Federal Reports

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The U.S. Department of Housing and Urban Development (HUD) and HUD Office of Inspector General (OIG) warns everyone affected by Hurricanes Harvey, Irma, and Maria to be alert for fraud schemes that commonly occur following a disaster. You need to protect yourself from fraudsters who will take advantage of the confusing nature of information after a major disaster.

The OIG performed data analytics to identify offices with lost or stolen stamp stock shipments. We identified expenses regarding stamp stock shipments for the William Penn Annex between May 1, 2016, and April 30, 2017. The objective of this audit was to determine whether internal controls over stamp stock shipments were in place and effective at the William Penn Annex.

Please see the below link for a video discussing the findings of this report.

In April 2017, we evaluated the VA Regional Office (VARO) in Detroit, Michigan, to determine how well Veterans Service Center (VSC) staff processed disability claims, processed proposed rating reductions, entered claims-related information, and responded to special controlled correspondence. Staff improved the accuracy of processing traumatic brain injury (TBI) claims but inaccurately processed a significant number of claims for special monthly compensation (SMC). We reviewed 30 of 679 veterans’ TBI claims and found Rating Veterans Service Representatives (RVSRs) accurately processed 28 cases. RVSRs did not always process entitlement to SMC and ancillary benefits consistently with Veterans Benefits Administration policy. We reviewed 30 of 52 SMC claims and found RVSRs inaccurately processed 5 cases due to ineffective second-signature reviews for higher-level SMC cases completed by VSC managers. Four errors resulted in 43 improper monthly payments totaling approximately $32,800. We sampled claims we considered at increased risk of processing errors, thus these results do not represent the overall accuracy of disability claims processing at this VARO. Staff generally processed proposed rating reductions accurately but needed better oversight to ensure timely actions. We reviewed 30 of 268 benefits reduction cases and found that RVSRs and Veterans Service Representatives delayed or inaccurately processed 8 cases. Delays occurred because management prioritized other workload higher to meet established performance goals related to processing disability claims. These delays and processing inaccuracies resulted in 66 improper monthly payments to 8 veterans, totaling approximately $48,000. Staff needed to improve the accuracy of data input into the electronic systems at the time of claims establishment. We reviewed 30 of 1,982 newly established claims and found Claims Assistants did not correctly input claim information in 20 cases due to inexperience and ineffective quality reviews. These inaccuracies may result in misrouted claims and delays in claims processing. Staff generally processed special controlled correspondence timely. We reviewed 30 of 173 special correspondences and found staff and management did not accurately control 21 inquiries due to insufficient oversight to ensure inquiries were properly established with the correct dates of claim. We recommended the VARO Director implement a plan to ensure the accuracy of reviews of higher-level SMC cases; implement a plan to ensure Claims Assistants receive comprehensive training on claims establishment; and improve the quality review process for claims establishment. The Director should ensure staff use the correct dates of claim for end product 500s to improve the management of special controlled correspondence. The Director concurred with our recommendations. Management’s planned actions are responsive. We will follow up as required.

The California Department of Social Services (Social Services), Community Care Licensing Division (licensing division), did not (1) accurately record or investigate one complaint, (2) complete investigations in a timely manner, (3) refer priority I and II complaints (the most serious) to the Investigations Branch, (4) adequately cross-report complaints to the Children and Family Services Division and to law enforcement, (5) conduct onsite inspections within 10 days, (6) associate an employee of a community care facility with the facility, and (7) adequately clear plan-of-correction deficiencies.

Wisconsin Physicians Service Insurance Corporation (WPS) claimed $1.2 million in unallowable administrative costs on its Medicare Part A final administrative cost proposals (FACPs) for fiscal year 2012. We recommended that WPS reduce its FACPs by $1.2 million to eliminate the unallowable costs identified and improve procedures to identify allowable and unallowable costs in accordance with the applicable Medicare contract, Cost Accounting Standards (CAS), and FAR provisions. In written comments on our draft report, WPS did not concur with $1.2 million in recommended reductions related to unallowable residual home office expenses, employee incentive program bonuses and related taxes, and salary allocations. WPS provided limited comments on our recommendation for procedural improvements. We maintain that all of our findings and recommendations are valid.

Wisconsin Physicians Service Insurance Corporation (WPS) claimed $1.3 million in unallowable administrative costs on its Medicare Part B final administrative cost proposals (FACPs) for fiscal year 2012.

In March 2015, February and October 2016, the Postal Service administered Postal Pulse surveys to evaluate employee engagement. Results indicated postal employee engagement improved slightly over the course of the three surveys. However, the Postal Service ranked in the bottom one percent of scores for all organizations Gallup surveyed in each of the three survey administrations. In January 2016, management created an employee engagement team within the Human Resources function, which subsequently developed eight engagement activities. Our objective was to assess Postal Service Human Resources’ employee engagement activities to determine whether they are effective in enhancing employee engagement. We also reviewed employee comments on social media sites to gauge employee sentiments.

In 2016, the Postal Service managed 31,585 retail offices serving 877 million customers. To reduce wait-time-in-line and expedite customer transactions, the Postal Service developed the mobile Point-of-Sale (mPOS) system, which allows retail associates to accept credit card and non-PIN debit card payments for customers’ retail transactions. Our objective was to determine if the mPOS devices and application are managed in accordance with Postal Service policy and best practices.

The VA Office of Inspector General (OIG) evaluated the quality of care at the Wilmington VA Medical Center. This included reviews of key processes that affect patient care outcomes—Quality, Safety, and Value; Environment of Care (EOC); Medication Management; Coordination of Care; Diagnostic Care; Moderate Sedation; Community Nursing Home (CNH) Oversight; and Management of Disruptive/Violent Behavior. OIG provided crime awareness briefings to 84 employees.OIG identified certain system weaknesses in EOC Committee meeting minutes; general safety; Sterile Processing Service (SPS) employee competencies; hemodialysis unit infection prevention; anticoagulation processes and employee competencies; transfer data and documentation; point-of-care testing actions; CNH oversight, clinical visits, and policies; and management of disruptive/violent behavior policy, committee representation, and employee training.As a result of the findings, OIG could not gain reasonable assurance that:(1) EOC minutes track actions taken for deficiencies until closed.(2) Community based outpatient clinic (CBOC) fire extinguishers are inspected monthly, and CBOC information technology network room logs contain access documentation.(3) SPS employees complete annual competencies.(4) Hemodialysis unit employees wear gloves when handling patient equipment.(5) Clinicians obtain required laboratory testing prior to initiating anticoagulants and have documented competency to manage anticoagulation therapy patients.(6) The facility collects and reports data on transfers out and includes required elements in transfer documentation.(7) The facility takes and documents all required actions in response to glucose point-of-care testing results.(8) The facility oversees the CNH program and performs cyclical reviews of care provided.(9) The facility’s disruptive behavior policy reflects current practice, members attend committee meetings, and employees are trained to reduce and prevent disruptive behaviors.OIG made recommendations for improvement in the following six reviews: (1) EOC, (2) Medication Management, (3) Coordination of Care, (4) Diagnostic Care, (5) CNH Oversight, and (6) Management of Disruptive/Violent Behavior.

OIG conducted a healthcare inspection to assess allegations made by confidential complainants regarding quality of care and other concerns at the Captain James A. Lovell Federal Health Care Center (FHCC), North Chicago, IL. We substantiated the Home Based Primary Care program’s Joint Commission accreditation status was “threatened” after a March 2015 FHCC accreditation survey; however, in August 2015, the Joint Commission determined the program complied with accreditation standards.We substantiated a Community Living Center patient who fell had an inaccurately low Morse Fall Scale assignment and incomplete Morse Fall Scale Notes. We substantiated that Community Living Center patient falls increased during fiscal year (FY) 2014; however, facility leadership recognized the issue and completed an action plan, which led to a decrease in patient falls in FY 2015.We substantiated the Emergency Department (ED) was left unattended by a qualified physician when ED physicians left the ED to perform emergency airway management in other FHCC care areas. We substantiated the ED did not have clerical staff support on weekends and most weekdays during the dayshift; however, this did not conflict with Veterans Health Administration policy and did not negatively affect delivery of patient care. We did not substantiate the ED length of stay for admitted patients was long or that ED transfer rates were high. We substantiated nurses did not consistently follow proper hand-hygiene practices. We substantiated primary care providers referred Navy recruits to the ED for non-emergent care needs; however, we determined the practice was permitted to ensure recruits were ready for deployment. We did not substantiate FHCC staff mishandled the suicides of two individuals. We did not substantiate the medical/surgical unit length of stay was long. We did not substantiate the Associate Director of Inpatient Services lacked the required education and experience to qualify for the position.We made three recommendations.

We determined that although a complainant alleged there were systemic security challenges in the Office of Intelligence and Analysis (OIA), there were few documented security incidents over the past 5 years, all of which OIA addressed with corrective actions. Further, OIA has improved the effectiveness of its Field Intelligence Division and the Field Intelligence Officers by hiring qualified, experienced intelligence professionals and implementing clear policies and procedures, but it could enhance officer training. OIA is also addressing weaknesses in coordination among its watches and perceived delays in intelligence reporting. We made two recommendations to improve the effectiveness of OIA operations; the Transportation Security Administration (TSA) concurred with both recommendations.

Our audit determined that Western Governors University did not comply with the institutional eligibility requirement that limits the percentage of students who may enroll in correspondence courses. As a result, the school received more than $712 million in Federal student aid funds that it was not eligible to receive. We also found that the school did not comply with requirements governing Federal student aid disbursements and did not always comply with the requirements governing the return of Federal student aid.

Integrated Health Administrative Services, Inc. (Integrated), (located in Mamaroneck, New York) complied with certain Medicare Part B requirements for 91 of the 112 claims that we sampled. However, the remaining 21 claims did not comply with certain Medicare requirements. On the basis of our sample results, we estimated that Integrated improperly claimed at least $914,109 in Medicare reimbursement for unallowable portable x-ray services.

The U.S. Postal Service participates in three retirement plans: the Civil Service Retirement System (CSRS), the Federal Employee Retirement System (FERS), and the Postal Service Retiree Health Benefits Fund (PSRHBF). These plans are restricted to government trust funds invested solely in U.S. Treasury securities. They are often regarded as riskless in the sense that there is virtually no possibility of loss of principal. However, the trade-off for this safety is a low rate of return that has a high probability of not generating adequate investment income to meet all the future obligations of the funds. The OIG retained Segal Consulting (Segal), experts in actuarial science and pension plan management, to explore options to improve the funding situation on the assets side. Segal identified six alternative investment strategies. All of Segal’s proposed portfolios outperform the current strategy.

We determined that the County’s accounting policies, procedures, and business practices appear adequate to account for FEMA grant funds according to Federal regulations and FEMA guidelines. However, the County could benefit from Florida, as FEMA’s grant recipient, providing additional technical assistance and monitoring of its pending projects

We determined that Downe Township did not always follow Federal procurement standards in awarding contracts for disaster work. We recommended that FEMA disallow $832,040 of $2.5 million in grant funds awarded to the Township. The Township did not have support for $445,385 of the questioned costs. We also recommended that the Administrator, FEMA Region II, deobligate unused project costs, and withhold $2.3 million in funds requested for additional project work until New Jersey provides assurance that the Township complies with all Federal procurement standards for FEMA funded work. FEMA Region II concurred with all of our recommendations.

This report contains the results of our audit of the U.S. Consumer Product Safety Commission’s (CPSC) Fast Track Recall Program (Fast Track). The purpose of Fast Track is to remove potentially hazardous products from the marketplace as quickly and efficiently as possible. Overall, we found Fast Track is effective in getting unsafe products off the market quickly and efficiently.

At the request of Senator Bill Nelson, OIG conducted a healthcare review to address questions regarding VA suicide prevention efforts and suicide data collection:• How do you know if VA’s suicide prevention programs are working and what percent of veterans who die by suicide have been under the care of the Veterans Health Administration (VHA)?• Are data on suicides turned over to mental health providers in real time; what risk factors associated with higher veteran suicides are being explored in-depth, and by whom; and what ways can be identified to gather more reliable suicide data?We found that VHA tracked suicide rates of veterans and other VHA users by matching suicide deaths from the National Death Index; state-based reporting and Suicide Prevention Applications Network initiatives may not have included the full population of veteran suicides; and the VA/Department of Defense (DOD) Suicide Data Repository was developed. We found that real time data was not available to mental health providers in all states; VHA implemented a predictive analytics risk model; and non-VA researchers analyzed military service members’ social media posts for mental health status changes/suicidal ideation to determine suicide risk factors. We found that Veterans Integrated Service Network (VISN) 2 Center of Excellence and VISN 19 Mental Illness Research, Education and Clinical Center had over 20 suicide prevention research studies and projects; reliability of suicide data was contingent on usage of clear, standardized terminology; training was critical for persons responsible for completing the medical portion of the death certificate; and VHA and DOD Suicide Prevention program staff were developing a sharing agreement to establish a routine method to transfer data. This OIG review was informational and had no recommendations.

Seek link below for the full report, report summary, multimedia or any agency follow-up.

Seek link below for the full report, report summary, multimedia or any agency follow-up.

The OIG used data analytics to identify offices with lost or stolen stamp stock shipments. We identified three expenses totaling $27,429 related to stamp stock shipments for the Bensalem, PA, Post Office and the Croydon Post Office, a small post office whose stamp stock is shipped to the Bensalem Post Office, between May 1, 2016, and April 30, 2017.

The Office of the Inspector General audited the adequacy of the Tennessee Valley Authority's (TVA) process to surplus and dispose of information technology (IT) equipment due to the risk of (1) protected information disclosure and (2) environmental compliance and regulatory compliance violations associated with the surplus and disposal of IT equipment. We found weaknesses with TVA's policies, procedures, and process to surplus and dispose of IT equipment, including (1) surplus IT equipment was not properly sanitized, tracked, and processed; (2) badge access control reviews of areas holding surplus IT equipment were not being performed as required by policy; and (3) processes for the surplus and disposal of cathode ray tubes do not address environmental regulations to prevent release of the lead into the environment. TVA management agreed with our findings and recommendations.

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. These reviews assess the Units' adherence to the 12 MFCU performance standards and compliance with applicable Federal statutes and regulations.

An insider threat program helps an organization prevent, detect, and respond to the threat of an employee, contractor, or business partner misusing their trusted access to computer systems and data. Threats to the U.S. Postal Service include the theft and disclosure of sensitive, proprietary, or national security information, and the sabotage of its computer systems or data. Our objective was to determine if the Postal Service has established and implemented an effective insider threat program in accordance with Postal Service policies and best practices.

The Office of Inspector General evaluated NASA’s ongoing research that seeks to safely integrate unmanned aircraft systems – more commonly known as “aerial drones” – into the national airspace.

Medicare did not appropriately pay acute-care hospitals any of the $51.6 million for outpatient services that we reviewed. In addition, beneficiaries were held responsible for unnecessary deductibles and coinsurance of $14.4 million paid to the acute-care hospitals for outpatient services. Generally, Medicare should not pay an acute-care hospital for outpatient services provided to an inpatient of another facility, such as a long-term-care hospital. Instead, the services should be provided under arrangements between the two facilities, and Medicare should pay the inpatient facility for all services provided to a beneficiary (as part of the facility's inpatient payment rate).

OHRP receives and responds to alleged violations of protections for human subjects in research conducted or supported by the Department of Health and Human Services (HHS). Employees of research institutions (e.g., researchers or study coordinators) with insider knowledge of the circumstances can help identify noncompliance in human subjects research earlier than other complainants or OHRP oversight activities. Such information allows OHRP to address any noncompliance, hold institutions accountable, minimize risk to human subject volunteers, and ensure public confidence in federally funded research. However, when employees are considering whether to disclose information about potential noncompliance, they may fear reprisal, such as demotion, suspension, or termination. Under certain circumstances, employees at research institutions with HHS-funded grants or contracts may be entitled to relief commonly called "whistleblower protections." Such protections may be available if an HHS contractor, subcontractor, grantee, or subgrantee takes a prohibited employment action (e.g., termination) against an employee for making a "protected disclosure." For complainants who fear reprisal, information regarding whistleblower protections may encourage disclosures of noncompliance.

Seek link below for the full report, report summary, multimedia or any agency follow-up.

Federal regulations require each State to ensure that Medicaid beneficiaries have necessary transportation to and from medical providers. During the period October 1, 2012, through September 30, 2013, the Minnesota Department of Human Services (State agency) claimed at least $6.4 million for payments to nonemergency medical transportation (NEMT) providers. Prior OIG reviews have found that States' claims for NEMT services were not always in accordance with Federal and State requirements.

Congress has expressed concerns about the safety and well-being of children in foster care. These issues were highlighted in a media report that provided several examples of children who died while in foster care. Additionally, in a recent series of OIG health and safety audits of State-monitored childcare facilities, we found that the majority of childcare providers in various States had instances of potentially hazardous conditions and noncompliance with State health and safety requirements, including criminal records checks requirements.

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. These reviews assess the Unit's adherence to the 12 MFCU performance standards and compliance with applicable Federal statutes and regulations.

The summarized results of our individual Medicare contractor reviews (issued between June 2014 and September 2015) revealed that for the period October 2003 through March 2011, Medicare contractors did not always refer Medicare cost reports that qualified for reconciliation, and the Centers for Medicare & Medicaid Services (CMS) did not always ensure that Medicare contractors reconciled the outlier payments associated with cost reports that had been referred. CMS relies on Medicare contractors to reconcile outlier payments, which compensate hospitals for high-cost cases. These reconciliations ensure that outlier payments reflect hospitals' actual costs.

The Massachusetts Department of Children and Families (State agency) generally complied with applicable Federal and State regulations for ensuring that children who were Title IV-E eligible and residing in foster care congregate care group homes received medical services during calendar year 2015 as required pursuant to Title IV-E of the Act.