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.

What We Looked AtThe Civil Aviation Registry (The Registry) processes and maintains ownership information on approximately 300,000 private and commercial aircraft and records on almost 1.5 million airmen. The Registry is critical for ensuring aircraft are legally owned, maintained, and operated, and many users in law enforcement, safety, the aviation industry, and the public rely on the accuracy and timeliness of its data. The Chairman of the House Transportation and Infrastructure Committee and its Subcommittee on Aviation requested that we assess FAA's overall management of the Registry and public access to certain Registry elements. We received a similar request from the Chairman of the Senate Committee on Commerce, Science, and Transportation. Our audit objective was to assess FAA's management of the Civil Aviation Registry. Specifically, we assessed FAA's (1) progress in modernizing the Registry and (2) policies for providing public access to Registry-related activities.What We FoundThe Registry's systems are outdated, and FAA has yet to develop a detailed plan for modernization. The Registry's current systems cannot support online access outside of the Registry's offices in Oklahoma City, OK. While FAA is in the early stages of developing plans to modernize the Registry's systems, the Agency has not yet made key decisions regarding the system. Consequently, the cost and timeframes for Registry modernization remain uncertain, even though FAA is mandated to complete Registry upgrades by October 2021. In addition, the regulations that govern aircraft registration do not reflect current technology or business practices, and FAA will likely need to conduct a rulemaking in conjunction with Registry modernization. If FAA does not complete the rulemaking in coordination with the development of the new system, the Agency risks spending resources on a system that lacks key capabilities.Due to the current system's limitations, users who need to access aircraft registration information in real time must access the system through the use of Government-owned computer terminals located at the Registry's Public Documents Room (PDR) in Oklahoma City. For users who cannot or do not want to travel to Oklahoma City, they can obtain aircraft information online, but that information is updated once a day, rather than in real time. Moving towards a more efficient process hinges on modernizing the Registry, but FAA has not yet developed a plan for allowing real-time access to aircraft information.Our RecommendationsFAA concurred with all four of our recommendations and proposed appropriate actions and completion dates.