Federal Reports

The Reports Consolidation Act of 2000 requires Executive Branch Inspectors General to identify and report annually on the top management challenges facing their agencies. We also adopt this requirement as a best practice. These top management challenges provide a forward-looking assessment for the coming fiscal year to aid GPO in focusing attention on the most serious management and performance issues.

This report identifies our views of the top management and performance challenges facing the company. This year, the challenge of responding to the COVID-19 pandemic supersedes and permeates the company’s ability to address all other challenges. We believe the company will need to account for and adapt to these challenges and develop a strategy to position itself to become a transportation mode of choice in what appears to be a rapidly evolving national economy.

Despite the urgent pressures of this operating environment, there are also opportunities for the company to reimagine its future by taking a fresh, holistic view of its circumstances and the forces that affect it. We identified several longstanding challenges, summarized below, where the company has made progress, but significant work remains. Addressing these challenges will help ensure Amtrak emerges from the pandemic as a more efficient and effective company.

• Safety and Security: Assessing New Risks and Addressing Longstanding Challenges

• Financial Management and Stewardship: Using Resources Wisely and Being Good Stewards of Federal Funds

• Governance: Institutionalizing More Effective Management, Accountability, and Data-driven Decision-making

• Information Technology: Advancing the Company’s Capabilities and Addressing Cybersecurity Risks

The objective of the performance audit was to determine whether SSA's overall information security program and practices were effective and consistent with Federal Information Security Modernization Act of 2014 (FISMA) requirements, as defined by the Department of Homeland Security (DHS).

We audited the Tennessee Valley Authority’s (TVA) travel expenses reimbursed within 50 miles of an official station to determine if they complied with Federal Travel Regulation and TVA policies and procedures. Our audit scope included approximately $500,000 of travel expenses within 50 miles of a TVA employee's official duty station occurring from October 1, 2018, through March 26, 2020.We found that (1) TVA’s approval process did not ensure expenses for travel within 50 miles of an official station complied with TVA’s travel policy, (2) TVA does not have documented procedures to ensure flat-rate-travel reimbursements are being verified appropriately or reimbursed properly, (3) TVA’s human resources system had incorrect official stations shown for 25 of 74 employees included in our samples, and (4) TVA’s travel policy provides limited guidance addressing the assignment and review of official stations. We made four recommendations to TVA management to strengthen controls around travel expenses reimbursed within 50 miles of an official station. TVA management provided actions they plan to take to address each of our recommendations.

Several interested parties requested that we investigate whether U.S. Department of the Interior (DOI) officials disclosed sensitive or confidential tribal information to entities outside the U.S. Government. Some of these individuals also alleged that DOI or U.S. Department of the Treasury employees intentionally released confidential tribal information to Alaska Native Corporations (ANCs). We investigated these allegations in collaboration with the Treasury’s Office of Inspector General.We found that the Treasury emailed the DOI a spreadsheet of Coronavirus Aid, Relief, and Economic Security Act (CARES Act) tribal registration data the Treasury had requested and collected from tribes. The Bureau of Indian Affairs (BIA) requested this information from the Treasury to confirm whether the tribes had registered to receive CARES Act funding. When the Treasury emailed the information to the DOI as requested, it did not mark the data as confidential.We also found that four BIA regional employees forwarded the spreadsheet containing tribal registration data to officers of tribes (not ANCs) outside the Government. The evidence showed that the BIA employees did this in an effort to remind these tribes that, according to the spreadsheet, they had not yet registered for CARES Act funding. We found that forwarding the entire spreadsheet was inconsistent with DOI guidance.We did not find evidence that any DOI or Treasury employees intentionally released this data to ANCs.This management advisory provides a recommendation to help the DOI ensure proper identification and handling of potentially confidential tribal information and prevent future improper disclosures of this information.

The Medicaid drug rebate program became effective in 1991 (the Social Security Act (the Act)§ 1927). For a covered outpatient drug to be eligible for Federal reimbursement under the program, the drug’s manufacturer must enter into a rebate agreement that is administered by the Centers for Medicare & Medicaid Services (CMS) and pay quarterly rebates to the States. CMS, the States, and drug manufacturers each have specific functions under the program. Manufacturers are required to submit a list of all covered outpatient drugs to CMS and to report each drug’s average manufacturer price and, where applicable, best price. On the basis of this information, CMS calculates a unit rebate amount for each drug and provides the information to the States quarterly. Covered outpatient drugs reported by participating drug manufacturers are listed in the CMS Medicaid Drug File, which identifies drugs with such fields as National Drug Code (NDC), unit type, units per package size, and product name.Section 1903(i)(10) of the Act prohibits Federal reimbursement for States that do not capture the information necessary for invoicing manufacturers for rebates as described in section 1927 of the Act. To invoice for rebates, States capture drug utilization data that identifies, by NDC, the number of units of each drug for which the States reimbursed Medicaid providers and report the information to the manufacturers (the Act § 1927(b)(2)(A)). The number of units is multiplied by the unit rebate amount to determine the actual rebate amount due from each manufacturer.States report drug rebate accounts receivable data to CMS on the Medicaid Drug RebateSchedule. This schedule is part of the Quarterly Medicaid Statement of Expenditures for theMedical Assistance Program report, which contains a summary of actual Medicaid expenditures for each quarter and is used by CMS to reimburse States for the Federal share of Medicaid expenditures.Drugs administered by a physician are typically invoiced to the Medicaid program on a claim form using Healthcare Common Procedure Coding System (HCPCS) codes. For purposes of the Medicaid drug rebate program, physician-administered drugs are classified as either single-source or multiple-source. The Deficit Reduction Act of 2005 (DRA) amended section 1927 of the Act to specifically address the collection of rebates on physician-administered drugs for all single-source physician-administered drugs and for the top 20 multiple-source physician-administered drugs. Beginning on January 1, 2007, CMS was responsible for publishing annually the list of the top 20 multiple-source drugs by HCPCS codes that had the highest dollar volume dispensed. Before the DRA, many States did not collect rebates on physician-administered drugs if the drug claims did not contain NDCs. NDCs enable States to identify the drugs and their manufacturers and to facilitate the collection of rebates for the drugs.The State agency is responsible for paying claims and collecting Medicaid drug rebates for physician-administered drugs. The State agency uses a contractor to perform drug rebate processing and to submit invoices to manufacturers. The contractor uses claim utilization data for physician-administered drugs, which it derives from claims submitted by providers, to invoice manufacturers quarterly. The State agency maintains the record of rebate accounts receivable due from the manufacturers and collects the rebates from the manufacturer.In Massachusetts, there are two sources of claims for physician-administered drugs. Claims can come from hospital outpatient billings or physician billings.

The Cybersecurity and Infrastructure Security Agency (CISA) has improved coordination efforts to secure the Nation’s systems used for voting, but should take additional steps to protect the broader election infrastructure, which includes polling and voting locations and related storage facilities, among other things. For example, CISA has developed or updated a set of plans and guidance aimed at securing election systems for the 2020 election cycle. However, these documents do not sufficiently factor in risks associated with physical security, terrorism threats, and targeted violence to the election infrastructure. CISA can also improve the quality of information shared, as well as the timeliness of its assistance to election stakeholders. With the 2020 elections at hand and increased potential for revised election processes due to the COVID 19 pandemic, it is critical that CISA institute a well-coordinated approach and provide the guidance and assistance necessary to secure the Nation’s election infrastructure. We made three recommendations to CISA to address the deficiencies we identified. CISA concurred with all three recommendations.

We audited TVA’s onboarding actions completed for all active IT contractors as of March 26, 2020, including background investigations and cybersecurity awareness training requirements to determine if IT contractors are granted logical access in accordance with TVA policy. TVA Information Technology and TVA Police require contractors have various levels of background investigations completed for logical access to different classifications of information. We found that (1) TVA policy does not align between business units, (2) the majority of Tier 1 IT contractor suitability background investigations were not in accordance with TVA policy, and (3) the majority of IT contractor higher level background investigations were not in accordance with TVA policy. TVA management agreed with the recommendations.

Our objective was to assess whether the Postal Service is effectively achieving EPS program objectives, controlling program costs, and accurately attributing costs to products. We began fieldwork before the President of the U.S. issued the national emergency declaration concerning the novel coronavirus disease (COVID-19) outbreak on March 13, 2020. The results of this audit do not reflect any management process changes related to the expedited packaging supplies program that may have occurred as a result of the pandemic.

Our objective was to determine whether the Social Security Administration (SSA) had taken appropriate actions for disabled beneficiaries whose benefits it suspended for address development, whereabouts unknown, or miscellaneous reasons.

This audit is part of a series of hospital compliance audits. Using computer matching, data mining, and other data analysis techniques, we identified hospital claims that were at risk for noncompliance with Medicare billing requirements. For calendar year (CY) 2017, Medicare paid hospitals $206 billion, which represents 55 percent of all fee-for-service payments; accordingly, it is important to ensure that hospital payments comply with requirements.

For a covered outpatient drug to be eligible for Federal reimbursement under the Medicaid program's drug rebate requirements, manufacturers must pay rebates to the States for the drugs. Previous OIG audits 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).Our objective was to determine whether Minnesota complied with Federal Medicaid requirements for billing manufacturers for rebates for drugs dispensed to MCO enrollees.

We investigated allegations that a then senior political employee of the U.S. Department of the Interior (DOI) did not comply with his Federal ethics pledge under Executive Order No. 13770 when he communicated with a former employer during the required 2-year recusal period following the political employee’s Federal appointment in the fall of 2017.We identified a number of interactions between the senior political employee and representatives of the former employer—namely, several email exchanges, three phone calls, one in-person meeting, and one presentation at an event hosted by the former employer. While some of these interactions with the former employer may have been relatively minor in nature, we found that the senior political employee nonetheless did not comply with the ethics pledge because those interactions occurred during the 2-year recusal period. In contrast, we found that, under the circumstances, a presentation made by the senior political employee at an event hosted by the former employer was permissible under the ethics pledge because the senior employee attended in his official capacity.In making these findings, we note that the senior political employee told us he initially did not understand that his unpaid, volunteer position with an entity related to an organization (the former employer described above) was itself considered former employment under the ethics pledge. In fact, the organization itself as well as the related entity are considered a “former employer” under the pledge. After it was alleged that the senior political employee violated ethics rules in his interactions with the former employer, the Departmental Ethics Office (DEO) provided the senior political employee with written guidance about communications with former employers and specifically found that the organization in question qualified as a former employer under the ethics pledge. In its written guidance, the DEO acknowledged that the senior political employee had not received specific written or verbal guidance from the DEO identifying the organization as a “former employer” for purposes of the ethics pledge. We found no further communications between the senior political employee and representatives of the organization after the senior political employee received this guidance.We provided our report to the Chief of Staff for the Office of the Secretary for any action deemed appropriate.

What We Looked AtAs required by law, we report annually on the Department of Transportation’s (DOT) most significant challenges to meeting its mission. We considered several criteria in identifying DOT’s top management challenges for fiscal year 2021, including their impact on safety, documented vulnerabilities, large dollar implications, and the ability of the Department to effect change. In addition, we recognize that the Department faces the extraordinary task of meeting these challenges while also responding to the Coronavirus Disease 2019 (COVID-19) global pandemic, including implementing the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Accordingly, we included CARES Act and COVID-19 considerations in all eight of our top management challenges. What We FoundWe identified the following top management challenge areas for fiscal year 2021: Aviation safety. Key challenges: improving FAA’s oversight of aircraft certification processes and enhancing aviation safety oversight while working in a collaborative environment. Surface transportation safety. Key challenges: ensuring compliance with safety regulations and programs and continuing progress in safety monitoring and enforcement. Air traffic control and airspace modernization. Key challenges: modernizing new systems while introducing new capabilities and implementing new performance-based navigation flight procedures and delivering benefits to airspace users. Surface transportation infrastructure. Key challenges: enhancing oversight of surface transportation projects and employing effective asset and performance management. Contract and grant fund stewardship. Key challenges: awarding pandemic relief and other DOT contracts and grants efficiently, effectively, and for intended purposes and enhancing contract and grant management and oversight to achieve desired results and compliance with requirements. Information security. Key challenges: addressing longstanding cybersecurity weaknesses and developing Departmentwide policy to validate the proper adoption and security of cloud services. Financial management. Key challenges: strengthening procedures to monitor and report grantee spending and preventing an increase in improper payments. Innovation and the future of transportation. Key challenges: adapting oversight approaches for emerging vehicle automation technologies and ensuring the safe integration of Unmanned Aircraft Systems in the National Airspace System.

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). To date, the CARES Act has provided the U.S. Department of the Interior (DOI) with $909.7 million, which includes direct apportionments of $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas, and a $153.7 million transfer from the U.S. Department of Education (ED) to the BIE.In this report, we present lessons learned from and the risks identified in our earlier audit and investigation work related to the Coastal Impact Assistance Program (CIAP). Under CIAP, the DOI disbursed $1 billion in grant funds across six States—Alabama, Alaska, California, Louisiana, Mississippi, and Texas—to respond to impacts from offshore drilling. We particularly highlight our 2013 CIAP audit report because, like the CARES Act, CIAP provided significant funding to recipients through a series of grants that were primarily managed from afar. As of August 31, 2020, the DOI has obligated nearly $522 million of its CARES Act funding—in addition to more than $102 million in CARES Act funding the DOI received from the ED—using grants, cooperative agreements, and direct payments. Our previous CIAP-related work demonstrated that grant awards can present substantial risks. Using our earlier work to illustrate areas of particular risk, we highlight the following factors as essential to successful oversight of the DOI’s CARES Act funds:• Review grant applications to ensure proposals seek to use grant funds for the intended purposes• Conduct risk assessments of potential recipients to understand grant recipient backgrounds• Ensure the grant recipients have proper internal controls, such as segregation of duties and conflict-of-interest policies• Maximize competition when awarding contracts using grant funds• Monitor the grant recipients’ documentation and use of grant funds• Review the grant recipients’ performance and financial reportsOur prior work detailed the impact of the mismanagement that can occur because of ineffective oversight. We believe that many of the same risks present themselves today and that careful attention to our earlier work can help the DOI avoid some of the mistakes that occurred then.

The OIG investigated a complaint by a National Park Service (NPS) employee who, in 2018, alleged that another NPS employee sexually assaulted them while they were both stationed at the Grand Canyon National Park (GRCA) in 2003.We found insufficient evidence to substantiate the allegation.

This report responds to an August 7, 2020, congressional request regarding concerns that Postmaster General Louis DeJoy’s modifications to U.S. Postal Service staffing and policies had an adverse effect on Postal Service operations, leading to slower and less reliable mail delivery. This report also responds to a number of recent similar congressional requests. We are issuing a separate report to the Postmaster General which details these issues with recommendations for corrective action. Our objective was to address specific concerns related to Postal Service changes put in place after the Postmaster General was sworn in on June 15, 2020, and their effect on operations; whether the changes comply with internal policies and legal requirements and sufficient notice was provided to Congress and customers; and whether the Postmaster General complied with ethical requirements.

Our objective was to (1) determine whether the Social Security Administration (SSA) made payments to beneficiaries and/or representative payees who were deceased according to Virginia’s Department of Health, Division of Vital Records, and (2) identify non-beneficiaries in the Commonwealth’s files whose death information did not appear in Agency records.

Under the Medicare 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 part-time or intermittent skilled nursing care and home health aide visits, therapy (physical, occupational, and speech-language pathology), medical social services, and medical supplies.Our prior audits of home health services identified significant overpayments to HHAs. These overpayments were largely the result of HHAs improperly billing for services to beneficiaries who were not confined to the home (homebound) or were not in need of skilled services. Our objective was to determine whether Gem City Home Care, LLC, (Gem City) complied with Medicare requirements for billing home health services on selected types of claims.Our audit covered $35,689,451 in Medicare payments to Gem City for 10,417 claims. These claims were for home health services provided in fiscal years 2016 and 2017. We selected a stratified random sample of 100 claims with payments totaling $385,724 for review. We evaluated compliance with selected billing requirements and submitted these claims to an independent medical review contractor to determine whether the services met coverage, medical necessity, and coding requirements.

Summary of the top management and performance challenges facing ARC.

As a part of our oversight responsibilities for the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) appropriations to the U.S. Department of the Interior (DOI), we have reviewed the Office of Insular Affairs’ (OIA’s) initial oversight steps for the CARES Act grant funds to the Insular Area governments.The CARES Act provided the DOI with $756 million to support the needs of its programs, bureaus, Indian Country, and the Insular Areas. The OIA was allocated $55 million, which it distributed to the seven Insular Area governments through its Technical Assistance Program (TAP) Office in April 2020, to help prepare for, prevent, and respond to the COVID-19 pandemic. American Samoa received $4.08 million of the CARES Act funds, to be expended by September 30, 2021. As part of the award, American Samoa must meet the grant terms and conditions, which include a requirement to document how it used the funds to prevent and respond to the pandemic and how the funds supported its pandemic plan.We issued this management advisory American Samoa’s Office of the Territorial Audit Office to share some of the lessons we have learned from auditing grant awards during emergency situations. We attached two of our CARES Act flash reports, The Office of Insular Affairs Took Appropriate Action With CARES Act Funds and Lessons Learned for CARES Act Awards, for additional information.

As a part of our oversight responsibilities for the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) appropriations to the U.S. Department of the Interior (DOI), we have reviewed the Office of Insular Affairs’ (OIA’s) initial oversight steps for the CARES Act grant funds to the Insular Area governments.The CARES Act provided the DOI with $756 million to support the needs of its programs, bureaus, Indian Country, and the Insular Areas. The OIA was allocated $55 million, which it distributed to the seven Insular Area governments through its Technical Assistance Program (TAP) Office in April 2020, to help prepare for, prevent, and respond to the COVID-19 pandemic. The Commonwealth of the Northern Mariana Islands (CNMI) received $4.04 million of the CARES Act funds, to be expended by September 30, 2021. As part of the award, the CNMI must meet the grant terms and conditions, which include a requirement to document how it used the funds to prevent and respond to the pandemic and how the funds supported its pandemic plan.We issued this management advisory to the CNMI’s Office of the Public Auditor to share some of the lessons we have learned from auditing grant awards during emergency situations. We attached two of our CARES Act flash reports, The Office of Insular Affairs Took Appropriate Action With CARES Act Funds and Lessons Learned for CARES Act Awards , for additional information. We also discussed challenges unique to the CNMI.

As a part of our oversight responsibilities for the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) appropriations to the U.S. Department of the Interior (DOI), we have reviewed the Office of Insular Affairs’ (OIA’s) initial oversight steps for the CARES Act grant funds to the Insular Area governments.The CARES Act provided the DOI with $756 million to support the needs of its programs, bureaus, Indian Country, and the Insular Areas. The OIA was allocated $55 million, which it distributed to the seven Insular Area governments through its Technical Assistance Program (TAP) Office in April 2020, to help prepare for, prevent, and respond to the COVID-19 pandemic. The Federated States of Micronesia (FSM) received $7.74 million of the CARES Act funds, to be expended by September 30, 2021. As part of the award, the FSM must meet the grant terms and conditions, which include a requirement to document how it used the funds to prevent and respond to the pandemic and how the funds supported its pandemic plan.We issued this management advisory the FSM’s Office of the National Public Auditor to share some of the lessons we have learned from auditing grant awards during emergency situations. We attached two of our CARES Act flash reports, The Office of Insular Affairs Took Appropriate Action With CARES Act Funds and Lessons Learned for CARES Act Awards, for additional information. We also discussed challenges unique to the FSM.

As a part of our oversight responsibilities for the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) appropriations to the U.S. Department of the Interior (DOI), we have reviewed the Office of Insular Affairs’ (OIA’s) initial oversight steps for the CARES Act grant funds to the Insular Area governments.The CARES Act provided the DOI with $756 million to support the needs of its programs, bureaus, Indian Country, and the Insular Areas. The OIA was allocated $55 million, which it distributed to the seven Insular Area governments through its Technical Assistance Program (TAP) Office in April 2020, to help prepare for, prevent, and respond to the COVID-19 pandemic. Guam received $12.04 million of the CARES Act funds, to be expended by September 30, 2021. As part of the award, Guam must meet the grant terms and conditions, which include a requirement to document how it used the funds to prevent and respond to the pandemic and how the funds supported its pandemic plan.We issued this management advisory to Guam’s Office of Public Accountability to share some of the lessons we have learned from auditing grant awards during emergency situations. We attached two of our CARES Act flash reports, The Office of Insular Affairs Took Appropriate Action With CARES Act Funds and Lessons Learned for CARES Act Awards, for additional information. We also discussed challenges unique to Guam.

As a part of our oversight responsibilities for the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) appropriations to the U.S. Department of the Interior (DOI), we have reviewed the Office of Insular Affairs’ (OIA’s) initial oversight steps for the CARES Act grant funds to the Insular Area governments.The CARES Act provided the DOI with $756 million to support the needs of its programs, bureaus, Indian Country, and the Insular Areas. The OIA was allocated $55 million, which it distributed to the seven Insular Area governments through its Technical Assistance Program (TAP) Office in April 2020, to help prepare for, prevent, and respond to the COVID-19 pandemic. The Republic of Palau received $1.59 million of the CARES Act funds, to be expended by September 30, 2021. As part of the award, Palau must meet the grant terms and conditions, which include a requirement to document how it used the funds to prevent and respond to the pandemic and how the funds supported its pandemic plan.We issued this management advisory to Palau’s Office of the Public Auditor to share some of the lessons we have learned from auditing grant awards during emergency situations. We attached two of our CARES Act flash reports, The Office of Insular Affairs Took Appropriate Action With CARES Act Funds and Lessons Learned for CARES Act Awards, for additional information. We also discussed challenges unique to Palau.

As a part of our oversight responsibilities for the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) appropriations to the U.S. Department of the Interior (DOI), we have reviewed the Office of Insular Affairs’ (OIA’s) initial oversight steps for the CARES Act grant funds to the Insular Area governments.The CARES Act provided the DOI with $756 million to support the needs of its programs, bureaus, Indian Country, and the Insular Areas. The OIA was allocated $55 million, which it distributed to the seven Insular Area governments through its Technical Assistance Program (TAP) Office in April 2020, to help prepare for, prevent, and respond to the COVID-19 pandemic. The Republic of the Marshall Islands received $3.9 million of the CARES Act funds, to be expended by September 30, 2021. As part of the award, the Marshall Islands must meet the grant terms and conditions, which include a requirement to document how it used the funds to prevent and respond to the pandemic and how the funds supported its pandemic plan.We issued this management advisory to the Marshall Islands’ Office of the Auditor General to share some of the lessons we have learned from auditing grant awards during emergency situations. We attached two of our CARES Act flash reports, The Office of Insular Affairs Took Appropriate Action With CARES Act Funds and Lessons Learned for CARES Act Awards, for additional information. We also discussed challenges unique to the Marshall Islands.

The Office of Inspector General is required by statute to report annually the most serious management and performance challenges facing the Department of Commerce. Attached is our final report on the Department’s top management and performance challenges for fiscal year 2021.

Medicare paid hospitals $372 million for bariatric surgeries provided to Medicare beneficiaries in calendar years 2015 and 2016. Bariatric surgery helps those with morbid obesity to lose weight by making changes to their digestive system. Although OIG has not conducted an audit in this area, the Centers for Medicare & Medicaid Services’ (CMS’s) study of certain bariatric surgery procedure codes found that 98 percent of improper payments lacked sufficient documentation to support the procedures. After analyzing Medicare claim data for bariatric surgery claims with dates of service from January 2015 through December 2016 (audit period), we selected for audit Cedars-Sinai Medical Center (Cedars-Sinai), located in Los Angeles, California. Our objective was to determine whether Cedars-Sinai complied with Medicare requirements and the Medicare contractor’s local coverage determinations (LCDs) and local coverage article (LCA) when billing for bariatric surgeries.Our audit covered $1.3 million in Medicare payments to Cedars-Sinai for 62 bariatric surgery claims. We reviewed the beneficiaries’ medical records to determine whether the claims met Medicare requirements and the specifications in Noridian Healthcare Solutions, LLC’s (Noridian’s) LCDs and LCA for bariatric surgery. An independent medical review contractor reviewed the medical records for 23 claims.

An Amtrak coach cleaner in Chicago, Illinois, was terminated from employment on October 14, 2020, following her administrative hearing. The former employee participated in a medical fraud scheme in violation of company policies. Our investigation found that the former employee provided a chiropractor based in Dolton, Illinois, with her medical and personally identifiable information and that of her dependents in exchange for cash kickbacks. The chiropractor used the information to fraudulently bill Amtrak’s health insurance plan for services that were not provided.

The United States Capitol Police (USCP) Office of Inspector General (OIG) Strategic Plan for FY 2014-2019 sets forth our mission, vision, and goals for 5 years. OIG plans to provide positive return on U.S. taxpayer investments by asking the following critical questions of work we plan to undertake: Are we addressing the most important matters? Are we adding value, achieving positive change, or significant results? And, are we making USCP programs and operations more efficient and effective?

FY 2020 management and performance challenges.

As part of the Office of Inspector General’s effort to provide oversight of the U.S. Department of Housing and Urban Development’s (HUD) relief efforts provided by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), we reviewed HUD’s communication to renters regarding the eviction moratorium found in Section 4024. The objective of our review was to highlight the progress HUD has made and identify areas for improvement. We found that HUD provided critical information to many of these renters through its website and published guidance. However, we identified several aspects of HUD’s communication to renters on its website and published guidance that could be strengthened. Further, we identified areas of the joint website that could be improved. While the Section 4024 eviction moratorium expired on July 24, 2020, it is still crucial that HUD have clear, complete, and accessible guidance available to help renters at a time when their health and financial stability may be at risk. If HUD maintains up-to-date and easily accessible information for all impacted renters, including information on any new renter protections, it would help to ensure that renters know their rights, maintain housing stability through the pandemic, and avoid homelessness.

The National Reconnaissance Office (NRO) OIG conducted this evaluation to identify any best practices implemented or challenges encountered by NRO Headquarters and selected field sites in responding to the pandemic. Areas of evaluation contained in this report include mission sustainment, policy, leadership, facilities and logistics, health and safety, communications, and human resources. This report is fundamentally informational and contains perspectives and opinions of NRO’s leadership and workforce.

We conducted surveys of GPO’s COVID-19 response and maximum telework status. The report contains our analysis and considerations for GPO Leadership and also contains the raw survey results as an attachment.

The Smithsonian Office of the Inspector General conducted this audit to determine to what extent the Office of Human Resources and the units comply with Smithsonian policies and procedures for hiring Trust employees. This audit did not review the hiring of Trust employees in Smithsonian Astrophysical Observatory and Smithsonian Enterprises.

Facet-joint injections of an anesthetic with or without a steroid are used to diagnose or treat chronic neck and back pain. To address inappropriate billing for pain management tied to overuse of spinal facet-joint injections, the Medicare Administrative Contractors (MACs) developed a limitation of coverage.1 The coverage limitation allows physicians to be reimbursed, during a rolling 12-month period,2 for a maximum of five sessions3 in which facet-joint injections are delivered to the lumbar region of the spine (lumber spine) and a maximum of five sessions in which facet-joint injections are delivered to the cervical and thoracic regions of the spine (cervical/thoracic spine).4 (We refer to injection sessions in these two spinal areas during a rolling 12-month period as “selected facet-joint injection sessions.”) However, Noridian Healthcare Solutions, LLC (Noridian), one of the MACs, confirmed that a common error identified in audits it performed during calendar years 2016 through 2018 was that Medicare paid for more than five sessions in which facet-joint injections were delivered to the lumbar or cervical/thoracic spines during a rolling 12-month period. Therefore, we conducted this audit to determine whether Medicare made improper payments for selected facet-joint sessions in the MAC jurisdictions that had a coverage limitation from January 1, 2017, through May 31, 2019 (audit period).

The Newark Post Office is located in the Ohio Valley District of the Central Area. We conducted this audit in response to concerns raised by the OIG Office of Investigation of potential stamp stock manipulation. Our objective was to determine whether stamps, money orders, and cash were adequately protected at the Newark, OH, Post Office.

2021 Management and Performance Challenges for the Gulf Coast Ecosystem Restoration Council.

We conducted this audit in response to an inquiry we received from The White House, Office of Presidential Correspondence, on March 25, 2020, on behalf of a constituent who raised concerns of alleged theft by a postal employee. The inquiry was initially referred to the OIG’s Office of Investigations (OI). OI did not find evidence of misconduct by the employee. However, OI suggested that the High Shoals (NC) Post Office restrict stamp inventory and conduct surprise counts. This audit was designed to provide Postal Service management with additional information on financial control risks at the High Shoals Post Office. The objective was to determine whether the internal controls over stamps, money orders, and cash at the High Shoals Post Office were managed effectively.

The OIG investigated allegations that QEP Energy Company (QEP) failed to properly value minerals produced from Tribal and Indian Allottee properties for 2013 and 2014.We found that QEP underpaid mineral royalties owed to Indian mineral owners in North Dakota, Oklahoma, and New Mexico by $118,716. Subsequently, the Office of Natural Resources Revenue (ONRR) discovered QEP also undervalued natural gas liquids associated with the leases included in our investigation. This separate violation directly affected QEP’s overall royalty obligation. As a result, ONRR needed to complete an audit to determine any further extent of QEP’s royalty obligations. This matter was referred to ONRR for administrative resolution.

Ryan Taylor Minter, of Calumet City, Illinois, was sentenced in United States District Court, Central District of Illinois, on October 6, 2020, to 18 months in prison, one-year probation and was ordered to pay restitution of $15,938 for wire fraud charges. Our investigation found that Minter participated in a scheme to defraud Amtrak and others by using stolen credit card information from at least 216 different credit or debit cards to purchase Amtrak tickets online valued at over $29,000. Minter used Amtrak’s mobile application and website to purchase the tickets and then advertised them at a discounted price on social media sites frequented by college students.

Our objective was to analyze the risk of illegal, improper, and erroneous purchases made through the Social Security Administration's (SSA) charge card programs.

We identified and evaluated AMS’ management controls over SCBGP.

We audited the U.S. Department of Housing and Urban Development’s (HUD) implementation of the prevailing wage provisions of the Davis-Bacon Act for its Federal Housing Administration (FHA)-insured multifamily construction projects.  We conducted the audit because we received an anonymous complaint alleging that HUD did not implement correct wage determinations for a $33 million multifamily construction project located in Oxnard, CA.  Our audit objectives were to determine whether (1) the allegation in the complaint had merit and (2) HUD implemented the correct Davis-Bacon wage determinations for its multifamily construction projects.The allegation that HUD did not implement correct wage determinations for the FHA-insured multifamily construction project in Oxnard, CA, had merit.  HUD’s use of incorrect wage determinations caused wage rates paid to laborers and mechanics to be incorrect.  Additionally, our review of wage determinations associated with four other FHA-insured multifamily construction projects not mentioned in the complaint showed that HUD also did not implement correct wage determinations for them.  This condition occurred because HUD lacked controls and did not implement guidance provided by the U.S. Department of Labor’s longstanding policy regarding the application of multiple wage determinations for construction categories in construction projects covered by prevailing wage provisions of the Davis-Bacon Act.  As a result, workers could have been underpaid.We recommend that HUD (1) seek guidance from the Department of Labor to correct the wage determinations for the five projects addressed in this report; (2) determine the correct wages to be paid to workers and ensure that appropriate actions are taken to pay the workers; (3) update HUD’s guidance to comply with the Department of Labor’s policies and guidance on the application of multiple wage determinations for construction projects; and (4) develop and implement controls to ensure that the appropriate Davis-Bacon wage rate determinations are implemented in the contracts of FHA-insured multifamily construction projects that require multiple wage determinations, including the requirement that contract specifications clearly identify the portions of the contract subject to each assigned wage determination.