Federal Reports

Medicare Part B covers dialysis services for beneficiaries with end-stage renal disease (ESRD). Prior OIG reviews identified inappropriate Medicare payments made for ESRD (dialysis) services that were medically unnecessary, not properly ordered, undocumented, or did not comply with Medicare consolidated billing requirements.

To see our report, click on the link below

DHS’ funding and payments for PALMS violated Federal appropriations law. Specifically, DHS violated the bona fide needs rule in using fiscal year (FY) 2011 component funds in FYs 2012 and 2013 for e-Training services and PALMS implementation respectively, when the funds were not legally available for those needs. As a result of the bona fide needs rule and purpose statute violations, DHS may also have violated the Antideficiency Act in FYs 2013 – 2015 when the Department augmented appropriations for the Human Resources Information Technology program with component funds. We made nine recommendations to address violations of Federal appropriations law and to improve controls to prevent such potential violations in the future.

Seek link below for the full report, report summary, multimedia or any agency follow-up.

The VA Office of Inspector General (OIG) conducted a healthcare inspection that assessed whether (1) a research study cardiologist provided follow-up cardiac care to a research patient; (2) a cardiology fellow failed to provide follow-up care and correctly interpret electrocardiograms; (3) the Subcommittee on Research Safety and Institutional Review Board failed to ensure adherence to a research plan; and (4) stress-test laboratory procedure instructions were inconsistent. A research patient had a positive stress-test result. Follow-up studies were ordered only as part of the research study. The research cardiologist failed to initiate cardiac follow-up care or notify the patient or primary care provider of positive stress-test results. The OIG found that the cardiology fellow provided follow-up care for patients with positive stress tests, but the OIG was unable to determine if the fellow had difficulty interpreting electrocardiograms. The OIG determined that supervising providers were involved with the fellow’s patient encounters. The Subcommittee on Research Safety and Institutional Review Board failed to ensure a research team’s adherence to the research plan related to notification of primary providers of their patients’ enrollment in the study. The OIG found that primary providers were inconsistently alerted. The OIG identified inconsistencies between instructions provided to cardiology fellows and the protocol used by facility staff for a stress-test laboratory procedure. The stress-test laboratory protocol did not include elements required by facility policy for establishing internal policy and standard operating procedures. The OIG made six recommendations related to ensuring research providers take action on stress-test results; conducting a retrospective review of enrolled patients’ result notifications and follow-up care; providing disclosure to the patient’s family; performing research oversight of the study plan to ensure communication of patient enrollment in the study to primary providers; and reviewing the stress-test laboratory educational material.