), and Retired and Senior Volunteer Program (RSVP), due to AmeriCorps’ sampling methodology and statistical projections.AmeriCorps attributes the decreases in the improper payments rates to the implementation of an approved third-party vendor solution that grantees may use to perform required criminal history checks, previously the primary root cause of AmeriCorps’ improper payments. Although this corrective action reduced the improper payment rates in FY 2020, AmeriCorps continued to report improper payment rates equal to or above the ten percent threshold for the FGP, SCP, and RSVP programs.AmeriCorps agreed to implement our recommendations to update its improper payment standard operating procedures, strengthen supervision and oversight of the sample selection, testing, and statistical projection procedures, and develop and implement actions to reduce the improper payment rates below ten percent for FY 2021. AmeriCorps Management’s Response can be found in Appendix C of the report.

The purpose of this flash report is to apprise the U.S. Department of Education (Department) of the risk that the Puerto Rico Department of Education (Puerto Rico DOE) used Department program funds for payroll costs related to inactive employees1 from 2007 to 2020.We found that the Puerto Rico DOE may have charged up to $1.3 million in unallowable payroll costs to the Emergency Impact Aid program.

Our audit covered 6,864 claims for which NW Hospice (located in Tigard, Oregon) received Medicare reimbursement of $31.5 million for hospice services provided from June 1, 2016, through May 31, 2018. We reviewed a random sample of 100 claims. We evaluated compliance with selected Medicare billing requirements and submitted these sampled claims and the associated medical records to an independent medical review contractor to determine whether the services met coverage, medical necessity, and coding requirements.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the John D. Dingell VA Medical Center in Detroit, which includes multiple outpatient clinics in Michigan. The inspection covers key clinical and administrative processes associated with promoting quality care. This inspection focused on Leadership and Organizational Risks; COVID-19 Pandemic Readiness and Response; Quality, Safety, and Value; Medical Staff Privileging; Medication Management: Long-Term Opioid Therapy for Pain; Mental Health: Suicide Prevention Program; Care Coordination: Life-Sustaining Treatment Decisions; Women’s Health: Comprehensive Care; and High-Risk Processes: Reusable Medical Equipment.The medical center’s executive leadership team appeared stable, with one of the five positions permanently filled for four months at the time of the OIG’s virtual review. Employee survey results revealed opportunities for the Associate Director for Patient Care Services to improve staff satisfaction and reduce moral distress. Patient experience surveys revealed opportunities for leaders to improve patient satisfaction. The OIG’s review of the medical center’s accreditation findings, sentinel events, and disclosures did not identify any significant concerns. Leaders were knowledgeable selected data used in Strategic Analytics for Improvement and Learning models and should continue to sustain and improve performance.The OIG issued five recommendations for improvement in three areas:(1) Medical Staff Privileging• Provider exit review process(2) Mental Health• Suicide prevention training completion(3) Women’s Health• Women veterans health committee membership• Women veterans program manager responsibilities• Designated maternity care coordinator