Federal Reports

In 2012, we issued a report to the Centers for Medicare & Medicaid Services (CMS) indicating that during 2009, Medicare Part D paid for prescription drugs that likely should have been paid for by hospice organizations under the Medicare Part A hospice benefit. We matched Part A and Part D data to identify occurrences when Part D paid for drugs for beneficiaries who were receiving hospice care at the same time. We conducted this audit to follow up and expand on the previous audit.

The Postal Service uses Account Identifier Code (AIC) 526, Refund Spoiled/Unused Customer Meter Stamps, to record refunds of spoiled/unused postage meter stamps from customer postage meters. OIG data analytics identified that the New Brighton Branch recorded $50,125 to AIC 526 from April 1 to September 30, 2018. Meter revenue refunds at the New Brighton Branch accounted for 28 percent of all refunds processed under AIC 526 in the Northland District for the same timeframe, making the New Brighton Branch the facility with the most refunds in the Northland District for the scope period. The objective of this audit was to determine whether meter revenue refunds were properly issued, supported, and processed.

For a covered outpatient drug to be eligible for Federal Medicaid reimbursement, the manufacturer must enter into a rebate agreement administered by the Centers for Medicare & Medicaid Services (CMS) and pay quarterly rebates to the States. Previous OIG reviews found that States did not always bill and collect all rebates due for drugs administered by physicians to enrollees of Medicaid managed-care organizations (MCOs).

The VA Office of Inspector General (OIG) performed this audit to determine if Veterans Health Administration (VHA) medical facilities are scanning and entering medical documentation into patients’ records accurately and in a timely manner. VHA healthcare staff rely on medical records to manage veterans’ care. Incorporating records into patients’ electronic health records is critical because it ensures complete, accurate, and readily accessible health information to guide clinicians’ decisions. The OIG found limited VHA monitoring and oversight created backlogs that put the continuity of patient care at risk. Based on provided data, the audit team calculated that VHA medical facilities have a cumulative medical document backlog of approximately 5.15 miles of stacked paper and at least 597,000 individual electronic document files dating back to October 2016. This occurred because staff did not scan documents and enter them into the electronic medical records in a timely manner. Staff also did not always perform appropriate reviews and monitoring to assess the overall quality and legibility of scanned documents. The OIG also found staffing shortages contributed to the backlogs. The audit team documented that officials at seven of eight medical facilities visited did not ensure compliance with mandatory quality assurance reviews to identify and correct any errors before medical documents were shredded. Officials at the eight facilities also did not meet training requirements or consistently follow training policy. The OIG made nine recommendations for VHA to define and promptly reduce backlogs; account for scanning demand in staffing decisions; and develop monitoring roles, controls, and procedures.

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This report presents the results of our self-initiated audit of Miscellaneous Non-Postal Revenue Refunds – South Hackensack, NJ, Annex. The South Hackensack Annex is in the Northern New Jersey District of the Northeast Area. This audit was designed to provide Postal Service management with timely information on potential financial control risks at Postal Service locations. The objective of this audit was to determine whether refunds for miscellaneous non-postal revenue were valid and properly supported at the South Hackensack, NJ Annex.