Federal Reports

We audited the Joint Programs of the Northern Arapaho and Eastern Shoshone Tribes of the Wind River Reservation’s Tribal Transportation Agreement (Agreement No. A13AP00014) with the Bureau of Indian Affairs (BIA) to determine whether: 1) the costs claimed by the Wind River Tribes were allowable, allocable, and reasonable according to applicable Federal laws and regulations and BIA guidelines; and 2) the BIA oversaw the agreement in accordance with applicable Federal laws and regulations and BIA guidelines.We determined costs claimed by the Wind River Tribes on their Tribal Transportation Program were not allocable to Agreement No. A13P00014. This occurred because the Tribes’ accounting system and procedures are not configured to manage Federal funds.As a result, the Wind River Tribes could not support expenses claimed on Agreement No. A13AP00014. We question $6.2 million in costs claimed by the Wind River Tribes—specifically, $3.6 million in unapproved capital expenditures, $2.6 million in indirect costs claimed without an approved indirect cost rate, and $7,422 in unallowable costs.In addition, we determined the BIA did not oversee the agreement in accordance with applicable Federal laws and regulations and BIA guidelines. This occurred because BIA management overseeing the Tribes’ transportation program did not provide staff with sufficient training to fulfill their responsibility to provide oversight and administration to the Tribes since 2013.We made 11 recommendations to help the BIA oversee the Wind River Tribes’ transportation program and resolve questioned costs.

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The VA Office of Inspector General (OIG) conducted a healthcare inspection to evaluate the 2016 overdose death of a patient in a residential treatment program (Program) at a Veterans Integrated Service Network 10 medical facility (Facility). The purpose of the inspection was to review the supervision and care of the patient while enrolled in the Program. The OIG identified issues relating to the supervision of the Program patient. Supervision issues involved inconsistent Facility policy directions for patient check-ins, staff compliance with Veterans Health Administration (VHA) and Facility policies/procedures regarding the management of patient check-ins and missing patients when they failed to check-in, and random screening of patients for drugs and alcohol abuse. The OIG identified issues relating to the quality of care of the Program patient. Specifically, the OIG found that Program staff did not develop and implement a timely and comprehensive interdisciplinary treatment plan, provide services during the weekends, reassess the patient’s restrictions, and submit timely and accurate documentation as required by VHA and Facility policies/procedures. The OIG was unable to assess whether the impact of these failures directly affected the patient’s outcome. The OIG made five recommendations to the Facility Director related to the development and implementation of uniform Program policies and a comprehensive interdisciplinary plan, provision of daily services, the reassessment of patient privileges, and accurate electronic health record documentation. The name of the Facility is not being disclosed to protect the privacy rights of the subject of the report pursuant to 38 U.S.C. §7332, Confidentiality of Certain Medical Records, January 3, 2012.

This grant was awarded to the Board to provide funding for the development and deployment of a wireless broadband network to serve Garrett county

This audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements.

The OIG investigated allegations that an official at a tribally controlled college bribed members of the college board of trustees, submitted false mileage claims for work-related travel, retaliated against employees who disagreed with his policies, and failed to report the theft of college funds by a former employee.We did not substantiate the allegations of bribery, false claims, or retaliation. We also found the official ensured the theft was properly reported to law enforcement and that the stolen funds had been repaid in full.The U.S. Attorney’s Office for the District of South Dakota declined to prosecute the former employee for the theft.

Medicare made improper payments of $8.7 million to providers for nonemergency ambulance transports to destinations not covered by Medicare, including the identified ground mileage associated with the transports. Medicare covers ambulance transports to only certain destinations, such as hospitals, skilled nursing facilities (SNFs), and beneficiaries' residences. Medicare also covers these transports from a SNF to the nearest supplier of medically necessary services (diagnostic or therapeutic sites) when the beneficiary is a SNF resident and those services are not available at the SNF. The majority of the improperly billed claim lines (59 percent) were for transports to diagnostic or therapeutic sites, other than a physician's office or a hospital, that did not originate from SNFs. As of the publication of this report, the total improper payment amount of $8.7 million included claim lines outside of the 4-year claim-reopening period.

The objective of the Council of the Inspectors General on Integrity and Efficiency purchase card initiative was to analyze and review Government purchase card data to determine the risks associated with purchase card transactions.