Federal Reports

Billings Clinic Hospital (the Hospital) (operating in Billings, Montana) complied with Medicare billing requirements for 173 of the 179 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining six claims, resulting in overpayments of approximately $57,000 for calendar years 2012 and 2013. Specifically, five outpatient claims had billing errors, resulting in overpayments of $52,000, and one inpatient claim had a billing error, resulting in an overpayment of $4,500. 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.

ARC awards a Consolidated Technical Assistance grant to the West Virginia Development Office (WVDO) annually to provide funding for technical assistance and outreach to local economic development organizations through the main Street, ON TRAC, and Growing Healthy Communities programs.

Maryland's Department of Health and Mental Hygiene (State agency) did not always comply with Federal and State requirements when it claimed costs for communicable disease care services. Of the 124 claim lines that we sampled, 49 complied with Federal and State requirements; however, 75 did not. On the basis of our sample results, we estimate that the State agency claimed at least $16 million (Federal share) in unallowable costs. The State agency claimed these unallowable costs because it did not have sufficient internal controls to ensure that nursing facilities were correctly claiming communicable disease care services.

The OIG's audit of the NARA) Refile Processes in Federal Records Centers assessed the effectiveness and adequacy of management controls in place for the refile processes at selected FRCs.

During the audit, our independent public accountant, CliftonLarsonAllen LLP, identified certain matters related to PBGC's internal control and operations that while significant were not of sufficient magnitude to impact the financial statement opinion and were not included in the report on internal control dated November 13, 2015 (AUD-2016-3/ FA-15-108-3). This management letter summarizes CliftonLarsonAllen's findings and recommendations regarding these matters and includes the status of prior years' management letter recommendations. PBGC management agreed with the recommendations and provided planned corrective actions and estimated completion dates.

Freeman Hospital (the Hospital) (operating in Joplin, Missouri) complied with Medicare billing requirements for 180 of the 225 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 45 claims, resulting in overpayments of $311,000. Specifically, 42 inpatient claims had billing errors, resulting in overpayments of $304,000, and 3 outpatient claims had billing errors, resulting in overpayments of $7,000. 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.

At the request of the Tennessee Valley Authority (TVA) Supply Chain, the OIG examined a cost proposal submitted for construction and modification services. Our objective was to determine if the vendor's cost proposal was fairly stated for a planned $100 million contract. In our opinion, the proposal (1) included inconsistent and overstated labor markup rates; (2) did not comply with the request for proposal requirements related to nonmanual wages, resulting in overstated wage rates; and (3) included multiple fees in the Paradise Fossil Plant baseline costs. We estimated TVA could avoid about $3.34 million by (1) negotiating reduced labor markup rates and (2) reimbursing the contractor's actual salaries within established wage ranges instead of paying a single estimated wage rate for each labor classification. In addition, we found the contract's compensation terms and related attachments were inconsistent with the methodology TVA intends to use to compensate the contractor.(Summary Only)

For our final report on the sufficiency of the National Marine Fisheries Service’s (NOAA Fisheries’) research and progress toward implementation of electronic monitoring (EM) programs, our objectives were to evaluate NOAA Fisheries’ study, oversight, progress, implementation, and incorporation of EM into its National Observer Program and determine how NOAA Fisheries is executing its EM policy.

We performed a wireless penetration test of select Centers for Medicare & Medicaid Services' Data Centers and facilities to determine whether CMS's security controls over its wireless networks were effective.

Overall, the Department continues to implement changes to strengthen its enterprise-wide information security program. However, opportunities were identified that will allow HHS to continue to enhance its enterprise-wide information security program. We identified several reportable exceptions in the Department's security program. Areas for improvement were identified in the Department's Continuous Monitoring Management, Configuration Management, Identity and Access Management, Incident Response and Reporting, Risk Management, Security Training, Plan of Action and Milestones, Remote Access Management, Contingency Planning, and Contractor Systems.

For the time period reviewed, we found that the Pennsylvania Department of Labor and Industry, Office of Vocational Rehabilitation (Pennsylvania) had adequate internal controls to provide reasonable assurance that the data it reported in its Case Services Report (RSA-911) were complete, but it did not have adequate internal controls to ensure that the data were accurate and adequately supported. Specifically, we found that Pennsylvania lacked policies and procedures to require verification of the data entered into participants’ case files and for its RSA-911 reporting process and lacked an adequate monitoring process to ensure that data were accurate and required documentation was maintained in participant case files. In addition, we found that Pennsylvania did not have written policies and procedures for its RSA-911 reporting process. Our testing of data that Pennsylvania reported to the Rehabilitation Services Administration (RSA) found a significant number of unverifiable data entries for data elements that RSA used to calculate Pennsylvania’s performance indicator results. Consequently, we have no assurance that the performance indicator results that RSA calculated were reliable.

This is a publication by GAO's Inspector General that concerns internal GAO operations. This report addresses the extent to which GAO identifies and collects student loan repayment (SLR) debts from former employees who did not fulfill their 3-year service agreements.

For the time period reviewed, we determined that the Opportunities for Ohioans with Disabilities (Ohio) had adequate internal controls to ensure that the data it reported to the Rehabilitation Services Administration (RSA) were complete; however, it did not have adequate internal controls to ensure that the data it reported in its Case Services Report were accurate and adequately supported. Specifically, we found that Ohio (1) lacked policies and procedures to require verification of the data entered into participants’ case files and (2) lacked an adequate monitoring process to ensure that data were accurate and required documentation was maintained in participant case files. In addition, our testing of the data that Ohio reported to RSA found a significant number of incorrect and unverifiable data entries used to calculate Ohio’s performance indicator results. Consequently, we have no assurance that the performance indicator results that RSA calculated were reliable.

Under a contract monitored by the National Credit Union Administration Office of Inspector General, KPMG LLP, an independent certified public accounting firm, performed an audit of the NCUA’s financial statements as of December 31, 2015. This report transmits KPMG’s report on its financial statement audit of the NCUA's financial statements for the Temporary Corporate Credit Union Stabilization Fund as of and for the years ended December 31, 2015 and 2014.

Final Report Assessing the Federal Trade Commission’s Compliance with the Federal Information Security Modernization Act for Fiscal Year 2015

The OIG audited TVA's Ethics Program to determine (1) compliance with applicable statutes and regulations and (2) if management has identified and incorporated best practices. In summary, we did not identify any areas where TVA's Ethics Program did not comply with requirements for federal agencies' ethics programs in Title 5, Code of Federal Regulations, § 2638.203. Additionally, TVA's Ethics Program has incorporated many of the best practices identified, with the exception of having embedded ethics champions throughout the organization. We also found references to an Ethics Council in TVA's Code of Conduct, but we found the Council has been inactive since at least 2011. We recommended TVA's Executive Vice President and General Counsel and Designated Agency Ethics Official consider (1) having ethics champions embedded throughout the organization who could emphasize the importance of ethical conduct at an individual and organizational level and (2) reinstating the Ethics Council or removing references to it from the TVA Code of Conduct. TVA management agreed with our findings and recommendations and plans to take corrective actions.

Limited scope audits involve a limited review of financial and non-financial information of grant recipients to ensure validity and accuracy of reported information, and compliance with state and Federal requirements. Our audit was conducted in accordance with the Government Auditing Standards (2011), issued by the Comptroller General of the United States, and concluded that NASAA generally complied with financial management system and record keeping requirements. However, we identified some areas requiring improvement to ensure that NASAA complies with grant requirements and improve its management of NEA awards. We determined that NASAA did not have written policies and procedures on suspension and debarment, and did not have updated policies and procedures for the management of Federal awards. Additionally, NASAA did not properly document in-kind transactions. Finally, NASAA included unallowable costs in its total outlays reported on its Federal Financial Report.

The Texas Department of Aging and Disability Services incorrectly claimed approximately $3 million in costs as Medicaid medical assistance expenditures and inappropriately received approximately $570,000 in Federal share.

I am pleased to be here today to discuss our recent work on issues relating to Amtrak’s vehicle fleet management.

In the past year, we issued three reports identifying recurring problems with the management and oversight of the vehicle fleet.1 Although the focus of these reports was vehicle fleet management, the root cause of the specific issues we identified were weaknesses in Amtrak’s management controls, issues we have repeatedly identified as the cause of operational and programmatic deficiencies throughout the company. The management control weaknesses affecting the vehicle management program are similar to those we have noted elsewhere in the company—ineffective internal control processes, inadequate policies and procedures, and fragmented oversight responsibilities.

My testimony today focuses on three areas where we believe that Amtrak has opportunities to improve its vehicle fleet management: fleet growth and utilization, costly leasing practices, and fuel card oversight.

CNCS-OIG investigators determined that District of Columbia Commission officials misused Federal program funds when they purchased T-shirts for events held by the Mayor's Office. As a result of the investigation and CNCS program and grant officials' review, management recovered $45,455.29 in disallowed and misspent funds.

The OIG performed this audit to evaluate the effectiveness of TVA's Information Technology Enterprise Solutions Delivery (ESD) group in meeting TVA's mission and values. In summary, we found that ESD's operational maturity is well defined, there are opportunities to improve efficiencies in the documentation of IT development work. In addition, Enterprise Data Warehouse efforts planned withing the IT1K initiatives were not fully implemented as originally planned. TVA management agreed with our findings and recommendations.

The New Jersey Department of Human Services (State agency) claimed Federal Medicaid reimbursement for some Global Options for Long-Term Care (GO-LTC) waiver services that did not comply with certain Federal and State requirements. Of the 131 beneficiary-months in our sample, the State agency properly claimed Medicaid reimbursement for all GO-LTC waiver services during 69 beneficiary-months. However, the State agency claimed Medicaid reimbursement for unallowable GO-LTC waiver services during the remaining 62 beneficiary-months. Of the 62 beneficiary-months with services for which the State agency improperly claimed Federal Medicaid reimbursement, 29 contained more than 1 deficiency.

The Texas Health and Human Services Commission (State agency) claimed $72.2 million in expenditures that were not related to eligible noninstitutional long-term services and supports and inappropriately received $1.4 million in Balancing Incentive Payments Program funding. Additionally, the State agency did not calculate or return the family planning Federal share of experience rebates, which totaled $502,000.

The OIG performed this evaluation to determine whether the Nuclear Employee Concerns Program (ECP) was addressing employee concerns in an effective and timely manner for fiscal years 2013 and 2014. In summary, we determined Nuclear ECP generally addressed employee concerns in an effective manner; however, we identified areas for improvement related to documentation, the resolution follow-up process, and reporting to site management. We could not form an overall conclusion related to timeliness in addressing Nuclear ECP cases because there was no defined timeliness goal for some types of cases; however, the Nuclear ECP did not meet its timeliness goal of 45 days for eight of ten sample cases we reviewed that were classified as Concerns (i.e., issues that require ECP to open an investigation). TVA management agreed with our findings and recommendations.

This report details the results of our audit of Trademark’s controls and use of U.S. Patent and Trademark Office’s (USPTO’s) Activity-Based Information (ABI) system. Specifically, our objectives were to review allocation algorithms and controls of the ABI system and determine whether Trademark’s use of ABI justifies and supports fee changes.

This report provides the results of our audit of the effectiveness of the Census Bureau’s unliquidated obligation (ULO) review policies and procedures developed in response to an OIG audit report issued in June 2013 (OIG-13-026-A). In that report, we concluded that Department-wide controls over the management of ULOs needed strengthening. Further, effective management of outstanding obligation balances allows agencies to review and deobligate unneeded funds, promoting a better use of federal resources.

This report addresses the status of the Census Bureau’s (the bureau’s) 2020 Census program preparation and planning efforts. Our audit objectives were to (1) assess the methods and costs of continuously updating the Master Address File Topologically Integrated Geographic Encoding and Referencing database (MTdb);(2) determine how efforts, such as the fiscal year (FY) 2015 Address Validation Test (AVT), support the accuracy of the Master Address File; and (3) evaluate the preparation of the Local Update of Census Address (LUCA) program for the 2020 decennial census. This report focuses on risks identified for objectives 2 and 3 to provide timely recommendations for the bureau’s operational design decisions. We reported on the results of objective 1 subsequent to the completion of additional fieldwork.

To reimburse the Postal Service for unpaid amounts for revenue forgone, Congress promised to pay the Postal Service $29 million a year from 1994 through 2035 without interest. Starting in FY 2011, the $29 million payments were reduced or skipped for 4 years. They have now resumed, but there is a risk that payments could stop again. If payments stop permanently, the Postal Service will have to declare a bad debt on its bottom line. One solution is to offset the remaining amount owed with interest, $1.6 billion, against the Postal Service’s current debt to the Treasury.

As required by the Affordable Care Act (ACA), HealthCare.gov is the Federal website that facilitates purchase of private health insurance for consumers who reside in States that did not establish health insurance marketplaces. At its launch on October 1, 2013, and for some time after, HealthCare.gov users were met with website outages and technical malfunctions. After corrective action by CMS and contractors, HealthCare.gov performance improved and facilitated health plan enrollment for millions of consumers. The problems at launch raised concerns about the effectiveness of CMS management of the Federal Marketplace. The objective of this case study was to gain insight into CMS implementation of the Federal Marketplace, focusing primarily on HealthCare.gov.

Not all of the District of Columbia marketplace's (District marketplace) internal controls were effective in ensuring that individuals were enrolled in qualified health plans (QHP) according to Federal requirements.