Federal Reports

This Newsletter provides a bimonthly summary of selected investigative accomplishments.

Audit of the NLRB electronic backpay payments for FY 11 through FY 15

Our report made 27 recommendations focused on improving programming, training, and Volunteer support at the post.

To see our report, click on the link below

Department did not comply with IPERA for FY 2016 because it did not meet two of IPERA’s six compliance requirements. First, the Department reported improper payment rates for the William D. Ford Federal Direct Loan Program (Direct Loan) and the Federal Pell Grant (Pell) program that did not meet the FY 2016 reduction targets it established in its FY 2015 Agency Financial Report. Second, the Department’s improper payment risk assessments for its Department-managed grant programs and Federal Student Aid-managed contracting activities did notconform to the Improper Payments Information Act of 2002, as amended, and with Office of Management and Budget guidance, because it did not consider all nine required risk factors in its assessments. In addition, the Department did not report the Vocational Rehabilitation State Grants program as a program that may be susceptible to significant improper payment in its Agency Financial Report even though the Department’s risk assessment showed that the program exceeded the statutory thresholds to be reported as such. We found that the Department’s improper payment estimates, methodologies, and reporting were generally accurate and complete; however, we identified issuesin all three areas. First, the Department needs to improve its policies and procedures over the Direct Loan and Pell programs’ improper payment estimates because we found errors with how the Department included the results of five program reviews in the two programs’ improper payment calculations.

Our review objectives were to (1) assess whether the Department complied with all applicable improper payment requirements and (2) evaluate the accuracy and completeness of its reporting, as well as its performance in recapturing improper payments.

The Program Support Center (PSC) obligated and expended funds for 17 of the 30 contracts we reviewed in accordance with appropriations law and Federal acquisition requirements; however, for the remaining 13 contracts, the PSC did not always obligate and expend funds for its contracts in compliance with applicable law and requirements, resulting in unreported Antideficiency Act obligation violations totaling $20.3 million and expenditure violations totaling $29.2 million. Also, for 4 of the 30 contracts reviewed, the PSC incorrectly extended the period of performance and the fiscal year funding beyond its 12 month period of availability. In addition, the PSC did not always submit contracts to the Office of Grants and Acquisition Policy and Accountability and Office of General Counsel for appropriations funding reviews before awarding the contracts. These conditions occurred because the PSC (1) funded nonseverable service contracts incrementally; (2) expended funds on a first-in, first-out basis instead of on the basis of a fund's period of availability; and (3) did not use correct product/service codes. Further, the Unified Financial Management System did not validate that expenditures were matched to obligations with an appropriate period of availability.

This summary report provides an overview of the results of our audit of the information security controls over Virginia's Medicaid Management Information System (MMIS). It does not include specific details of the vulnerabilities that we identified because of the sensitive nature of the information. We determined that Virginia did not adequately secure its Medicaid data and information systems in accordance with Federal requirements. Virginia had adopted a security program for its MMIS, but numerous significant system vulnerabilities remained. We have provided more detailed information and recommendations to Virginia so that it can address the issues we identified. The findings listed in this summary report reflect a point in time regarding system security and may have changed since we reviewed these systems.

The Office of the Inspector General previously conducted an evaluation of Kingston Fossil Plant (KIF) (Evaluation Report 2015-15329, dated March 10, 2016) to identify operational and cultural strengths and areas for improvement that could impact KIF's organizational effectiveness. Our final report identified several operational and cultural areas for improvement, along with recommendations for addressing those issues. We subsequently received KIF's management decision on June 20, 2016. The objective of this follow-up evaluation was to assess management's actions to address areas for improvement from our initial organizational effectiveness review. In summary, we determined the actions taken by KIF appear to address most areas for improvement identified during our initial organizational effectiveness evaluation. Some concerns remain related to the administration of discipline and unresolved conflict in one group. However, in general, individuals reported seeing positive changes at KIF.

The IPERIA requires agencies and entities, such as the U.S. Equal Employment Opportunity Commission (EEOC), with improper payment estimates that do not meet the statutory thresholds to report an estimate of the annual amount and rate of improper payments, as well as reduction targets in their annual Agency Financial Reports (AFRs) or Performance and Accountability Reports (PARs) per M-15-02 Part IA 9 Step 4c (page 16). These agencies also are required to conduct a risk assessment to identify programs/activities that may be susceptible to significant improper payments. If an agency determines that it is not at high risk for significant improper payments, then risk assessments are required every 3 years. If no programs are at risk for significant improper payments, the other requirements on annual reduction targets, corrective action plans, etc. are not applicable. Additionally, small agencies should have a payment recapture program in place.

Wounded Warriors Federal Leave Act

Our review determined that EEOC has complied with the Improper Payments Information Act (IPIA), as amended by the IPERIA.

This is our final audit report conducted in support of OIG’s oversight role for the planning and implementation of the 2020 Census. The audit’s original objective was to assess the risk that the Address Canvassing Test would not accomplish its stated goals. However, after we began audit fieldwork, the Bureau removed the term “goals” from the test plan. As a result, we modified our audit objective to review the Address Canvassing Test’s cost and schedule, as well as in-field and in-office components of the test.

Civil money penalty (CMP) collections received by the Minnesota Department of Human Services (State agency) during our audit period totaled $592,000. However, the State agency reimbursed nursing facilities $114,000, or only about 20 percent of the amount collected, for expenditures incurred during the same time period. Although expenditures incurred during the audit period were generally allowable, we identified claims of $5,000 for nursing facility staff wages and supplies that were already supported by other Federal and State funding sources.

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

Kentucky did not always determine Medicaid eligibility in accordance with Federal and State requirements. Of our sample of 120 beneficiaries, Kentucky correctly determined eligibility for 111 beneficiaries, but it did not determine eligibility for the remaining 9 beneficiaries in accordance with Federal and State requirements. Specifically, Kentucky did not always electronically or manually verify income and citizenship. In addition, although it did not violate an eligibility requirement, Kentucky did not perform, or maintain documentation of, identity-proofing for 40 beneficiaries in accordance with Federal requirements. The Federal identity-proofing requirements are intended to reduce the potential for identity theft.

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

The Office of Inspector General (OIG) must review the Department of Health and Human Services (HHS) compliance with the Improper Payments Information Act of 2002 (IPIA; P.L. No. 107-300) as amended by the Improper Payments Elimination and Recovery Act of 2010 (P.L. No. 111-204) and the Improper Payments Elimination and Recovery Improvement Act of 2012 (IPERIA; P.L. No. 112-248). Ernst & Young (EY), LLP, under its contract with the HHS OIG, audited the fiscal year 2016 HHS improper payment information reported in the Agency Financial Report (AFR) to determine compliance with IPIA and related guidance from the Office of Management and Budget (OMB).

We reported that Harvey Public School District 152 had designed policies that should have been sufficient to remediate most of the findings relevant to Title I, Part A that were disclosed in audit and monitoring reports. We concluded that Harvey Public School District 152 implemented the policies, procedures, and practices that it designed to remediate findings in several areas. However, we found that the school district did not follow all of the policies that it designed to remediate inventory management findings and did not design procedures to provide reasonable assurance that it submits accurate periodic expenditure reports to the State.

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

Medical Ambulance Services, Inc. (MAS), located in San Juan, Puerto Rico, claimed Medicare Part B reimbursement for ambulance services that did not comply with Federal and Commonwealth of Puerto Rico requirements. Of the 100 claims in our random sample, 5 complied with Federal and Commonwealth requirements, but 95 did not. Of these, 40 contained more than 1 deficiency.

CGS Administrators, LLC, claimed unallowable Medicare pension costs of $1,200 for Medicare reimbursement for fiscal years 2008 through 2011.

CGS Administrators, LLC, claimed $23,000 of unallowable Medicare pension costs on its Incurred Cost Proposals for calendar years 2010 and 2011.

CGS Administrators, LLC, did not claim $6,000 of allowable Medicare postretirement benefit costs that on its Incurred Cost Proposals for calendar years 2010 and 2011.

The House Committee on Energy and Commerce's Subcommittee on Oversight and Investigations and Subcommittee on Health requested that the U.S. Department of Health and Human Services, Office of Inspector General, provide information regarding the Centers for Medicare & Medicaid Services' (CMS) automated system for processing financial assistance payments (e.g., advance premium tax credits and cost-sharing reductions). This briefing document presents our initial review of the design and implementation of CMS's automated system from May 1 through October 31, 2016. As of May 2016, CMS has fully implemented the automated system for the Federal marketplace and plans to fully transition issuers operating through State marketplaces to the automated system in 2018.

A Missouri physical therapy practice (the Therapy Practice) claimed Medicare reimbursement for some outpatient physical therapy services that did not meet Medicare reimbursement requirements. Of the 100 beneficiary days in our random sample, the Therapy Practice properly claimed Medicare reimbursement on 65 beneficiary days. The Therapy Practice improperly claimed Medicare reimbursement on the remaining 35 beneficiary days. On the basis of our sample results, we estimated that the Therapy Practice improperly received at least $151,000 in Medicare reimbursement for outpatient physical therapy services that did not comply with certain Medicare requirements. Accordingly, we made procedural and monetary recommendations to the Therapy Practice.

Before the start of our audit, the Iowa Department of Human Services, Iowa Medicaid Enterprise (State agency), did not invoice rebate-eligible physician-administered drugs dispensed to enrollees of Medicaid managed-care organizations (MCOs) in the State. Specifically, the State agency did not invoice drug manufacturers for rebates totaling $709,000 ($401,000 Federal share). These errors occurred because the State agency was still in the process of developing policies and procedures to ensure that it accurately invoiced manufacturers to collect rebates for physician-administered drugs dispensed to enrollees of MCOs.

FY 17 annual improper payments report to OMB and Congress.