Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection to evaluate allegations regarding a patient death following a urology procedure and conflicts of interest in hiring urologists at the facility. A facility urologist performed extracorporeal shock wave lithotripsy (ESWL) on a patient who died 25 days later. The patient did not have significant risk factors and was a suitable candidate for ESWL. The OIG found an abnormal pathology blood smear result in the electronic health record for the patient. The ordering provider failed to consult with the facility pathologist and address the abnormal pathology blood smear result with the patient. Several urologists were hired from a private practice that was associated with the Associate Chief of Staff for Acute Care Services (ACOS), which could be considered a violation of standards of ethical conduct for VA employees. However, the OIG determined that facility leaders other than the ACOS approved the hiring of the urologists to meet the needs of the facility and patients. The ACOS did not sign recruitment requests for the urologist positions. Urologists hired by the facility had ownership in a company associated with ESWL rental equipment. The OIG was unable to determine an increase in ESWL procedures was due to the urologists’ ownership interest in the company. Facility leaders were aware of the potential conflict of interest and sought guidance from the VA Office of General Counsel. Although the General Counsel found “no actual conflict of interest” given the facts offered, the OIG found that these facts may have contained inaccurate statements. The OIG found no evidence that facility urologists failed to respond when on call. The OIG made two recommendations relating to abnormal blood smear results and conflicts of interest.

OIG reviewed FNS’ controls over FDPIR household eligibility and administrative costs, as well as its controls to prevent damaged, spoiled, and lost food.

We audited the U.S. Department of Housing and Urban Development’s (HUD) Federal Housing Administration, Home Affordable Modification Program’s (FHA-HAMP) policies for reporting nonincentivized loan modifications and filing partial claims. The audit was a result of a prior Office of Inspector General (OIG) external review in which we identified delays in reporting FHA-HAMP nonincentivized loan modifications and filing partial claims. This audit was also part of our annual audit plan. The objective of the audit was to determine whether there was a need for HUD to issue a policy requiring servicers to report FHA-HAMP nonincentivized loan modifications and file FHA-HAMP nonincentivized partial claims within specific timeframes.HUD’s FHA-HAMP loss mitigation policy did not include deadlines to ensure timely reporting for nonincentivized loan modifications and filing of nonincentivized partial claims. Therefore, the servicers were not obligated to always report or report in a timely manner nonincentivized loan modifications and file or file in a timely manner nonincentivized partial claims in FHA Connection (FHAC). This condition occurred because HUD was aware of these issues but have yet to establish a policy for reporting the terms of nonincentivized loan modifications and filing the nonincentivized partial claims within specified timeframes or deadlines to address them. As a result, mortgage data from HUD’s systems may not have accurately reflected the status of the FHA-insured mortgages for monitoring and financial reporting of the Mutual Mortgage Insurance Fund (MMIF). In addition, our recent corrective action verification review showed that HUD’s Claims Subsystem programming did not always properly calculate the time between claims to suspend payment for claims that had a reported prior loss mitigation action within 24 months because the claims were not submitted in order. We recommend that the Deputy Assistant Secretary for Single Family Housing to (1) update HUD’s loss mitigation policies, to include deadlines for the servicers to file the FHA-HAMP nonincentivized partial claims, and consider imposing sanctions for noncompliance with these deadline requirements and (2) update HUD’s loss mitigation policies, to include deadlines for the servicers to report the new terms of the FHA-HAMP nonincentivized loan modifications, and consider imposing sanctions for noncompliance with these deadline requirements.

Amtrak (the company) contracted with the independent certified public accounting firm of Ernst & Young LLP to audit its consolidated financial statements as of September 30, 2019, and for the year then ended, and to provide a report on internal control over financial reporting and on compliance and other matters. Because the company receives federal assistance, it must obtain an audit performed in accordance with generally accepted government auditing standards.As required by the Inspector General Act of 1978, we monitored the audit activities of Ernst & Young to help ensure audit quality and compliance with auditing standards. Our monitoring focused on two Ernst & Young reports and disclosed no instances in which Ernst & Young did not comply, in all material respects, with generally accepted government auditing standards. We reached this conclusion by monitoring Ernst & Young’s audit activities, which included reviewing its reports, auditor independence and qualifications, audit plans, detailed testing results, summary work papers, and quality controls. We also attended key meetings.

DOJ News Release