Federal Reports

This report addresses the status of the Census Bureau’s (the Bureau’s) 2020 decennial program preparation and planning efforts. The Bureau maintains all known living quarters in the Master Address File (MAF). Each address in the MAF is linked to a geographic location in the Topologically Integrated Geographic Encoding and Referencing database (TIGER), to create the MAF/TIGER database (MTdb). Our audit objectives were to (1) assess the methods and costs of continuously updating the MTdb; (2) determine how efforts, such as the 2015 Address Validation Test, support the accuracy of the MAF; and (3) evaluate the preparation of the Local Update of Census Addresses (LUCA) program for the 2020 decennial census. This report focuses on risks identified for objective 1. A report on objectives 2 and 3 was released on February 23, 2016.

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The lack of internal guidance and implementation of controls puts the U.S. Chemical Safety and Hazard Investigation Board's (CSB) $11 million budget at risk.

States can prevent inappropriate payments, protect beneficiaries, and reduce time-consuming and expensive "pay and chase" activities by ensuring that providers that intend to engage in fraudulent or abusive activities are not allowed to enroll in Medicaid. For States to identify potentially fraudulent providers, as well as those that may be associated with excluded individuals or entities, providers must disclose accurate and timely information about their owners (i.e., individuals or corporations with a 5 percent or more ownership or controlling interest; agents; or managing employees). According to CMS, the highest incidence of regulatory noncompliance among State Medicaid programs is in their collection of ownership information from providers.

CMS can prevent inappropriate payments, protect beneficiaries, and reduce time-consuming and expensive "pay and chase" activities by ensuring that providers that intend to engage in fraudulent or abusive activities are not allowed to enroll in Medicare. For CMS to identify potentially fraudulent providers, as well as those that may be associated with excluded individuals or entities, providers must disclose accurate and timely information about their owners (i.e., individuals or corporations with a 5 percent or more ownership or controlling interest; agents; or managing employees).

To bill for items and services provided to beneficiaries, providers must enroll, and periodically revalidate this enrollment, in Medicaid. Effective provider enrollment screening is an important tool in preventing Medicaid fraud. To protect Medicaid against ineligible and fraudulent providers, the Affordable Care Act requires States to screen Medicaid providers according to their risk for fraud, waste, and abuse using enhanced screening procedures. These can include fingerprint-based criminal background checks and site visits. To help States meet the demands of applying enhanced screening to all new and existing providers, the Centers for Medicare & Medicaid Services (CMS) allows States to substitute Medicare or other State Medicaid agency or Children's Health Insurance Program screening results for their own. Ensuring that States screen all providers in accordance with the new requirements is vital to protecting Medicaid, especially as it grows to serve more beneficiaries.