Federal Reports

Inadequate oversight at both the Centers for Medicare & Medicaid Services (CMS) and the State Medicaid agency (State agency) level created vulnerabilities in State agencies' use of random moment timestudies (RMTS) as a basis to allocate and claim Federal Medicaid reimbursement for costs associated with school-based administrative activities and health services. Previous OIG reviews of 10 State agencies that used RMTS to allocate costs for school district administrative claiming (SDAC) and school-based health services (SBHS) determined that the State agencies claimed a total of $435.4 million in SDAC and SBHS costs that were not in accordance with Federal requirements and guidance.

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Intensity-modulated radiation therapy (IMRT) is an advanced type of radiation procedure used to treat difficult-to-reach tumors. National Government Services, Inc. (NGS), the Medicare Administrative Contractor responsible for processing Medicare payments for outpatient services in Jurisdictions 6 and K, incorrectly paid hospitals for IMRT services provided to nearly all of the beneficiaries associated with our review.

In most instances, Immigration and Customs Enforcement (ICE), Office of Professional Responsibility, Investigative offices accurately maintained equipment records and complied with vehicle and availability pay requirements. Offices were also accurate in accounting for all firearms. Investigative staff were diligent in complying with the DHS Management Directive relating to the referral of allegations. However, we noted deficiencies in compliance with evidence inventory requirements, and observed inaccuracies in ammunition records. We also found a systemic absence of training on certain firearms and problems with the timeliness of submitting investigative reports. Finally, we found that supervisors did not always review cases on a quarterly basis.