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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Defense
Quality Control Review of the Baker Tilly Virchow Krause, LLP, FY 2016 Single Audit of National Marrow Donor Program
Operation Inherent Resolve - Summary of Work Performed by the Department of the Treasury and Office of Inspector General Related to Terrorist Financing, ISIS, and Anti-Money Laundering
The Colorado Department of Health Care Policy and Financing (State agency) claimed Federal Medicaid reimbursement for some Targeted Case Management (TCM) services that did not comply with Federal and State requirements for fiscal years (FYs) 2014 and 2015. Of the 150 randomly sampled TCM claims we reviewed, 49 claims were unallowable because they had at least 1 of the following errors (some claims had more than 1 error): (1) the TCM providers could not provide documentation supporting that the case managers had the qualifications-that is, the education or experience-required by the Colorado TCM State plan amendment (43 claims); (2) the TCM providers could not provide documentation to support that they had actually provided 1 or more TCM services to the Medicaid recipients (10 claims); (3) the TCM providers' case notes lacked sufficient detail to support that claimed services were allowable (5 claims); and (4) the TCM providers were unable to provide complete documentation of recipients' eligibility for TCM services (3 claims).
In accordance with our annual plan, the Office of Inspector General (OIG) conducted an assessment to determine if the United States Capitol Police (USCP or the Department) (1) established adequate processes for ensuring efficient and effective operations and (2) complied with applicable guidance. Our scope included internal controls, processes, and operations during Fiscal Years (FYs) 2016 and 2017.
