Federal Reports

The Government Charge Card Abuse Prevention Act of 2012 (Public Law 112-194) requires Offices of Inspector General to, among other things, conduct periodic assessments of the government purchase card program to identify and analyze risks of illegal, improper, or erroneous purchases and payments. According to Office of Management and Budget memorandum M-13-21, this risk assessment should be performed annually. The purpose of this memorandum is to fulfill the requirements of the Act and OMB guidance. Generally, we found that PBGC has policies and procedures in place to address the requirements in the Act, and has internal controls to assist in the monitoring of this program. Based on our review, we determined that the risk of illegal, improper, or erroneous purchases is low.

To further its monitoring of collections-related issues, the Office of the Inspector General (OIG) conducted a performance audit of the Prints and Photographs (P&P) Division’s administrative and accounting controls over its collection. Our objectives were to examine (1) the criteria guiding the P&P Division’s acquisition process, (2) the P&P Division’s mechanisms for tracking and accounting for the items acquired, and (3) how the performance of the P&P Division’s acquisition efforts are assessed. The OIG has reported on collections-related issues previously.

This is the report to Congress on the state of the NEA's policies and practices to protect personally identifiable information on agency information systems, as of July 2016. Due to security concerns, this report is not published on the internet. A copy of this report may be obtained by submitting a freedom of information request at the following link: https://www.arts.gov/freedom-information-act-guide

Alerted to allegations that Senior Corps grantee Great Lake Inter-Tribal Council, Lac du Flambeau, WI, misused program funds, CNCS-OIG investigators conducted a review in conjunction with an agency grant officer and a program officer. This joint review found that the grantee had abused the funds awarded by CNCS in multiple ways.

As part of the Consolidated Appropriations Act of 2016 (Public Law 114-113), Congress passed the Cybersecurity Act of 2015 which required Offices of Inspectors General to conduct an evaluation and submit a report on “covered” computer systems to the appropriate committees of jurisdiction in the Senate and the House of Representatives by August 14, 2016. We evaluated aspects of PBGC computer systems that provide access to personally identifiable information (PII). Our objective was to provide descriptions of certain policies, practices, and procedures identified in the statute and listed below. The scope of our work was limited to obtaining and analyzing PBGC’s information security policies, practices, and procedures governing computer systems that provide access to PII. We did not test the Corporation’s internal controls or compliance with the policies and procedures provided in this report. Information on whether the Corporation followed the appropriate standards was based on OIG open recommendations and the Corporation’s Plan of Actions and Milestones.Sensitive information contained in the evaluation report has been redacted.

Under the Children's Health Insurance Program Reauthorization Act of 2009, Congress appropriated $3.225 billion for qualifying States to receive performance bonus payments (bonus payments) for Federal fiscal years (FYs) 2009 through 2013 to offset the costs of increased enrollment of children in Medicaid.

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The Chemical Safety Board has lowered to low risk its purchase card program, for which it spent $302,556 in fiscal year 2015.

We received a complaint from a former pension benefits supervisor (Complainant) of a PBGC contractor (Contractor) who claimed she was terminated in October 2014, in retaliation for making protected disclosure of certain information, in violation of 41 U.S.C. § 4712, (Pilot Program for Enhancement of Contractor Protection from Reprisal for Disclosure of Certain Information). The Contractor operates one of PBGC’s Field Benefit Administration services offices which provide participant and benefit processing services and assistance.Based on information received from the Complainant, we identified six separate disclosures. We concluded that four of her disclosures were not “protected” disclosures as defined by the statute. We concluded two disclosures about the Contractor’s alleged failure to pay her overtime could reasonably be considered protected as defined by the statute. However, we were unable to show that the Contractor official who terminated the Complainant knew of these disclosures. Even if the evidence were to show that the Complainant’s disclosures were a contributing factor in her termination, we found there is reasonable grounds to conclude that the Contractor can show by clear and convincing evidence that the Contractor official would have terminated her on other grounds absent her disclosures. In sum, we concluded there is insufficient evidence to substantiate the Complainant’s allegation that the Contractor subjected the Complainant to a reprisal for whistleblowing.Because the final report contains information protected by the Privacy Act of 1974, disclosure of the report is restricted.

From July 1, 2011, through December 31, 2013, the West Virginia Department of Health and Human Resources, Department of Medical Assistance Services (the State agency) paid $50.3 million to 42 eligible hospitals in West Virginia for Medicaid electronic health record (ERD) incentive payments. We reviewed hospitals that received an incentive payment totaling $1 million or more. There were five hospitals that each received total incentive payments exceeding $1 million.

From January 1, 2011 to June 30, 2014, the Pennsylvania Department of Health and Human Resources, Department of Medical Assistance Services (the State agency), made approximately $287.4 million for Medicaid Electronic Health Record incentive payments. Of this amount, $158.1 million was paid to 136 eligible hospitals in Pennsylvania. We reviewed 31 hospitals that received a total of $88.1 million, each receiving $1.5 million or more. The State agency made the EHR incentive payments in accordance with Federal and State requirements.

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Medicare Administrative Contractors (MACs) are responsible for reviewing Part B outpatient drug claims to ensure that Medicare pays for drugs that meet the criteria for coverage. Each MAC determines whether a particular use for a given drug, such as a use not approved by the Food and Drug Administration, is "medically accepted" and therefore, covered in its jurisdiction. If MACs do not have appropriate methods to determine drug coverage, Medicare and its beneficiaries may pay for drug uses that are not medically accepted. Further, beneficiaries' access to drugs may vary based on the coverage criteria set in their jurisdictions. This study reviewed the methods MACs used to make coverage determinations for Part B drugs, as well as their methods for ensuring that claims were paid according to these coverage determinations.

This is our final report on OIG’s audit of CS China operations. We conducted this audit as part of our FY 2015 audit plan. Our audit objectives were to (1) assess the roles and responsibilities of Commerce staff components in China and the adequacy of cost-sharing agreements; (2) assess the adequacy of controls over personal property inventory at CS China’s six offices; and (3) review the responsiveness of USFCS staff with respect to client service delivery.

The Office of Inspector General (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 onsite reviews of all Units and prepares public reports based on these reviews. The reviews assess the Units' adherence to the 12 MFCU performance standards and compliance with applicable Federal statutes and regulations.

The Texas Health and Human Services Commission (State agency) did not always calculate supplemental payments made to the University of Texas (UT) health institutions in accordance with Federal and State requirements. Specifically, the supplemental payment calculations included overstated Medicare equivalent fees for claims that included payment modifiers and diagnostic test modifiers, Medicaid services that were performed by ineligible providers, and Medicaid services that did not have Medicare equivalent fees. As a result, the State agency claimed $57.9 million (Federal share) in unallowable supplemental payments made to the UT health institutions for the period May 1, 2004, through September 30, 2007.

A chiropractic clinic based in Michigan (Michigan Chiropractor) did not comply with Medicare billing requirements for 100 chiropractic service line items that we sampled. Specifically, the medical records did not support the medical necessity for 92 of the 100 sampled chiropractic services. On the basis of our sample results, we estimated that at least $339,000 of the $392,000 paid to the Michigan Chiropractor for chiropractic services in 2012 and 2013 was unallowable for Medicare reimbursement. These overpayments occurred because the Michigan Chiropractor did not have adequate policies and procedures to ensure that the medical necessity of chiropractic services billed to Medicare was adequately documented in the medical records.

The North Carolina Department of Commerce (NCDOC) is the state's lead agency for economic, community and workforce development. ARC provides grant annually to State ARC offices for consolidated technical assistance programs.

The ARC grant was to support creating a regional industrial park (designated as Wildwood Commerce Park) by acquiring 167 acres of land near interstate 77 in Carroll County, constructing roads, a sewer and water system, and other infrastructures and marketing the site to potential businesses for locating and operating there.

The Cybersecurity Act of 2015 (the Act) requires that each office of inspector general (OIG) submit a report to Congress on the national security systems and systems that provide access to personally identifiable information (PII) operated by or on behalf of its department. The objective of this audit is to examine the IT security policies, procedures, practices, and capabilities—as defined in the Cybersecurity Act of 2015—for national security and PII systems.

New York-Presbyterian Hospital (the Hospital) located in New York, New York, complied with Medicare billing requirements for 162 of the 285 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 123 claims for the audit period (calendar years 2011 and 2012). On the basis of our sample results, we estimated that the Hospital received overpayments totaling at least $14.2 million for the audit period. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.

CMS established loan agreements with Consumer Operated and Oriented Plans (CO-OPs) to provide startup and solvency loan funding. CMS issued a memo to the CO-OPs in July 2015 allowing the CO-OPs to convert startup loans into surplus notes. A surplus note is a bondlike instrument issued to provide needed capital. Under the terms of a surplus note, CO-OPs are not required to make any repayment on the surplus note that could lead to financial distress or default.

Although the Arizona Health Care Cost Containment System (State agency) made Medicaid electronic health record (EHR) incentive program payments to eligible hospitals, it did not always make these payments in accordance with Federal and State requirements. Specifically, from October 1, 2011, through January 31, 2016, the State agency made incorrect Medicaid EHR incentive payments to 24 of the 25 hospitals reviewed, totaling $15 million. These incorrect payments included both overpayments and underpayments, resulting in a net overpayment of $14.8 million. Because the incentive payment is calculated once and then paid out over 4 years, payments made after January 31, 2016, will also be incorrect. The adjustments to these payments total $1.7 million.

At the request of the Tennessee Valley Authority (TVA) Supply Chain, the Office of the Inspector General examined the cost proposal submitted by a contractor, for engineering, design, and construction support for Holistic Industrial Wastewater Treatment Program services at TVA fossil plants. Our objective was to determine if the contractor's cost proposal was fairly stated for a planned $45 million contract. In our opinion, the cost proposal was overstated. We estimated TVA could save about $1.12 million on the planned $45 million contract by negotiating reductions to the proposed labor markup rates and fee rate, including labor markup rates for work performed at TVA sites, and removing the markup on subcontract costs. In addition, we identified compensation terms in the draft contract that need to be revised to reduce the potential for billing discrepancies.(Summary Only)

This is a publication by GAO's Inspector General that concerns internal GAO operations. The Cybersecurity Act of 2015 requires Inspectors General to report on federal computer systems that are national security systems or that provide access to personally identifiable information. This report satisfies the requirement for the Government Accountability Office (GAO). Because GAO has no national security systems, our report is specific to its computer systems that provide access to personally identifiable information (PII). Our objective was to collect specific information on GAO's information security policies and practices governing systems that provide access to PII and to assess whether logical access policies and practices over these systems are appropriate and were being followed. We did not independently validate the information that GAO provided for this report, except to determine that appropriate logical access standards and guidance were being followed, as required.

Cornerstone Hospital of Austin (the Hospital), in Austin, Texas, did not comply with Medicare requirements for billing Kwashiorkor on any of the 54 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have billed for other forms of malnutrition. The 54 inpatient claims that were coded incorrectly resulted in overpayments of $358,000. The Hospital believed that all claims identified by OIG were appropriately submitted for payment.

From 2011 through 2014, the Louisiana Department of Health made incorrect Herceptin payments to Medicaid providers, which resulted in overpayments of approximately $2.1 million (Federal share).

This is our audit of the effectiveness of U.S. Patent and Trademark Office’s (USPTO’s) controls over information technology equipment issued to employees participating in the Patents Hoteling Program (PHP). The objective of our audit was to assess the effectiveness of USPTO’s controls over PHP employees’ laptops and other accountable equipment.

Our audit found that the Western Association of Schools and Colleges Senior College and University Commission’s (Commission) control activities did not provide reasonable assurance that schools properly classified the methods of delivery for competency-based education programs. As a result, the Commission’s evaluations of the schools’ classifications of the methods of delivery will not help the Department ensure that proposed competency-based education programs are properly classified for Title IV purposes. We specifically noted that the Commission did not evaluate whether proposed competency-based education programs were designed to ensure faculty-initiated,regular, and substantive interaction between faculty and students. Additionally, the Commission did not always ensure that the credit hours assigned to the programs from which schools derived competency-based education programs met the Federal definition of a credit hour. Finally, the Commission did not always follow its own policy relevant to the review of credit hours.

External peer review of the Farm Credit Administration Office of Inspector General's audit organization, conducted by the Federal Labor Relations Authority Office of Inspector General.

In Federal fiscal year 2014, the Texas Department of Health and Human Services Commission improperly charged Medicaid $55,000 for colocated warehouse costs included in the miscellaneous regional cost pool.

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