Federal Reports

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Along with steam, the coal combustion process produces hot gases (called flue gases), including sulfur dioxide, nitrogen oxides, and ash particles. Flue gas moves through ductwork to various air pollution control devices prior to being emitted through the stack. The objective of our evaluation was to determine if TVA is taking actions to address environmental and safety risks related to flue gas ductwork at coal plants. Since scrubbers increase the risk of corrosion within flue gas ductwork, our evaluation included plants with operational scrubbers. We found TVA has completed repairs to address environmental risks associated with flue gas ductwork at coal plants. However, TVA's framework for repairing and reporting ductwork leaks could be improved by (1) clarifying thresholds to repair and report cumulative leaks, (2) establishing realistic repair timelines, and (3) prioritizing the most environmentally damaging leaks for repair. We also found TVA has completed some repairs designed to address safety risks associated with ductwork, but TVA site management indicated long-term capital projects are needed and planned for remediation at Bull Run Fossil Plant and Cumberland where the worst material conditions were present. In addition, we found weakness in the identification of safety concerns related to ductwork at the sites. Additionally, we determined TVA is incurring risk by adopting a strategy to apply internal thermal coatings to ductwork at Cumberland to resist corrosion. Thermal coatings have not previously been used for this application nor have they been through a technical review involving Generation Engineering. This could result in TVA spending several million dollars on a solution that may not work.

From July 2011 through June 2014, the New York Department of Health (State agency) improperly claimed approximately $300,000 in incorrect Federal Medicaid reimbursement for the drug Herceptin.

The OIG audited TVA's fraud risk management activities to determine if it had incorporated the practices in its organizational culture and structure conducive to fraud risk management as identified by the U.S. Government Accountability Office (GAO) framework for managing fraud risk. In summary, we found while TVA has attempted to demonstrate a senior-level management commitment to integrity through various ethics and code of conduct policies, improvements are needed in TVA's practices to combat fraud and involve all levels of the agency in setting an antifraud tone. In addition, TVA management has not formally designated an entity to design and oversee fraud risk management activities. We recommended TVA management consider (1) developing policies and practices that directly communicate the senior-level commitment to combating fraud; (2) implementing practices, such as training and other fraud-awareness activities, that involve all levels of TVA in setting an antifraud tone that permeates the organizational culture; and (3) designating an entity within TVA to lead fraud risk management activities in accordance with the guidelines provided by the GAO framework. TVA management agreed with our recommendations, stating they were consistent with Public Law 114-186 signed by President Obama on June 30, 2016.

SIGTARP's Quarterly Report to Congress

An AmeriCorps member reported allegations that a New Mexico AmeriCorps grantee required members to engage in prohibited activities by participating in a syringe exchange program.

A grantee reported an AmeriCorps member serving as a tutor for suspected prohibited activity.

Public Website Security

ARC awarded the grant funds to support youth development programs administrated by JWVG in high schools of Cabell, Greenbrier and Wayne Counties.

Disruptions, such as natural disasters or technical malfunctions, can make electronic health records (EHRs) unavailable to hospital staff. Prior OIG work found, for example, that hospitals experienced substantial challenges responding to the effects of Superstorm Sandy, which included damage to health information systems and curtailed access to patient medical records. More recently, cyberattacks on hospitals have similarly prevented or limited access to EHRs. The Office for Civil Rights (OCR) enforces the Health Insurance Portability and Accountability Act (HIPAA) Security Rule, which requires all covered entities to have a contingency plan for responding to disruptions to electronic health information systems. Contingency plans specify processes to recover EHR systems and access backup copies of EHR data in the event of a disruption. This evaluation provides information about the status of hospitals' contingency plans in light of evolving threats to their electronic health information systems.

The Postal Service is among the top postal operators in digital services that enhance the core letter and parcel business, but it lags behind in terms of revenue-generating pure digital services. Despite legal constraints prohibiting the provision of non-postal services, the Postal Service should fortify its digital strategy. The future postal digital strategy would be based on four building blocks: increasing the use of data to optimize operations and build a more data-rich environment for customers; speeding up the digitization of its "physical" products; rejuvenating its limited portfolio of purely digital services, and accelerating digital transformation.

FDA approves new drugs for sale in the United States through the new drug application (NDA) review process. FDA requires all new drugs to undergo clinical testing to demonstrate their safety and efficacy prior to approval. However, premarket clinical trials may not always identify or fully characterize risks. Postmarketing research can provide additional information about the risks, benefits, and optimal use of an approved drug. In 2006, the Office of Inspector General (OIG) found that FDA could not readily identify whether or how timely postmarketing studies were progressing toward completion, and that FDA lacked an effective monitoring system for postmarketing studies. Since then, the Food and Drug Administration Amendments Act (FDAAA) expanded FDA's authority to require postmarketing studies and to take enforcement action when sponsors are out of compliance. This study follows up on OIG's previous work in light of FDA's expanded authority.

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The Federal Maritime Commission OIG reviewed the system of quality control for the audit organization of the EAC OIG in effect for the year ended March 31, 2015. This report discusses their findings.

This report is part of a series on adverse events in health care settings, defined as harm resulting from medical care. Previous OIG work identified harm rates of about 30 percent in both acute-care hospitals and skilled nursing facilities (SNF), with an attendant toll on patient health and taxpayers' costs, the latter amounting to billions of dollars annually. This report extends our work by evaluating care provided in rehabilitation (rehab) hospitals. Rehab hospitals are post-acute providers that specialize in intensive rehabilitative care for patients recovering from illness, injury, or surgery. While in recent years stakeholders have paid considerable attention to patient safety in acute-care hospitals and increasingly in SNFs, less is known about adverse events in other health care settings. An increased understanding of adverse events that occur in this unique setting would better equip health care providers and other stakeholders in taking actions to improve the safety of patient care in rehab hospitals.

Users are an important asset to digital platform companies such as Google, Facebook, and Snapchat. The way digital platforms treat their users offers valuable lessons for the Postal Service and the postal platform: focus on the platform experience, strengthen user engagement, and maximize the value of the platform for users and payers.

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At the request of the Tennessee Valley Authority (TVA) Supply Chain, the OIG examined the cost proposal submitted by a contractor for construction management services. Our objective was to determine if the contractor's cost proposal was fairly stated for a planned $100 million contract. In our opinion, the proposed general and administrative (G&A) rates were overstated in the proposal, compared to the G&A rates included in a current contract TVA has with this contractor. We estimated TVA could avoid about $4.1million on the planned $100 million contract by reducing the proposed G&A rates to the rates established in the other contract.(Summary Only)

Excellent Home Care Services, LLC (the Agency) (located in Brooklyn, New York), did not comply with Medicare billing requirements for 156 of the 555 home health claims we reviewed. As a result, the Agency received net overpayments of $498,000 for calendar years 2011 and 2012. Specifically, the Agency incorrectly billed Medicare for some beneficiaries who were not homebound, some beneficiaries who did not require skilled services, and some services for which the documentation from the certifying physician was missing or insufficient to support the services. These errors occurred primarily because the Agency did not have adequate controls to prevent the incorrect billing of Medicare claims within selected risk areas.

First Coast Service Options, Inc., a Medicare contractor, did not claim $740,000 of allowable Supplemental Executive Retirement Plan costs for fiscal years 2006 through 2009.