Federal Reports

DHS OIG issued a series of three reports between August 2014 and October 2016 examining DHS’ pandemic activities, including 28 recommendations to improve the efficiency and effectiveness of DHS planning and response activities. We conducted this verification review to determine the adequacy and effectiveness of DHS’ corrective actions. We focused our review on 11 of 28 key recommendations that dealt with DHS-wide pandemic planning and response activities. We determined that DHS provided the OIG with adequate documentation of its initial plans and actions to address the recommendations to improve the Department’s pandemic planning and response. However, DHS did not effectively implement corrective actions to address three recommendations to provide the operational efficiencies and controls needed in the current pandemic. Specifically, DHS did not ensure the office it designated to manage and account for pandemic personal protective equipment provided adequate management oversight; did not ensure components’ compliance with the Integrated Logistics Support Plan; and did not designate an office to ensure continued oversight, review, and approval of the Department’s and components’ pandemic plans. We made three new recommendations to improve oversight of pandemic planning and personal protective equipment. DHS agreed with all three recommendations.

Our objective was to (1) determine whether the Social Security Administration (SSA) made payments to beneficiaries and/or representative payees who were deceased according to Louisiana Department of Health vital records and (2) identify non-beneficiaries in the State files whose death information did not appear in Agency records.

Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits, therapy (physical, occupational, and speech-language pathology), medical social services, and medical supplies.Our prior audits of home health services identified significant overpayments to HHAs. These overpayments were largely the result of HHAs improperly billing for services to beneficiaries who were not confined to the home (homebound) or were not in need of skilled services.Our objective was to determine whether Tender Touch Health Care Services (Tender Touch) complied with Medicare requirements for billing home health services on selected types of claims.