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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
National Science Foundation
Quality Control Review of KPMG LLP’s FYs 2015 and 2016 Single Audits of the Research Foundation of the City University of New York
Review of Questionable Background Investigations Performed by the Office of Personnel Management's Former Contractor U.S. Investigations Services, Inc.
The OIG investigated allegations that U.S. Bureau of Reclamation (USBR) employees improperly awarded a sole-source security services contract at a dam, received kickbacks for rigging the contract bidding process, and approved inflated invoices.Our investigation found no evidence that USBR employees improperly awarded the contract or received kickbacks for rigging the contract bidding process.We referred the allegations of inflated invoices to our Office of Audits, Inspections, and Evaluations, which audited the contract for compliance with applicable laws and regulations. The findings of that audit will be issued in a separate report.
Missouri Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions
The Missouri Department of Social Services (State agency) did not comply with Federal and State requirements prohibiting Medicaid payments for inpatient hospital services related to treating certain provider-preventable conditions (PPCs), which are certain reasonably preventable conditions caused by medical accidents or errors in a health care setting. The State agency did not follow the provision of its Centers for Medicare & Medicaid Services (CMS)-approved State plan directing it to perform a retrospective clinical review of the claims with diagnosis codes identified as PPCs. In addition, the State agency paid inpatient hospital claims in which the present-on-admission (POA) indicator data field had been left blank. We identified inpatient hospital claims totaling $2.7 million ($1.7 million Federal share) that contained a diagnosis code identified as a PPC and (1) a POA code indicating that the condition was not present on admission, (2) a POA code indicating that the documentation in the patient’s medical record was insufficient to determine whether the condition was present on admission, or (3) no POA code. Therefore, we are setting aside this amount for resolution by CMS and the State agency.
The Iowa Department of Human Services (State agency) complied with most Federal requirements prohibiting Medicaid payments for inpatient hospital services related to treating certain provider-preventable conditions (PPCs), because its automated system edits identified claims submitted by the hospitals for those services that related to treating PPCs and reduced the related payment amounts accordingly. PPCs are certain reasonably preventable conditions caused by medical accidents or errors in a health care setting.
