Federal Reports

In recent years, Congress has expressed concerns about the Indian Health Service’s (IHS’s) administrative and financial management of program funds for health services to American Indians and Alaska Natives. Before we could address Congress’ broader concerns, we needed to assess how the 12 IHS Area Offices receive and disburse funds for services provided to Tribal members. We chose to audit the Bemidji Area Office’s (BAO’s) procedures for disbursing IHS funds because it disburses funds to all program types.

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). To date the CARES Act has provided the U.S. Department of the Interior (DOI) with $909.7 million, which includes direct apportionments of $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas, and a $153.7 million transfer from the U.S. Department of Education to the BIE.This report presents the DOI’s progress as of December 31, 2020, in spending CARES Act appropriations. Specifically, the DOI’s expenditures to date total $600,876,882, and its obligations total $668,075,114.We are also monitoring the DOI’s progress on reporting milestones established by the CARES Act and the U.S. Office of Management and Budget.

The OIG investigated allegations that an enrolled member of a Native American tribe paid bribes or kickbacks to an elected member of a tribal business committee in exchange for preference on tribal construction contracts.We did not substantiate the allegations. A financial analysis revealed no evidence to suggest the enrolled member received construction contracts awarded by the tribe or that he owned or operated a construction company. We also found no evidence that the enrolled member paid bribes or kickbacks to tribal officials.

A supervisor based at Sunnyside Yard in New York City was terminated on February 18, 2021, following an administrative hearing. The former employee violated company policies by fraudulently claiming and accepting payment for regular pay, overtime pay, or both during hours when he was not working. In addition, company rail pass records showed that his pass was in use on days when he also claimed work hours, indicating that either he claimed labor hours while he was on personal travel or that he allowed others to use his rail pass privileges.

This report presents the results of the U.S. Government Publishing Office (GPO) product billing rates, Project No. A-20-005. We contracted with the Independent Public Accounting firm, KPMG LLP (KPMG), to conduct this review. The objective was to determine if GPO’s rate structure allows the agency to identify and recover total costs for products and services in accordance with 44 U.S.C. § 309(b)(1).

The VA Office of Inspector General (OIG) conducted an inspection to assess an allegation that the Cardiac Catheterization Lab (CCL) was closed due to concerns of risk to patients at the Samuel S. Stratton VA Medical Center (facility) in Albany, New York. The OIG did not receive a response from Veterans Integrated Service Network (VISN) 2 staff following an inquiry and subsequently opened the healthcare inspection.The OIG substantiated that the CCL was closed due to concerns of risk to patients and determined the closure was in response to issues including use of improper clinical procedural techniques, personnel disputes, and a hostile work environment. A facility fact-finding review identified concerns with communication and team dynamics among staff and suspended CCL procedures. The OIG found that VISN and facility leaders acted promptly to obtain unbiased assessments when they arranged for an external review of the CCL by the National Cardiology Program Office (NCPO). The NCPO made recommendations addressing the clinical judgment and technical skills of the CCL cardiologists. Facility leaders convened an administrative investigation board and initiated management reviews. Clinicians independent of the facility and well versed in interventional cardiology assessed the CCL cardiologists’ clinical competence. VISN and facility leaders decided that the CCL should remain closed indefinitely.According to the NCPO, its role is typically confined to advising the Veterans Health Administration (VHA) and facilities on policy matters. In this instance, the offering of recommendations by NCPO extended beyond policy matters and addressed operations, including the safe resumption of interventional cardiology at the facility. The OIG made three recommendations: two recommendations to the Under Secretary for Health regarding the designation of a VHA specialty leader in interventional cardiology and one recommendation to the VISN Director to review the circumstances that led to the failure to respond to an OIG inquiry.