Federal Reports

The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCU or Unit). This MFCU Fiscal Year (FY) 2015 Annual Report highlights statistical achievements from the investigations and prosecutions the 50 MFCUs conducted for FYs 2011 through 2015. The report also identifies improvements made in Unit operations.

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 Ohio Department of Medicaid (State agency) did not always use the correct Federal medical assistance percentages (FMAP) when processing Medicaid claim adjustments reported on the CMS-64. Of the 1,585,792 claim adjustments we reviewed, we determined that 1,204,718 adjustments (composed of 900,413 private and 304,305 public provider claims) used the correct FMAP or did not result in a payment difference. However, the remaining 381,074 claim adjustments were paid using incorrect FMAPs resulting in an overpayment to the State agency of $151,000 (Federal share). These errors occurred because the State agency did not have adequate internal controls to process all private and public claim adjustments in accordance with Federal requirements. Specifically, the State agency did not always report claim adjustments using the FMAP associated with the original claim when required.

The grant was awarded to provide monies for the grantee's applied science initiative.

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We found that improvements were needed in the Department’s monitoring of Rural Education Achievement Program grantees’ performance and use of funds. We specifically noted that the Department conducted limited monitoring to determine whether grantees were makingprogress toward program goals or spending grant funds in accordance with statutory and regulatory guidelines. Instead, oversight efforts were primarily focused on ensuring grantees were obligating and spending funds by established deadlines. Although we concluded that the Department’s program monitoring could be improved, we found that the Department’s rural education coordination efforts appeared to be effective.

Treasury’s Housing Finance Agency Innovation Fund for the Hardest Hit Housing Markets (the “Hardest Hit Fund” or “HHF”) program provides Troubled Asset Relief Program (“TARP”) dollars tohomeowners in 19 states to prevent foreclosures. This includes homeowners in Nevada. HHF is largely targeted at unemployment and underwater homes.Rather than Treasury giving these rescue funds directly to homeowners, Treasury entered into a contract with each state’s housing finance agency to make decisions on which homeowners are admitted into the program and be the conduit for these funds from Treasury to homeowners. Treasury contracted with Nevada’s housing finance agency, the Nevada Housing Division (“NHD”), who outsourced HHF to what was its component entity at the time, the Nevada Affordable Housing Assistance Corporation (“NAHAC”). At the time, NHD officials comprised a majority of the Executive Committee of NAHAC’s board. Given that NHD is the agency responsible under Treasury’s contract, SIGTARP refers to both as the “state agency.”Treasury will pay only those expenses of the state agency necessary to provide the HHF services. In 2015, SIGTARP reported that homeowners in Nevada were not receiving HHF funds. This ledSIGTARP to open a forensic audit of spending of Hardest Hit Fund dollars in Nevada.

CNCS management asked CNCS-OIG to investigate an AmeriCorps member serving at the Nevada Clean Energy Corps, Carson City, NV, who was suspended after a completed criminal history check revealed him to be a registered sex offender.

In early 2015, a confidential complainant contacted OIG alleging potential policy and regulatory violations taking place in the office of a high-ranking political appointee. The evidence developed over the course of inquiry established that a variety of problems arose in the appointee's office during the appointee's tenure with the Department.

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This grant is a continuing, annual grant awarded by ARC under Section 302 of the Appalachian Regional Development Act of 1965 (ARDA) to provide the Tri-County Council for Western Maryland (TCC), funding for administrative costs necessary for conducting its LDD program.

The Digital Age transformed the way many businesses advertise, and while mail has maintained its market share thus far, the Postal Service should innovate to remain a competitive advertising medium. The OIG identified two opportunities for the Postal Service to modernize its advertising mail offerings: integrating digital technologies with advertising mail and developing online platforms for small businesses. By meeting the new digital wave head-on, the Postal Service can enhance the value of the advertising mail channel and attract new mailers to use the Postal Service for their advertising needs.

Five States received almost $475 million in Social Services Block Grant funding to help cover social service and reconstruction expenses resulting directly from Superstorm Sandy. When Congress made funds available to States to help pay for their Superstorm Sandy-related expenses, it noted that such funds were "susceptible to significant improper payments." Therefore, the Office of Management and Budget instructed Federal agencies to establish additional oversight of the funds. This evaluation examined States' experiences using Superstorm Sandy Social Service Block Grant (Sandy SSBG) funds and Administration for Children and Families (ACF) oversight of these funds.

As required by statute, Medicare sets payment amounts for drugs infused through durable medical equipment (DME infusion drugs) at 95 percent of the average wholesale prices (AWPs) in effect on October 1, 2003. AWPs, which represent list prices rather than actual marketplace prices, have been long been recognized as a flawed pricing benchmark. In February 2013, OIG issued a report to CMS regarding Medicare payments for DME infusion drugs. In that report, we made one recommendation and suggested two options for its implementation. Because CMS had not taken steps to address our recommendation, and payments continued to be misaligned with drug costs, OIG revisited this issue in a 2015 report.

The Office of Inspector General released a report examining NASA’s progress in managing the technical, schedule, and cost risks of the Orion Multi-Purpose Crew Vehicle Program.

The Office of Inspector General evaluated the status of NASA's Commercial Crew Program under which private U.S. companies will transport NASA astronauts to the International Space Station.

OIG's comprehensive analysis focused on two overlapping periods: a 9-month period (8.6 million hours) and a 15-month period (14.6 million hours). The 1-year average of unsupported time amounted to nearly 180,000 unsupported hours. However, the total unsupported hours over the 9- and 15-month periods could be twice as high as reported in this investigation.

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OIG oversees all State Medicaid Fraud Control Units (MFCUs or Units). 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.

The Head Start program is the largest Federal investment in early childhood education. The Improving Head Start for School Readiness Act of 2007 required ACF to begin awarding 5-year grants for Head Start and to require grantees that ACF determines are not providing a high-quality and comprehensive Head Start program to "recompete"-i.e., to participate in open competition for funding renewal. In response, ACF began in 2012 to implement the Designation Renewal System (DRS). The DRS uses seven "trigger conditions" to assess a subset of grantees (known as a cohort) each year and determine which grantees will be required to recompete. These changes are intended to improve the quality of grantees receiving Head Start funds. However, stakeholders have raised concerns about the efficacy and fairness of this process.

From January 1, 2011, through December 31, 2012, the Ohio Department of Medicaid (State agency) made incorrect Medicaid electronic health record (EHR) incentive payments totaling $526,000 to 10 hospitals. Incorrect payments included both overpayments and underpayments, for a net overpayment of $524,000.