Federal Reports

The VA OIG did not find that the Northern California Health Care System Director violated VA policy regarding the use of government vehicles. The Director was unaware employees drove these vehicles between work and home. The OIG found that Dr. Dawn Erckenbrack (GS-15), the Associate Director of the Sacramento VA Medical Center, improperly authorized a local policy permitting her to delegate authority for the approval of no-cost travel orders to the Chief of Logistics Management Service (CLMS). The CLMS used this authority to allow employees to take government vehicles home overnight and on weekends under the provisions applicable to TDY travel with the use of no-cost travel orders. The Director said that upon learning of this policy, he immediately rescinded it. The OIG did not substantiate another allegation, negating the need for further discussion in the report.

Intensity-modulated radiation therapy (IMRT) is an advanced type of radiation procedure used to treat difficult-to-reach tumors. Novitas Solutions, Inc. (the Medicare Administrative Contractor responsible for processing Medicare payments for outpatient services in Jurisdictions H and L), incorrectly paid hospitals for IMRT services provided to nearly all of the beneficiaries associated with our review.

Since 2003, the United States Government Accountability Office has identified Medicaid as a high-risk program. Between Federal fiscal years (FYs) 2011 and 2017, Medicaid expenditures rose 42 percent from $430 billion to $610 billion. By FY 2025, Medicaid is projected to have annual expenditures of $958 billion. The Social Security Act requires States to provide at least 40 percent of the non-Federal share of Medicaid expenditures, while up to 60 percent may be derived by local sources, including health-care-related taxes, as long as the taxpayer is not held harmless for the tax payment. However, this cost sharing requirement only applies to the aggregate of annual Medicaid program expenditures, not on a service-specific basis.

OIG audited the consolidated financial statements of FNS for fiscal years 2018 and2017.

OIG audited the consolidated financial statements of Rural Development for fiscal years 2017 and 2018.

OIG audited FCIC/RMA’s financial statements for fiscal years 2018 and 2017

We reviewed the California State agency’s controls for operating under the Summer Food Service Program requirements and sponsor and site compliance with those requirements. We have reported our separate findings in an interim report dated September 2017 and this final report.