Federal Reports

The CSB lacks established procedures for automated processes and authentication technologies, which could permit unauthorized access to agency systems.

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.

Federal regulations effective July 1, 2011, prohibit Medicaid payments for services related to provider-preventable conditions (PPCs). The Centers for Medicare & Medicaid Services delayed its enforcement of the regulations until July 1, 2012, to allow States time to develop and implement new payment policies. This review is part of a series of reviews to determine whether the States ensured that their Medicaid managed-care organizations (MCOs) complied with these regulations for inpatient services. Our objective was to determine whether Massachusetts ensured that its MCOs complied with Federal and State requirements prohibiting payments to providers for inpatient hospital services related to treating certain PPCs.

We audited the Talladega Housing Authority’s (Authority) Rental Assistance Demonstration Program (RAD) conversion. We selected the Authority for review as part of our annual audit plan and because it was one of the larger RAD conversions in Alabama, converting 499 units to project based voucher units. Our objective was to determine whether the Authority administered its RAD conversion in compliance with U.S. Department of Housing and Urban Development (HUD) requirements.The Authority generally administered its RAD conversion in accordance with HUD’s requirements for written agreements, project-financing sources, separate books and records, RAD conversion expenditures, tenant occupancy, calculated tenant rents, and noncritical renovations. However, the Authority did not comply with requirements to complete all critical renovations prior to the RAD conversion, on August 1, 2017, as required by its RAD Conversion Commitment agreement with HUD. This occurred because the Authority did not have adequate controls in place to verify products shipped by its vendors and verify the renovation work completed by the contractors. As a result, the Authority received $36,022 in ineligible housing assistance from HUD and the tenants in these units were at risk of carbon monoxide exposure while their units lacked carbon monoxide detectors. We recommend that the Director of HUD’s Birmingham Office of Public Housing require the Authority to repay, from non-Federal funds, the $32,620 in ineligible housing assistance to the program, the $3,402 in ineligible administrative fees to the Treasury, and establish effective procedures and controls to verify that it receives correct products from its vendors and ensures the proper completion of renovation work by its contractors.